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Background: Diabetes complications are prevalent in people with diabetes, causing considerable individual suffering and increased health costs. However, the relationships of multidimensional, modifiable, and nonmodifiable factors to diabetes complications and the role of diabetes distress have been rarely examined. Objective: The aims of this study were to examine the associations of age, sex, knowledge, self-efficacy, self-compassion, resilience, self-esteem, depressive symptoms, diabetes distress, social support, and body mass index with diabetes complications and to investigate the mediating role of diabetes distress. Methods: In this cross-sectional, correlational study, data on all study variables were collected from 148 people with diabetes through REDCap in 2023. Multiple regression analysis and the PROCESS macro for SPSS were used to address the aims. Results: Older age and higher levels of diabetes distress were associated with more diabetes complications. Depressive symptoms were associated with diabetes distress; and diabetes distress, but not depressive symptoms, was associated with diabetes complications, controlling for all other variables. Conclusions: Depressive symptoms and diabetes distress were directly or indirectly associated with diabetes complications, and diabetes distress was a mediator in the relationship between depressive symptoms and diabetes complications. Health care providers can target reduction of depressive symptoms and diabetes distress to reduce diabetes complications. [ABSTRACT FROM AUTHOR]

Background: Evidence from animal and human studies suggests glutamatergic dysfunction in posttraumatic stress disorder (PTSD). The purpose of this study was to investigate glutamate abnormalities in the dorsolateral prefrontal cortex (DLFPC) of individuals with PTSD using 7T MRS, which has better spectral resolution and signal-to-noise ratio than lower field strengths, thus allowing for better spectral quality and higher sensitivity. We hypothesized that individuals with PTSD would have lower glutamate levels compared to trauma-exposed individuals without PTSD and individuals without trauma exposure. Additionally, we explored potential alterations in other neurometabolites and the relationship between glutamate and psychiatric symptoms. Methods: Individuals with PTSD (n = 27), trauma-exposed individuals without PTSD (n = 27), and individuals without trauma exposure (n = 26) underwent 7T MRS to measure glutamate and other neurometabolites in the left DLPFC. The severities of PTSD, depression, anxiety, and dissociation symptoms were assessed. Results: We found that glutamate was lower in the PTSD and trauma-exposed groups compared to the group without trauma exposure. Furthermore, N -acetylaspartate (NAA) was lower and lactate was higher in the PTSD group compared to the group without trauma exposure. Glutamate was negatively correlated with depression symptom severity in the PTSD group. Glutamate was not correlated with PTSD symptom severity. Conclusion: In this first 7T MRS study of PTSD, we observed altered concentrations of glutamate, NAA, and lactate. Our findings provide evidence for multiple possible pathological processes in individuals with PTSD. High-field MRS offers insight into the neurometabolic alterations associated with PTSD and is a powerful tool to probe trauma- and stress-related neurotransmission and metabolism in vivo. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus (DM) is a main, highly prevalent, and challenging public health issue. Suboptimal self-care for type II diabetes can lead to poor glycemic control, complications, and even death. Objective: This study investigated the incidence of distress and its link with self-care habits of patients with diabetes type II. Methods: A correlational, cross-sectional design with a convenient sample of 200 patients was used to conduct this study. Three questionnaires were administered: (A) the demographic and medical data questionnaire; (B) diabetes self-care activities in brief; and (C) the diabetes distress scale in Arabic language. Results: The patients' mean age was 51.78 ± 11.34; 80% of patients practiced lower levels of diabetes self-care, and 37% of them had a high level of diabetes distress. Self-care is associated with diabetes distress (R = −0.152, p -value =.032). Conclusion: Self-care activities can help in the early detection and management of diabetes distress. Sustained self-care education is promising to minimize diabetes distress. The potential advantages of association between diabetes distress and self-care can offer self-care programs that enhance diabetes distress management. [ABSTRACT FROM AUTHOR]

A simulation study was conducted to investigate the heuristics of the SIBTEST procedure and how it compares with ETS classification guidelines used with the Mantel–Haenszel procedure. Prior heuristics have been used for nearly 25 years, but they are based on a simulation study that was restricted due to computer limitations and that modeled item parameters from estimates of ACT and ASVAB tests from 1987 and 1984, respectively. Further, suggested heuristics for data fitting a two-parameter logistic model (2PL) have essentially went unused since their original presentation. This simulation study incorporates a wide range of data conditions to recommend heuristics for both 2PL and three-parameter logistic (3PL) data that correspond with ETS's Mantel–Haenszel heuristics. Levels of agreement between the new SIBTEST heuristics and Mantel–Haenszel heuristics were similar for 2PL data and higher than prior SIBTEST heuristics for 3PL data. The new recommendations provide higher true-positive rates for 2PL data. Conversely, they displayed decreased true-positive rates for 3PL data. False-positive rates, overall, remained below the level of significance for the new heuristics. Unequal group sizes resulted in slightly larger false-positive rates than balanced designs for both prior and new SIBTEST heuristics, with rates less than alpha levels for equal ability distributions and unbalanced designs versus false-positive rates slightly higher than alpha with unequal ability distributions and unbalanced designs. [ABSTRACT FROM AUTHOR]

Survivors of interpersonal violence are at increased risk of negative mental health outcomes; however, scant research has explored the relationship between violence exposure and mental health symptoms among formerly incarcerated individuals. This cross-sectional survey study investigates the demographic characteristics and mental health symptoms (i.e., psychological distress and suicidal ideation) associated with interpersonal violence exposure, including physical and sexual intimate partner violence, non-partner sexual violence, and sexual violence perpetrated by prison employees in a sample of formerly incarcerated men and women, with the aim that the findings both deepen the understanding of the effects of sexual violence exposure and help inform prison and jail policies. Surveys were administered to English-speaking adults ages 18 and older to recruit a sample of adults who were formerly incarcerated (N = 201). Questions on the survey included questions regarding demographic details, sexual violence exposure, mental health symptoms, and time incarcerated. Findings show that higher levels of sexual violence exposure were significantly associated with higher levels of psychological distress and reporting of suicidal ideation. Results also suggest that higher levels of income and education and younger age were significantly associated with sexual violence perpetrated by prison employees. In addition, most forms of interpersonal violence were independently associated with psychological distress and suicidal ideation in this population. The findings make recommendations for prison and jail policies to include targeted treatment for individuals with sexual victimization histories, to mitigate the risk of revictimization and appropriately treat adverse mental health outcomes from sexual victimization within and outside the confines of incarceration. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) dramatically increases the risk of both substance use disorder (SUD) and suicide in veterans. Military-related trauma, however, may not be the only or most significant trauma experienced by veterans. Trauma exposure is high among those joining the military. This study sought to identify the prevalence of five types of childhood trauma (emotional, physical, and sexual abuse and emotional and physical neglect) and three adult trauma symptom clusters (intrusive thoughts, avoidance, and hyperarousal) among veterans seeking SUD treatment and to clarify the associations between types of trauma and specific symptom clusters. Veterans at three Veterans Affairs (VA) SUD treatment facilities in the Midwest completed surveys at treatment entry (n 1 = 195) and at 6-month follow-up (n 2 = 138). Measures included the Childhood Trauma Questionnaire-Short Form and the PTSD Checklist, either a military or a civilian version, depending on whether the most traumatic event occurred in or out of the military. The prevalence of childhood trauma was high, ranging from 40.5% experiencing physical abuse down to 22.8% experiencing sexual abuse. At baseline, 60.2% of the military trauma group met criteria for PTSD, compared with 33.9% of the civilian trauma group, a significant difference, χ2(1, N = 195) = 14.46, p <.01. Childhood emotional and physical abuse were moderately associated with intrusion and hyperarousal in the military trauma group, but in the civilian trauma group a broader spectrum of childhood traumas were associated with a broader array of symptom clusters, including avoidance. At follow-up, symptoms improved and were less associated with childhood trauma. These findings illuminate the persistence of effects of childhood trauma and recommend more targeted PTSD treatments. [ABSTRACT FROM AUTHOR]

