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Traditionally, the subjective questionnaire collected from game players is regarded as a primary tool to evaluate a video game. However, the subjective evaluation result may vary due to individual differences, and it is not easy to provide real-time feedback to optimize the user experience. This paper aims to develop an objective game fun prediction system. In this system, the wearables with photoplethysmography (PPG) sensors continuously measure the heartbeat signals of game players, and the frequency domain heart rate variability (HRV) parameters can be derived from the inter-beat interval (IBI) sequence. Frequency domain HRV parameters, such as low frequency(LF), high frequency(HF), and LF/HF ratio, highly correlate with the human's emotion and mental status. Most existing works on emotion measurement during a game adopt time domain physiological signals such as heart rate and facial electromyography (EMG). Time domain signals can be easily interfered with by noises and environmental effects. The main contributions of this paper include (1) regarding the curve transition and standard deviation of LF/HF ratio as the objective game fun indicators and (2) proposing a linear model using objective indicators for game fun score prediction. The self-built dataset in this study involves ten healthy participants, comprising 36 samples. According to the analytical results, the linear model's mean absolute error (MAE) was 4.16%, and the root mean square error (RMSE) was 5.07%. While integrating this prediction model with wearable-based HRV measurements, the proposed system can provide a solution to improve the user experience of video games. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a common health complaint and a prominent factor in the development of LBP among the working population is stress. Mostly, stress is addressed as a general problem, which is why LBP prevention programs are often imprecise. Accordingly, a closer look at the association between specific stress types and the development of LBP is necessary. Therefore, this paper aims (1) to identify the stress types most closely associated with LBP; (2) to examine the relationship between stress accumulation and LBP. Methods: n = 100 call-center workers were approached for participation. Stress levels and LBP were assessed with questionnaires (TICS, ERI, CPG, BPI) and hair cortisol levels were measured (ELISA-KIT, 3-months period). Mann-Whitney U tests were used to identify stress types most closely associated with LBP. Further, ANCOVA analysis was conducted to determine the association of the number of experienced stress types with LBP intensity and impairment. Results: Finally, data from n = 68 participants (mean age: 43.2 (± 12.8) years; 62% female) were used for presented analysis. Participants, who were affected by work-related stress showed higher pain severity (excessive demands at work: 23.6 ± 21.8 vs. 42.4 ± 25.0 (p = 0.005)) and more impairment (excessive demands at work: 13.7 ± 17.6 vs. 28.7 ± 22.3 (p = 0.003); work overload: 15.4 ± 20.4 vs. 26.3 ± 17.4 (p = 0.009)) than their less affected colleagues. Other stress types (e.g. Effort, Reward) showed no significant association with LBP. Furthermore, participants who experienced two or more of the most associated stress types simultaneously suffered from stronger pain and more impairment (p < 0.01). Conclusions: The results suggest that it is essential to divide and evaluate stress in specific domains. Furthermore, the accumulation of different stress types and the resulting physiological load should be taken into account when designing prevention and intervention programs. Results may be of high relevance for the development of LBP prevention programs for people within a predominantly sitting working context. [ABSTRACT FROM AUTHOR]

Background: Understanding environmental correlates of sedentary behaviour (SB) among young people is important as such data can identify approaches to limit sedentary time. This paper estimates associations of parent-reported neighbourhood and adolescent-reported home environments with SB among adolescents aged 11–19 years from 14 countries. Methods: In the International Physical activity and the Environment Network (IPEN) Adolescent Study (an observational, cross-sectional multi-country study), adolescents wore a triaxial accelerometer for seven days that assessed sedentary time (ST). Adolescents completed survey measures of sedentary behaviour (SB) related to recreational screen time and sitting time in motor vehicles. Parents and adolescents completed surveys assessing neighbourhood and home environments. Accelerometer based ST was available in 3,982 adolescents while survey data were available for 6,302 dyads. We estimated the total and direct effects of each environmental attribute on ST and SB. Sex of the adolescent and city/country were examined as moderators. Results: The average ST in adolescents from 14 countries ranged from 7.8 to 10.5 h/day. Personal social media was the only significant correlate of total ST across both sexes. With respect to self-reported SB, adolescents accumulated an average of 3.8 h of non-school screen time per day and nearly 40 min of transport-related sitting time. Screen time was associated with all home environment variables, including social media account, as well as land use mix—diversity, traffic safety, and crime safety. Transport-related sitting time was related to land use mix—diversity, recreation facilities, walking facilities, and pedestrian infrastructure, but no home environment variables. City/country and sex were significant moderators of several associations. Conclusions: Both home and neighbourhood environment features were related to ST and SB. Having social media accounts emerged as a major contributor towards sedentarism in adolescents. [ABSTRACT FROM AUTHOR]

Observational studies have a critical role in disability research, providing the opportunity to address a range of research questions. Over the past decades, there have been substantial shifts and developments in statistical methods for observational studies, most notably for causal inference. In this review, we provide an overview of modern design and analysis concepts critical for observational studies, drawing examples from the field of disability research and highlighting the challenges in this field, to inform the readership on important statistical considerations for their studies. What this paper adds: Descriptive research questions have specific analytical complexities, so careful statistical design before analysis is critical.Prediction research aims to produce a model with good predictive ability and requires thorough statistical design prior to analysis.Causal research requires careful statistical analysis planning, facilitated by modern causal inference concepts and analytical methods.Adopting these approaches will strengthen the quality of observational studies addressing a range of research questions in the disability space. What this paper adds: Descriptive research questions have specific analytical complexities, so careful statistical design before analysis is critical.Prediction research aims to produce a model with good predictive ability and requires thorough statistical design prior to analysis.Causal research requires careful statistical analysis planning, facilitated by modern causal inference concepts and analytical methods.Adopting these approaches will strengthen the quality of observational studies addressing a range of research questions in the disability space. [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]

In this paper, we investigate the association between evaluating a romantic partner as deviating from relationship ideals (i.e., ideal-partner discrepancy) and a widely studied form of self-regulatory behavior in romantic relationships—accommodation (i.e., inhibiting one's own destructive relationship behaviors and enacting constructive behaviors). We also consider the moderating role of relationship commitment. Two studies tested these associations using self-reports (Study 1, N = 450 individuals) and by observing accommodation behaviors in couples (Study 2, N = 116 dyads). Across both studies, a negative-ideal partner discrepancy (i.e., a partner is deemed as falling below ideals) was associated with more accommodation when relationship commitment was high than for when it was low. The findings provide novel insights into understanding accommodation behavior in romantic relationships. [ABSTRACT FROM AUTHOR]

