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Introduction: Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors. Objectives: The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses' demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration. Methods: This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software. Results: The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace (P <.01), education level (P <.05), and area of practice (P <.001). Similarly, the EHR workflow integration scores varied according to workplace (P <.05), education level (P <.05), and area of practice (P <.001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses' workflow. Conclusion: The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses' workflow. [ABSTRACT FROM AUTHOR]

Objectives: To investigate response rates for online and paper versions of an identical questionnaire and the differences between respondents to each and between respondents and non-respondents among a population with type 2 diabetes.Methods: We mailed letters containing an invitation to complete an online questionnaire to 2045 individuals, followed by two reminders; the second included a paper version of the questionnaire.Results: In total, 1081 people responded to either version of the questionnaire, yielding a response rate of 54%. Compared to total respondents, respondents completing the online version were more likely to be male, better educated, and younger, and have had diabetes for a shorter period of time. Compared to non-respondents, respondents were more likely to be male and have a lower hemoglobin A1c level.Conclusion: Web-based surveys are capable of delivering a substantial number of responses cost-effectively. However, disadvantages related to selection bias should be taken into account, and mixed-mode methods should be considered when surveying populations with type 2 diabetes. [ABSTRACT FROM PUBLISHER]

The quantity and quality of research focused on autism spectrum disorder (ASD) have grown over the past several decades. Ensuring that research findings are accessible and understood by education professionals is essential for improving outcomes for individuals with ASD. In this study, we evaluated education professionals' knowledge about ASD, specifically (a) beliefs about causes of ASD, (b) their familiarity with evidence-based practices (EBPs) and non-EBPs, (c) the likelihood of using or recommending EBPs compared with non-EBPs, and (d) the extent to which source credibility influenced the likelihood of using or recommending different types of practices. Education professionals (N = 62) completed a paper survey. Responses on a modified version of the Illness Perception Questionnaire–Revised (Moss-Morris et al., 2002) were used to evaluate participants' beliefs regarding causal attributes of ASD. Educators were also asked to read texts describing four EBPs and four non-EBPs. The text presentation was based on a 2 × 2 within-subjects factorial design with practice status (EBP or non-EBP) and source credibility (credible or not credible) as the independent variables. After reading each text, participants reported on whether they were (a) familiar with the practice and (b) the extent to which they would use or recommend the practice. Results indicate that school personnel were highly confident that neurobiological factors were a causal attribute of ASD. In addition, respondents were more familiar with, and more likely to recommend or use, EBPs as compared with non-EBPs. Source credibility did not significantly affect participants' likelihood of using or recommending practices. [ABSTRACT FROM AUTHOR]

It is important that nurses fully engage with the development and use of evidence-based practice so they can influence policy and improve patient care. There are significant challenges in developing nursing research and evidence-based practice in the United Arab Emirates (UAE). Therefore, the UAE Nursing and Midwifery Council formed a Scientific Research Subcommittee to lead the development of nursing research. Following a literature review to assess the status of nursing research in the UAE, the Subcommittee initiated a study to clarify UAE nurses' perceptions of barriers to implementing research. The results were expected to enable comparisons with other countries and establish a baseline on which to build and prioritize initiatives to address identified barriers. A cross-sectional design with convenience sampling was used to survey 606 nurses from across the UAE. The survey included the BARRIERS questionnaire and was administered online and in paper-based formats. The top three nurse-perceived barriers that affected nurses' use of research in the UAE (in descending order) were as follows: lack of authority to change patient care procedures, insufficient time to read research, and insufficient time on the job to implement new ideas. The highest ranked barriers to nurses conducting research in the UAE were lack of time and competing demands for time. The findings of this survey and a published literature review informed development of a strategy to address identified barriers to nurses in the UAE using and conducting research. This multifaceted strategy includes initiatives to reform policy and practice at local and national levels. [ABSTRACT FROM AUTHOR]

This cross-sectional study describes knowledge, perceived competence, and behaviors relative to intimate partner violence (IPV)-related brain injury (BI) among staff in residential domestic violence shelter programs across a New England state. A 23-item questionnaire was administered to registrants of an online IPV-related BI training series. Within this sample, knowledge about IPV-related BI was high, but relative to providing screening, accommodations, and specialized referrals to survivors with BI, perceived competence was low, and behaviors were infrequent. IPV shelter agencies should facilitate IPV-related BI training programs for staff and prioritize developing and implementing BI screening, accommodation, and referral policies and procedures. [ABSTRACT FROM AUTHOR]

Children with language disorder frequently experience difficulties with vocabulary acquisition, and these difficulties often persist into adolescence. The literature indicates that clinical studies tend to investigate phonological-semantic approaches, whereas educational studies focus on the derivation of meaning within a literacy context. Little is known about whether the practices of speech and language therapists and teachers reflect these findings from the literature. The current paper reports on a survey which gathered information from speech and language therapists and mainstream secondary school teachers, about their current practice concerning vocabulary support for adolescents, aged 11–16, who have language disorder. An online questionnaire was distributed through teaching and speech and language therapy professional networks. The aim of the study was to establish which specific strategies were used in practice by speech and language therapists and mainstream secondary school teachers to teach vocabulary to adolescents with language disorder, and which strategies were the most effective. Responses were obtained from 127 speech and language therapists and 47 mainstream secondary school teachers in the UK. Speech and language therapists were more likely than mainstream secondary school teachers to teach phonological awareness and semantic feature analysis as strategies for developing vocabulary skills. Both professions used literacy-related strategies as well as strategies for independent word learning such as the derivation of meaning from morphology and context. Increased joint working and training opportunities would further develop the knowledge and skills of both mainstream secondary school teachers and speech and language therapists, enabling theoretically-grounded and relevant vocabulary support for this group of adolescents. [ABSTRACT FROM AUTHOR]

Purpose: Substantial cancer burden may be prevented through lifestyle modifications. The purpose of this study was to determine the preliminary effectiveness of health coaching for the improvement of health, fitness, and overall well-being of cancer survivors in a community setting. Methods: Participants were recruited from Cancer Support Community Delaware locations. Health coaching was provided to people diagnosed with cancer anywhere along the survivorship continuum. Coaches provided 6 individual sessions. Surveys were sent pre- and post-intervention on topics including fitness, eating habits, sleep, perceived stress, anxiety, depression, and quality of life. Results were analyzed using multilevel modeling. Results: 48 participants completed an average of 85% of health coaching sessions. Coaching participants noted improvements in weekly physical activity frequency, including moderate–vigorous physical activity. Increases were found in healthy eating behavior. Participants reported improvements in the quality of their sleep, including changes in sleep duration and sleep efficiency. Significant reductions were found in perceived stress, anxiety, and depression. Importantly, participants reported improved quality of life, particularly in areas of physical and emotional well-being, as well as functional and total well-being. Conclusion: Preliminary findings indicate significant behavior change in measured outcomes and suggest health coaching may be an important tool for cancer survivorship. [ABSTRACT FROM AUTHOR]