This study examined public perceptions of sentencing severity for males convicted of domestic violence assault compared with non-domestic violence assault. Over the years, surveys have reported changes in community attitudes toward seeing domestic violence as a more serious issue and an increased understanding of what acts constitute a domestic violence offense (Carlson & Worden, 2005). This study aimed to (a) examine whether public perceptions of sentencing severity differ between domestic and non-domestic violence assault offenses committed under similar circumstances; and (b) whether these perceptions remain after adjusting for personal attitudes, victimization experiences, and sociodemographic factors. After reading vignette scenarios depicting domestic and non-domestic assault, 284 undergraduate students responded to a survey about their perceptions of appropriate sentence outcomes and length. Results found that regardless of participants' punitiveness (and other factors), the manipulation of the victim–offender relationship was a significant predictor for judgments of sentencing severity. Notably, the results highlighted a leniency effect in the perceptions of participants toward perpetrators of domestic violence when compared with those who received the non-domestic violence scenario. These findings imply that undergraduate students judge domestic violence as less serious and hence not warranting as severe sentencing as non-domestic violence assault perpetrators. The study indicates that public perceptions of sentencing severity for domestic violence perpetrators are not consistent with the reported shift in public perceptions toward seeing domestic violence as a serious public issue. These findings highlight the importance of continued community education about domestic violence as well as the need to take care when considering engaging public opinion in sentencing practices for domestic violence perpetrators. [ABSTRACT FROM AUTHOR]

Insecure attachment orientations are disproportionately frequent in child sexual abuse (CSA) survivors and have been found to mediate some of the effects of CSA on adult interpersonal and romantic difficulties, including sexual revictimization (SR). A sense of relational entitlement (SRE) has received growing attention in psychological discourse and research in recent years. It reflects both adaptive (assertive) and pathological (restricted or inflated) attitudes to the assertion of needs and rights and has not been studied in adult CSA survivors. The purpose of this study was to examine associations between CSA, attachment orientations, SR, and SRE. Sixty-seven Israeli women aged 25 ± 3.95 years (30 adult CSA survivors and 37 healthy female controls with no history of CSA) completed a demographic questionnaire and self-reported measures of adult attachment orientations, sense of entitlement in romantic relationships, and adult SR. CSA survivors reported greater attachment anxiety and attachment avoidance, more restricted SRE, and higher revictimization rates than control women. No difference was found between the groups in inflated SRE. In the CSA but not the control group, anxious and avoidant attachment orientations were significantly and negatively associated with assertive SRE. Insecure (anxious and avoidant) attachment fully mediated the association between CSA and restricted SRE. Our findings suggest that the interplay between insecure attachment and CSA is related to a sense of impaired assertive entitlement and elevated restricted entitlement in adult CSA survivors. This entitlement pattern can be destructive to survivors' romantic relationships and should be addressed in therapy. [ABSTRACT FROM AUTHOR]

Background: Impairments in squat depth have been reported in patients with femoroacetabular impingement syndrome (FAIS). However, little is known about single-leg squat (SLS) performance in these patients, despite this task being commonly used in the rehabilitation and training settings. Purpose/Hypothesis: The aims of this study were (1) to investigate whether patients with FAIS demonstrate differences in SLS performance compared with healthy controls and (2) to determine whether dynamic range of motion (ROM), muscle strength, hip morphologic measures, hip pain, and hip-specific function predict SLS performance in patients with FAIS. We hypothesized that patients with FAIS would demonstrate impaired SLS performance and that impaired hip biomechanics, muscle strength, and hip-specific function would predict squat performance in patients with FAIS. Study Design: Controlled laboratory study. Methods: Three-dimensional (3D) kinematic data were collected at 100 Hz using a 20-camera 3D motion capture system during 3 SLS trials in 34 patients with FAIS and 26 healthy controls. Isometric muscle strength was tested with a stationary handheld dynamometer in all participants. Squat performance was quantified by squat depth (in meters), and the biomechanical variables of dynamic ROM of the pelvis, the hip, the knee, and the ankle in all planes were calculated. In patients with FAIS, femoral and acetabular morphology were measured using radiographic alpha angles and lateral center-edge angles. Hip pain and hip-specific function were measured using the visual analog scale for pain and the Hip Outcome Score Activities of Daily Living subscale, respectively. Two-tailed independent-samples t tests were used to determine between-group differences for squat depth, dynamic ROM variables, and muscle strength. A hierarchical multiple linear regression (MLR) model was used to determine whether biomechanical variables, muscle strength, hip morphology measures, hip pain, and hip-specific function were predictors of squat depth. All statistical analyses were performed using SPSS Version 26. Results: There were no between-group differences in age (FAIS, 30.0 ± 7.0 years vs controls, 27.3 ± 7.0 years; P =.18) or body mass index (FAIS, 23.1 ± 2.8 vs controls, 22.6 ± 3.2; P =.51). Squat depth was less in patients with FAIS compared with healthy controls (FAIS, 0.24 ± 0.4 m vs controls, 0.29 ± 0.05 m; P <.001). In the sagittal plane, patients with FAIS demonstrated less dynamic ROM of the hip (FAIS, 67.8°± 12.4° vs controls, 79.2°± 12.5°; P =.001) and the knee (FAIS, 71.9°± 9.4° vs controls, 78.9°± 13.2°; P =.02) compared with controls. Patients with FAIS also demonstrated a less dynamic coronal plane pelvis ROM (FAIS, 11.3°± 5.0° vs controls, 14.4°± 6.7°; P =.044). Patients with FAIS had reduced hip muscle strength of the hip external rotator (FAIS, 1 ± 0.3 N/kg vs controls, 1.2 ± 0.3 N/kg; P =.034), hip internal rotator (FAIS, 0.8 ± 0.3 N/kg vs controls 1 ± 0.3 N/kg; P =.03), and hip flexor (FAIS, 4 ± 1.1 N/kg vs controls, 4.8 ± 1.2 N/kg; P =.013) muscle groups. The hierarchical MLR revealed that the dynamic ROM of the hip, the knee, and the pelvis, the hip external rotation muscle strength, and the femoral alpha angles were all significant predictors of squat performance, and the final MLR model explained 92.4% of the total variance in squat depth in patients with FAIS. Conclusion: Patients with FAIS demonstrate impaired SLS squat performance compared with healthy controls. This impaired squat performance is predominantly predicted by sagittal plane knee and hip biomechanics and hip external rotator strength, and less by frontal plane pelvic ROM and hip morphology in patients with FAIS. Clinical Relevance: Clinicians should focus treatment on improving dynamic ROM and hip external rotator muscle strength to improve squat performance; however, femoral morphology should also be considered in the treatment paradigm. [ABSTRACT FROM AUTHOR]