Background: Inadequate handover documentation may result in delay and adverse outcomes during continuity of care. This is much more important in interfacility transfers where improper or missing documentation of prior events from a referring point may result in a break in the continuity of care. Subjects and Methods: This was a cross-sectional observational study done to evaluate the quality of referral documentation available with the patients who were referred to a tertiary care center after consultation in a peripheral center between March 2024 and May 2024. A semi-structured pro forma was used to collect transfer characteristics and quality of transfer documents at the time of admission. Results: A total of 156 children were enrolled in the study. The mean age of children was 6.81 ± 5.79 years. 68 (43.6%) were referred from a private nursing home. Healthcare workers accompanied only 19 (12.2%) children. Referral documentation was available in 121 (77.6%). 96/121 (61.5%) had handwritten referral papers. Pretransport communication was received only in one patient. Patients being referred by private physicians (70.8%) and smaller hospitals (80.9%) have better documentation than medical colleges (40.9%) (P = 0.03), patients being transported in an ambulance (87.23% vs. 73.4%, P = 0.05) have higher chances of having referral documentation. Conclusions: There is a lack of pretransfer referral communication and quality referral documents. Pediatric referral services in the region are fragmented and nonuniform. There is a need to improve pediatric referral documentation and transfer services. [ABSTRACT FROM AUTHOR]

Background: Cryosurgery remains an important treatment modality in dermatology practice. HYDROZID®, a new portable cryosurgery medical device using norflurane as a cryogen, was recently introduced in the Indian market. This paper reports the findings of the phase IV study conducted in India. Aims: This is a prospective phase IV study to evaluate its safety and efficacy in the treatment of superficial epidermal and dermal lesions. Methods: The study was conducted across 4 centres in India. The cryosurgery cycles were decided based on the skin lesion considered for the treatment. Safety and efficacy parameters were assessed at day 1, day 7, day 14, day 30 (±2) (end of treatment), and day 60 (±2) after the initial cryosurgery treatment. The local skin reactions scale, pain VAS scale, and Vancouver scale for assessment of pigmentation and scarring were used for the assessment of cutaneous reactions. Assessment of efficacy was done by evaluating the total disappearance of skin lesions at the end of the study visit. Results: Ninety-seven patients completed the study. The reported post-procedural pain was mild to moderate and subsided over the period of 24 hours. There was no pain observed in 84.76% of patients at the end of 24 hours. Complete disappearance of the lesion was seen in 47.4% of patients at the end of the study, while the reduction in the diameter of skin lesions by more than 50% was observed in 79.38% of patients. Conclusion: The data from this study support good clinical tolerability and safety of the Hydrozid® portable cryo device. [ABSTRACT FROM AUTHOR]

Automated driving systems are deployed on public roads with little empirical support for the dominant justifications of enhanced safety and enhanced productivity. Furthermore, development of automated driving systems has been piecemeal rather than systematic while research on driver-automation interaction has relied on individual analysis of accidents and on observational studies of driving behavior in a simulator or on the road. In this paper, we apply Work Domain Analysis to develop a more systematic and comprehensive model of automated driving. We use a strategy of layering the driving automation onto the resulting Abstraction-Decomposition Space for manual driving to mimic the existing design strategy of introducing automation to take over driving functions previously the responsibility of the human driver. Our analysis shows that automation does not unequivocally supports dominant driving values. Furthermore, our analysis revealed subtle interdependencies between human and technological functions. We conclude that an Abstraction Decomposition Space offers a systematic view of driver-automation interaction that can suggest new insights for automation design. [ABSTRACT FROM AUTHOR]

Background: Nonsuicidal self-injury (NSSI) is highly prevalent in adolescents and young adults worldwide. It is linked to a broad variety of mental disorders and an increased suicide risk. Despite its high prevalence, research on the underlying mechanisms and on potential risk and resilience factors for maintaining or quitting NSSI remains scarce. This manuscript presents an overview of the "Self-injury: Treatment-Assessment-Recovery" (STAR) collaboration, which aimed to address these gaps. Methods: We investigated the natural course of NSSI as well as its social, psychological, and neurobiological predictors (observational study; OS). OS data collection occurred at four timepoints (baseline [T0], 4 [post, T1], 12 [follow-up (FU), T2], and 18 [FU, T3] months after baseline) for the NSSI group, which was compared to a healthy control (HC) group at T0 only. Online self-report was used at all timepoints, while semi-structured interviews (face-to-face (f2f)) were conducted at T0 and T3. At T0 only, we conducted ecological momentary assessment and neurobiological investigations. Here, we present the general methodology and sample characteristics of the completed OS including the f2f subprojects, while other subprojects are not within the scope of this paper. Sample description: The OS sample consists of 343 participants at T0 (180 NSSI, 163 HC). Mean age in the NSSI group (T0) was 18.1 years (SD = 2.09, range: 15–25), gender-related data is available for 166: 156 = female, 7 = male, 3 = transgender, 10 = not disclosed). In the HC group, mean age (T0) was 19.1 years (SD = 2.35, range: 15–25) (142 = female, 21 = male). At T1, 128 (71.11%) of the NSSI participants completed the questionnaires, at T2 125 (69.44%) and at T3 104 (57.78%). In the fMRI subproject, 126 adolescents participated (NSSI = 66, HC = 60, 100% female; mean age (T0): NSSI = 18.10 years, SD = 2.21; HC = 19.08, SD = 2.36). Conclusion: Understanding predictors is of utmost importance for adequate diagnosis and intervention for NSSI. Our OS applied a multimodal investigation of social, psychological, and neurobiological parameters and is the largest sample of adolescents with NSSI to date including follow-up assessments. As health care providers require specific knowledge to develop new treatments, we believe that our in-depth assessments can potentially enhance care for youths engaging in NSSI. [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]