Purpose: Currently, 1 in 5 college students struggle with suicidal ideation while 7% to 44% engage in nonsuicidal self-injury. Illinois has one of the highest teenage and college student suicide rates in the United States. This pilot study assessed suicide ideation and self-harm behaviors at a public Illinois university. This is the first study to use 5 standardized psychological instruments to investigate these 2 crises in freshmen college students who are all required to reside in dormitories. The main hypothesis was to determine if the independent effects of freshmen students' depression, Five-Factor Model, and Reasons for Living affected the dependent variables, self-harm behaviors and suicide ideation. Methods: Forty first-year college dormitory students completed the Beck Depression Inventory-II, Scale of Suicidal Ideation, Five-Factor Model, Inventory of Statements About Self-Injury, and Reasons for Living Scale in person. Results: Participants were 18 to 19 years old, predominantly female (65%), and non-White (62%). Forty percent reported self-harm behaviors and 19% reported suicidal ideation. The top reasons for contemplated suicide attempts included the inability to solve problems (33%) and attention/revenge (28%). Students experienced high levels of anxiety (55%), self-consciousness (43%), and depression (18%). Depression was associated with suicide ideation (β = 0.05, P =.006), while neuroticism and openness were associated with self-harm behaviors (aOR = 3.36, P =.02, aOR = 0.48, P =.047, respectively). Ninety-five percent reported "responsibility to family" as a Reason for Living. Conclusions: Preliminary evidence necessitates an examination of self-harm and suicide ideation among all freshmen, investigating both risk and protective factors. In the future, a prevention intervention should be implemented campus-wide (and eventually nationwide) for all first-year dormitory students to enhance their mental well-being. [ABSTRACT FROM AUTHOR]

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

Depression is recognized as a significant public health issue in the United States. The National Survey on Drug Use and Health reports that 21.0 million adults aged 18 or older had major depressive disorder in 2020, including 14.8 million experiencing a major depressive episode with severe impairment. The aim is to predict the positivity of Patient Health Questionnaire-2 (PHQ-2) outcomes among patients in primary care settings by analyzing a range of variables, including socioeconomic status, demographic characteristics, and health behaviors, thereby identifying those at increased risk for depression. Employing a machine learning approach, the study utilizes retrospective data from electronic health records across 15 primary care clinics in South Florida to explore the relationship between social determinants of health (SDoH), including area of deprivation index (ADI) and PHQ-2 positivity. The study encompasses 15 primary care clinics located in South Florida, where a diverse patient population receives care. Analysis included 94,572 patient visits; 74,636 records were included in the study. If a zip+4 was not available or an ADI score did not exist, the visit was not included in the final analysis. Screening involved the PHQ-2, assessing depressed mood and anhedonia, with a cutoff >2 indicating positive screening. ADI was used to assess SDoH by matching patients' residential postal codes to ADI national percentiles. Demographics, sexual history, tobacco use, caffeine intake, and community involvement were also evaluated in the study. Over 40 machine learning algorithms were explored for their accuracy in predicting PHQ-2 outcomes, using software tools including Scikit-learn and stats models in Python. Variables were normalized, scored, and then subjected to predictive regression models, with Random Forest showing outstanding performance. Feature engineering and correlation analysis identified ADI, age, education, visit type, coffee intake, and marital status as significant predictors of PHQ-2 positivity. The area under the curve and model accuracies varied across clinics, with specific clinics showing higher predictive accuracy and others (p >.05). The study concludes that the ADI, as a proxy for SDoH, alongside other individual factors, can predict PHQ-2 positivity. Health organizations can use this information to anticipate health needs and resource allocation. [ABSTRACT FROM AUTHOR]

Background: Nurses often face ethical issues in their daily work that can have an impact on their level of job embeddedness. And positive job embeddedness is essential to reduce burnout among nurses and improve professional retention in the medical industry. However, few studies have focused on the relationship between moral distress, moral resilience, and job embeddedness. Objectives: To investigate the relationship between moral distress, moral resilience, and job embeddedness, and explore the mediating role of moral resilience between moral distress and job embeddedness among nurses. Design: A quantitative, cross-sectional study. Methods: Nurses from a number of tertiary general hospitals in central China were surveyed and assessed using the Moral Distress Scale, the Nurse Moral Resilience Scale, and the nurse job embeddedness Scale from February to March 2023. The study was conducted in line with the 1964 Declaration of Helsinki. Ethical consideration: All study procedures were approved by the Ethics Committee of Hunan Normal University (No. 2023-313). Findings: Moral distress was positively correlated with moral resilience (β = 0.525, p < 0.01) and negatively correlated job embeddedness (β = −0.470, p < 0.01). Moral resilience partially mediated the relationship between moral distress with job embeddedness (β = −0.087, p < 0.01). Discussion: The findings reveal a relationship between moral distress, job embeddedness, and moral resilience among nurses. Conclusion: Moral distress and moral resilience are important correlates of job embeddedness in nurses. Interventions to reduce moral distress and increase moral resilience may have potential benefits for improving nurses' job embeddedness. It is recommended that clinical nursing administrators create a favorable ethical atmosphere, educate nurses about ethics, and increase nurses' moral resilience. [ABSTRACT FROM AUTHOR]

Background: Minimal research has been done to determine how well European nursing students understand the core principles of academic integrity and how often they deviate from good academic practice. Aim: The aim of this study was to find out what educational needs nursing students have in terms of academic integrity. Research design: A quantitative cross-sectional study in the form of a survey of nursing students was conducted via questionnaire in the fall of 2020. Participants: The sample was composed of 79 students in the BScN and MScN programs at Zürich University of Applied Sciences. Ethical considerations: An application for a non-competence clearance was approved by the Ethics Committee in Zurich (BASEC No. Req-2020-00868). The survey was anonymous, and informed consent was obtained prior to participation. Results: The participants had a high level of confidence in their own knowledge but were in many cases unable to correctly identify clear-cut examples of misconduct and to differentiate them from questionable practices. About 13% of the participants admitted that during their university education they had copied shorter passages from other sources into their own text without marking them as quotes. Conclusions: The study documents extensive knowledge gaps among nursing students regarding both academic misconduct and questionable practices and indicates a need for improved academic integrity training. [ABSTRACT FROM AUTHOR]

This study aims to determine the impact of 2 (low vs high volume) high-intensity interval training (HIIT) programs with Mediterranean diet (MedDiet) recommendations on health-related quality of life (HRQoL) and lifestyle modification, and to examine the relationships between the changes in anxiety and depression with HRQoL and lifestyle variables after myocardial infarction (MI). Participants (n = 80) were randomized to attention control or one of the two supervised HIIT groups (2 d/weeks). Surveys before and after intervention (16 weeks): HRQoL (SF-36), anxiety and depression (HADS), MedDiet adherence (MEDAS), and physical activity (PA) and sedentary behavior (SB) levels. After intervention, there were improvements (P <.05) in HRQoL, HADS scores, and MedDiet adherence, with higher PA level in both HIIT groups with no between-HIIT group differences. The HADS score decline correlated (P <.05) with both the increase in physical component of SF-36 (r =.42), the overall metabolic expenditure (r =.26), and adherence to the MedDiet (r =.24), and the reduction in the SB (r =.35). HIIT exercise intervention with MedDiet recommendations improved HRQoL, along with reduced anxiety and depression symptoms, and a healthier lifestyle after MI. Better mental health was related to higher values of PA and MedDiet adherence. [ABSTRACT FROM AUTHOR]

