Search

We integrate the job characteristics and dual work passion models to explore the indirect (via work meaningfulness) effects of job characteristics (i.e., job autonomy, task identity, skill variety, task significance, feedback from the job and feedback from others) on two types of work passion, harmonious passion (HP) and obsessive passion (OP). We first advance occupation‐specific predictions for job characteristics‐to‐work passion relationships and then explore differences in those relationships between HP and OP across four occupational sectors: knowledge work (n = 201), blue‐collar work (n = 148), nonprofit work (n = 141), and managerial work (n = 133). Our findings demonstrate that job characteristics are important drivers of work passion. However, our key discovery is that the motivational impact of the job characteristics is not universally applicable but rather depends on the specific occupational context and whether passion is harmonious or obsessive. We therefore conclude that when it comes to translating job characteristics into work passion, the one‐size‐fits‐all approach is not appropriate. [ABSTRACT FROM AUTHOR]

Aims: Echocardiographic diastolic parameters are used to diagnose and monitor increased left ventricular filling pressure (LVFP) and we hypothesized that increased loading conditions cause increased E/e′. Our aim was to assess the effect of preload augmentation on diastolic parameters among both healthy subjects and subjects with known cardiac disease. Methods and results: We included 129 subjects merged from two cohorts; one dialysis cohort (n = 47) and one infusion cohort (n = 82). Echocardiography was performed immediately before and after hemodialysis (HD) or saline infusion, under low and high loading conditions. Elevated LVFP was defined as septal E/e′ ≥ 15 and/or lateral E/e′ ≥ 13 at high‐loading conditions. The population was divided according to elevated LVFP (n = 31) and normal LVFP (n = 98). The load difference for the population was 972 ± 460 mL, with no differences in load difference between elevated and normal LVFP (p NS). The subjects with elevated LVFP were older (63 ± 11 vs. 46 ± 16 years, p <.001), and had lower LV ejection fraction (50 ± 14 vs. 59 ± 8.1%, p <.01). After augmented preload, EDV increased in the normal LVFP group (p <.01) but remained unchanged in the elevated LVFP group (p NS). Both E and e′ increased among the subjects with normal LVFP, whereas E/e′ remained unchanged (∆E/e′ +.1 [‐.5–1.2]), p NS). Among the subjects with elevated, LVFP we observed increased E but not e′, resulting in significantly increased E/e′ (∆ average E/e′ +2.4 [0–4.0], p <.01). Conclusion: Augmented preload does not seem to affect E/e′ among subjects with normal LVFP, whereas E/e′ seems to increase significantly among subjects with elevated LVFP. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to predict the prevalence of osteopenia and osteoporosis and their associated risk factors among postmenopausal women from Jordan. Methodology: In this cross‐sectional study, a total of 368 postmenopausal women were recruited from King Abdullah University Hospital (KAUH) in the North of Jordan between September 2022 and April 2023. Bone mineral density (BMD) was measured using a dual‐energy X‐ray absorptiometry scan. T‐score was used for osteoporosis diagnosis in accordance with the International Society for Clinical Densitometry (ISCD) guidelines. Data about sociodemographic and lifestyle variables were collected using face‐to‐face interviews. Medical records were used to retrieve participants' BMD information. Predictors of osteoporosis were identified using logistic regression. Results: Prevalence of osteoporosis was 40.5%, while 44.6% of participants were diagnosed with osteopenia. The lumbar spine had the highest frequency of osteoporosis (30.4%), while the left femoral neck had the highest prevalence of osteopenia (46.3%). Postmenopausal women's age (p‐value =.024), and history of chronic diseases (p‐value =.038) were significant factors associated with increased osteoporosis risk. Conclusions: Postmenopausal women from Jordan had high prevalence of osteoporosis and osteopenia. It is therefore necessary to target risk factors leading to osteoporosis and to improve patients' lifestyles through patient education. Healthcare systems should consider early screening approaches for osteoporosis at the age of menopause and thereafter. Supplements of calcium and vitamin D may be routinely considered for this age group depending on their serum levels. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted as a randomized controlled trial to evaluate the technology‐based parent school program. Design: The study was conducted in the well‐child care outpatient clinic of a hospital in Turkey. Data were collected between October 31, 2022 and February 17, 2023. The parent school was prepared based on Meleis' transition theory. Sample: Forty‐eight parents participated in the study. Parents in the intervention group participated in a 10‐week parent school program (five website modules, five online interactive group trainings, and counseling). Measures: Data were collected before the program, after the program, and 1 month after the program. Results: There were increases in the mean scores of the "Parent Skill Assessment Form" and "Skills Assessment Form for the Toddler Development" items in the intervention group compared to the control group. The difference between the groups in the mean scores of the Self‐Efficacy for Parenting Task Index Toddler Scale (1–3 years) was not statistically significant. However, the difference between the times was statistically significant. Conclusion: It was concluded that the technology‐based parent school training program could guide parents with children aged 1–3 years on child‐rearing. Trial registration: It was registered at ClinicalTrials.gov in May 2022 (NCT05370989). [ABSTRACT FROM AUTHOR]

Background: Physical restraint of patients in intensive care units (ICUs) has an estimated prevalence of 50%. Many medical centres do not have specific protocols for physical restraint, and the decision of whether to physically restrain a patient is up to the nursing staff. Disadvantages of physical restraint include injuries, exacerbation of agitation and an increased risk of developing post‐traumatic stress disorder (PTSD). Aim: To report prevalence and outcomes in terms of morbidity and mortality of physical restraint in general ICU patients in an 800‐bed secondary medical centre. Study Design: This retrospective study included 647 patients admitted to a general ICU in an 800‐bed secondary medical centre in Kfar Saba, Israel, between January and December 2020. Data included demographics, medical history, length of stay, need for mechanical ventilation, number of ventilation days, 28‐day mortality, reason for admission, agitation rate assessed by Richmond Agitation and Sedation Scale (RASS) score, need for physical restraint and need for anti‐psychotics. Results: Among the patients, 40% (256 of 647) required physical restraint. Older adult patients had a greater likelihood of being physically restrained along with those admitted because of sepsis or acute respiratory failure. Among the study sample, 11% (71 of 647) required anti‐psychotics. Patients who were restrained had longer duration of ventilation (5.9 ± 8.2 vs. 0.36 ± 1.4 days; p <.001) and higher 28‐day mortality (0.26 ± 0.45 vs. 0.07 ± 0.25, Z = 6.86, p <.001). There was no difference in medical history, except for chronic drug abuse, which was more frequent in the restraint group (18 [6.9%] vs. 11 [2.8%], respectively; p =.019), as well as the use of anti‐psychotic medications (24 [9.3%] vs. 19 [4.8%], respectively; p =.034) and anti‐depressants (55 [21.2%] vs. 59 [14.8%], respectively; p =.042). The restraint group had higher disease severity scores, as reflected in requirements for vasopressor support (174 [67.2%] vs. 69 [17.3%], respectively; p <.001) and need for dialysis (39 [15.1%] vs. 19 [4.8%], respectively; p <.001); higher frequency of in‐hospital anti‐psychotic treatment (60 [23.2%] vs. 11 [2.8%], respectively; p <.001); a greater tendency for agitation events and more severe agitation scores (episodes of RASS above zero [1.7 ± 4.0 vs. 0.04 ± 0.27, respectively; p <.001] and maximum RASS score [0.19 ± 1.6 vs. 0.01 ± 0.54, respectively; p <.001]). Overall, advanced age, number of ventilation days and need for dialysis were associated with increased 28‐day mortality. In the restraint group, advanced age, chronic use of diuretics and the use of dialysis during ICU admission were associated with increased mortality risk. Conclusions: Restrained patients tended to have higher morbidity and mortality during ICU and hospital stays, as well as a greater tendency for agitation events and more severe agitation scores, with an increased need for in‐hospital anti‐psychotic treatment. These findings regarding patient characteristics might be used to formulate treatment plans to reduce the rate of physical restraint in the ICU. Relevance to Clinical Practice: Because restrained ICU patients tend to have higher morbidity and mortality, treatment plans should be formulated to reduce the rate of physical restraint in the ICU. Clinical trial registration: NCT04771793. [ABSTRACT FROM AUTHOR]