Introduction: New immigrants underutilize health care because of multiple barriers. Although culturally competent health care improves access, it is typically assessed by providers, not newcomers whose perceptions matter most. Methodology: Surveys that included measures of cultural competence and health-related quality of life (QOL) were completed by 117 new immigrants in Windsor, Ontario, Canada. A series of stepwise linear regression analyses were conducted to identify independent predictors of QOL and its four domains: physical health, psychological, social relationships, and environment. Results: Our adjusted results suggest that experiences of discrimination was negatively associated with overall QOL (β = −.313; p <.001) and its psychological (β = −.318; p <.001), social (β = −.177; p =.048), and environmental (β = −.408; p <.001) domains. Discussion: Discrimination negatively influences new immigrant QOL. Provider cultural competency training should emphasize the influence of provider discrimination on immigrant health and explore learners' values and biases. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic resuscitation of organ donors and the attenuation of oxidative stress incurred by organs following brain death and transplantation have the potential to improve organ yield and allograft function. Thiamine (vitamin B1) is a vital coenzyme in both energy metabolism and the production of antioxidants that has not been studied in the donor population. Research Aim: To determine the frequency of subclinical thiamine deficiency in brain-dead organ donors and its correlation with demographics, length of hospitalization, donor management, lactic acidosis, and the requirement for vasoactive support. Design: Prospective cohort study of brain-dead donors managed at a single organ procurement organization's organ recovery facility. Results: A total 64 donors were enrolled; 24 donors had thiamine levels drawn upon arrival and 40 donors had levels drawn at the time of organ procurement. Whole blood thiamine levels were inversely correlated with the time from death (P =.007) and 20% (8/40) of donors had levels below the normal range at the time of organ procurement. Demographic features of the donor were not associated with thiamine levels although longer hospital stays prior to death were associated with lower levels (P <.05). The presence and resolution of lactic acidosis was not associated with whole blood thiamine level. Higher thiamine levels were associated with earlier discontinuation of vasoactive support (P =.04). Discussion: Whole blood thiamine deficiency was not uncommon at the time of organ procurement. Thiamine may be associated with the requirement for hemodynamic support. [ABSTRACT FROM AUTHOR]

Poor self-care is prevalent in patients with heart failure and adversely affects heart failure symptoms, hospitalization, and mortality. Adherence rates to different types of self-care vary in patients with heart failure. The purpose of this study was to examine factors associated with medication adherence, dietary sodium adherence, and symptom management in patients with heart failure. Data were collected using questionnaires, Medication Electronic Monitoring System, and 24-hour urine sodium output (N = 94). In logistic regression analysis, social support, education level, and race were associated with medication adherence (p =.002). Gender, race, perceived control, and depressive symptoms were associated with dietary sodium adherence (p =.030). Gender, education level, and depressive symptoms were associated with symptom management (p =.006). Different factors were associated with each type of self-care. Thus, clinicians need to manage each type of self-care by considering factors associated with it. [ABSTRACT FROM AUTHOR]

Background: Meniscal injuries are among the most common orthopaedic injuries, with a significant volume of published literature. Purpose: To perform a comprehensive bibliometric analysis that appropriately evaluates the 50 most cited articles in meniscal research. Study Design: Cross-sectional study. Methods: We performed a keyword search of the ISIWeb of Knowledge database and then pared the results down to the 50 most cited articles using specific inclusion and exclusion criteria. Data extracted included title, first author, citation count, year of publication, topic, journal, article type, country of origin, and level of evidence. Correlation coefficients were calculated between publication date and citation density and between publication date and raw citation count. Results: The 50 most cited articles were published from 1975 to 2013. The mean number of citations was 258.24 (range, 163-926; median, 225). The majority of articles were published in The American Journal of Sports Medicine (19%), the Journal of Bone and Joint Surgery (12%), and Arthritis & Rheumatology (14%). Most articles focused on either the anatomy and biomechanics of meniscal injury or on prevention and physical rehabilitation (12 papers each). Conclusion: The most popular fields of meniscal research involved anatomy/biomechanics and prevention/rehabilitation, and both are areas that will likely increase the probability of an article's being highly cited in the future. This study provided a quality selection of the most cited articles on meniscal injury and may provide a foundation for both beginner and senior clinician readers for further discussion and research. [ABSTRACT FROM AUTHOR]

Background: Youth baseball players who experience elbow pain during the season frequently exhibit radiographic elbow abnormalities. However, it is unknown whether asymptomatic elbow abnormalities are risk factors for in-season elbow injuries. Purpose: To determine whether the preseason presence of asymptomatic medial epicondyle apophysitis is a risk factor for inseason elbow injuries in youth baseball players. Study Design: Cohort study; Level of evidence, 2. Methods: Youth baseball players (N ¼ 210; age range, 7-12 years) with no pain or history of injury in their throwing arms underwent preseason evaluations that included shoulder and elbow range of motion measurements, shoulder muscle strength testing, and ultrasound elbow scans with a multifrequency 13-MHz linear array transducer. Over 1 year of play, the players and their parents maintained daily elbow pain diaries. Elbow injuries were defined as medial elbow symptoms that prevented ball throwing for 8 days. Results: The preseason ultrasound evaluation revealed medial epicondyle apophysitis in 59 players. In the year following, elbow injuries occurred in 17 (28.8%) players with preseason medial epicondyle apophysitis and 18 (11.9%) players without apophysitis. Independent predictors of elbow injuries were preseason medial epicondyle apophysitis (odds ratio [OR], 2.488; 95% confidence interval [CI], 1.152-5.376; P ¼ .02) and deficits of abduction (ABD) and external rotation of the dominant shoulder (OR, 0.963; 95% CI, 0.936-0.992; P ¼ .012). Conclusion: Asymptomatic medial epicondyle apophysitis and ABD and external rotation deficits in the dominant shoulder were risk factors for elbow injuries in 7- to 12-year-old youth baseball players. These findings may aid in the design of programs to prevent elbow injuries in this population. [ABSTRACT FROM AUTHOR]

Thirty-one children with and without autism spectrum disorder were asked to draw the meaning of 10 basic concepts. Following each drawing, children explained their drawing to the experimenter. Transcripts of the drawing task were coded for children's use of personal pronouns and internal state terms. Children's use of on- and off-task comments while explaining each drawing was examined. Both groups of children had a longer mean length of utterance when prompted to explain their drawings than while they were drawing. Analyses revealed no significant differences between children with and without autism in their use of internal state terms, pronouns, or their use of on- and off-task language during the drawing task. Clinical implications for the use of drawings as expressive language supports for children with autism are discussed. [ABSTRACT FROM AUTHOR]

The institutional anomie theory is a proposal that states competitive materialism, an intense cultural pressure for economic success at any costs, and increased female employment may be related to a high homicide rate. The current work tested this proposition by utilizing homicide data collected from 45 developed and developing countries. Regression results did not support the proposition. Competitive materialism and female employment were not significantly related to the cross-national variation of homicide rates. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among nurses and are frequently accompanied by depression. However, the association between the comorbidity of MSDs and depression and working conditions has not been studied, which was the aim of this study. Methods : In 2015, all nurses (n = 1,102) employed at a community hospital in the Northeast United States were invited to participate in this cross-sectional study. A survey was distributed in which participants were asked to report on MSDs, depressive symptoms, as well as subjective working conditions assessed including physical demands, psychological demands, decision authority, social support, and work–family conflict. Findings : 397 nurses responded (36%), and the prevalence of the comorbidity of MSDs and depression was 14.5%. Poisson regression (PR) models suggested that work–family conflict was associated with increased risk of the comorbidity (PR = 2.18; 95% confidence interval [CI] = 1.33–3.58), as was 8-hour night shift (PR = 2.77; 95% CI = [1.22, 6.31]) or 12-hour day shift (PR = 2.20; 95% CI = [1.07, 4.50]). Other working conditions were not directly associated with the comorbidity. Conclusions/Application to Practice : The comorbidity of MSDs and depression is prevalent among hospital nurses, and work–family conflict and working night shift or longer shifts were significantly associated with this. Effective workplace programs are needed to address nurses' working conditions to reduce their work–family conflict, thereby improving their musculoskeletal and mental health. [ABSTRACT FROM AUTHOR]