The use of complementary and alternative medicine during pregnancy is currently on the rise. A validated survey was conducted at the Central Association of Obstetrician and Gynecologists annual meeting to evaluate the knowledge, attitude, and practice of general obstetricians and gynecologists and maternal-fetal medicine specialists in America. We obtained 128 responses: 73 electronically (57%) and 55 via the paper survey (43%). Forty-five percent reported personally using complementary and alternative medicine and 9% of women respondents used complementary and alternative medicine during pregnancy. Overall, 62% had advised their patients to utilize some form of complementary and alternative medicine in pregnancy. Biofeedback, massage therapy, meditation, and yoga were considered the most effective modalities in pregnancy (median [semi-interquartile range] = 2 [0.5]). Maternal-fetal medicine specialists were significantly more likely to disagree on the use of complementary and alternative medicine for risk reduction of preterm birth compared to obstetricians and gynecologists (P = .03). As the use of complementary and alternative medicine continues to rise in reproductive-age women, obstetricians will play an integral role in incorporating complementary and alternative medicine use with conventional medicine. [ABSTRACT FROM AUTHOR]

Introduction: The effects of COVID-19 lockdowns and the discontinued face-to-face clinical practicum had negative consequences on nursing and midwifery students at many levels. The clinical learning environment includes all the training and learning experiences that nursing students undergo during their clinical practicum. Objectives: This study aimed to assess the effects of the COVID-19 lockdowns on the nursing and midwifery students' practicum training in governmental and private universities and academic faculties of nursing in Jordan. Methods: A descriptive cross-sectional study of 1025 nursing and midwifery students from academic faculties of nursing of both governmental and private Jordanian universities was conducted in September 2021. The research group from two Jordanian universities designed and validated a 13-item survey to determine and evaluate the impact of mass lockdowns on nursing and midwifery students' practicum training. The responses were assessed using descriptive and inferential analyses. Results: The findings revealed that the lockdown had a negative impact on nursing and midwifery students' self-confidence and competency in performing nursing procedures. The academic year of the students was a significant independent predictor of their self-confidence and competency levels in performing nursing procedures. Conclusion: The study concluded that nursing and midwifery students were dissatisfied with their clinical education during the COVID-19 pandemic, which led to poor self-confidence in performing nursing procedures. The study group recommended repeating the clinical practicum, incorporating extensive laboratory and hospital courses, and implementing a one-year internship for newly graduated nurses and midwives to address the training gap and enhance self-confidence in clinical procedures. [ABSTRACT FROM AUTHOR]

Previous research reveals that rejection sensitivity is associated with both sexual violence victimization and self-silencing behavior, yet the association among these variables has not been examined. As the foundation for this study, we propose a theoretical model that integrates these constructs. Using mediational analyses with bootstrapping, the results from a sample of 241 heterosexual college women revealed that consistent with the proposed model, self-silencing mediated the link between rejection sensitivity and reports of unwanted sexual contact and rape. The implications of the findings for the prevention of victimization/revictimization and interventions with victimized women are discussed. [ABSTRACT FROM AUTHOR]

Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t- test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program. [ABSTRACT FROM AUTHOR]

There is a dearth of studies exploring how younger children engage in civic life, what may be expected of them given their age, and what instruments may be used to capture their levels of civic engagement. Addressing these questions, this article presents key findings from a pilot study that aimed to create a validated instrument designed to measure the civic engagement of primary school children. Based on a survey administered to 655 primary school children aged 9–11 across England, this article focuses on the new measure that was specifically designed, and then tested and validated through both exploratory and confirmatory analyses. The findings validate a tripartite measure of civic engagement that assesses the civic attitudes, actions and awareness of 9–11-year-olds. This measure was found to be both practical and efficient in its administration, and it has been shown to be easily comprehensible by this age group. This new measure addresses an important gap in the literature on civic engagement in children, providing researchers with a validated tool to effectively measure civic engagement in 9–11-year-olds. The findings have implications for both researchers and educators interested in designing and evaluating interventions aimed at promoting civic engagement among younger children. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that for completely displaced midshaft clavicular fractures, surgery offers no clear benefit over nonoperative treatment in a general adolescent population from 10 to 18 years of age. However, the comparative outcomes of comminuted and/or severely shortened clavicular fractures specifically in older adolescent athletes have not been explored in a focused, methodologically rigorous fashion. Hypothesis: The study hypothesis was that outcomes would be superior in older adolescent athletes who underwent operative treatment compared with nonoperative treatment for comminuted and/or severely shortened clavicular fractures. Study Design: Cohort study; Level of evidence, 2. Methods: A level 2, multicenter, prospective cohort study investigating the outcomes of midshaft fractures in adolescents between 2013 and 2017 was filtered to analyze the subcohorts of athletes 14 to 18 years of age with either fracture comminution or fracture shortening of ≥25 mm or both. Patient characteristics, injury mechanisms, fracture characteristics, and treatments were compared. Complications, rates, timing of return to sports (RTS), and patient-reported outcomes (PROs) were analyzed. Results: The 2 treatment groups, which included 136 older adolescent athletes (69 nonoperative, 67 operative), showed similar distributions of primary sport type, competition level, comminution, shortening, and 2-year PRO response rate (n = 99; 73%). The operative group demonstrated 3 mm–greater mean superior displacement, which was therefore statistically controlled for as a confounder in the comparative PRO analysis. No 2-year differences in nonunion, delayed union, symptomatic malunion, refracture, clinically significant complications, or rates of RTS were detected between treatment groups. The difference in timing of RTS (operative, 10.3 weeks; nonoperative, 13.5 weeks) was statistically significant. After controlling for the minor difference in superior displacement, regression analysis and matched comparison cohorts demonstrated no differences between the nonoperative and operative groups in mean or dichotomized PRO scores. Conclusion: In this prospective, multicenter cohort study investigating older adolescent athletes with comminuted and/or severely shortened clavicular fractures, contrary to the study hypothesis, there were no differences in complications, RTS, or PROs between nonoperatively and operatively treated patients at 2 years. Comparably excellent outcomes of severe clavicular fractures in adolescent athletes can be achieved with nonoperative treatment. [ABSTRACT FROM AUTHOR]