Background: Preoperative nursing care affects many factors such as reducing the length of hospital stay of the patients in the perioperative period, the rate of postoperative complications, the duration of the operation, decrease of postoperative pain level and early mobilization. Aim: We aimed to determine the effect of preoperative evidence‐based care education that given to cardiac surgery clinical nurses on the postoperative recovery of patients. Study Design: The research was planned as quasi‐experimental. Eighty‐six patients who underwent cardiovascular surgery were divided into control and intervention groups. First, the ongoing preoperative care practices and patient recovery outcomes of the clinic were recorded for the control group data. Second, education was provided for the clinical nurses about the preoperative evidence‐based care list, and a pilot application was implemented. Finally, the evidence‐based care list was applied by the nurses to the intervention group, and its effects on patient outcomes were evaluated. The data were collected using the preoperative evidence‐based care list, descriptive information form, intraoperative information form and postoperative patient evaluation form. Results: The evidence‐based care list was applied to the patients in the intervention group, with 100% adherence by the nurses. All pain level measurements in the intervention group were significantly lower in all measurements (p =.00). The body temperature measurements (two measurements) of the intervention group were higher (p =.00). The postoperative hospital stays of the control group and the intervention group were 11.21 ± 8.41 and 9.50 ± 3.61 days. Conclusion: The presented preoperative evidence‐based care list can be used safely in nursing practices for patients. It provides effective normothermia, reduces the level of pain, shortens the hospital stay and reduces the number of postoperative complications. Relevance to Clinical Practice: By applying a preoperative evidence‐based care to patients undergoing cardiac surgery, pain levels, hospital stays and the number of complications decrease, and it is possible to maintain normothermia. An evidence‐based care can be used to ensure rapid postoperative recovery for patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

Background: Pneumonia has a high incidence in traumatic brain injury (TBI) patients and lacks effective treatments. Early mobilization (EM) may be a potentially effective treatment. Aim: To explore the impact of EM on TBI‐related pneumonia in the neurosurgical intensive care unit (NICU). Study Design: This study was a historical control study. 100 TBI patients who received EM intervention were prospectively included as the experimental group (EM cohort), and 250 TBI patients were retrospectively included as the control group. The propensity score matching (PSM) method was employed to balance baseline and minimize potential bias. The relationship between EM and TBI‐related pneumonia was investigated by univariate and multivariate logistic regression, then further determined by subgroup analysis. The influence of other variables was excluded by interaction analyses. Finally, the effect of EM on the prognosis of TBI patients was analysed by comparing the Glasgow Coma Scale (GCS) and the hospital stay. Results: After screening, 86 patients were included in the EM cohort and 199 patients were included in the control cohort. There were obvious differences between the two cohorts at baseline, and these differences were eliminated after PSM, when the incidence of pneumonia was significantly lower in the EM cohort than in the control cohort (35.0% vs. 61.9%, p <.001). Multivariate logistic regression showed that EM was an independent risk factor for TBI‐related pneumonia and was significantly associated with a decreased incidence of pneumonia. This correlation was present in most subgroups and was not affected by other variables (p for interaction >.05). Patients in the EM cohort had shorter length of ICU stay (6 vs. 7 days, p =.017) and higher GCS at discharge (12 vs. 11, p =.010). Conclusion: EM is a safe and effective treatment for TBI patients in NICU, which can reduce the incidence of pneumonia, help to improve prognosis and shorten the length of ICU stay. Relevance to Clinical Practice: Although the utilization rate of EM is low in TBI patients for various reasons, EM is still an effective method to prevent complications. Our study confirms that a scientific and detailed EM strategy can effectively reduce the incidence of pneumonia while ensuring the safety of TBI patients, which is worthy of further research and clinical application. [ABSTRACT FROM AUTHOR]

Background: Physical restraint is frequently used in intensive care units to prevent patients' life‐threatening removal of indwelling devices. In France, their use is poorly studied. Therefore, to evaluate the need for physical restraint, we have designed and implemented a decision support tool. Aims: Besides describing the prevalence of physical restraint use, this study aimed to assess whether the implementation of a nursing decision support tool had an impact on restraint use and to identify the factors associated with this use. Study Design: A large observational, multicentre study with a repeated one‐day point prevalence design was conducted. All adult patients hospitalized in intensive care units were eligible for this study. Two study periods were planned: before (control period) and after (intervention period) the deployment of the decision support tool and staff training. A multilevel model was performed to consider the centre effect. Results: During the control period, 786 patients were included, and 510 were in the intervention period. The prevalence of physical restraint was 28% (95% CI: 25.1%–31.4%) and 25% (95% CI: 21.5%–29.1%) respectively (χ2 = 1.35; p =.24). Restraint was applied by the nurse and/or nurse assistant in 96% of cases in both periods, mainly to wrists (89% vs. 83%, p =.14). The patient‐to‐nurse ratio was significantly lower in the intervention period (1:3.0 ± 1 vs. 1:2.7 ± 0.7, p <.001). In multivariable analysis, mechanical ventilation was associated with physical restraint (aOR [95% CI] = 6.0 [3.5–10.2]). Conclusion: The prevalence of physical restraint use in France was lower than expected. In our study, the decision support tool did not substantially impact physical restraint use. Hence, the decision support tool would deserve to be assessed in a randomized controlled trial. Relevance to Clinical Practice: The decision to physically restrain a patient could be protocolised and managed by critical care nurses. A regular evaluation of the level of sedation could allow the most deeply sedated patients to be exempted from physical restraint. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (ED) have recently been studied from a network approach, conceptualising them as a complex system of interconnected variables, while highlighting the role of non‐ED symptoms and personality dimensions. This study aims to explore the connections between personality and ED symptoms, identify central nodes, and compare the EDs network to a healthy control network. Methods: We employed network analysis to examine the personality‐ED symptom connections in 329 individuals with an ED diagnosis and 192 healthy controls. We estimated a regularised partial correlation network and the indices of centrality and bridge centrality to identify the most influential nodes for each group. Network differences between groups were also examined. Results: Low Self‐Directedness and high Harm avoidance emerged as central bridge nodes, displaying the strongest relationship with ED symptoms. Both networks differed in their global connectivity and structure, although no differences were found in bridge centrality and centrality indices. Conclusions: These findings shed light on the role of personality dimensions, such as Self‐Directedness and Harm Avoidance in the maintenance of ED psychopathology, supporting the transdiagnostic conceptualisation of ED. This study advances a deeper understanding of the complex interplay between personality dimensions and ED symptoms, offering potential directions for clinical interventions. Highlights: This study used a network approach to further our understanding of eating disorders (ED), viewing them as complex systems of interconnected variables. Our goal was to explore the relevance of different personality dimensions in ED symptomatology and examine differences in this network compared to a control group.The network comparison revealed significant differences in both the quantitative and qualitative aspects of the EDs network. Higher connectivity and a distinct structure in the EDs network suggested variations in the interplay between personality dimensions and ED symptoms in individuals with ED, proposing potential avenues for clinical interventions.Self‐Directedness and Harm Avoidance were identified as central bridge nodes in the network, displaying the strongest relationships with ED symptoms. Significant attention should be placed on personality dimensions in the conceptualisation and treatment of EDs. [ABSTRACT FROM AUTHOR]