Background: The cause of osteochondritis dissecans (OCD) is unknown. Purpose: To determine if mechanical axis deviation correlates with OCD lesion location in the knee, if degree of mechanical axis deviation correlates with size of OCD lesion, and if the deformity was primarily in the distal femur or proximal tibia. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We identified 61 knees that underwent osteochondral allograft (OCA) transplantation for femoral condyle OCD lesions and used preoperative lower extremity alignment radiographs to measure lower extremity mechanical axis, mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and hip-knee-ankle angle. Lesion location and area were retrieved from operative records. Results: The location of the OCD lesion was the medial femoral condyle (MFC) for 37 knees and lateral femoral condyle (LFC) for 24 knees. Among knees with MFC lesions, alignment was varus in 25 (68%). Conversely, knees with LFC lesions had valgus alignment in 16 (67%). The mLFDA was significantly more valgus in the LFC group. mMPTA was not different between MFC and LFC groups. There was no significant correlation between degree of mechanical axis deviation and lesion size. Conclusion: In this cohort, two-thirds of patients with symptomatic OCD lesions had associated mechanical axis deviation. Lesion location correlated with mechanical axis deviation (LFC lesions were associated with a deformity in the distal femur). Degree of deformity was not correlated with lesion size. Mechanical axis deviation may play a role in OCD pathogenesis. These data do not allow analysis of the role of mechanical axis deviation in causation or prognosis of OCD lesions, but surgeons treating OCD should be aware of this common association. [ABSTRACT FROM AUTHOR]

Background: Subgroup analyses of the Latarjet procedure have suggested that age over 40 years is a risk factor for dislocation arthropathy. Purpose: To analyze long-term results of the open Latarjet procedure for recurrent anterior shoulder dislocation in patients at least 40 years of age. Study Design: Case series; Level of evidence, 4. Methods: A total of 39 consecutive patients (40 shoulders) with a mean age of 48 years (range, 40-66 years) at surgery were evaluated at a mean follow-up of 11.0 years (range, 8-16 years). Of these, 15 patients (38%) had undergone previous soft tissue stabilization surgery. Long-term results were assessed clinically and radiographically, including computed tomography scanning at final follow-up. Results: No recurrence of dislocation was noted. Subluxation had occurred in 3 patients (8%), and apprehension persisted in 5 patients (13%). The total Walch-Duplay score averaged 89 points at the final follow-up, and the mean Subjective Shoulder Value (60%-91%) had improved significantly (P <.001). In total, 36 patients rated their result as excellent, 3 as good. Further, 6 patients (15%) underwent joint-preserving reoperation, and 1 patient (3%) had reverse total shoulder arthroplasty for severe dislocation arthropathy. Dislocation arthropathy was severe in 14 patients (37%) and had progressed by at least 2 grades in 17 patients (45%). Patients with severe dislocation arthropathy had already shown degenerative changes preoperatively as opposed to those who ultimately had no or moderate dislocation arthropathy (n = 24) (P <.001). Progression of dislocation arthropathy was associated with lateral (>1 mm) graft positioning (P <.001) and older age at surgery (r = 0.58; P <.001). Conclusion: The open Latarjet procedure for recurrent anterior shoulder instability in patients older than 40 years reliably restores stability and leads to high patient satisfaction. This procedure is, however, associated with a substantial rate of advanced but clinically mild symptomatic dislocation arthropathy, which is associated with the degree of preoperative joint degeneration, older age at surgery, and lateral graft placement. [ABSTRACT FROM AUTHOR]

Background/purpose: Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students' ethical position; no studies have been conducted in the United States on students' ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States. Participants and Research Context Objectives: The study's two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students' level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated. Research design: A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA. Ethical Considerations: The study was approved by the Institutional Review Board at Adelphi University. Results: Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents' place of birth, and if participants were US born. Students' level of education or participation in past courses on ethics did not influence idealism. Conclusions: The study's findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students' culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education. [ABSTRACT FROM AUTHOR]

Purpose: This research project aims to evaluate the effectiveness of a physical activity (PA) intervention model for people with severe mental illness in a Chinese society. Methods: A quasi-experimental design was adopted in this study. In addition to treatment-as-usual (TAU), the treatment group (n = 52) participated in a supervised jogging activity twice a week for a total of eight sessions, followed by four sessions of psychoeducation on nutrition and personal appearance. The control group (n = 42) received TAU. Standardized assessment tools were used for the outcomes assessment at pre- and posttreatment. Results: 2 × 2 repeated measures analysis of covariance demonstrated that the treatment group was significantly more effective than the control group in reducing depressive symptoms and increasing self-esteem and social support. Conclusions: This study supports the effectiveness of a PA intervention model in a Chinese society, suggesting the importance of incorporating regular physical exercises into community-based mental health services. [ABSTRACT FROM AUTHOR]

Background: Osteochondral allograft transplantation (OCA) is a successful knee joint preservation technique; however, the effects of defect size and defect size:condyle ratio (DSCR) are poorly understood. Purpose: To quantify clinical outcomes of isolated OCA of the knee based on defect size and DSCR. Study Design: Cohort study; Level of evidence, 3. Methods: Data from patients who underwent OCA of the knee without major concomitant procedures by a single surgeon were analyzed at a minimum follow-up of 2 years. Osteochondral defect size was measured intraoperatively, and femoral condyle size was measured with preoperative imaging. Patient-reported outcomes, reoperations, and survival rates were analyzed per defect size and DSCR, comparing males and females and patients <40 and ≥40 years old. Results: Sixty-eight patients were included, of whom 57% were male (mean ± SD: age, 34.5 ± 10.3 years; follow-up, 5.2 ± 2.6 years). Mean osteochondral defect size and DSCR were 3.48 ± 1.72 cm2 and 0.2 ± 0.1, respectively. Defect size was larger among males as compared with females (3.97 ± 1.71 cm2 vs 2.81 ± 1.16 cm2, P =.005), while DSCRs were not significantly different between sexes (P =.609). The cohort as a whole demonstrated improvements in the following scores: Lysholm, International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, and 12-Item Short Form Health Survey Physical (P <.05). There were 27 reoperations (39.7%) at a mean of 2.5 ± 1.92 years and 8 failures (11.8%) at a mean of 2.62 ± 1.3 years. Mean DCSR was higher among patients with graft failure (0.26 ± 0.20 vs 0.19 ± 0.07, P =.049). After stratification by age, failures among patients ≥40 years old were associated with a larger defect size (mean 5.37 ± 3.50 cm2 vs 3.22 ± 1.32 cm2, P =.03) and higher DSCR (mean 0.30 ± 0.25 vs 0.19 ± 0.06, P =.05) when compared with nonfailures. Failures among patients <40 years old were not significantly associated with defect size or DSCR (P >.05) as compared with nonfailures. Conclusion: Patients undergoing isolated OCA transplantation demonstrated significant clinical improvements and a graft survival of 88.2% at 5.2 years. Failures overall were associated with a larger DSCR, and failures among patients ≥40 years old with a larger DSCR and larger defect size. Increasing defect size among males was positively correlated with some improved outcomes, although this was not maintained in analysis of the DSCR, suggesting similar prognosis after OCA regardless of sex. Clinical Relevance: Failed osteochondral allografts are associated with larger defect sizes and defect:condyle ratios in this study, providing additional information to surgeons for appropriate patient consultation. [ABSTRACT FROM AUTHOR]