Introduction: The use of simulated patients is well established in medicine and nursing. There is little research evaluating the use of simulated patients in occupational therapy education and none which focuses on mental health. This study sought to determine the acceptability and effectiveness of using simulated patients in a mental health occupational therapy course. The pilot also sought to address the challenge of providing simulation experience to a large number of students in a cost and time effective manner. Method: Occupational therapy students participated in a simulation which involved an initial interview assessment with an actor portraying a person with a mental health diagnosis. The students worked in small groups for the simulation, rotating into the therapist role using a carousel model. Students completed a survey about their experience of the simulation. Results: The students rated the simulation experience highly in terms of authenticity and learning outcomes. Qualitative analysis of open-ended responses produced five themes: authentic experience, developing skills, feedback and reflection, we should do more of this, and developing the experience further. Conclusion: The pilot was effective in allowing a large number of students to engage directly with the simulated patient without negatively impacting on the experience. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic in the United States, healthcare workers were devastated by the insufficient preparedness to respond to their patients' and personal health needs. A gap exists in resources to prevent or reduce acute and long-term healthcare worker mental illnesses resulting from COVID-19 frontline response. Methods: We performed an exploratory, mixed methods, longitudinal study of healthcare workers at a regional rural-urban hospital system in the Midwest United States during the COVID-19 response (4 timepoints, 2020). Using the Total Worker Health® (TWH) participatory needs assessment approach, self-identified frontline COVID-19 workers participated in a survey including Health-Related Quality of Life, Impact of Event Scale, and a modified version of the American Nursing Association COVID-19 survey; and a hospital timeline tracked system-level activities. Findings: Response rate at Timepoint (T)1 was 21.7% (N = 39) and of those, 14 (36%) completed all four surveys. From T1 to T4, the rate of COVID-19 patients steadily increased, staff exceeded the threshold for post-traumatic stress disorder at T1 and T4; staff reported not enough rest or sleep 50% of the month, T1-T4. Helpfulness of family support increased but community support decreased, T1-T4. Concerns with performing new tasks increased; the challenges related to lack of protective equipment and negative media decreased. Workers wanted to be involved in decision-making, desired timely communication, and needed adequate physical, environmental, and psychological supports. Conclusions/Applications for Practice: Utilization of a TWH® strategy for describing health needs, hospital response, and multi-level staff suggestions to workplace health solutions during the COVID-19 pandemic identified evidence-based health promotion interventions in a hospital system. [ABSTRACT FROM AUTHOR]

Background: Despite advances in biomedical HIV prevention modalities such as pre-exposure prophylaxis to prevent the transmission of HIV, racial/ethnic and sexual/gender minority populations are disproportionately impacted by HIV epidemic. Alarming rates of HIV have persisted among Black gay and bisexual men, particularly in Southern states. Methods: Utilizing data from the ViiV ACCELERATE! initiative, we explored the impact of As Much As I Can, an immersive theatre production, on HIV-related stigma behaviors. A self-administered post-performance survey was conducted with a cohort (n = 322) of randomly selected audience members. Results: Overall, the results showed participants had a highly favorable experience, rating the performance with a mean score of 9.77/10. Respondents indicated they intended to change behaviors to promote HIV prevention education and to reduce stigma and discrimination including: (1) Say something if I hear stigmatizing language against people living with HIV (75.4%), (2) Say something if I hear anti-gay language (69.7%) and (3) Tell others about HIV prevention options (e.g., PrEP, PEP, condoms (64.1%). The findings show there is an association between HIV-related behavior intention and linkage to HIV care. Respondents who reported they were more likely to say something about HIV stigma were almost three times (O.R. 2.77; 95% C.I. 0.98–7.8) more likely to indicate they would follow up with a healthcare professional. Conclusions: This study suggests that immersive theatre is an effective method for communicating HIV prevention education and reducing HIV-related structural stigma and discrimination that increases HIV vulnerability for Black sexual minority men. [ABSTRACT FROM AUTHOR]

Relationships between rape myths, revictimization, and postassault well-being were examined in a sample of adult victims of sexual assault (n = 88). Correlation, multiple regression, and path analyses investigated whether conformity to stereotypes of "real rape" or "real victim" was associated with revictimization and well-being. A possible mediating effect of revictimization on the relationship between rape myth conformity and well-being was assessed. The relationship between specific revictimization behaviors and emotions was also analyzed. Questioning victims' resistance to the assault was correlated with revictimization emotions. "Real victim" characteristics were associated with well-being, but no mediating effect of revictimization was observed. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) platforms, such as ChatGPT, have become increasingly popular outlets for the consumption and distribution of health care–related advice. Because of a lack of regulation and oversight, the reliability of health care–related responses has become a topic of controversy in the medical community. To date, no study has explored the quality of AI-derived information as it relates to common foot and ankle pathologies. This study aims to assess the quality and educational benefit of ChatGPT responses to common foot and ankle–related questions. Methods: ChatGPT was asked a series of 5 questions, including "What is the optimal treatment for ankle arthritis?" "How should I decide on ankle arthroplasty versus ankle arthrodesis?" "Do I need surgery for Jones fracture?" "How can I prevent Charcot arthropathy?" and "Do I need to see a doctor for my ankle sprain?" Five responses (1 per each question) were included after applying the exclusion criteria. The content was graded using DISCERN (a well-validated informational analysis tool) and AIRM (a self-designed tool for exercise evaluation). Results: Health care professionals graded the ChatGPT-generated responses as bottom tier 4.5% of the time, middle tier 27.3% of the time, and top tier 68.2% of the time. Conclusion: Although ChatGPT and other related AI platforms have become a popular means for medical information distribution, the educational value of the AI-generated responses related to foot and ankle pathologies was variable. With 4.5% of responses receiving a bottom-tier rating, 27.3% of responses receiving a middle-tier rating, and 68.2% of responses receiving a top-tier rating, health care professionals should be aware of the high viewership of variable-quality content easily accessible on ChatGPT. Level of Evidence: Level III, cross sectional study. [ABSTRACT FROM AUTHOR]

Introduction: The use of social networking sites (SNSs) is growing among higher education students, including healthcare students. Nonetheless, limited research has examined the perceived use behavior among healthcare students in developing countries such as India. Objective: This study attempts to assess the use behavior of SNSs by undergraduate students in the fields of nursing and pharmacy in India through the lens of Connectivism and New Social Learning theories. Method: The study used a Google form to collect data through an online questionnaire. A sample of 483 participants included 258 Bachelor of Science in Nursing students, 161 General Nursing and Midwifery students, and 64 Bachelor of Pharmacy students from various Indian nursing and pharmacy schools. Results: The majority of the respondents prefer to use SNSs for several purposes such as watching academic videos on YouTube, sharing their ideas, thoughts, and current development in their respective fields through WhatsApp, getting job-related information from different Facebook pages, etc. A substantial number of nursing students believed that these SNSs help them build relationships with professionals across the country. At the same time, many students also indicated that extensive use of SNSs might cause sleep difficulties, data privacy concerns, and a lack of focus while studying. Conclusion: To have an impact on how SNSs are used in healthcare education, more attention should be paid to build connectivism between educators and their students on social learning environment, which the findings of this study's suggestions could be put into practice. [ABSTRACT FROM AUTHOR]