This study examined the development of social power perceptions among Chinese children aged 3–5 years (N = 105). After watching videos about various social power cues, such as resource possession, resource control, goal achievement, permission, giving orders, setting norms and popularity, the children were asked to identify the powerful agents (whom do you believe is the more powerful person?) in the videos and provide explanations (why do you think he (she) is a powerful person?). Three‐year‐olds can recognize powerful agents who can grant 'permission' to other agents. By the age of 4, children begin to associate 'popularity', 'resource possession' and 'goal achievement' with social power. Five‐year olds demonstrated the ability to recognize agents who control resources as being more powerful. Analysis of the reasons the children provided for their judgements revealed that for almost every cue (except giving orders), more than 14% of the responses highlighted 'possession of material resources' as an indicator of power. For children aged 3–5 years, 'resource possession' cues may be their preferred basis for inferring and explaining power differences. These results would facilitate researchers to further unravel the mechanisms underlying the development of children's social power perceptions. [ABSTRACT FROM AUTHOR]

Background: The goal of the research was to examine the value of peripheral blood indicators in forecasting survival and recurrence among people suffering central‐type non‐small cell lung cancer (NSCLC) undergoing sleeve lobectomy (SL). Methods: Clinical information was gathered from 146 individuals suffering from NSCLC who had SL at our facility between January 2014 and May 2023. Peripheral blood neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR) levels were determined by receiver operating characteristic (ROC) curve to establish the threshold points. Kaplan–Meier survival analysis was employed to evaluate the prognostic value of different groupings, and both univariate and multivariate Cox proportional hazards model (referred to as COX) were performed. Results: The disease‐free survival (DFS) and overall survival (OS) cutoff values were carried out via ROC analysis. Kaplan–Meier survival analysis revealed notable differences in OS for NLR (≥2.196 vs. <2.196, p = 0.0009), MLR (≥0.2763 vs. <0.2763, p = 0.0018), and PLR (≥126.11 vs. <126.11, p = 0.0354). Similarly, significant differences in DFS were observed for NLR (≥3.010 vs. <3.010, p = 0.0005), MLR (≥0.2708 vs. <0.2708, p = 0.0046), and PLR (≥126.11 vs. <126.11, p = 0.0028). Univariate Cox analysis showed that NLR (hazard ratio [HR]: 2.469; 95% confidence interval [CI]: 1.416–4.306, p < 0.001), MLR (HR: 2.192, 95% CI: 1.319–3.643, p = 0.002) and PLR (HR: 1.696, 95% CI: 1.029–2.795, p = 0.038) were correlated alongside OS. Multivariate Cox analysis showed that NLR (HR: 2.036, 95% CI: 1.072–3.864, p = 0.030) was a separate OS risk variable. Additionally, the pN stage (HR: 3.163, 95% CI: 1.660–6.027, p < 0.001), NLR (HR: 2.530, 95% CI: 1.468–4.360, p < 0.001), MLR (HR: 2.229, 95% CI: 1.260–3.944, p = 0.006) and PLR (HR: 2.249, 95% CI: 1.300–3.889, p = 0.004) were connected to DFS. Multivariate Cox analysis showed that pN stage (HR: 3.098, 95% CI: 1.619–5.928, p < 0.001) was a separate DFS risk variable. Conclusion: The study demonstrates that NLR, MLR, and PLR play a convenient and cost‐effective role in predicting survival and recurrence among individuals alongside central‐type NSCLC having SL. [ABSTRACT FROM AUTHOR]

Background: Due to insufficient near‐field resolution and artifacts, it is challenging to evaluate the left ventricular apical perfusion with phased‐array probes. By combining high‐frequency linear probe and contrast‐enhanced ultrasound (CEUS), imaging of apical myocardial perfusion could be improved. The study aims to evaluate the preliminary application of CEUS by high‐frequency linear probes to assess the apical perfusion. Methods: The study enrolled retrospectively 91 patients to test the feasibility of the novel method. In protocol 1, patients were stratified into a group with left anterior descending artery (LAD) stenosis (N = 40) and a group without LAD stenosis or coronary artery disease (N = 41) based on the degree of coronary artery narrowing, quantified by >50% stenosis in coronary angiography. Receiver operating characteristics (ROC) analysis was performed to test the diagnostic value of perfusion parameters. In protocol 2, the reproducibility of high‐frequency linear probe in apical perfusion analysis was compared with the conventional phased‐array probe in 30 patients. Results: (1) The novel method is feasible in 81(89.01%) patients. (2) In protocol 1, to detect LAD stenosis, the best cut‐off of β, T, A, and MBF were 10.32, 3.28, 9.39, and 4.99, respectively. Area under the curve of β, T, A, and MBF were.880,.881,.761, and.880, respectively. (3) In protocol 2, compared with phased‐array probe, the quantitative analysis of high‐frequency linear probe is of high reproducibility and could get good curve fitting (R2 =.29 vs. R2 =.71, P <.01). Conclusion: Observation of apical perfusion using this method is feasible and quantitative analysis allows an accurate and convenient identification of LAD stenosis. This method provides an alternative for patients who have difficulties in visualizing the apical region with a phased‐array probe. [ABSTRACT FROM AUTHOR]

Rescue workers (policemen, firefighters, emergency medical staff, etc.) experience intense stress due to rescuing and helping victims of accidents, terrorist attacks, violent crimes, and natural disasters. Overexposure and ineffective coping with such stressful events may lead to developing Post‐Traumatic Stress Disorder (PTSD). Meta‐regression procedures were applied to examine moderators such as the sample sex composition, age, working experience, occupation, country, or type of PTSD evaluation. The 9.8% PTSD prevalence found here was virtually the same compared with earlier findings from 10 years ago. There was a large heterogeneity, however, associated with geographical location and the instrument used to evaluate PTSD. The main findings revealed that rescue workers are a high‐risk group with increased levels of Post‐traumatic Stress Disorder (PTSD). Moreover, PTSD prevalence could depend on a great extent on geographical and cultural factors, and on the type of PTSD evaluation. [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship between point‐of‐care β‐hydroxybutyrate (BHB) concentration and outcomes in adult patients without diabetes admitted through ED. Methods: This was a prospective study from 10 March to 2 July 2021. Admitted patients without diabetes had capillary BHB sampled in ED. Outcomes of length‐of‐stay (LOS), composite mortality/ICU admission rates and clinical severity scores (Quick Sepsis Organ Failure Assessment score/National Early Warning Score [qSOFA/NEWS]) were measured. BHB was assessed as a continuous variable and between those with BHB above and equal to 1.0 mmol/L and those below 1.0 mmol/L. Results: A total of 311 patients were included from 2377 admissions. Median length‐of‐stay was 4.1 days (IQR 2.1–9.8), 18 (5.8%) died and 37 (11.8%) were admitted to ICU. Median BHB was 0.2 mmol/L (IQR 0.1–0.4). Twenty‐five patients had BHB ≥1.0 mmol/L and five were >3.0 mmol/L. There was no significant difference in median LOS for patients with BHB ≥1.0 mmol/L compared to non‐ketotic patients, 5.3 days (IQR 2.2–7.5) versus 4.1 days, respectively (IQR 2.0–9.8) (P = 0.69). BHB did not correlate with LOS (Spearman ρ = 0.116, 95% confidence interval: 0.006–0.223). qSOFA and NEWS also did not differ between these cohorts. For those 25 patients with BHB ≥1.0 mmol/L, an infective/inflammatory diagnosis was present in 11 (44%), at least 2 days of fasting in 10 (40%) and ethanol intake >40 g within 48 h in 4 (16%). Conclusions: Routine BHB measurement in patients without diabetes does not add to clinical bedside assessment and use should be limited to when required to confirm a clinical impression. [ABSTRACT FROM AUTHOR]