Background: The dynamic environment of the emergency department (ED) poses unique challenges to the execution of well-designed research. There is limited investigation into the viability of studies conducted in the ED. This paper offers a systematic evaluation of our recruitment of emergency patients for a prospective observational research study, shedding light on the intricate landscape of research feasibility within the ED setting. Results: Research coordinators dedicated 2816.83 h to screening, recruiting, and enrolling patients between June 2018 and September 2023, having to stop recruitment twice due to financial constraints and the COVID-19 pandemic. 485 patients were approached and 84 of them were enrolled, resulting in a 31.94% enrollment rate, with approximately 2.8 participants recruited per month. Of those enrolled, 77 completed all study endpoints. Most participants were Hispanic (n = 44; 52.3%) and/or Black (n = 37; 44%), middle-aged (µ = 51.7 years), and female (n = 48; 57.1%). Participant recruitment was challenged by competing mindsets, the COVID-19 pandemic, and high staff turnover. Conclusions: Recruiting emergency patients for a prospective observational study is feasible given adequate staffing and financial resources. Standardizing feasibility assessments for the recruitment of patients in the emergency department is important to the success of future study. [ABSTRACT FROM AUTHOR]

Over-The-Top (OTT) platforms have seen a significant rise in popularity, especially during the COVID- 19 pandemic. They offer convenience and a vast array of content, but their impact on mental health presents a complex picture. This SWOT analysis explores the strengths, weaknesses, opportunities, and threats of OTT platforms in relation to mental health. The proliferation of digital streaming services has redefined entertainment consumption patterns, presenting both opportunities and challenges for societal norms and individual well-being. Through a multidimensional analysis, this study investigates the evolving dynamics of Indian culture in the context of OTT content, examining how it shapes societal values, interpersonal relationships, and traditional norms. Furthermore, the paper scrutinizes the potential effects of OTT content on mental health, considering factors such as content diversity, representation, and the psychological implications of binge-watching. [ABSTRACT FROM AUTHOR]

To understand graduate employability, this paper uses a landscape of practice (LofP) lens, and methods including narrative frames, observations, and interviews to interpret capability development and identity construction of learners in a work-based learning masters program. It argues that learners enhance employability, capabilities, and knowledge through mutual engagement in practices of their communities of practice (CofP). Furthermore, it showcases that this process is enacted through learners’ membership and negotiating boundaries of their community as they move from one community to another within their LofP. It then re-examines the definition of capability and argues that capability should be understood as a social construct through which individuals participate in the practices of their CofP and express knowledgeability of community norms and practices. It concludes that individuals build capabilities through a process involving problem solving, negotiation and learning, resilience, and reflection on their own and other members’ actions as they engage in interactions. [ABSTRACT FROM AUTHOR]

This paper follows an earlier report of young children's object play activities investigated in a cross-sectional sample of 289 typically developing children. Thirty-minute videotaped observations were taken of children at 8, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months of age in their homes. Forty-nine percent were boys. Children were identified as White (70%); mixed racial/cultural backgrounds (14%); Asian (7%); Black (6%); and Latinx (3%). This study reports patterns of cognitive development based on mastery scores derived from frequency and variety of activities in the 27 categories identified in the earlier study. Mastery scores afforded evaluation of the robustness of certain play categories, and the retention and reduction of others, yielding a final set of 14 to describe and assess developments in play. Discussion centers on the value of differentiated categories along with scores that yield a standard for an assessment of children's play. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess anxiety, depression and quality of life (QoL) in patients with head and neck cancer undergoing laryngectomy using comprehensive self‐reported questionnaires for a period of up to 5 years. Methods: This prospective observational study enrolled 150 consecutive patients with locally advanced head and neck cancer who underwent laryngectomy at Nagoya University Hospital between 2007 and 2020. Anxiety, depression and QoL were assessed at baseline (preoperative) and at 3, 6, 12, 24, 36, 48 and 60 months after surgery using two brief self‐reported questionnaires, such as the eight‐item Short Form Health Survey (SF‐8) and the Hospital Anxiety and Depression Scale (HADS). Results: The surgical procedures were total laryngectomy, pharyngo‐laryngectomy and pharyngo‐laryngo‐oesophagectomy in 97 (65%), 41 (27%) and 12 (8%) patients, respectively. All eight items of the SF‐8 were significantly worse than those of the normal population at baseline and at 3 months after surgery. However, general health, vitality, mental health and bodily pain improved to normal levels within 1 year after surgery and were maintained for 5 years. In this study, 35% of patients were categorised as potential cases of depression, and 35% were potential cases of anxiety. During the follow‐up period, the proportion of patients with anxiety gradually decreased after surgery. Further analysis revealed that the SF‐8 and HADS scores and trends in 89 patients without tumour recurrence were similar to those in the total enrolled 150 patients. Conclusion: Anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. What this paper adds: What is already known on the subject: Laryngectomy is associated with prolonged functional and psychological effects and has a major impact on patient quality of life (QoL). Several prospective studies evaluating the QoL in laryngectomised patients have been reported, in which significant deterioration in social functioning was found even 1 year after surgery. What this paper adds to existing knowledge: One year is not a sufficient period for laryngectomised patients to return to normal life and spend their time in a social community. A recent review showed that most studies on QoL in laryngectomised patients were conducted under 1 year after the procedure, and there were not enough studies of sufficient quality. This is the first long‐term prospective observational study of Japanese patients with head and neck cancer who underwent laryngectomy up to 5 years after surgery. What are the potential or actual clinical implications of this work?: Our long‐term observational study showed that the scores for anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Clinicians should recognize the importance of psychosocial risk factors in their QoL and multidisciplinary management, including social and psychological support, is essential for long‐term laryngectomised survivors. [ABSTRACT FROM AUTHOR]

BACKGROUND: This paper presents the process taken by a nonprofit educational organization to create authentic evaluation tools for Food Education in K‐12 schools. Development was a collaborative effort between organization staff and teachers during an Evaluation Summit. The program background, development of the Summit, and plans for post‐Summit work continuation are described. The Summit included 14 teacher participants (3‐4 per grade band in preK‐1, 2‐5, 6‐8, 9‐12). METHODS: The process of tool development was captured via direct observations and analysis of artifacts (eg, participants' brainstorming chart paper, online development documents) to identify themes in successful approaches and challenges. Additional post‐Summit activities were also captured via surveys and artifacts. Outcomes of this work are outlined, including the challenges in carrying out the creation of authentic assessments that accurately reflect the classroom teaching experience, and the value of in‐person community building in the Food Education space. RESULTS: Key findings relate to the importance of in‐person collaboration amongst teachers, centering students in evaluation, and equity and accessibility in tool development. CONCLUSIONS: Although outlining challenges and outcomes was not an a priori goal of this work, it provides important information for others working in the education nonprofit space—especially as it pertains to new approaches to classroom evaluation. [ABSTRACT FROM AUTHOR]