Introduction: During the pandemic, health issues associated with using digital devices and exploring social media, such as Computer Vision Syndrome (CVS), have increased considerably. Objectives: This study looked into CVS and its significance in Jordan and the CVS outcomes of undergraduate nursing students who used digital devices to surf social media during COVID-19. Methods: To assess CVS, a quantitative cross-sectional research design was used. Data were collected in 2022 through an online diagnostic and formative survey utilizing the CVS-Questionnaire (CVS-Q) with 310 undergraduate nursing students from a government and a private university in Jordan. Descriptive statistics and the univariate general linear model were used to analyze the collected data. Results: To report the prevalence of CVS among the studied sample, the median score was 1.80. The median prevalence score was 24.50 (range = 13–31), and 26.75% of participants reported having intense social media searches. For a student in this study to be diagnosed with CVS, they must receive a score of at least 5, and the current sample score was around 2, indicating they didn't have a CVS; however, it was moderate when it occurred. About 26.75% of participants reported having problematic social media searches. Back and neck pain and headaches were the typical signs of CVS. The average daily hours spent using digital devices for social media searches increased during the pandemic utilizing mobile phones, especially among male nursing students. Being a junior student with no social media account and unable to balance study and social media were among the predictors of CVS. Most students used protective tools on their digital devices, such as protective films and phone screens, to prevent or accommodate CVS. Conclusion: There were no prior collected data about CVS in Jordan, and based on the international trend, the COVID-19 pandemic didn't directly contribute to the prevalence of CVS. However, when the CVS occurred, it was moderate, which mandates proactive and prophylactic redesigning of our educational system. [ABSTRACT FROM AUTHOR]

Objectives: Syrian refugee women have faced myriad adversities as they have navigated the realities of war, increasing the risk for mental health concerns such as depressive symptomatology. This study explores the nuances of relevant sociocultural factors that can contribute to depressive symptomatology among widowed Syrian refugee women who live in an institutionalized care setting. We explored the impact of past trauma exposure, perceived independence, and a desire to leave the current place of displacement and the interplay between them. Methods: The PCRF Traumatic Events Questionnaire and Patient Health Questionnaire (PHQ-9) were administered to 57 Syrian refugee women in Lebanon (M age = 37; M number of children = 3) to measure levels of trauma exposure and depressive symptoms, respectively. Perceived independence and a desire to leave their current place of residence were measured using 1-item measures. Results: Using hierarchical regression models, past trauma exposure (B = 1.51, p =.002) and perceived independence (B = 0.33, p =.04) significantly predicted depressive symptoms. A desire to travel (B = 0.84, p =.07) marginally predicted depressive symptoms. Past trauma exposure attenuated the impact of perceived independence on depressive symptoms such that at lower levels of past trauma exposure, higher perceptions of independence predicted higher depression (simple slope = 0.29, t = 2.13, p =.05), while at higher levels of past trauma higher perceptions of independence predicted lower depressive symptoms (simple slope = -0.16, t = -2.21, p =.04). Trauma exposure did not moderate the impact of a desire to leave on depression, but age did. Conclusion: These findings suggest that sociocultural factors may influence women's experiences with depressive symptoms differently, and this heterogeneity must be accounted for when treatment programs are proposed. Further, Syrian refugee women who have lost primary family members may pose different profiles of depressive symptoms than other groups of women. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Japanese version of the Life Skills Scale for Adolescents and Adults (LSSAA) into Chinese, English, and Korean, simplify it, and assess its reliability and validity. Validation was performed using individual data of 9941 high-school students from China, Japan, Korea, and the United States collected by the 2021 "Survey on Experiences and Attitudes Related to the Corona Crisis" conducted by the National Institution For Youth Education. Confirmatory factor analysis showed that the four-factor model of the LSSAA fit the data for all four countries. Testing of the measurement invariance of the four-factor model among the four countries supported the adoption of a weak invariance model, and the LSSAA scores were comparable across all four countries. These results suggest that the LSSAA has good reliability and validity and applies to adolescents in English-speaking countries and some Asian counties. [ABSTRACT FROM AUTHOR]

Background: Resilience, a person's ability to adapt to adverse events, is associated with positive outcomes, especially in the field of healthcare. Research into the effects of the COVID-19 pandemic may help to understand and combat the long-term mental health burden for trainees in health care. Objective: This cross-sectional study aimed to assess the impact of the pandemic on health profession students' educational experiences, determine the association between their self-reported resilience and psychological distress and assess group differences between students from different graduate health profession programs in an academic medical center. Methods: Graduate health profession students completed a 44-question online survey and the 10-item Connor Davidson Resilience Scale (CD-RISC-10) during the COVID-19 pandemic period between January-March 2021. We used descriptive statistics, independent samples t test, Related-samples Wilcoxon signed rank test, Pearson correlations test and Analysis of variance (ANOVA) to analyze the data. Results: Majority of respondents reported that COVID-19 had a negative impact on their education and caused a reduction in educational opportunities (76.6% and 73% respectively). Majority also reported feeling burned out, lonely/isolated, or frustrated by COVID-19 restrictions (70.0%, 67.4%, and 61.8% respectively). Students reported increased use of both avoidant and adaptive coping strategies during the pandemic. Higher resilience scores were associated with higher self-reported stress, fewer burnout symptoms, and better overall well-being. Conclusion: The COVID-19 pandemic significantly affected students in graduate health profession programs. Instructional quality, educational opportunities, institutional trust, peer socialization, and personal health and wellbeing were perceived to be negatively impacted. Students may require additional support and resources from their training programs to mitigate these concerns. Future studies should evaluate the long-term impact of the COVID-19 pandemic among pandemic-era graduate health profession students. [ABSTRACT FROM AUTHOR]

This study aims to estimate and compare Roman Catholic Church-related child sexual abuse (CSA) prevalence and characteristics to CSA in other social spheres in France since 1950. Using a cross-sectional representative web-based survey of 28,026 adults in 2021, the weighted prevalence of CSA was estimated according to six social spheres of perpetration: family, Church, school, sports club, artistic activities, and summer camps. Altogether, 14.60%, 95% confidence interval [CI: 13.41; 15.80] of female respondents and 6.38% [5.73; 7.03] of male respondents had experienced CSA. Family was the most common social sphere of perpetration (3.55% [3.18; 3.92]), followed by the Church (0.81% [0.62; 0.99] of respondents exposed) and public schools (0.32% [0.23; 0.40] of respondents exposed). Altogether, we estimate 213,000, 95% CI [147,000; 278,000] people were victims of Church CSA since 1950 in France. Church CSA was more common among men than women (1.28% [0.93; 1.64] vs. 0.34% [0.20; 0.48]) while the opposite was true for other social spheres. CSA was overwhelmingly perpetrated by men ranging from 93.37% in the Church to 97.65% in schools. Many victims spoke with someone about these abuses: 41.81% of the Catholic Church compared to 41.25% of school CSA victims and 51.68% of family CSA victims. Results suggest structural factors including gender norms, but also the spiritual authority of the priest and the culture of secrecy contribute to clerical CSA. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: A culture of joy in the workplace supports well-being, but less is known about the effect of a shared experience on well-being and burnout in a health care setting. This pilot study investigated personal well-being and occupational burnout among primary care staff who participated in a 3-month virtual book club. Methods: In December 2021, health care workers from a primary care practice were invited to participate in a 3-month virtual book club. Participants were emailed a preintervention survey with questions regarding well-being and burnout, the pandemic's influence on emotional health, and demographic information. The book club met virtually every month from January 2022 through March 2022. After the March 2022 book club meeting, a paired postintervention survey was sent to participants with additional questions regarding their participation in the book club. Well-being and burnout were measured with the 11-point Well-Being Index, and the pandemic's influence on emotional health was assessed with the 64-point Pandemic Emotional Impact Scale. Results: Of 12 book club participants, 9 participants (6 physicians and 3 nurses) completed surveys before and after the intervention. Postintervention improvement in the median score of the Pandemic Emotional Impact Scale was significant (7 points, P =.04). Although Well-Being Index results uniformly favored improved well-being after book club participation, the median improvement of 1 point was not significant (P =.69). Conclusions: Social connection through a virtual workplace activity such as a book club may contribute to well-being and may decrease occupational burnout. [ABSTRACT FROM AUTHOR]