Background: The use of intracytoplasmic sperm injection (ICSI) currently extends beyond male factor infertility, notably replacing conventional in vitro fertilisation (IVF) in scenarios like limited oocyte availability, where it is used as a precaution against complete fertilisation failure. While existing studies on the use of conventional IVF in such situations provide some reassurance, the available evidence is somewhat insufficient and ICSI is commonly used. Aims: To evaluate whether conventional IVF can be a feasible option when only one oocyte is retrieved. Materials and Methods: A retrospective study was performed to evaluate the fertilisation rate with conventional IVF in women retrieving only one oocyte and whose partner had normal semen. The study aimed at evaluating whether the fertilisation rate was aligned with the threshold indicated by recognized IVF laboratory performance indicators (Vienna Consensus). Clinical pregnancy and live birth rates were secondary outcomes. Results: Out of 304 cycles with a single oocyte inseminated with conventional IVF, 209 achieved normal fertilisation and 82 did not. Thirteen had no mature oocytes. The fertilisation rate was 69% (95% CI: 63–74%) and increased to 72% (95% CI: 66–77%) when immature oocytes were excluded. The fertilisation rate surpassed the minimum competency threshold of the Vienna Consensus (60%), even if below the benchmark value (75%). Clinical pregnancy and live birth rates per oocyte retrieval were 10% and 8%, respectively. Univariate and multivariate analyses failed to identify any predictive factor of fertilisation. Conclusion: Conventional IVF with one oocyte met Vienna Consensus standards even if it fell short of higher benchmarks. [ABSTRACT FROM AUTHOR]

Purpose: The primary aims of this study were to examine the effects of 9 weeks of aerobic training, comprising three 30‐min sessions per week, on V̇O2max, inhibitory control, and plasma brain‐derived neurotrophic factor (BDNF) levels among adolescents aged 16–19 years. Methods: One hundred twenty‐one untrained or recreationally active adolescents from a Danish high school were enrolled in the study, with 58 females (17.8 ± 0.8 years) and 27 males (18.0 ± 0.9 years) completing it. Participants were randomly divided into three groups performing aerobic training at either moderate‐intensity (MIT: 60%–70% heart rate reserve [HRR]) or high‐intensity (HIT: 80%–100% HRR) or a passive control group (CON) continuing their habitual lifestyle. Both the training groups exercised for 3×30 min per week for 9 weeks using a combination of cycling and running. Before and after the intervention period maximal oxygen uptake (V̇O2max) and the primary outcomes (inhibitory control measured by a modified flanker task, and resting plasma levels of BDNF) were evaluated. Results: After the intervention period, the HIT group demonstrated a larger increase in V̇O2max compared to both the CON and MIT groups, while no significant effects were observed on inhibitory control or plasma BDNF levels in any training group. However, compared to the CON group, the HIT group exhibited a tendency for greater improvement in the flanker interference score (accuracy), attributable to enhanced accuracy on the incongruent stimuli from pre to post. Conclusion: Aerobic training in adolescents increased cardiorespiratory fitness in an intensity‐dependent manner, but no clear effects were observed on neither inhibitory control nor resting plasma BDNF levels. Clinical Trial Registration: ClinicalTrials.gov: NCT02075944. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) poses significant risks to maternal and fetal health. Current diagnostic methods based on glucose tolerance tests have limitations for early detection. tRNA‐derived small RNAs (tsRNAs) have emerged as potential molecular regulators in various diseases, including metabolic disorders. However, the diagnostic value of tsRNAs in plasma for early GDM or postpartum remains unclear. Methods: This longitudinal study profiled the expression of tsRNAs across different gestational stages and postpartum in women with GDM (n = 40) and healthy control gestational women (HCs, n = 40). High‐throughput small RNA sequencing identified candidate tsRNAs, which were then validated and correlated with clinical biochemical markers such as fasting blood glucose (FBG), HOMA‐IR, and GHbA1c. Results: tRF‐1:32‐Val‐AAC‐1‐M6, tRF‐1:31‐Glu‐CTC‐1‐M2, and tRF‐1:30‐Gly‐CCC‐1‐M4 were consistently upregulated in the GDM group compared to HCs during the second trimester (p < 0.05). Only tRF‐1:31‐Glu‐CTC‐1‐M2 was highly expressed during the first trimester, and tRF‐1:30‐Gly‐CCC‐1‐M4 increased during postpartum. tRF‐1:31‐Glu‐CTC‐1‐M2 showed a significant correlation with FBG levels in the first trimester (R = 0.317, p = 0.047). The expression of tRF‐1:30‐Gly‐CCC‐1‐M4 was significantly correlated with HOMA‐IR (r = 0.65, p < 0.001) and GHBA1c (r = 0.33, p = 0.037) during postpartum. A joint diagnostic model incorporating tsRNAs expression and clinical markers demonstrated enhanced predictive power for GDM (ROC AUC = 0.768). Conclusion: Our results revealed distinct expression patterns of specific tsRNAs in GDM, showcasing their correlation with key metabolic parameters. This underscores their promising role as biomarkers for early prediction and diagnosis of GDM. The integration of tRFs into a composite biomarker panel holds the potential to improve clinical outcomes by enabling personalized risk assessment and targeted interventions. [ABSTRACT FROM AUTHOR]

Objective: Research suggests that both compulsive exercise and eating disordered behaviors increase during college. Despite strong cross‐sectional associations between compulsive exercise and eating disorders, it is unknown if compulsive exercise is a variable risk factor for eating disorders or simply a correlate. It was hypothesized that increases in compulsive exercise would significantly and prospectively predict increases in overall number of eating disorder symptoms over the study period. Method: A total of 265 first year college students who did not meet criteria for a full or subthreshold eating disorder diagnosis at Time 1 (age M = 18.15; SD = 0.42; 122 female [46%] at Time 1) completed reports of compulsive exercise and eating disorder symptoms via online questionnaires at four timepoints over the 9‐month 2021–2022 academic year (76% retention rate). Hypotheses were tested using a bivariate latent change score model. Results: Hypotheses were not supported. Change in compulsive exercise did not predict change in number of eating disorder symptoms. Change in number of eating disorder symptoms also did not predict change in compulsive exercise. Conclusions: Compulsive exercise did not emerge as a variable risk factor for the development of eating disorder symptoms among first year college students. The relationship between these behaviors should be investigated at different developmental timepoints, such as early adolescence, and potential third variables that may explain the observed co‐occurrence should be explored. Public significance: This study investigated whether increases in compulsive exercise predicted increases in number of eating disorder symptoms among first year college students. Compulsive exercise did not significantly predict number of eating disorder symptoms. Additional research is warranted to clarify the relationship between compulsive exercise and eating disorder symptoms. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of cancer death in Australia. Immunotherapy has improved outcomes in patients with metastatic non‐small cell lung cancer (NSCLC). Pembrolizumab is approved in first‐line treatment as single‐agent immunotherapy (SAI) or combination chemoimmunotherapy (CIT). In metastatic NSCLC programmed death‐ligand 1 (PD‐L1) ≥50% either regimen may be used. Aims: We aim to identify patient and tumour characteristics that influence treatment selection. Methods: This is a retrospective observational study. Pharmacy records identified patients with metastatic/recurrent NSCLC receiving pembrolizumab at two metropolitan centres in Victoria, Australia, since 2018. Demographics, tumour characteristics, Charlson Comorbidity Index (CCI) and treatment data were collected. Descriptive and multivariate analyses were performed. Results: Sixty‐one patients had metastatic NSCLC PD‐L1 ≥50% and received pembrolizumab with median age of 65.6 years, Eastern Cooperative Oncology Group 0–1 in 82%. CIT was administered to 23% (14) with no difference in rate of delivery between centres (P = 0.808). CCI mean score differed (3.38 SAI vs 2.36 CIT, P = 0.042). Patients with high CCI score (≥2) were less likely to receive CIT (OR = 0.15, P = 0.003, 95% confidence interval (CI) 0.04–0.57). Primary tumours over 5 cm were more likely to receive CIT (OR = 3.74, P = 0.043, 95% CI = 1.04–13.42). Site‐specific metastases of liver, brain and pericardial effusion were not associated with CIT. Conclusions: Patients with higher comorbidity score were less likely to receive CIT, suggesting chemotherapy avoidance in comorbid patients. Larger tumours are associated with CIT use, indicating that oncologists may use tumour size as a surrogate of disease burden. Limitations include small sample size and data cut‐off. Future prospective studies could incorporate comorbid status and a validated disease burden score to stratify patients. [ABSTRACT FROM AUTHOR]