Introduction: The understanding of the temporal pattern of individuals can add a wider perspective to interventions. Therefore, the present study is aimed toward analysis of the temporal activity pattern of individuals with stroke compared to healthy adults. Method: This study is a prospective, case–control, analytic research study. The study sample comprised 50 individuals with stroke and 50 individuals without disease, for 80% power with a 5% type 1 error. The Modified Occupational Questionnaire was administered to assess the temporal activity pattern. Individuals identified the activities performed at each hour of the day and data was analyzed. Results: The temporal activity pattern of individuals with stroke differed from healthy controls; education and play activities were not part of stroke participants' daily routines. Also, participation in work, leisure and social participation activities was significantly different for people with stroke compared to healthy controls (p < 0.01). The study group assigned very low values to the activities; the value perceived by individuals differed significantly between groups (p < 0.01). Conclusion: Clinicians are in a position to enable individuals' time use and help to engage them in meaningful activity. Individuals with stroke may benefit from a program focusing on the temporal aspect of activities. [ABSTRACT FROM AUTHOR]

Learning problems (LP) can have wider implications than the academic deficits per se. The goal of the present series of studies was to develop a reliable and valid quality-of-life measure targeted to children and adolescents with LP. In Study 1, using a 35-item questionnaire, we surveyed 151 parents/guardians of children referred for assessment of learning disorders. Exploratory factor analysis identified a three-factor model: Academic Performance, School Understanding, and Child/Family Psychological. These factors were validated against standardized measures of academic achievement and psychosocial functioning. The questionnaire was then reduced to 15 items—the LD/QOL15 —and administered to a community sample of 325 parents/guardians of children in Grades 1 to 8 (Study 2). The three-factor model was verified with confirmatory factor analysis. Comparison of general education (n = 232) and LP (n = 93) groups within the community sample documented substantial group differences (p < .0001), with the LP group having higher mean scores. These differences were larger for older students (Grades 5–8) than younger students (Grades 1–4; p < .01). The LD/QOL15 is a brief and reliable measure that is valid to assess quality of life and, potentially, outcomes in children and adolescents with LP. [ABSTRACT FROM AUTHOR]

Background: Anterior shoulder instability is a debilitating condition that can require stabilization via a Latarjet procedure. Purpose: The aim of this study was to characterize the histological composition of the articular-sided surface of the coracoid bone graft after Latarjet procedure. Specific features of cells isolated from the coracoid and graft tissues were assessed. Study Design: Case series; Level of evidence, 4. Methods: Tissue samples were harvested from 9 consecutive patients undergoing arthroscopic debridement and screw removal after arthroscopic or open Latarjet procedure. Tissues were processed histologically. In 2 patients, the samples were analyzed to assess specific cellular properties. Results: Safranin O staining indicated that glenoid tissues contained variable amounts of glycosaminoglycan (GAG) and round chondrocytic cells mainly organized in clusters. Graft tissues contained less GAG and were more cellular but were not organized in clusters and had variable morphological features. An association appeared to exist between the cartilage quality of glenoid tissues and that of the graft tissues. Cells isolated from glenoid and graft tissues exhibited similar proliferation capacity. Conclusion: The results of our analysis show that cells located at the articular-sided surface of transferred coracoid grafts demonstrate fibrocartilaginous properties and may have the capacity for chondral proliferation. Further studies are needed to confirm this observation and future application. [ABSTRACT FROM AUTHOR]

Previous work showing that revised parallel analysis can be effective with dichotomous items has used a two-parameter model and normally distributed abilities. In this study, both two- and three-parameter models were used with normally distributed and skewed ability distributions. Relatively minor skew and kurtosis in the underlying ability distribution had almost no effect on Type I error for unidimensional data and reduced power for two-dimensional data slightly with smaller sample sizes of 400. Using a two-parameter model on three-parameter data produced dramatically increased rejection rates for the unidimensional data. Using the correct three-parameter model reduced the unidimensional rejection rates but yielded lower power than the two-parameter data in some conditions. [ABSTRACT FROM AUTHOR]

Background: Recent clinical studies identified sagittal plane posterior tibial slope as a risk factor for increased postoperative laxity after single-bundle posterior cruciate ligament reconstruction (PCLR). Purpose/Hypothesis: To retrospectively compare the degree of posterior tibial slope and its effect on posterior tibial translation (PTT) after double-bundle (DB) PCLR. Our null hypothesis was that preoperative tibial slope would not be associated with graft laxity. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent DB PCLR between 2010 and 2017 by a single surgeon were retrospectively analyzed. Measurements of posterior tibial slope were performed on lateral radiographs, and PTT was measured with pre- and postoperative kneeling stress radiographs. Simple and multiple linear regression was performed to estimate the unadjusted and adjusted effect of tibial slope on postoperative graft laxity, respectively. Results: A total of 103 patients with posterior cruciate ligament tears and subsequent reconstructions were included. There was a significant reduction of the mean ± SD side-to-side difference in PTT between stress radiographs (preoperative, 10.6 ± 2.7 mm; postoperative, 1.5 ± 2.6 mm; mean difference, 9.1 mm; 95% CI, 8.4-9.8; P < .001). Linear regression analysis revealed no significant correlation between preoperative posterior tibial slope and the amount of side-to-side difference in PTT on postoperative stress radiographs obtained at a mean 18.5 months (R = −0.115, P = .249). Combined ligament injury (beta = −1.01; 95% CI, −2.00 to −0.01; P = .047) was a significant independent predictor of decreased postoperative side-to-side difference in PTT. Conclusion: Graft laxity, determined by PTT in posterior kneeling stress radiographs, was not influenced by decreased posterior tibial slope after DB PCLRs. The observed results in the current study support the use of DB PCLR. Future studies should be conducted to compare the effect of tibial slope after SB PCLR and DB PCLR at long-term follow-up. [ABSTRACT FROM AUTHOR]

Background: Recent efforts have focused on eliminating dangerous hits in ice hockey. Fair play rule changes have successfully reduced injury risk but have not been widely implemented. Purpose: To determine the effect of a penalty infraction minutes (PIM) rule change in high school boys' ice hockey on injuries and game disqualification penalties. Study Design: Cohort study; Level of evidence, 3. Methods: Injury data were collected from 2 Rhode Island hospital systems and game/penalty data through the Rhode Island Hockey Coaches Association website. Participants included high school boys' hockey varsity players aged 13 to 19 years presenting to 5 emergency departments for hockey injuries during 6 seasons (December 2012–April 2018). Rule change for the 2015-2016 season implemented varying suspensions for players accumulating ≥50 PIM and ≥70 PIM during regular season and playoffs. Injuries were classified as body checking or non–body checking related, and injury rates pre– versus post–rule change were compared via the Cochran-Mantel-Haenszel chi-square test with the odds ratio (OR) to measure risk reduction. Results: During the study period, 1762 boys' high school varsity hockey games were played. Of 134 game-related injuries, 82 (61.2%) were attributable to body checking. The PIM rule change was associated with a significant reduction in all injuries (OR, 0.55; 95% CI, 0.35-0.86; P = .008), concussion/closed head injury (OR, 0.44; 95% CI, 0.23-0.85; P = .012), and combined subgroups of concussion/closed head injury and upper body injury (OR, 0.50; 95% CI, 0.31-0.80; P = .003). Game disqualification penalties per season were not significantly reduced following the rule change, occurring in 5.2% of games before the rule change and 4.4% of games after (OR, 0.84; 95% CI, 0.54-1.31; P = .440). Conclusion: Implementation of a statewide PIM restriction rule change effectively reduced the mean number of game-related injuries per season among high school boys' hockey varsity players. [ABSTRACT FROM AUTHOR]