When estimating treatment effects, the gold standard is to conduct a randomized experiment and then contrast outcomes associated with the treatment group and the control group. However, in many cases, randomized experiments are either conducted with a much smaller scale compared to the size of the target population or accompanied with certain ethical issues and thus hard to implement. Therefore, researchers usually rely on observational data to study causal connections. The downside is that the unconfoundedness assumption, which is the key to validating the use of observational data, is untestable and almost always violated. Hence, any conclusion drawn from observational data should be further analyzed with great care. Given the richness of observational data and usefulness of experimental data, researchers hope to develop credible methods to combine the strength of the two. In this paper, we consider a setting where the observational data contain the outcome of interest as well as a surrogate outcome, while the experimental data contain only the surrogate outcome. We propose an easy-to-implement estimator to estimate the average treatment effect of interest using both the observational data and the experimental data. [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]

Hospital to home transfers for older people require effective communication, coordination and collaboration across multiple service settings. Rural Nursing Theory and the Beyond Periphery model explain why this is particularly difficult in rural areas, but there are few examples of how rural services respond. This paper presents a case study of the district of Tärnaby in the inland north of Sweden. Data are drawn from interviews with health and care staff in Tärnaby, observations, and experiences of the researchers. Data were analyzed thematically, with four main themes emerging – role clarity, communication, geography, and understanding of the rural context. Responses to challenges included increasing opportunities for communication between service providers and improving documentation. The paper concludes that informal "workarounds" run the risk of further disconnecting rural service settings from "the city". Rather, the aim needs to be to improve contextual understanding through formally incorporating "the rural" in service design. [ABSTRACT FROM AUTHOR]

Background: Oral fluid intake decreases in advanced cancer in the dying phase of illness. There is inadequate evidence to support the assessment, and management, of hydration in the dying. Bioelectrical impedance analysis (BIA) is a body composition assessment tool. BIA has the potential to inform clinal management in advanced cancer, by examining the relationships between hydration status and clinical variables. Aim: BIA was used to determine the association between hydration status, symptoms, clinical signs, quality-of-life and survival in advanced cancer, including those who are dying (i.e. in the last week of life). Materials and methods: We conducted a prospective observational study of people with advanced cancer in three centres. Advance consent methodology was used to conduct hydration assessments in the dying. Total body water was estimated using the BIA Impedance index (Height – H (m)2 /Resistance – R (Ohms)). Backward regression was used to identify factors (physical signs, symptoms, quality of life) that predicted H2/R. Participants in the last 7 days of life were further assessed with BIA to assess hydration changes, and its relationship with clinical outcomes. Results: One hundred and twenty-five people participated (males n = 74 (59.2%), females, n = 51 (40.8%)). We used backward regression analysis to describe a statistical model to predict hydration status in advanced cancer. The model demonstrated that 'less hydration' (lower H2/R) was associated with female sex (Beta = -0.39, p < 0.001), increased appetite (Beta = -0.12, p = 0.09), increased dehydration assessment scale score (dry mouth, dry axilla, sunken eyes - Beta = -0.19, p = 0.006), and increased breathlessness (Beta = -0.15, p = 0.03). 'More hydration' (higher H2/R) was associated with oedema (Beta = 0.49, p < 0.001). In dying participants (n = 18, 14.4%), hydration status (H2/R) was not significantly different compared to their baseline measurements (n = 18, M = 49.6, SD = 16.0 vs. M = 51.0, SD = 12.1; t(17) = 0.64, p = 0.53) and was not significantly associated with agitation (rs = -0.85, p = 0.74), pain (rs = 0.31, p = 0.23) or respiratory tract secretions (rs = -0.34, p = 0.19). Conclusions: This is the first study to use bioimpedance to report a model (using clinical factors) to predict hydration status in advanced cancer. Our data demonstrates the feasibility of using an advance consent method to conduct research in dying people. This method can potentially improve the evidence base (and hence, quality of care) for the dying. Future BIA research can involve hydration assessment of cancers (according to type and stage) and associated variables (e.g., stage of illness, ethnicity and gender). Further work can use BIA to identify clinically relevant outcomes for hydration studies and establish a core outcome set to evaluate how hydration affects symptoms and quality-of-life in cancer. Key message: What is already known about this topic? - Oral fluid intake decreases in people with advanced cancer, especially when they approach the dying phase of their illness. - There is inadequate evidence to support hydration assessment and decision making in the dying phase of illness. - It is important to understand which clinical factors are associated with hydration status in advanced cancer, to enable healthcare professionals, to evaluate hydration status and support clinical decision making. - Bioimpedance is a non-invasive technology, which has potential to identify clinically relevant variables for cancer hydration assessment. What this paper adds. - This is the first study to use bioimpedance to report a model (using clinical factors) to predict hydration status in advanced cancer. - The variables with combined significance for predicting hydration status were biological sex, appetite, dry mouth, dry axilla, sunken eyes, breathlessness and oedema. In the dying phase, hydration status did not significantly change compared to baseline, and hydration status was not significantly associated with survival. Implications for practice, theory or policy. - Further work can use bioimpedance to identify clinically relevant outcomes for hydration studies, to establish a core outcome set to evaluate how hydration affects symptoms and quality-of-life in cancer. [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]

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF–LPF frameworks and suggestions to increase the transformative power of future studies. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]

Background and Objective: The systematic assessment evaluated long-term observational research on the efficacy, comfort and security of Cannabis based Medications (CbMs) for Chronic Non-Cancer Pain (CNCP). Methods: The research was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic assessment and Meta-Analyses). Results: After reviewing five papers in their entirety, the study excluded them due to lack of pain-related outcomes. Results of a 48-weeks Indian experiment with 143 patients were reported for both responders and nonresponders. An average follow-up of 48 weeks-28 weeks was noted in another Indian experiment including 101 participants. Additionally, 1144 persons using medicinal cannabis for various conditions did not separately publish results for individuals experiencing pain at the 6-months follow-up. Conclusions: It's important to use care when interpreting data from observational research. CbMs were generally well tolerated and safe in the context of observational studies, and they showed beneficial effects on a variety of symptoms for certain CNCP patients’ modalities. Significance: According to reports of prospective observational studies, the long-term efficiency of medicinal cannabis for CNCP, tolerability, and safety have extremely poor-quality evidence. These kinds of research did not meet the predefined requirements for an effect size of a big magnitude. However, for certain carefully chosen and well-watched CNCP patients, long-term medicinal cannabis treatment may be an option. [ABSTRACT FROM AUTHOR]