This study examined the extent, source, and individual, microsystem, exosystem, and macrosystem-level (Heise's Ecological Model) predictors of help-seeking behaviors among women of different age groups in Colombia. Data on 12,915 married or cohabitating women who had experienced diverse forms of intimate partner violence (IPV) were obtained from the Colombia Demographic Health Survey 2015. More than half of the Colombian women who reported some form of IPV experience did not seek any help. Women aged 25–39 were less likely to seek help. Type of violence and experience of IPV and education were the strongest predictors of help-seeking among women in all age groups. Implications for research and programming are discussed. [ABSTRACT FROM AUTHOR]

Although research has indicated the association between child abuse and non-suicidal self-injury (NSSI), few studies have examined their relationship in a particular sample of Chinese rural-to-urban migrant adolescents who tend to experience parental abuse and engage in NSSI. More importantly, factors moderating the relationship between child abuse and migrant adolescents' NSSI have been understudied. To address this issue, this study aimed to examine whether beliefs about adversity and family socioeconomic status (SES) moderated the longitudinal relationship between child abuse and NSSI in a sample of Chinese migrant adolescents. 308 Chinese rural-to-urban migrant adolescents (aged 10–14; 138 boys) completed the two-wave survey. Self-reported questionnaires regarding child abuse, NSSI, beliefs about adversity, and family SES were used. Results showed that child abuse was significantly positively related to NSSI a year later. Moreover, the interaction of child abuse, beliefs about adversity, and family SES was significant. Specifically, for migrant adolescents with low SES, positive beliefs about adversity played a protective role in the association between child abuse and NSSI; while for those with high SES, such beliefs showed vulnerability. Findings underscore the importance of considering multiple resilient factors simultaneously by examining beliefs about adversity and SES as the moderating mechanisms in the association between child abuse and NSSI. Findings also emphasize the significance of developing differential interventions targeting NSSI in abused Chinese migrant adolescents. Positive beliefs about adversity are important in buffering the negative effect of child abuse for migrant adolescents with low SES. For those with high SES, special attention should be given to the interactive impact of child abuse, beliefs about adversity, and family SES. [ABSTRACT FROM AUTHOR]

This study investigates the effects of adolescent bariatric surgery among young adults approximately 10 years post-surgery. Participants were recruited from a hospital-based bariatric registry. We used an exploratory, qualitatively-driven mixed methods design. Findings were integrated with medical chart data and the SF-36, Body QoL, and the Transition Readiness Assessment Questionnaire. Of the 22 participants who completed surveys (14 females and 8 males), 20 participants also completed a phone interview. Median participant age was 25 years (range = 19–30). Median weight-loss was 23% (6.0%‒58%). Four themes emerged: taking control, weight loss challenges, body image adjustment, and growing up. Participants reported physical benefits of surgery yet were challenged by eating habits, body image, and interpersonal relationships. Participants were indifferent to preventative healthcare, despite the potential for vitamin deficiencies and the return of weight-related comorbidities. Clinicians can facilitate the transition to young adulthood by providing continued mental support, education, and medical monitoring. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prescription drug use including pain relievers and stimulants has been a growing problem in young adults and the issue has been a public health concern for years. METHODS: This Quantitative Cross-sectional study aimed to collect preliminary data regarding prescription opioid use, prescription stimulant drug use and overdose treatment knowledge in young adults between 18 and 24 years old in a southern New Jersey university through administering an online survey. RESULTS: Of the 1663 students who completed the survey, 33% reported using prescription pain relievers and 15% reported using prescription stimulant drugs. Stimulant drug users were found to be more likely to use prescription pain relievers (49%) as compared to non-stimulant users (30%). Furthermore, students with overdose treatment knowledge of opioids were more likely to report misuse of prescription drugs (15%) than students with less knowledge (8%). CONCLUSIONS: This study reiterates the increasing usage of prescription drugs and stimulant use among college students. There is a need for effective education strategies to inform students about the prescription medication uses and misuse to reduce nonmedical use of prescription medications. [ABSTRACT FROM AUTHOR]

In 2016, World Health Organization (WHO) estimated more than 650 million obese adults, resulting in a country's health burden. This study aims to determine the prevalence of obesity and its associated factors among Malaysian adults. A total of 5820 respondents, aged 18 to 59 years, from the National Health and Morbidity Survey 2019, were included for the data analysis. The prevalence of obesity was described and multivariate analyses were conducted to determine the factors associated with obesity. The prevalence of obesity among Malaysian adults was 20.1%, based on the findings from this study. Multivariate analyses showed that women, being Malays, Indians, and other Bumiputeras, were significantly associated with a higher risk of obesity. Besides, those diagnosed with diabetes mellitus and hypertension were also significantly associated with greater risk of obesity. This information is crucial for policy makers in formulating effective strategies or targeted programs in preventing obesity among Malaysian adults. [ABSTRACT FROM AUTHOR]

Abuser-initiated workplace disruptions are experienced by women who are in abusive intimate relationships. However, workplace disruptions may be prevented with targeted workplace supports. Using pilot data, this study examined relationships between workplace disruptions and workplace supports. Crosstabulation and Fisher's exact test results were stratified by race to understand potential racial discrimination of survivors. Findings revealed supports are associated with infrequent workplace disruptions for Black women, but White women were extended a wider variety of supports, even with frequent disruptions. Discussion of results is applied to workplaces and policy makers seeking to better support employees experiencing partner violence. [ABSTRACT FROM AUTHOR]