Background: Femoral nerve block (FNB) is a commonly performed technique that has been proven to provide effective regional analgesia after anterior cruciate ligament (ACL) reconstruction. The adductor canal block (ACB) uses a similar sensory block around the knee while avoiding motor blockade of the quadriceps muscles. Purpose/Hypothesis: The purpose of our study was to compare the efficacy of FNB versus ACB for pain control after ACL reconstruction. It was hypothesized that there would be no difference in pain levels or opioid requirements between the 2 groups. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: We performed a prospective, double-blinded, randomized controlled trial. Sixty patients undergoing primary ACL reconstruction with bone-patellar tendon-bone autograft were randomized to receive either an ACB or an FNB preoperatively. The primary outcomes assessed were pain levels (visual analog scale) and narcotic requirements for 4 days after surgery. Secondary outcomes included ability to perform a straight leg raise in the recovery room and difference in thigh circumference between the operative and nonoperative leg measured at 7 days postoperatively. Results: Morphine requirements were less in the ACB group in the first 4 hours postoperatively (P = .02). Aside from this time interval, no differences were found between the 2 groups with regard to opioid requirements and pain scores at any other time. Similarly, no differences were noted in patients' ability to perform a straight leg raise in the recovery room (P = .13) or in thigh circumference at the first postoperative visit (P = .09). Conclusion: The results of our study suggest similar efficacy in perioperative pain control with the use of an ACB for ACL reconstruction when compared with FNB. The potential long-term benefit of quadriceps preservation with the ACB is worthy of future study. Registration: NCT03033589 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Substance abuse has long been identified as a risk factor for elder mistreatment, yet research on the topic remains sparse. This study tested hypotheses whether perpetrator and victim substance use problems were associated with financial exploitation, physical abuse, emotional abuse, and neglect versus no abuse. Cross-sectional data were collected on 948 cases with yes/no substantiation decisions where 357 cases had no abuse in elder mistreatment investigations. Hypotheses were tested using odds ratios, bivariate, and multiple linear regression analyses including a control for victim vulnerability. Of 948 alleged victims, 42 (4.4%) exhibited signs of substance use problems. Among the 323 alleged perpetrators, 87 (26.9%) were reported to have substance use problems. Substance use problems by alleged perpetrators were associated (p < .01) with financial exploitation, physical abuse, and emotional abuse but not neglect. Substance use problems by alleged victims were associated with neglect, but not the other types. Alleged perpetrators with substance use problems tended to commit multiple forms of abuse, were male and not caregivers. Except for the findings on neglect, the associations with elder mistreatment were stronger for alleged perpetrators with substance use problems, than for alleged victims. Clarification of the role of perpetrator risk factors such as substance abuse should improve risk identification and subsequent intervention. [ABSTRACT FROM AUTHOR]

Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation. Design: Randomized controlled trial. Setting: Geriatric department, participants' residential care facilities, and ordinary housing. Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included. Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge. Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits. Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively. Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation. [ABSTRACT FROM AUTHOR]

Background While research has established the negative impact of medical errors or adverse events on healthcare providers, few organizations have evaluated support programs for second victims. Thus, we examined satisfaction with a peer support program to provide lessons learned from early implementation. Methods Participants (N = 466) were recruited from seven neonatal intensive care units affiliated with a large, pediatric hospital. Following implementation of a peer support program, a mixed-method online survey assessed program satisfaction at 12 month follow-up (n = 250, 54%). Results Most participants were female (n = 243, 97%), white (n = 239, 96%), and nurses (n = 180, 72%), with an average age of 40.80 (SD = 11.89) years. Ninety-three (37%) participants observed or were directly involved in an error or adverse event during the preceding six months. Thirty-six (14%) received support from someone within the neonatal intensive care unit, and 16 (16%) had spoken with a peer supporter after the event. All users reported benefit from the interaction. However, most participants were unaware of the program or had not utilized it. Conclusion Findings suggested that peer support programs are likely to be viewed favorably by second victims. Healthcare providers who accessed the program felt it was a valuable resource and helped them return to work effectively after an error or adverse event. Better communication is needed during early implementation of any peer support program to increase awareness and use of this resource among healthcare providers. [ABSTRACT FROM AUTHOR]

Introduction: In South Korea, approximately 40% of older adults are reported to have low health literacy. The purpose of this study was to evaluate the relationship between health literacy and patient participation among Korean older adults with heart failure. Method: This cross-sectional descriptive study involved 145 Korean patients at one prominent medical center in South Korea. The Korean Health Literacy Scale short form and the 13-item Perceived Involvement in Care Scale were administered between June and September, 2016. Results: Among participants (mean age = 71.30 years; 26.9% female), approximately 30% had poor health literacy. A significant correlation was observed between health literacy and participation scores (r = .538, p < .01). Health literacy was the most important predictor of patient participation (β = .488, p < .001). Discussion: The results imply that effective knowledge acquisition may encourage greater patient participation. By identifying health literacy in Korean older adults, we can provide more culturally congruent health care by improving participation between providers and patients. [ABSTRACT FROM AUTHOR]

Introduction Individuals with cognitive impairment are more susceptible to falls associated with decreased executive function and balance. This pilot study investigated whether functional task exercise could improve executive function, which might further affect the functional balance in older adults with mild cognitive impairment. Method This was a single-group pre-test/post-test pilot. A total of 43 participants completed a 10-week structured functional task exercise programme, performing simulated functional tasks. Paired-samples t-test was performed to evaluate intervention effects. Associations between variables were examined using Pearson's correlation coefficient. Multiple regression analysis was performed to explore the contribution of cognitive variables to functional balance. Results Significant improvements were shown in general cognitive functions, executive function, functional balance and functional status. All executive function outcomes were significantly associated with functional balance. Everyday problem-solving ability was the only significant cognitive contributor (β = 0.407, p < 0.05) to functional balance after controlling for the confounding factors. Conclusion This pilot showed functional task exercise using simulated functional task as a means of intervention was feasible and was associated with observed improvements in executive function and functional balance in older adults with mild cognitive impairment, whereas everyday problem-solving ability was found to be associated with functional balance. Further well-designed controlled studies are needed to draw more definitive conclusions. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effects of self-management educational intervention on the symptoms of patients with functional constipation. From January 2014 to April 2015, 66 patients with functional constipation were randomly assigned into intervention group receiving intensive educational interventions and control group receiving routine nursing care. The constipation score of all clinical symptoms (Bristol stool form scale, defecation interval, incomplete evacuation, evacuatory difficulty) at 1 month postdischarge were all significantly lower in the intervention group than in the control group (all, p < .05). At 1 month postdischarge, the intervention group had a significantly higher proportion of patients with good health habits (reasonable diet, regular exercise, good defecation habits, proper use of laxatives) as compared with the control group (all, p < .05). These data suggest educational intervention can effectively improve constipation symptoms and compliance with treatment of patients, and lead to the development of good health habits. [ABSTRACT FROM AUTHOR]