As the population continues to age, the occurrence of chronic illnesses and comorbidities that often necessitate the use of polypharmacy has been on the rise. Polypharmacy, among other factors that tend to coincide with chronic diseases, such as obesity, impaired kidney and liver function, and older age, can increase the risk of medication errors (MEs). Our study aims to evaluate the prevalence of MEs in the Internal medicine, Cardiology, and Neurology departments at the secondary‐level university hospital. We conducted a prospective observational study of 145 patients' electronic or paper‐based data of inpatient prescriptions and patients' pharmacokinetic risk factors, such as an impairment of renal and/or hepatic function, weight, and age. All included patients collectively received 1252 prescribed drugs. The median (Q1; Q3) number of drugs per patient was 8 (7;10). At least one ME was identified in 133 out of the 145 patients, indicating a significantly higher prevalence than hypothesized (91.7% vs. 50%; p <.001). There was moderate, positive correlation between the quantity of prescribed drugs and the number of MEs, meaning that the more drugs are prescribed, the higher the number of identified MEs (Spearman's ρ = 0.428; p <.001). These findings suggest that there is a need for continuous medication education activity for prescribing physicians, continuous evaluation of prescription appropriateness to objectively identify the MEs and to contribute to more rational patient treatment. [ABSTRACT FROM AUTHOR]

Introduction: Digitalization in medicine is steadily increasing. Complex treatments, scarce personnel resources and a high level of documentation are a constant burden on healthcare systems. The balancing between correct manual documentation in the digital records and limited staff resources is rarely successful. The aim of this study is to evaluate the adherence between documentation and lack of documentation in the treatment of critical care patients. Material and Methods: For the evaluation, data from the hospital information system (HIS) of several intensive care units (ICU) were examined in conjunction with data collected from a checklist. All boluses of sedatives, analgesics and catecholamines were documented paper based across all shifts and all weekdays and compared with corresponding digital data from the HIS (2019–2022) of previous years. Results: 939 complete digital patient records revealed a massive under-documentation of the medication administration compared to that applied according to the checklist. Only 12% of all administered catecholamines, 11% of α2-agonists, 33% of propofol, 92% of midazolam and 46% of opioids were found in the digital recordings. In comparison, the effect was more pronounced on weekdays compared to weekends. In addition, the highest documentation gap was found in the comparison of early shifts. Comparing neurosurgical vs. internal vs. anesthesiologic ICUs there was a highly significant difference between anesthesiologic ICUs compared with other disciplines (p < 0.0001). Discussion: Our data shows that there is a remarkable documentation gap and incongruence in the area of applied boli. Automated documentation by connecting syringe pumps that enter data directly into the HIS can not only reduce the workload, but also lead to comprehensive and legally required documentation of all administered medication. [ABSTRACT FROM AUTHOR]

Background: Primary care physicians are not adequately trained to tackle mental health problems. The study aimed to evaluate undergraduate training in Psychiatry: An observational perspective of medical officers. Materials and Methods: It was a cross-sectional study conducted in North India. Participants were assessed on a self-designed questionnaire developed by the Indian psychiatric society to assess various aspects of undergraduate training. Other questionnaires measured residents' satisfaction with the quality of training programs and perceived need for psychiatric training in undergraduate courses. Results: The participant's mean age was 32.4 years; majorities were male medical officers. About one-tenth reported that there were no separate psychiatry departments and designated psychiatry consultants in their college. Approximately 50% reported: No regular supervision by any psychiatric faculty or having psychiatric disorders discussions in clinical rounds. More than half (50.9%) were not confident enough to identify common signs and symptoms of psychiatric problems. From one-third to half of the participants were unsatisfied with various aspects of the training program, like teaching skills, diagnostic interviews, clinical posting, etc. Majority (77.3%–83.7%) agreed that there is a need to improve the psychiatry training program; during the clinic rounds, psychiatric diagnosis should be discussed, and psychiatry should be a separate subject in under-graduation. Conclusion: Primary health-care physicians were unsatisfied with an undergraduate psychiatry training program. Hence, psychiatry should be an independent subject during the undergraduate training program, with dedicated theoretical and clinical hours for psychiatry training and a separate paper for evaluation. [ABSTRACT FROM AUTHOR]

Background: integrated Rehabilitation and EnAblement Program (iREAP) is an innovative redesign of the traditional day rehabilitation model, providing an anticipatory, early assessment and intervention program that manages care of community-dwelling older people with complex needs. It coordinates access to disciplines across medical, allied health and nursing, with a self-management focus, partnering with primary health in an integrated approach. Objective: This observational study reviews the effectiveness of iREAP on frailty, patient activation, quality of life and physical outcome measures on older people at risk of, or experiencing falls and frailty, or with neurodegenerative conditions, including Parkinson's Disease. Methods: 99 participants completed the eight-week multidisciplinary program. Patient outcome measures included Rockwood Clinical Frailty Scale, quality of life measures, Patient Activation Measure, Timed Up and Go, 6 Minute Walk Test and Berg Balance Scale. Results: On completion of iREAP, participants displayed improvements in their Rockwood Clinical Frailty Scores (mildly frail to vulnerable), 'patient activation' (55.08 to 60.61), quality of life (Parkinson's Disease Questionnaire-39, 49.93 to 47.16; WHO Quality of Life – Bref physical domain, 21 to 22.7) and physical measures including balance (44 to 49/56 Berg Balance scale) and mobility (294 m to 336 m, 6-minute walk test). Falls were not reduced at twelve months post-program (3.40 to 2.01). Conclusion: iREAP is an interdisciplinary, early assessment and intervention program with the potential to reverse frailty and improve quality of life for complex older patients. This paper offers a platform for future research, given the paucity of evidence reviewing the efficacy of integrated anticipatory models of care in older adults with complex needs. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: New modern era, new modern age, the paper has been replaced by the screen. However, this screen might be started from the age of the television to the computer, smartphones, and tablets. With this new era the health is lacking and has taken a back step. Aim: This study aims to assess the screen time usage and its effects on mental well-being to promote the mental health among students. Methods: A quantitative research approach, nonexperimental descriptive research design was used. Data were collected from 100 professional college students and 100 school-going students. Nonprobability convenient sampling technique was used. Responses were collected on sociodemographic profile, self-structured screen time usage, The Warwick–Edinburgh Mental Well-being (2006), and Self-Structured Screen Time Effects Likert Scale. Results: The study revealed that 55% of the college students and 42% of the school-going students were using smartphone for 1–3 h on weekends, 56% of the college students and 45% of the school-going students were using smartphone for 1–3 h on weekdays (58%) of the professional college students having high mental well-being and 42% having low mental well-being, almost half (54%) of the school-going students having high mental well-being and 46% having low mental well-being. Conclusion: The study concluded that the professional college students had higher screen time usage than school-going students on both weekdays/weekends and majority of them were using it for educational purpose. High mental well-being was found in both groups of students. [ABSTRACT FROM AUTHOR]

Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Nurses are at high risk of burnout and subsequent mental health concerns due to problems with overstaffing, immense workload volume, and personal health risks associated with the job. Effective mental health treatments are available but potential barriers to receiving care may prevent nurses from benefiting. The Emotional Health and Well-Being Clinic (EHWC) at Houston Methodist is an outpatient mental health clinic offering therapy and medication management services for employees and employee dependents of our institution. The EHWC is uniquely positioned to observe how nurses utilize mental health services and to address barriers to effective care for this vital group of healthcare professionals. This paper provides descriptive data on the utilization of mental health services by nurses in the EHWC and a discussion of possible challenges faced by this group when seeking care. Based on these data, we propose potential solutions to ensure that nurses can achieve maximum benefit from outpatient mental health services. [ABSTRACT FROM AUTHOR]

As access to an essential part of clozapine research from the former Union of Soviet Socialist Republics (USSR) states is very limited, quality aspects have not gained attention so far, and harmonization with modern research standards remains unclear. We performed a systematic search in PubMed, Embase and scientific indexes from former USSR states for articles published in Russian language till January 2023 (PROSPERO Reg. Number CRD42023386737) and assessed their quality using the modified Strengthening the reporting of observational studies in epidemiology (STROBE)-Checklist. We compared quality aspects for papers published before and after 2000. A total of 60 papers were considered. Conflicts of interests and funding sources were reported in 5 and 3 (8 % and 5 %) studies respectively; ethical approval was warranted in two studies (3 %). Statistical analysis was performed in 57 (95 %) studies, but statistical methods were described in 21 (35 %) studies. When comparing studies before and after 2000, there was a trend towards improvement for several aspects, with the only significant differences being the objectives' specification (43 vs 83 %, p < 0.003) and the reporting of statistical methodology (0.0 vs 46 %, p < 0.001), which were more frequently available in papers after 2000. Clozapine papers in Russian language suffered from severe methodological drawbacks limiting generalizability. Changes regarding standardization, transparency, ethics, and good scientific practice are urgently required. Using reporting checklists and predefining protocols are the first steps towards quality upgrade and accelerate the integration of science from the former USSR states into the world scientific system. [Display omitted] [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses' observation of patients in seclusion is essential to ensure patient safety.Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy.Direct observation and video monitoring are widely used in observing patients in seclusion.Coercive practices may cause distress to patient‐staff relations. What the paper adds to existing knowledge?: We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients.Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness.Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized.Observation via camera and nurses' presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion.Pixellating the video camera would give a sense of privacy and dignity. What are the implications for practice?: The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients' unique needs.A consistent approach to relational contact and communication is essential. A care plan must include patient's preferred approach for interacting while in seclusion to support individualized care provision.Viewing panels (small window on the seclusion door) are important in establishing two‐way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients.Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient's presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness.More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations.Patient education is paramount. Providing prior information to patients using a co‐produced information leaflet might reduce their anxiety and make them feel safe in the room.When using cameras in the seclusion room, these should be pixelated to maintain patients' privacy. Introduction: A lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study. Aim: The aim of the study was to explore patients' experience of different methods of observation used while the patient was in seclusion. Method: A retrospective phenomenological approach, using semi‐structured interviews, ten patients' experiences of being observed in the seclusion room was investigated. Colaizzi's descriptive phenomenological method was followed to analyse the data. Results: Communicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion. Discussion: The mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation. Implications for Practice: Different observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion. [ABSTRACT FROM AUTHOR]

Engaging in 'reflexive practice' throughout the research process (Benson and O'Reilly, 2022) and a 'reflexivity of discomfort' (Hamdan, 2009) through an intersectional lens, this article presents a reflective account of accessing and conducting observations and interviews at a South Asian women's organisation, in North England, to explore Pakistani and Bangladeshi Muslim (PBM) lone motherhood. It critically explores how researchers' own subjectivities and intersecting identities – in this case, my intersecting identities and positionalities as a young British Pakistani Muslim women, researcher and volunteer – impact interactions in different circumstances with different groups of participants and the importance of having continuous critical self-awareness. Moving beyond simplistic insider–outsider debates, the paper contributes towards further developing reflexivity debates taking an 'intersectional reflexivity' approach. It argues for thinking about the research process and engagements in the field as socially constructed, changing, adapting and negotiated overtime and to utilise intersectionality to unpick broader categories. Finally, it encourages researchers to adopt reflexivity in their research practices. [ABSTRACT FROM AUTHOR]

The effects of preterm birth, neonatal morbidities and environmental influences on infant sleep development is an important yet under-researched topic, with little known about normative sleep for infants born sick or preterm. The aim of this prospective, observational longitudinal study was to evaluate maternal perceptions and degree of bother with infant sleep behaviours and feeding outcomes across the first 9 months after discharge for sick/preterm infants cared for in the neonatal intensive care unit (NICU) and for healthy term-born infants. This paper reports outcomes for the sick/preterm cohort (I = 94) that were recruited from two NICUs in Perth, Western Australia. Total bother scores were on average 20.2% higher at 9 months than at two weeks post-discharge (p < 0.001). Increased night waking frequency, evening settling duration and crying duration were all positively associated with total bother scores. Maternal confidence scores were negatively associated with maternal bother scores; with each unit increase in confidence, maternal bother decreased by 8.5% (p < 0.001). Covariates such as birth gestation, breastfeeding status and multiple births were not associated with maternal bother. Families may benefit from additional support when experiencing increased night waking frequency and crying and settling durations in the first 9 months after discharge from NICU. [ABSTRACT FROM AUTHOR]