Background: In scientific inquiry learning, students often have difficulties conducting hypothetical reasoning with multiple intertwined variables. Concept maps have a potential to facilitate complex thinking and reasoning. However, there is little investigation into the content of student‐constructed concept maps and its association with inquiry task performance. Objectives: This study explored students' concept mapping style and its association with task performance in computer‐based inquiry learning. Methods: An exploratory study was conducted with 80 Grade 11 students, who collaboratively constructed concept maps in a free style to support inquiry learning with a virtual ecosystem. Student‐constructed concept maps was analysed by firstly identifying different types of propositions formed in the maps and then determining the style of each concept map based on the dominant type of propositions in the map. Finally, the association between the concept map style and inquiry task performance was explored. Results and Conclusions: Two major concept map styles were identified: (1) knowledge‐oriented concept maps (KCMs) mainly representing problem‐related subject knowledge as a set of concepts and their relationships, and (2) problem‐oriented concept maps (PCMs) mainly representing problem situation as a sequence of changes and their causal relationships. Compared with those constructing KCMs, the students constructing PCMs formed higher‐quality propositions in their maps and performed better in hypothesising, reasoning, and drawing conclusions in the inquiry task. Implications: Besides KCMs, students in inquiry learning can be encouraged to construct PCMs to foster effective thinking and reasoning; that is, constructing a concept map to represent the problem situation as a sequence of changes and the causal relationships between the changes. Lay Description: What is currently known about the subject matter: Concept maps (CMs) can facilitate complex thinking and reasoning in inquiry learning.There is little investigation into the content of student‐constructed CMs.It is unknown how CM content might associate with inquiry task performance. What this paper adds: Students constructed two major styles of CMs in computer‐based inquiry learning.The two styles of CMs are problem‐oriented and knowledge‐oriented CMs.Students constructing problem‐oriented CMs performed better in the inquiry task. Implications for practitioners: Analysing student‐constructed CMs helps understand student thinking in inquiry.Students are encouraged to build problem‐oriented CMs in inquiry learning. [ABSTRACT FROM AUTHOR]

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

Introduction: Media comparison studies examining the effectiveness of immersive virtual reality in education have yielded inconclusive findings, leaving the question of its impact on learning compared to conventional media unanswered. To address this issue, our study employs a novel approach that combines media comparison with an investigation on the influence of broader educational context. Methods: In the experiment, 262 students from two distinct types of lower secondary schools—comprehensive school and multi‐year gymnasium (a selective academic school)—participated. The students received a lesson on topography and contour line interpretation, using either an immersive virtual environment or a PowerPoint slideshow. A transfer test was carried out before, immediately after, and 1 month after the lesson to measure knowledge application. Results: The impact of the media (immersive virtual reality vs. PowerPoint slideshow) on learning outcomes was found to be minimal, with no clear advantage of one over the other in any experimental condition. In contrast, a significant influence on learning gains was observed due to school type. Multi‐year gymnasium students consistently outperformed comprehensive school students in the pre‐test and demonstrated greater learning gains, regardless of the learning media. Conclusion: The present study employs an innovative approach by integrating a comparative analysis of different media types with an investigation into the impact of learner characteristics. By including students from distinct types of schools, the study provides insights into the differential effects of immersive virtual reality in varied educational contexts. Lay Description: What is already known about this topic: Media comparison studies typically assess the effectiveness of immersive virtual reality as a learning medium in comparison to other instructional methods in education.The findings of these studies differ markedly.Numerous factors impact learning outcomes in an immersive virtual environment. What this paper adds: Recommendation that research in the field should explore not only if but also when and how IVR learning is effective.Evidence that learning achievements may not be affected by the medium used.Evidence that the type of school can significantly influence learning gains.Evidence that cognitive dispositions, such as spatial abilities, can be another factor that influence learning outcomes. Implications for practice: A technology‐centred approach alone does not allow for a proper evaluation of the learning gain potential of IVR, learner characteristics and broader educational context should also be taken into account.IVR as a learning medium may not be appropriate for all students and every educational setting.To ensure reliable evaluation of learning gains, it is necessary to align the content and format of the intervention in both learning mediums as closely as possible.Measuring learning gains not only immediately after the intervention but also with a significant time delay can contribute to a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

Objective: To identify the technology and connectivity issues in rural and remote general practices, and the factors independently associated with these issues that negatively impact staff's capability to perform their job. Methods: An annual cross‐sectional survey of rural and remote general practice managers. Dependent variables included demographic data, practice size, geographic location, connection type and frequency of connectivity issues. Descriptive statistics are presented, and bivariate logistic regression was undertaken to determine factors independently associated with connectivity issues that negatively impact staff's capability to perform their job. Participants: One hundred sixty‐eight general practice managers from rural and remote New South Wales. Results: The majority of respondents (87%, n = 146) indicated that technology and connectivity issues had impacted staff's capability to perform their job. Internet problems were the most frequently reported issue (36%, n = 61). In bivariate analysis, practices that had a total clinical staff headcount between 5 and 7 (OR 0.27; 95% CI 0.10–0.67; p = 0.005) or between 8 and 11 (OR 0.39; 95% CI 0.16–0.95; p = 0.038) were significantly less likely to report technology and connectivity issues that negatively impact staff's capability to perform their job, compared with practices with a total clinical headcount of less than five. Conclusions: Technology and connectivity issues persist in rural and remote general practices. This is the first study to demonstrate that technology and connectivity issues impact on rural staff's capability to perform their job. Furthermore, smaller practices face more technology and connectivity issues that negatively impact staff's capability to do their job than larger practices. Further research is required to find solutions to address these challenges. [ABSTRACT FROM AUTHOR]

Background: It can be challenging to perform a second task at the same time as swallowing. Objective(s): The study aimed to investigate the effect of visual, auditory and motor dual‐tasking on swallowing and chewing function in healthy young adults. Method: Right‐handed healthy adults without any psychological and cognitive problems were included in the study. Swallowing was evaluated based on the dysphagia limit in different liquid textures such as water and nectar consistencies, and chewing was evaluated by the Test of Masticating and Swallowing Solids. For the second task, visual and auditory performance was assessed using reaction time, and the motor performance was assessed using a bilateral tapping task. Assessments were performed in two steps: baseline and dual‐task. For baseline, all evaluation methods were applied individually. After completing the baseline assessment, dual‐task assessment were carried out the following day. For dual‐task assessment, the swallowing and chewing tasks were performed simultaneously with visual, auditory and motor tasks. Results: Results showed a significant decrease in dysphagia limit in the nectar consistency, and significant increase in chewing time, visual reaction time and tapping rate (right–left) when compared to baseline and dual‐task conditions (χ2(3) = 9.61, p =.02; χ2(3) = 9.02, p =.02; χ2(3) = 28.09, p <.001; χ2(3) = 28.97, p <.001; χ2(3) = 21.56, p <.001, respectively). However, there were no differences in dysphagia limit in the water and auditory reaction time compared to baseline and dual‐task conditions (χ2(3) = 3.18, p =.36; χ2(3) = 2.56, p =.50, respectively). Conclusion: Results shedding light on how simultaneous dual tasks can influence swallowing and chewing. Dual‐tasking cause a decrease in both swallowing/chewing and the visual/motor performances. These results may provide valuable information for designing interventions or strategies aimed at improving or maintaining optimal swallowing and chewing during in various populations during daily life. [ABSTRACT FROM AUTHOR]