This study aims to determine the relationship between gossip functions, organizational revenge and job stress among working personnel in hospitals. The research is conducted on working personnel in a university hospital and the data from 310 people was analyzed. Data were collected by convenience sampling. Simple correlation and multiple regression analyses were performed to evaluate the relationships among the variables in the study. As a result of the analyses carried out, correlations between gossip functions and job stress are low. Correlations between gossip functions and organizational revenge and correlation between job stress and organizational revenge are average and significant. While the gossip functions explain 31.1 per cent of total variance on organizational revenge, organizational revenge explains 11.3 per cent of the variance on job stress. Limited number of works examining the gossip functions in the health sector and the relation among organizational revenge and job stress are the most important value of this study. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine paternalistic leadership behaviours’ impact on job performance and on intention to leave the job of the employees. Study sample consists of 267 medical and administrative personnel working at a university hospital in Ankara, Turkey. In order to collect data, Paternalistic Leadership Questionnaire developed by Cheng, Chou, Wu, Huang and Farh (2004), Job Performance Questionnaire developed by Kirkman and Rossen (1999) and Intention to Leave the Job Questionnaire adapted from Walsh, Ashford and Hill (1985) were used. SPSS 21.0 was used for all statistical analysis. It has been found that paternalistic leadership dimensions have direct impact on job performance and intention to leave the job of the employees. It can be suggested that leaders at healthcare organizations can emphasize benevolence if they wish to positively influence their subordinates’ job performance and that leaders at hospitals can emphasize benevolence and morality over behaviours if they wish to minimize the intention to leave the job. Since there is limited research on the relationship between paternalistic leadership and job performance and intention to leave the job, it is thought this study will contribute to the literature. [ABSTRACT FROM AUTHOR]

Background: The performance of nurses has become vital in hospitals. Some studies have suggested that nurses' perceptions of the ethical climate in their hospitals are related to higher job satisfaction and organizational commitment and in turn lessen the issue of nursing shortage. Hypothesis: (1) The ethical climate types "caring," "independent," "law and code," and "rules" have a significant positive impact on overall job satisfaction. (2) The ethical climate types and overall job satisfaction have significant positive influences on normative and affective and significant negative influences on continuance commitment. Research design: The study uses path analysis to understand which types of ethical climate impact overall job satisfaction. It also tries to find the effect of different types of ethical climate and overall job satisfaction on the components of organizational commitment. The relationships between variables were evaluated using factor analysis, reliability, descriptive statistics, correlations, and regression in this study. Participants and research context: A total of 171 useful questionnaires were collected from nurses working in public and private hospitals in Bosnia and Herzegovina. Ethical considerations: Formal research approval was obtained from the administration of each study hospital. Questionnaires with a cover letter were mailed to the hospitals that agreed to participate in the study. In the cover letter, the researchers explained the study purpose, encouraged nurses' voluntary participation, and guaranteed the anonymity of participants. Findings: In the first path analyses, "rules" and "caring' climates significantly and positively affected overall job satisfaction. In the second one, while overall job satisfaction and "rules" climate significantly influenced normative commitment, "caring" climate and overall job satisfaction significantly affected affective commitment. Discussion: The findings of the study have been convenient with the literature. Conclusion: Public and private hospitals can enhance overall job satisfaction and organizational commitment by altering the ethical climate of organizations. Hospital administrations should nurture caring and rule types of ethical climate which influence overall satisfaction. By this way, they could reduce nursing shortage. [ABSTRACT FROM AUTHOR]

Cosmetologists frequently develop occupational skin disease related to workplace exposures. The purpose of this study was to evaluate an educational intervention to increase cosmetology students' occupational skin disease knowledge and use of preventive practices. A quasi-experimental design was used to evaluate students' knowledge, behaviors, intentions, expectancies, and expectations. A 20-minute verbal presentation and printed two-page educational handout were provided for participants. Statistically significant increases in knowledge, frequency of glove use, and frequency of moisturizer use were found, but the frequency of handwashing did not increase. In addition, the Behavioral Strategies subscale, the Intention subscale, and the Expectancies subscale showed statistically significant improvements. The results of this study suggest an educational intervention can increase cosmetology students' knowledge of occupational skin diseases and their use of preventive strategies. [ABSTRACT FROM AUTHOR]

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse--an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities. [ABSTRACT FROM AUTHOR]

Psycho-educational interventions can moderate the negative impact of cancer on patients' mental wellbeing, although studies of the effect on colorectal cancer (CRC) patients are scarce. Hence, the primary aim of this study was to test whether a nurse-led psycho-educational programme (PEP) could affect the emotional wellbeing of persons being treated for CRC and anal cancer. A secondary aim was to test whether there were any differences in emotional wellbeing in the patients before undergoing a PEP compared to a subset of the Swedish population. A randomized controlled trial was used. In total, 86 patients were randomized either to a PEP comprising seven lectures followed by discussions and reflections with peers or to standard treatment. Mental wellbeing was measured with the Mood Adjective Check List. The PEP significantly (p<0.04) increased the patients' overall mood one month after the end of the intervention. The PEP seemed to have a short-term effect on patients' overall mood. Other outcomes such as self-efficacy could be useful measures when evaluating PEP. [ABSTRACT FROM AUTHOR]

Many rape survivors exhibit symptoms of post-traumatic stress disorder (PTSD), and recent literature suggests survivors' beliefs about sex and control may affect PTSD symptoms. The present study examined beliefs about sex and power as potential mediators of the relationship between rape and PTSD symptoms for men versus women. Participants (N = 782) reported lifetime history of rape, current PTSD symptoms, and beliefs about sex and power. Women reported higher levels of lifetime history of rape than men (19.7% for women; 9.7% for men). While rape history predicted PTSD symptoms for both genders, beliefs about sex and power were shown to be a significant partial mediator of this relationship for men, but not for women. Results extend the literature on rape and PTSD by suggesting that survivors' beliefs about sex and power are connected and can affect their PTSD symptoms. Additionally, results illustrate how sexual violence against men may reaffirm male gender roles that entail power and aggression, and ultimately affect trauma recovery. [ABSTRACT FROM AUTHOR]

With the expected future nurse shortage we need knowledge on nurses' life and work situation. The aim of this study is to examine 498 nurses' satisfaction with life (SwL) and job (SwJ), and intention to change job (IchJ), and to compare this with a control group of non-nurses (n=3,714). With data from a Norwegian population-based survey, we analysed associations between socio-demographic and work-related variables. In order to study SwL, SwJ and IchJ we performed bivariate and multivariate statistical analyses. The results show that nurses reported significantly higher SwL and SwJ than non-nurses. For nurses, high SwL was significantly associated with lower age, higher SwJ and appreciative leaders. Significant predictors of higher SwJ were: intention to stay in current job, autonomy, appreciative leader, less monotonous tasks and less stressful work. Intention to change job was associated with low age, nagging colleagues, temporary position and low SwJ. The conclusion is that nurses reported high SwL and SwJ; however, leaders should aim to promote permanent positions, and to minimize stressful work conditions and nagging coworkers. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the psychometric properties of the Spiritual Coping Strategies scale Arabic version (SCS-A) in a sample of nursing students in Saudi Arabia. Method: This study had a cross-sectional design with a convenience sample of 100 nursing students in Saudi Arabia. Using the SCS-A and the Muslim Religiosity Scale for data collection, data were analyzed to establish the reliability and validity of the SCS-A. Findings: Good internal consistency reliability (Cronbach’s α > .70) and stability reliability (intraclass correlation coefficient > .80) were observed. Two dominant factors were extracted from the scale items, the nonreligious coping strategies and religious coping strategies, which accounted for 35.5% and 32.7% of the variance, respectively. The religious coping subscale exhibited a strong positive correlation with the religious practices subscale of the Muslim Religious Involvement Scale (r = .45, p < .001) and total religiosity score (r = .48, p < .001) as well as a weak positive correlation with the intrinsic religious beliefs subscale (r = .25, p < .05). No significant relationship was found between nonreligious coping subscale and the Muslim Religious Involvement Scale. Conclusion: The SCS-A exhibited an acceptable validity and reliability, supporting its sound psychometric properties with respect to the responses from Saudi nursing students. [ABSTRACT FROM AUTHOR]