Background: Self-reported measures are relevant both for the clinic and for health evaluation because they provide an interpretation of quality parameters. Women who experience labour can express themselves through these measures, identifying indicators that need improvement. Objective: The objective of this study is to adapt the Childbirth Experience Questionnaire to the Portuguese context and to determine its psychometric properties. Method: A methodological study carried out with a convenience sample where the participants were 161 female users of a hospital in southern Portugal. They were aged between 20 and 43 years (M = 31.05, SD = 4.87) and answered a questionnaire approximately 48 h postpartum, preserving the ethical principles. The original instrument, with 22 items, underwent the linguistic and cultural adequacy process. Results: Factor analysis with Varimax rotation was performed, revealing a set of 19 items with factor weights above.400. The set of items remained four-dimensional as the original, explaining 62.517% of the variance. In the retest, the reliability results showed that similar characteristics to the original study are maintained in the two subscales that express 'Participation' (three items) and 'Professional Support' (four items), with internal consistency values of.807 and.782. The 'Own Performance' and 'Own Threshold' subscales were elaborated from the results of the Varimax rotation, presenting Cronbach's alpha coefficients of.840 and 714, respectively. The total scale showed alpha values of.873 and.823 in the test and retest, respectively. Time stability showed a positive association, with r =.659 (p <.001). Accuracy through the split-half method reached an alpha value of.880 with Spearman–Brown correction. The floor effect was high in the 'Participation' subscale, both in the test and in the retest. Convergent validity between the instrument and the 'Index of Strategies for Pain Relief in Labour' discrete variable showed a Spearman's rho value of.209 (p =.011) in the total scale. In discriminating validity, the Mann–Whitney test reveals that the women who recognize interactions with the midwife have more favourable scores in Childbirth Experience Questionnaire (U = 2748.000; Z = 2.905; p =.004). Conclusion: The current version in European Portuguese suggests that it is a valid and reliable measure. This study may facilitate other validation processes in Lusophony countries. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to explore the reactions of Native American adolescents to participating in survey research on sexual and dating violence. Participants were 149 Native American adolescents who completed a survey in school. Survey items included sexual assault, dating violence, sexual harassment, and demographic questions. At the end of the survey, participants were asked if they were upset by the survey. Results showed that almost a quarter of youth were upset by the survey (24.2%), victims were more likely than non-victims to be upset by the survey, perpetrators were more likely than non-perpetrators to be upset by the survey, and sexual minorities were more likely than non-sexual minorities to be upset by the survey. Sex and age did not emerge as significantly associated with being upset. Participants were asked to describe why they were upset, and a content analysis revealed four categories of responses (i.e., feeling awkward or weird, topic of the survey, reminders, and "other"). Overall, although the research was well tolerated by most of the participants, researchers should consider adding information about what might increase feelings of upset in parental consent and youth assent forms, such as being reminded of a past upsetting experience and/or feeling awkward or weird because of some of the questions. [ABSTRACT FROM AUTHOR]

Coercive control behaviors central to the abuse of power appear more frequent than other types of domestic violence, but little is known about its frequency, features, and consequences for women in India. We aimed to examine the prevalence of domestic coercive control and its association with physical, sexual, and emotional domestic violence in the preceding year and symptoms of depression, anxiety, and suicidal thinking. In a cross-sectional survey, we interviewed 4,906 ever-married women aged 18-49 years living in urban informal settlements in Mumbai, India. We developed a 24-item scale of coercive control, assessed physical, sexual, and emotional violence using existing questions, and screened for symptoms of depression with the Patient Health Questionnaire (PHQ9), anxiety with the Generalized Anxiety Disorder (GAD7) questionnaire, and suicidal thinking with questions developed by the World Health Organization. Estimates involved univariable and multivariable logistic regression models and the prediction of marginal effects. The prevalence of domestic coercive control was 71%. In total, 23% of women reported domestic violence in the past 12 months (emotional 19%, physical 13%, sexual 4%). Adjusted models suggested that women exposed to controlling behavior had greater odds of surviving emotional (aOR 2.1; 95% CI 1.7, 2.7), physical (1.4; 1.0, 1.9), and sexual (1.8; 1.1, 3.0) domestic violence in the past 12 months; and higher odds of a positive screen for moderate or severe depression (1.7; 1.3, 2.2), anxiety (2.1; 1.3, 3.1), and suicidal thinking (1.7; 1.2, 2.3), and increased with each additional indicator of coercive control behavior. When women reported 24 indicators of coercive control, the adjusted predicted proportion with moderate or severe depressive symptoms was 60%, anxiety 42%, and suicidal thinking 17%. Inclusion of coercive control in programs to support domestic violence, would broaden our understanding of domestic abuse to resemble most victims experience and improve interventions. [ABSTRACT FROM AUTHOR]

Objective: Current exercise guidelines recommend women to exercise throughout pregnancy, and the benefits are well documented. Still, there is an increasing decline of exercise levels during pregnancy and a high percentage of them are sedentary. It is well established that individual attitudes and perception of barriers may influence the ability to engage in sufficient amount of exercise. This has, however, not been examined in an Italian pregnant population. Hence, the aims of the present study were to increase knowledge of facilitators and barriers to regular exercise in Italian pregnant women and to report their social support in regard to maternal exercise. Methods: Healthy, pregnant women (n = 513) were allocated from Fatebenefratelli San Giovanni Calibita, a public hospital in Rome, and four antenatal clinics in Rome and Modena. The participants completed a validated self-administrated questionnaire, the Physical Activity Pregnancy Questionnaire, in gestational week 36. In line with current American College of Obstetricians and Gynecologists guidelines (2020), participants were categorized as "regular exercisers" (⩾150 min/week) and "not regular exercisers" (< 150 min/week). Results: Only 4.6% of the women engaged in regular physical activity/exercise in the third trimester. "Insufficient time" (54%) were the only barrier negatively associated with exercise. The facilitators "relaxation/recreation" (18%), "prevention of health complaints" (15%), "enjoyment" (10%), and "prevention of gestational weight gain" (4%) were associated with achieving the recommendations of exercise. This study found no association between achieving the recommendations and childhood exercise/having social modeling, or exercising network/milieu (p = 0.294 and p = 0.123). Nevertheless, exercising together with others was a significant predictor for regular maternal exercise (p < 0.001). Most women did not receive any advice on exercise during pregnancy from their doctor or midwife (60.0 %). Yet, those who received such advice were significantly more likely to exercise regularly compared to those who did not (75.0% vs 38.2%; p < 0.001). Conclusion: Italian pregnant women mainly reported internal facilitators for their willingness to participate in regular maternal exercise, while barriers were primarily related to inconveniences (such as insufficient time and difficulty combining with work/studies). The study addresses the positive association between achieving the recommended amount of exercise and social support in terms of exercising with others and getting advice from health professions. Because women respect their doctor and have regular prenatal checkups, this health care setting can play a pivotal role in the initiation and maintenance of exercise behavior during pregnancy. [ABSTRACT FROM AUTHOR]

Previous adverse childhood experiences (ACEs) research focused on the future effects of intimate partner violence (IPV) among adult men, as well as victimization patterns. Continuing evidence is needed informing how ACEs, communication, and IPV may emerge within the intimate partnerships of 18–24 year olds. The present study addresses a literature gap by investigating ACEs in relation to relationship communication quality and IPV, considering not only victimization but also perpetration. An online survey was distributed through social media outlets targeting college-aged adults (n = 228). Men were more likely to perpetrate and be victimized by IPV than women in the sample. However, both sexes had moderate associations between ACES and victimization as well as perpetration of physical, emotional, sexual, and cyber abuse. Poor communication quality was associated with ACEs and most forms of abuse experienced in the last year. Continued investigation of this topic is warranted to understand mechanisms for effective treatment and skill development. [ABSTRACT FROM AUTHOR]