Background: Evidence regarding the association between hyperuricemia and arrhythmia recurrence after catheter ablation for paroxysmal atrial fibrillation (AF) is scarce. We investigated whether hyperuricemia predicts arrhythmia recurrence after catheter ablation for paroxysmal AF and the relationship between hyperuricemia and alcohol consumption in AF recurrence. Methods: Patients who underwent catheter ablation for paroxysmal AF were divided into the hyperuricemia (index serum uric acid [UA] >7.0 mg/dL; n = 114) and control (UA ≤7.0 mg/dL; n = 609) groups and were followed for a median of 24 (12–48) months after ablation. Results: The hyperuricemia group had more patients with an alcohol intake of ≥20 g/day (33.3% vs. 22.7%, p =.017) and a lower incidence of AF‐free survival (p =.019). Similarly, those with an alcohol intake of ≥20 g/day had a lower incidence of AF‐free survival than other patients. Multivariate Cox regression analysis revealed the following independent predictors of AF recurrence (adjusted hazard ratio, 95% confidence interval): hyperuricemia (1.64, 1.12–2.40), female gender (1.91, 1.36–2.67), brain natriuretic peptide level >100 pg/mL (1.59, 1.14–2.22), and alcohol consumption ≥20 g/day (1.49, 1.03–2.15) (all p <.05). In addition, causal mediation analysis revealed that alcohol consumption of ≥20 g/day directly affected AF recurrence, independent of hyperuricemia. Conclusions: Patients with hyperuricemia may be at a high risk of arrhythmia recurrence after catheter ablation for paroxysmal AF. Although high alcohol consumption may contribute to increased UA levels, the presence of hyperuricemia may independently predict AF recurrence. [ABSTRACT FROM AUTHOR]

Background: Laser balloon (LB) pulmonary vein isolation (PVI) is an established ablation technique for atrial fibrillation (AF). We report long‐term follow‐up and procedural data of LB‐PVI and we compare the first and second LB generation. Methods: Patients undergoing LB ablation with first‐ (LB1) or second‐generation LB (LB2) for AF were retrospectively enrolled and divided into two groups. Procedural endpoint was complete PVI. Clinical success was defined as no recurrence of AF/atrial tachycardia after a 90 days blanking period. Results: 538 patients were included (age 66 ± 10 years, 58% paroxysmal AF), 427 in LB1 and 111 in LB2. 2079 PVs were targeted and 2073 (99.7%) were successfully isolated; 2027 (97.5%) using solely the LB. Additional touch‐up ablation was limited (46 PVs; 2.2%) with no difference between the groups. Procedural (LB1: 120 ± 33 minutes vs. LB2: 99 ± 22 min; p <.001) and fluoroscopy time (LB1: 11.2 ± 5 min vs. LB2: 8.5 ± 3 min; p <.001) were shorter with LB2. The complication rate was 8.9% (LB1: 10.1% vs. LB2: 4.5%; p =.067) with most complications resulting from the access site (21/48). Overall freedom from AF after 1‐year was 73.7% (paroxysmal AF: 76.9%; persistent AF: 69.3%; p <.001) with no difference between the groups (LB1: 73.4% vs. LB2: 74.7%; p =.491). Conclusion: LB showed a high efficacy and acceptable safety, with numerically lower complication rates with the second‐generation LB. Procedure and fluoroscopy times were shorter with LB2. Overall, 73.7% of patients were free from AF at 1‐year, with comparable results among both generations. [ABSTRACT FROM AUTHOR]

Background: There is ongoing debate around rate versus rhythm control strategies for managing atrial fibrillation (AF), however, much of the data comes from Western cohorts. Kerala‐AF represents the largest prospective AF cohort study from the Indian subcontinent. Objectives: To compare 12‐month outcomes between rate and rhythm control strategies. Methods: Patients aged ≥18 years with non‐transient AF were recruited from 53 hospitals across Kerala. Patients were stratified by rate or rhythm control. The primary outcome was a composite of all‐cause mortality, arterial thromboembolism, acute coronary syndrome or hospitalization due to heart failure or arrhythmia at 12 months. Secondary outcomes included bleeding events and individual components of the primary. Predictors of the composite outcome were analysed by logistic regression. Results: A total of 2901 patients (mean age 64.6 years, 51% female) were included (2464 rate control, 437 rhythm control). Rates of the primary composite outcome did not differ between groups (29.7% vs 30.0%; p =.955), nor did any component of the primary. Bleeding outcomes were also similar (1.6% vs 1.9%; p =.848). Independent predictors of the primary composite outcome were older age (aOR 1.01; p =.013), BMI <18 (aOR 1.51; p =.025), permanent AF (aOR 0.78; p =.010), HFpEF (aOR 1.40; p =.023), HFrEF (aOR 1.39; p =.004), chronic kidney disease (aOR 1.36; p <.001), and prior thromboembolism (aOR 1.31; p =.014). Conclusion: In the Kerala‐AF registry, 12‐month outcomes did not differ between rate and rhythm control cohorts. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the effects of profession‐related films on the professional pride of nursing students. Designs: The study was conducted with a randomised controlled experimental design. Methods: The sample of the study consisted of 102 students enrolled in the first year of the School of Nursing, Zonguldak Bulent Ecevit University in Türkiye in the 2022–2023 academic year. These students were randomly assigned to the experimental (n = 57) and control (n = 45) groups. The experimental group watched two documentaries and a film on YouTube with a one‐week break. Self‐administered online questionnaires were distributed via WhatsApp groups for pretests and posttests. Data were collected with a "Sociodemographic Data Form" and the "Nursing Professional Pride Scale (NPPS)" included in the questionnaire forms prepared on the Google Forms platform. Data were analysed using Spearman's rho, the Mann–Whitney U Test, and the Wilcoxon Signed‐Rank Test. Results: The mean age of the participants was 18.80 ± 0.99 years, 80% of the participants were female, the place where 79.4% had lived for the longest duration in their lives was the city, 85.3% had information about the profession of nursing before they started university (36.8% from the internet, 34.6% from people around them). The experimental group had significantly higher NPPS scores than the control group after the intervention (p = 0.017). There was also a significant increase in the dimensions of professional feeling (p = 0.012) and desire to continue the profession in the experimental group (p = 0.002). Patient or Public Contribution: Patients and public were not involved in this research. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate cardiac autonomic modulation using short‐term heart rate variability (HRV) and compare it among frailty statuses in older Indian adults. Methods: A total of 210 subjects aged 60 years and above were recruited into three groups: frail (n = 70), pre‐frail (n = 70), and non‐frail (n = 70) from the outpatient department of Geriatric Medicine at a tertiary care hospital in India. Frailty status was assessed using the Rockwood frailty index (FI) criteria. HRV was derived from a 5‐min ECG recording of standard limb leads and assessed using time domain, frequency domain, and nonlinear analysis of cardiac interval variability. Results: The HRV parameters indicative of parasympathetic modulation such as SDNN, SDSD, rMSSD, NN50, pNN50, absolute HF power, and SD1 were significantly lower in frail subjects compared with both pre‐frail and non‐frail subjects (P < 0.05). Absolute LF power and SD2 were also lower in frail subjects compared with pre‐frail and non‐frail subjects (P < 0.05). Measures of sympatho‐vagal balance (LF/HF and SD1/SD2 ratios) did not show statistical significance. The FI demonstrated negative correlations with all HRV parameters. Conclusions: Frail individuals exhibit decreased sympathetic and parasympathetic modulation compared with pre‐frail and non‐frail individuals, although maintaining a balanced sympatho‐vagal state. Furthermore, autonomic modulation declines progressively with increasing frailty. [ABSTRACT FROM AUTHOR]