Background. Trends show a significant decline with adolescent physical activity (PA). Knowledge regarding how sensory-processing patterns and body mass index (BMI) relate to adolescents’ PA participation is scarce. Purpose. This study investigated if relationships exist between adolescent BMI, sensory processing, and PA participation. Method. This correlational study collected data from 141 adolescents who completed the Adolescent/Adult Sensory Profile and the Physical Activity Questionnaire–Adolescent. Their BMIs were calculated using self-reported age, height, and weight. The data were analyzed using descriptive statistics and two-tailed Spearman’s rank correlation coefficients. Findings. Adolescents with different sensory-processing patterns reported participation in both similar and distinct PAs. Participation in PA and BMI shared no significant correlation. Sensory sensitivity and BMI total (rs = –.171, p = .044) and BMI percentile (rs = –.191, p = .024) demonstrated significant correlations. Analysis revealed a correlation between sensory seeking patterns and PA (rs = .224, p = .008) as well as correlations among sensory quadrants and participation in specific PAs. Implications. Occupational therapists should consider an adolescent’s sensory preferences when recommending PA interventions. [ABSTRACT FROM AUTHOR]

Background: Hand hygiene at key moments during patient care is considered an important infection prevention and control measure to reduce healthcare-associated infections. While there is extensive research in Western settings, there is little in the United Arab Emirates where particular cultural and religious customs are thought to influence hand hygiene behaviour. Aim: To examine the hand hygiene knowledge and beliefs of health professionals at a tertiary care hospital in the United Arab Emirates. Methods: A mixed methods design employed a survey followed by focus groups with nurses and doctors. Findings: A total of 109 participants (13.6%) completed the survey: 96 nurses (88%) and 13 doctors (12%). Doctors’ hand hygiene knowledge was slightly higher than that of nurses (78.5% versus 73.5%). There was no significant difference in scores on the hand hygiene beliefs scale between nurses (M = 103.06; SD = 8.0) and doctors (M = 99.00; SD = 10.53; t (80) = 1.55; p = 0.13, two-tailed). Seven categories emerged following transcript analysis. Discussion: Hand hygiene knowledge scores suggest further hand hygiene education is required, especially on alcohol-based hand rub use. Addressing doctors’ beliefs is particularly important given the leadership roles that doctors play in healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Patient selection is critical when choosing between arthroscopic joint preservation and total shoulder arthroplasty in young patients with glenohumeral osteoarthritis (GHOA). Purpose: To identify prognostic factors predictive of early failure in patients undergoing comprehensive arthroscopic management (CAM) for GHOA. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 107 shoulders in 98 patients with minimum 2-year follow-up who underwent CAM were identified and evaluated. All shoulders met clinical and radiographic criteria for total shoulder arthroplasty (TSA), but the patients opted for joint preservation with arthroscopic management. Radiographic and preoperative factors were analyzed to determine predictors of early failure, defined as progression to TSA within the study period. Results: There were 72 men and 26 women with a mean age of 52 years (range, 29-77 years). Seventeen (15.8%) of 107 shoulders progressed to TSA at a mean of 2 years (range, 0.46-8.2 years). Shoulder status for the rest had a mean follow-up of 3.9 years (range, 2-9.4 years). There were a number of radiographic features that were correlated with early failure. Patients who failed had significantly less preoperative joint space than did those who succeeded (1.3 vs 2.6 mm; P = .004). Higher Kellgren-Lawrence grades for osteoarthritis and age older than 50 were also associated with failure. Shoulders with Walch type B2 and C glenoid were significantly more likely to fail than were Walch types A1, A2, and B1 (P < .05). Conclusion: The CAM procedure has been shown to reliably improve pain and function in active patients with advanced GHOA; however, it is important to inform patients about the limitations of the procedure. Patients with less joint space and abnormal posterior glenoid shape were significantly more likely to progress to early failure. [ABSTRACT FROM AUTHOR]

Introduction: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. Purpose: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization. Methods: The sample included 278 patients ≥55 years old admitted to medicine units. Frailty was determined using clinical data from the electronic health record (EHR) for symptoms, syndromes, and conditions and laboratory data for four serum biomarkers. A frailty risk score (FRS) was created from 16 risk factors, and relationships between the FRS and outcomes were examined. Results: The mean age of the sample was 70.2 years and mean FRS was 9.4 (SD, 2.2). Increased FRS was significantly associated with increased risk of death (hazard ratio = 1.77−2.27 for 3 days ≤ length of stay (LOS) ≤7 days), but depended upon LOS (p < .001). Frailty was marginally associated with rehospitalization for those who did not die in hospital (adjusted odds ratio = 1.18, p = .086, area under the curve [AUC] = 0.66, 95% confidence interval for AUC = [0.57, 0.76]). Discussion: Clinical data in the EHR can be used for frailty assessment. Informatics may facilitate data aggregation and decision support. Because frailty is potentially preventable and treatable, early detection is crucial to delivery of tailored interventions and optimal patient outcomes. [ABSTRACT FROM AUTHOR]

Patients in intensive care units (ICUs) often experience stress and anxiety. Although stress and anxiety can be pharmacologically attenuated, some drugs cause adverse side effects such as bradycardia, immobility, and delirium. There is thus a need for an alternative treatment with no substantial adverse effects. Music intervention is a potential alternative. In the present study, we used cortisol levels, subjective questionnaires, and physiological parameters to explore the anxiety-reducing effects of music intervention in a sample of ICU patients on mechanical ventilation. Patients admitted to the ICU for ≥ 24 hr were randomly assigned to the music intervention (n = 41) or control group (n = 44). Music group patients individually listened to music from 4:00 to 4:30 p.m.; control group patients wore headphones but heard no music for the same 30 min. Anxiety was measured using serum cortisol levels, the Chinese Version of the State-Trait Anxiety Inventory, the Visual Analogue Scale for Anxiety, heart rate, and blood pressure. After adjusting for demographics, analysis of covariance showed that the music group had significantly better scores for all posttest measures (p < .02) and pre–post differences (p < .03) except for diastolic blood pressure. Because of music intervention’s low cost and easy administration, clinical nurses may want to use music to reduce stress and anxiety for ICU patients. A single 30-min session might work immediately without any adverse effects. However, the duration of the effect is unclear; thus, each patient’s mood should be monitored after the music intervention. [ABSTRACT FROM AUTHOR]

Background: Healthcare organizations are now challenged to retain nurses' generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses' dedication, commitment, satisfaction, and loyalty to their organization. Purpose: This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses' organizational commitment, job satisfaction, and turnover intention. Methods: A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent to participate in the research before data collection. Findings: The result revealed positive significant correlations between nurses' perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses' turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention. Recommendation: Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses' commitment and satisfaction and decreasing their turnover intention. [ABSTRACT FROM AUTHOR]