Background: Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs. Methods: This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018–2019. A self-report questionnaire was used to collect data about students' sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used. Results: The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% (n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration. Conclusion/Application to practice: The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of a 6-session (12-hour) empowerment self-defense classroom delivered curriculum (i.e., IMpower) among American Indian girls. Girls (N = 74) in one middle school and two high schools on an Indian Reservation in the Great Plains region of the United States received the intervention and completed a pre-test and a post-test six months following the final program session. The surveys administered assessed hypothesized intermediary (i.e., efficacy to resist a sexual assault, self-defense knowledge), primary (i.e., sexual violence victimization), and secondary (i.e., physical dating violence, sexual harassment) outcomes. Native American girls (N = 181) in five middle schools and three high schools in a nearby city where there was no sexual assault prevention occurring completed surveys assessing sexual violence, physical dating violence, and sexual harassment victimization approximately six months apart, thus serving as a comparison to girls in the treatment condition on primary and secondary outcomes. Girls exposed to the IMpower program reported significant increases over time in efficacy to resist a sexual assault and knowledge of effective resistance strategies. Furthermore, propensity score analyses suggested that girls who received the IMpower program reported significantly fewer types of sexual assault and sexual harassment at follow-up compared to girls in the control condition. However, no effect was found for physical dating violence. These data suggest that empowerment self-defense is a promising approach in preventing sexual assault and sexual harassment among American Indian girls. [ABSTRACT FROM AUTHOR]

This study explores intimate partner violence (IPV) evolution during the lockdown with a sample of 238 women (44% cohabitating and 56% not cohabitating with the perpetrator), attending five antiviolence centers in Italy (June–September 2020). Questions included 12 items on IPV and, for each item, a question about whether violence increased/stayed the same/decreased during lockdown; an indicator of IPV modifications was constructed. Two distinct patterns, confirmed after adjustment for socio-demographic factors, emerged: IPV increased for 28% of cohabitating and decreased for 56% of non-cohabitating women. Such results suggest the efficacy of physical distancing—strictly controlled by the State—in the prevention of IPV. [ABSTRACT FROM AUTHOR]

Intimate partner violence, including physical, psychological, and sexual violence, affects over one-third of Americans and is particularly common among college students. Previous work has found links between rejection sensitivity and aggressive or hostile behavior (i.e., perpetration) in intimate relationships, but this construct has only been tested as a predictor of violence in an all-male sample. A related body of work has found relationships between self-silencing and rejection sensitivity, and between self-silencing and both hostile and ingratiating behavior. The purpose of this study was to bridge these related literatures and examine the relationship between rejection sensitivity and intimate partner violence experiences and the role of self-silencing as a possible mediator. To test these relationships, we collected survey data from a sample of college students (N = 410) at a large university in the northeast United States. Using mediation analyses, we found that rejection sensitivity predicted intimate partner violence victimization (i.e., being the target of violence) through self-silencing. Similarly, rejection sensitivity predicted intimate partner violence perpetration (i.e., being violent toward one's partner) through self-silencing. Neither gender nor race significantly moderated either path of the models. Implications of this study include incorporating individual difference variables in intimate partner violence research and programming. [ABSTRACT FROM AUTHOR]

The purpose of this study is to identify whether emotional exhaustion, a component of burnout, mediates the relationship between job demands, job resources, and work–family conflict (WFC). A cross-sectional design was used with survey data. A total of 1,202 nurses in eastern Canada participated in this study. Data were collected via an online survey and analyzed using mediation analysis. The results indicated that job demands and emotional exhaustion predicted WFC. Moreover, emotional exhaustion partially mediated the relationship between job demands, supervisor support, and WFC. This model also showed that younger nurses had increased WFC. Our study indicates that there are several direct and indirect pathways leading to WFC. Moreover, workplace resources can reduce emotional exhaustion, which, in turn, may help maintain work–family balance in nurses. These findings contribute to the existing knowledge on the precursors and consequences of burnout symptoms. [ABSTRACT FROM AUTHOR]

Consistent mindful self-care practices mitigate professional burnout and improve resilience to enable nurses provide safe and effective patient care. This study determined the levels and the influencing factors of mindful self-care of nurses in acute care settings. Data were collected from a convenience sample of 258 nurses from seven acute care hospitals using the 36-item Mindful Self-Care Scale. Data were analyzed using descriptive and correlation analyses. Nurses' mindful self-care scores were low, and female nurses had higher levels of mindful self-care than male nurses. Statistically significant negative correlations were found between nurses' mindful self-care levels and their age and clinical experience. Nurses' engagement in mindful self-care is low which may negatively affect their interactions with and care of patients and their families. Therefore, a need exists to develop and evaluate more clinical-based personal and organizational strategies to enhance the mindful self-care practices of nurses. [ABSTRACT FROM AUTHOR]

Background: Sleep health disturbances can increase risks for workplace injury, error, and poor worker health. Essential workers have reported sleep disturbances since the COVID-19 pandemic onset, which may jeopardize their health and safety. The aims of this project were to assess sleep health among Continuing Care Retirement Community (CCRC) workers, examine potential differences between worker types, and describe the self-perceived impact of COVID-19 on workers' workload and sleep. Methods: Through an academic–practice partnership, this needs assessment used a cross-sectional design that collected self-report data during fall 2020 from CCRC workers. Guided by the Workplace Health Model, survey questions included work characteristics, sleep health, and COVID-19 impact on sleep and workload. Findings: Ninety-four respondents completed the survey across multiple departments. Respondents (n = 34, 36.2%) reported sleeping below recommended hours on workdays. The majority scored above the population mean on Patient-Reported Outcomes Measurement (PROMIS) measures of sleep disturbance (n = 52, 55.3%), sleep-related impairment (n = 49, 52.1%), and fatigue (n = 49, 52.1%). Differences in workday total sleep time and fatigue were noted among shift workers versus nonshift workers, with shift workers reporting less sleep and more fatigue. Shorter sleep duration was noted among respondents working shifts 10 or more hours compared with those working 8 hours. Pandemic-related workload increase was reported by 22.3% (n = 21) of respondents, with 17% (n = 16) noting more than one type of workload change. Since COVID-19 onset, 36.2% (n = 34) reported no sleep changes and 35.1% (n = 33) reported sleeping less. A medium, positive relationship was found between increased changes in work due to COVID-19 and increased difficulties sleeping (r =.41, n = 73, p =.000). Conclusion/Application to Practice: Proper sleep health is essential to workplace safety and worker health. By assessing sleep health during a crisis, occupational health nurses can identify opportunities to support worker health and safety, through sleep education, monitoring for sleepiness and fatigue, ensuring countermeasures are available (e.g., caffeine), and assessing for opportunities to change organizational policies. [ABSTRACT FROM AUTHOR]

Summary: The study objective was the identification of social workers' ethic profiles in their professional interventions. To conduct this pilot study, we used data from a national survey (N = 1071) carried out in Spain. The information was collected through an online questionnaire. Findings: Results show that social workers face a variety of ethical dilemmas in their professional practice. Through exploratory factor analysis, it was revealed that the underlying structure of the questionnaire consisted of three categories: direct service to individuals and families, design and implementation of social welfare policy and programmes and relationships among professional colleagues. Through latent class analysis, four unique social workers' ethical profiles were identified: professionals with minimum incidence of experiencing ethical dilemmas, professionals with low incidence of experiencing ethical dilemmas, professionals with a notable incidence of experiencing ethical dilemmas and, finally, professionals with high incidence of experiencing ethical dilemmas. A third of the social workers in the sample showed a very low probability to be conflicted by ethical dilemmas. Applications: The pilot study is expected to serve as a catalyst for discussion of social workers' ethical conduct and professional practice, to promote professional ethics training and education and to support the development of professional guidelines. [ABSTRACT FROM AUTHOR]