This randomized controlled trial was conducted to assess the effectiveness of a family‐based and mobile‐assisted lifestyle intervention in reducing weight gain among school‐age children with overweight and obesity. A total of 164 school‐age children with overweight or obesity and their parents were randomized to the treatment intervention (n = 82) or an attention‐control group (n = 82). The treatment intervention included three face‐to‐face education sessions, augmented by monthly text messages sent to parents on their mobile devices. The primary outcome was child BMI‐for‐age z‐score. Secondary outcomes included child BMI, percent body fat, and actigraphy‐assessed sleep as well as parental sleep quality. Outcomes were assessed at baseline, 3, 6, and 12 months after the intervention, with treatment effects analyzed using general linear models for repeated measures. Our results showed that children in the treatment intervention group had significantly lower BMI‐for‐age z score, BMI, and percent body fat than did those in the control group, with an adjusted mean difference of 0.31 units (95% CI: −0.59 to −0.03; p = 0.03), 1.34 kg/m² (95% CI, −2.42 to −0.26; p = 0.01), and 3.12% (95% CI, −5.93 to −0.30; p = 0.03), respectively. No treatment effects were observed for child and parental sleep. Our findings suggest that family‐based and mobile‐assisted lifestyle intervention results in significant and sustained benefits to enhanced weight management for school‐age children with overweight and obesity. Nurses planning and delivering childhood overweight and obesity treatment interventions should consider a family‐based approach with the assistance of mobile devices. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the effect of virtual reality distraction (VRD) on dental anxiety during scaling and root planing (SRP) in periodontitis patients. Materials and Methods: This randomized controlled split‐mouth study included 60 patients who scored 9 or above on the dental anxiety scale (DAS) and required SRP in at least two quadrants with at least five teeth and two sites with a probing depth of ≥4 mm. Randomly chosen quadrants were treated using virtual reality glasses, and other quadrants were treated without glasses at the same visit. During VRD, a video of nature scenes was projected onto the screen in front of the patient's eyes. DAS and a visual analogue scale about patient feelings were applied at the end of the procedure. Results: With VRD, the scale value of pain and discomfort level (VASP) was significantly reduced (p = 0.01, d = 0.57). Starting treatment without glasses significantly decreased VASP in both control and test sides (p = 0.00, d = 0.85; p = 0.00, d = 0.80, respectively) and increased the sensation of immersion and realism (p = 0.03, d = 0.45; p = 0.02, d = 0.46, respectively). Intraoperative and postoperative DAS values were significantly lower in patients who started treatment without VRD (p = 0.04, d = 0.34; p = 0.02, d = 0.44, respectively). Of the patients, 63.3% preferred VRD in the subsequent treatment. While patient preference did not correlate with sex, it correlated with age (r = −0.48, p = 0.01). Conclusions: The VRD and initiating SRP procedure with VRD affected the pain and discomfort level in anxious periodontitis patients. In addition, the anxiety level was also affected by starting the procedure with glasses. [ABSTRACT FROM AUTHOR]

Introduction: Providing oral care is an essential part of basic nursing care but receives little priority in daily practice, with a risk of adverse events. Also, nurses report many barriers to adequate provision of oral care, such as time restraints, insufficient materials, fear of causing pain, lack of knowledge and a negative attitude towards providing oral care. Methods: We performed a cluster‐randomized, stepped‐wedge study to explore the effect of the the implementation of a new nursing evidence‐based oral care protocol on nurses' knowledge, attitude and protocol adherence. The study population included both nursing students, graduated nurses and patients in selected wards. The implementation strategy included oral and written information, instruction videos and reminders. Nurses' knowledge and attitude towards oral care were assessed at baseline and after the implementation of the protocol with a validated 47‐item questionnaire with a score range of 0–100. Secondarily, nurses' protocol adherence to teeth brushing, measured in Activities of Daily Living (ADL) dependent patients, was evaluated. The Standards for Reporting Implementation Studies (StaRI) Statement was used. Results: At baseline, the questionnaire was completed by 226 nurses; after implementation by 283. Knowledge had significantly improved from 68.8 to 72.3. Nurses' attitude improved not significantly. Protocol adherence was assessed in 73 ADL‐dependent patients at baseline, in 51 after implementation. Adherence to teeth brushing significantly decreased in patients with permanent teeth. Also, adherence to both teeth brushing and usage of soap decreased in patients with (partial) dentures. Conclusion: Nurses' knowledge and attitude of oral care increased somewhat after the implementation of a new nursing evidence‐based protocol. After implementation, there was an unexplained decreased adherence to oral care in ADL‐dependent patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the impact of the uninstructed use of a toothpaste containing herbal ayurvedic ingredients on parameters of gingival health in a cohort of periodontal aftercare patients affected by gingival inflammation compared to the use of a standard, non‐herbal toothpaste. Materials and Methods: The monocentric, randomized, double‐blinded, two‐arm parallel‐group intervention was performed in a cohort of 88 periodontal aftercare patients with clinical signs of gingival inflammation. At baseline, bleeding on probing (BoP), gingival index (GI) and Quigley–Hein plaque index (QHI) were recorded. Subsequently, the study patients were randomly provided with a herbal ayurvedic toothpaste (n = 44) or a conventional, non‐ayurvedic control toothpaste (n = 44) and without additional oral hygiene training instructed to use it 2× daily for the next 28 days. On day 28, BoP, GI and QHI were recorded again. Results: At baseline, there were no significant differences between both groups. On day 28, mean GI and BoP scores were significantly lower (p < 0.001) compared to baseline in both groups. Differences between the groups could not be verified. Mean QHI scores did not change significantly between day 0 and day 28 in both groups. Conclusions: The impact of uninstructed toothbrushing with an ayurvedic toothpaste on the manifestation of gingival inflammation in periodontal aftercare patients is not significantly different to the use of a conventional, non‐herbal toothpaste. [ABSTRACT FROM AUTHOR]

Background: Risk of disease progression and tooth loss is higher in cases where deep probing pocket depths (PPDs) and bleeding on probing (BOP) persist after active periodontal treatment. This study aimed to investigate the efficacy of non‐surgical periodontal therapy on pocket closure (PC), defined as PPD ≤4 mm without BOP (PC1) or PPD ≤4 mm solely (PC2) 3 months after non‐surgical periodontal treatment and to compare PC between smokers and non‐smokers. Methods: This cohort study is a secondary analysis from a controlled clinical trial consisting of systemically healthy patients with stage III or IV grade C periodontitis. All the sites with baseline PPD ≥5 mm are included as diseased sites and PC at 3 months after completion of non‐surgical periodontal treatment was calculated. PC was compared between smokers and non‐smokers at site and patient levels. Multilevel analysis is used to investigate factors at patient, tooth and site levels affecting PPD changes and the probability of PC. Results: A total of 1998 diseased sites in 27 patients were included in the analysis. The rates of PC1 and PC2 were 58.4% and 70.2% and were significantly correlated to smoking habits at site level (r (1) = 7.03, p = 0.008; r (1) = 36.17, p < 0.001). Tooth type, mobility, clinical attachment level (CAL) and PPD at baseline significantly affected PC. Conclusions: The present findings indicate that non‐surgical periodontal treatment is effective in PC, but its performance is influenced by baseline PPD and CAL and residual pockets may remain. [ABSTRACT FROM AUTHOR]