Qualitative research has long critiqued a simplistic association between youth parenting and poor outcomes. Despite this, the UK youth parenting policy continues to view young parents through a narrow deficit lens, focused on assumed risk rather than structural inequalities. The paper brings together the direct accounts of young parents' experiences, with ethnographic observation of practice, to argue that discrimination is the critical issue associated with being a young parent. This is then set within a wider critique of the policy framework which, it is argued, perpetuates and normalises negative ideas about young parents prevalent in political, societal and cultural processes. An integrative theoretical approach is used to highlight how a deficit lens at a policy level upholds, rather than undermines, young parents' intersectional experiences of discrimination and has ethical implications for practitioners working with them. The paper calls for a reorientation of policy which addresses and disrupts discrimination. [ABSTRACT FROM AUTHOR]

Aims: This is the second of two papers conceptualizing emotional labour in the emergency department (ED). This paper aims to understand the environmental 'moderators' of ED nurses' emotional labour. Design: Ethnography, through an interpretivist philosophy, enabled immersion in the ED setting, gathering the lived experiences and narratives of the ED nurses. Methods: Observation and semi‐structured interviews over a 6‐month period. Two hospital sites (one district general and one major trauma centre based in the United Kingdom. Results: Over 200 h of observation plus 18 formal/semi‐structured interviews were completed. Environmental, institutional and organizational dynamics of the emergency department instrumented the emotional labour undertaken by the nursing team. Time and space were found to be 'moderators' of ED nurses' emotional labour. This paper focusses on the relevance of space and in particular, 'excessive visibility' with little respite for the nurses from their intense emotional performance. Conclusion: Emotional labour is critical to staff well‐being and the way in which healthcare spaces are designed has an impact on emotional labour. Understanding how emotional labour is moderated in different clinical settings can inform organizational, environmental and workforce‐related decision‐making. [ABSTRACT FROM AUTHOR]

Purpose: Whereas a large number of features are mentioned to connote the quality of medical research, no tool is available to comprehensively measure it objectively across different types of studies. Also, all the available tools are for reporting, and none includes quality of the inputs and the process of research. The present paper is aimed to initiate a discussion on the need to develop such a comprehensive scoring system (in the first place), to show that it is feasible, and to describe the process of developing a credible system. Method: An expert group comprising researchers, reviewers, and editors of medical journals extensively reviewed the literature on the quality of medical research and held detailed discussions to parse quality at all stages of medical research into specific domains and items that can be assigned scores on the pattern of quality-of-life score. Results: Besides identifying the domains of the quality of medical research, a comprehensive tool for scoring emerged that can be possibly used to objectively measure the quality of empirical research comprising surveys, trials, and observational studies. Thus, this can be used as a tool to assess Quality of Empirical Research in Medicine (QERM). The expert group confirmed its face and content validity. The tool can be used by the researchers for self-assessment and improvement before submission of a paper for publication, and the reviewers and editors can use this for assessing the submissions. Published papers can also be rated such as those included in a meta-analysis. Conclusion: It is feasible to devise a comprehensive scoring system comprising domains and items for assessing the quality of medical research end-to-end from choosing a problem to publication. The proposed scoring system needs to be reviewed by the researchers and needs to be validated. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Supervised Quarantine has been shown to impact the psychological well‐being of those in quarantine both during the COVID‐19 pandemic and in previous pandemics.There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID‐19 mitigation.There is little research regarding the psychological well‐being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. What the paper adds to existing knowledge?: This paper addresses the paucity of knowledge regarding the psychological well‐being of those undergoing quarantine in a purpose‐built facility.The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine.Lack of control, isolation and miscommunication were perceived as challenging mental well‐being. What are the implications for practice?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well‐being.Mental health workers need to be cognizant that point entry to COVID‐19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress.Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment. Introduction: Supervised quarantine may compromise psychological well‐being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities. Aims: To evaluate the mental well‐being of people undergoing and working in a supervised COVID‐19 quarantine facility. Method: Mixed methodology was used, including a cross‐sectional analysis of psychological distress (DASS‐21) and individual semi‐structured interviews (10 professionals maintaining quarantine and 10 quarantined persons). Results: Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication. Discussion: Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine. Implications for Practice: Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well‐being. [ABSTRACT FROM AUTHOR]

Assessing sensitivity to unmeasured confounding is an important step in observational studies, which typically estimate effects under the assumption that all confounders are measured. In this paper, we develop a sensitivity analysis framework for balancing weights estimators, an increasingly popular approach that solves an optimization problem to obtain weights that directly minimizes covariate imbalance. In particular, we adapt a sensitivity analysis framework using the percentile bootstrap for a broad class of balancing weights estimators. We prove that the percentile bootstrap procedure can, with only minor modifications, yield valid confidence intervals for causal effects under restrictions on the level of unmeasured confounding. We also propose an amplification—a mapping from a one-dimensional sensitivity analysis to a higher dimensional sensitivity analysis—to allow for interpretable sensitivity parameters in the balancing weights framework. We illustrate our method through extensive real data examples. [ABSTRACT FROM AUTHOR]

Background: Writing is an important and complex skill, which could be enhanced by teaching students effective writing strategies such as outlining. Electronic outlining ‐ integrated feature in Microsoft® Word – has been shown to enhance students' writing performance. However, little is known about the optimal didactic approach for electronic outlining. Objective: This study examined the effects of learning to use electronic outlining either via observational learning or via learning‐by‐doing on students' argumentative writing performance. Methods: Students (N = 129, 10th‐grade) were assigned with their complete class to one of three conditions: a control (traditional pen and paper outlines via learning‐by‐doing), outline (electronic outlines via learning‐by‐doing) or observation (electronic outlines via observational learning) condition. Students followed an argumentative writing lesson‐series that differed across conditions in terms of planning strategies and didactic approaches used. To examine the influence of the different conditions on students' writing, argumentative texts were used as pre‐ and post‐tests, and the quality was evaluated with an analytic assessment protocol. In addition, data regarding students' perceived mental effort and the organisation of the writing process were collected. Finally, students' attitudes towards electronic outlining were assessed. Results and Conclusion: Although the overall text structure had improved after the lesson series, no significant differences were found between conditions. Electronic outlining increased the total amount of time dedicated to the texts as well as the revision ratio. Students in the observation condition showed a higher pause ratio and a lower fluency on the post‐test as compared to students who learned by doing (both control and outline conditions). With regard to perceived mental effort, students in the outline and control conditions perceived significant decreases over tasks, as opposed to those in the observation condition. In conclusion, the self‐reports indicate that students in the outline condition appropriated electronic outlining significantly better than those in the observation condition, suggesting that practice enhanced students' appropriation of electronic outlining. Lay Description: What is already known about this topic: Planning as a writing strategy helps students organise their writing and reduce mental effort.Electronic outlining is an effective and efficient tool to support a planning strategy.Observational learning is an effective didactic approach in writing education. What this paper adds: Traditional planning and electronic outlining via either observational learning or learning‐by‐doing affect writing products equally.Tool appropriation is greater for students who learned‐by‐doing. Implications for practice: Importance of elaborated and explicit (strategy) instruction.Advantage of video‐based modelling for teacher efficiency. [ABSTRACT FROM AUTHOR]

This paper compares two strikingly different uses of water. The first by an adolescent young man on the autistic spectrum, in an art psychotherapy session; the second, by an ordinary developing toddler, observed at home. It uses insights gleaned from psychoanalytic infant observation to illuminate the seemingly enigmatic behaviours found in clinical practice. In doing so, it delineates the centrality of joint visual attention in the development of symbol formation. Understanding is advanced by making evident that water may be used to either enable or inhibit this process. As such, it argues that the phenomenon of liquidity be given greater consideration. Further, it critically champions for the inclusion of infant observation in art psychotherapy training. [ABSTRACT FROM AUTHOR]

Extensive surface and upper air measurements of a typhoon over the northern part of the South China Sea, namely, Typhoon Talim in July 2023, are documented and analysed in this paper. A number of features have been observed from the upper air measurements. First, the log law and the power law were found to be appropriate in fitting the wind profiles of the typhoon in the first 1000 m or so above the sea surface. Second, a low-level jet with the height of the maximum wind speed of around 1000 m was observed in the lower troposphere from the observations of the radar wind profilers. This paper is also novel from the perspectives that the vertical wind profile from a Doppler LIDAR on an offshore platform over the northern part of the South China sea and ocean radar data are used to analyse the surface wind observations of a typhoon in the region. The results of this paper would be useful in understanding the structure of tropical cyclones, e.g., in wind engineering applications. [ABSTRACT FROM AUTHOR]

Fine balance is a matching technique to improve covariate balance in observational studies. It constrains a match to have identical distributions for some covariates without restricting who is matched to whom. However, despite its wide application and excellent performance in practice, there is very little theory indicating when the method is likely to succeed or fail and to what extent it can remove covariate imbalance. In order to answer these questions, this paper studies the limits of what is possible for covariate balancing using fine balance and near‐fine balance. The investigations suggest that given the distributions of the treated and control groups, in large samples, the maximum achievable balance by using fine balance only depends on the matching ratio (ie, the ratio of the sample size of the control group to that of the treated group). In addition, the results indicate how to estimate this matching ratio threshold without knowledge of the true distributions in finite samples. The findings are also illustrated by numerical studies in this paper. [ABSTRACT FROM AUTHOR]

Background: There is a lack of simple tools that could allow members of the general population to estimate their own dietary patterns and to associate them with unfavourable health outcomes. The present study aimed to develop and validate a simple self‐administered tool, called the Easy Diet Screener (EDS), that would identify healthy and unhealthy dietary patterns and evaluate their association with unfavourable blood and anthropometric parameters (i.e. values outside the recommended values). Methods: In total, 259 adult people (31−50 years of age) participated in this observational study. They filled out an online version of the EDS questionnaire; those who scored highly were assigned to the healthy dietary pattern (HDP) group, whereas those with a low score were assigned to the western dietary pattern (WDP) group. The dietary records, anthropometric and biochemical parameters were evaluated in a subset of 200 participants who obtained similar score in the repeated EDS (paper version). Results: People assigned to HDP on the basis of EDS had significantly better diet quality than those assigned to WDP, with values of the Healthy Eating Index being 76.9 ± 9.2 and 58.7 ± 10.5, respectively. People classed as WDP had a higher risk of too high serum low‐density lipoproteins [odds ratio (OR) = 2.65], triglycerides (OR = 3.67), body mass index (OR = 2.87) and percentage of fat tissue (OR = 3.98) than did people in the HDP. Conclusions: EDS is an easy tool for quickly identifying healthy and western dietary patterns that are associated with lipid profile and body adiposity. Key Points: The newly developed Easy Diet Screener (EDS) distinguishes people with healthy and unhealthy dietary patterns.People classed as having an unhealthy/western dietary pattern on the basis of EDS have a higher risk of an undesirable lipid profile and body fat content.EDS can be used by anyone willing to self‐evaluate his or her diet because no nutritional knowledge is required to use it. [ABSTRACT FROM AUTHOR]

Despite the apparent centrality of supervision to the effectiveness of social work practice, this topic remains largely under researched. The majority of studies to date have relied on self-reporting mechanisms to understand 'what happens' in supervision, with few accessing supervision directly, and none, to the writer's knowledge, attempting to analyse the impact of unconscious processes. This paper aims to contribute to this gap in the knowledge base by analysing the conscious and unconscious processes at play in two cohorts of systemic group supervision held in UK children's services, and how such processes, alongside the leadership styles of the supervisors, impacted on the nature of supervision practice. A psychoanalytically informed research methodology is employed to study the group supervision sessions, and the subsequent data analysed through a thematic analysis. This paper employs Bion's model of thought outlined in Learning from Experience to explore how each group developed its own unique ability to think in light of its capacity to contain anxiety. Implications for the nature of reflective practice in the supervision, and social work practice more broadly, are then discussed. [ABSTRACT FROM AUTHOR]