Objectives: To develop a caries‐risk assessment application (myRisk app) and assess the psychometric properties based on content validity, construct validity, and how well it classifies the participants into different caries risk groups using caries increments at 10 months. Methods: The myRisk mobile application was developed using Android Studio 4.1.1. The content validity was assessed by three dental experts. To evaluate construct validity and the prediction of future dental caries, the participants (N = 88) were recruited from Rajvithi Home for Girls in Thailand by convenience sampling. The participants were completed a caries risk assessment (CRA) of myRisk app and ADA form. The oral examination was performed at the time of CRA and 10 months following the baseline. Results: Eighty‐eight participants aged 12–29 used the myRisk app and completed the ADA form. The app content validity was acceptable (IOC = 0.67). According to myRisk, 7.9%, 71.6%, and 20.5% of the participants were classified into the low‐, moderate‐, and high‐risk groups, respectively. The percent agreement of the caries‐risk classification with the ADA form was 30.7%. Significant differences between the three risk groups were found in active caries (p < 0.001), type, and frequency of sugary snacks (p = 0.002). The app had a sensitivity of 68%, a specificity of 61%, and an area under the receiver operating characterisitic (ROC) curve of 0.61. Conclusions: The myRisk app has acceptable content validity and sufficient diagnostic accuracy (sensitivity, specificity, and ROC curve). However, there is a different outcome in caries‐risk classification compared with the ADA form. [ABSTRACT FROM AUTHOR]

Purpose: Determine if different technology‐based health education interventions can reduce oral health inequalities between the sexes in a sample of adolescents. Methods: A cluster randomized clinical trial was conducted in three phases with an initial sample of 291 male and female adolescents 14–19 years of age. Phase I (n = 288) comprised a clinical examination performed by a calibrated examiner using the simplified oral hygiene index (OHI‐S) and gingival bleeding index (GBI). Phase II involved two educational interventions: video (VD; n = 147) or oral counselling (OR; n = 141) with standardized content. In phase III, an App was made available to half of the clusters (OR + App; n = 66/OR without App; n = 71/VD + App; n = 63/VD without App; n = 63), and the clinical examination was performed a second time. Data were evaluated using descriptive analysis and nonparametric tests. Results: In phase I, boys had a lower standard of oral hygiene compared with girls, with higher mean OHI‐S (p = 0.039) and GBI (p = 0.015). After VD and OR interventions, no significant difference between sexes was found regarding the mean OHI‐S. However, males had a higher mean GBI compared with females in the OR group (p = 0.006). When the App was added to OR and VD groups, males in the 'OR without App' group had a higher mean GBI compared with females (p = 0.007). Conclusion: This clinical trial demonstrated that educational interventions involving information technologies were effective at reducing oral health inequalities between the sexes among adolescents. However, oral counselling alone was not efficient in reducing GBI in male adolescents. [ABSTRACT FROM AUTHOR]

Background and Objectives: Dysphagia is a common complication following stroke. It corresponds to the development of pneumonia, which is always associated with bad prognosis, longer hospital stays and increased mortality. The aim of the study was to assess the impact of physical therapy intervention of dysphagia on preventing pneumonia in acute stroke patients. Methods: A single‐blind randomized controlled trial was carried out on 70 ischemic stroke patients with oropharyngeal dysphagia, age ranged from 49 to 65 years. They were randomly assigned to two groups (control and study) of equal number. Patients in the control group received oral care and nasogastric tube feeding, while patients in the study group received the same program in addition to the designed physical therapy program (exercises and neuromuscular electrical stimulation). The intervention program was applied for 40 min/session, 1 session/day, and 5 days/week for 4 weeks. Gugging swallowing screen (GUSS), and stroke associated pneumonia (SAP) control and prevention criteria were used to assess dysphagia and incidence of pneumonia at baseline, after two and 4 weeks of intervention for both groups. Results: Before treatment, all patients were susceptible to pneumonia after two and 4 weeks of intervention; there were a significant increase in GUSS score in both groups with more improvement in favor of the study group (p < 0.05) and a statistically significant increase in incidence of SAP after 2 weeks of intervention only in the control group (p < 0.05). The results also showed a significant negative correlation between GUSS score and SAP (r = − 0.3662, p = 0.0018) Implications for Physiotherapy Practice: adding physical therapy (exercise therapy and neuromuscular electrical stimulation) to oral care and nasogastric tube feeding is effective in improving oropharyngeal dysphagia and decreasing the incidence of aspiration pneumonia in acute ischemic stroke patients. [ABSTRACT FROM AUTHOR]

The aim was to investigate methicillin‐resistant Staphylococcus aureus (MRSA) incidence, conversion and outcomes in diabetic foot infections (DFIs). This is a pooled patient‐level analysis of combined data sets from two randomised clinical trials including 219 patients admitted to the hospital with moderate or severe DFIs. Intraoperative bone and tissue cultures identified bacterial pathogens. We identified pathogens at index infections and subsequent re‐infections. We identified MRSA conversion (MSSA to MRSA) in re‐infections. MRSA incidence in index infections was 10.5%, with no difference between soft tissue infections (STIs) and osteomyelitis (OM). MRSA conversion occurred in 7.7% of the re‐infections in patients who initially had MSSA in their cultures. Patients with re‐infection were 2.2 times more likely to have MRSA compared to the first infection (10.5% vs. 25.8%, relative risk [RR] = 2.2, p = 0.001). Patients with MRSA had longer antibiotic treatment during the 1‐year follow‐up, compared to other pathogens (other 49.8 ± 34.7 days, MRSA 65.3 ± 41.5 days, p = 0.04). Furthermore, there were no differences in healing, time to heal, length of stay, re‐infection, amputation, re‐ulceration, re‐admission, surgery after discharge and amputation after discharge compared to other pathogens. The incidence of MRSA at the index was 10.5% with no difference in STI and OM. MRSA incidence was 25.8% in re‐infections. The RR of having MRSA was 2.2 times higher in re‐infections. Patients with MRSA used more antibiotics during the 1‐year follow‐up. Furthermore, there were no differences in clinical outcomes compared to other bacterial pathogens. [ABSTRACT FROM AUTHOR]

Aim: To explore predictors of spiritual well‐being behaviors among heart failure patients based on Wilson and Cleary's conceptual model of health‐related quality of life and to clarify the interrelationships among these variables. Design: A descriptive and correlational study design was used. Methods: This study included 202 heart failure patients treated between October 2020 and July 2021. Data were collected using the Symptom Status Questionnaire‐Heart Failure, Perception of Health Scale, and Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐Being Scale. Descriptive analysis, correlation, and structural equation modeling were performed. Results: Characteristic factors positively affected spiritual well‐being both directly (β = 0.19, p = 0.007) and indirectly (β = 0.19; CI (0.106; 0.311)). The direct relationship between health perception and spiritual well‐being was significant (β = 0.83, p < 0.05). Symptom status acted as an essential mediator between model variables and spiritual well‐being (β = −0.28; CI (−0.449; −0.133)). Comorbidity and symptom status also influence spiritual well‐being through health perceptions. These variables explain 77% of the variance in spiritual well‐being. Conclusion: The modified structural equation modeling based on Wilson and Cleary's conceptual model fits well in predicting spiritual well‐being in patients with heart failure. Spiritual well‐being was reported to be poor, and changes in spiritual well‐being were predicted by age, educational level, marital status, comorbidity, symptom status, and health perception. The results can be applied to patients with heart failure and may serve as a guide for assessment and interventions for improving spiritual well‐being. Clinical Relevance: This study mainly concludes that symptom status and perceived health status affect spiritual well‐being in heart failure patients. Symptom relief and improvement in perceived health status interventions may help enhance spiritual well‐being in this population. Future studies are needed to investigate the different predictor's effects on spiritual well‐being and examine whether symptom management and health status‐enhancing interventions result in improved spiritual well‐being in the heart failure population. Reporting Method: This study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: The mental and emotional health of persons diagnosed with cancer is frequently affected. The acceptance and commitment therapy (ACT) is one of the psychological interventions that has proven successful in easing these psychological symptoms and enhancing cancer patients' psychological well‐being. Methods: A two‐arm randomized controlled trial study was utilized, 30 eligible clients with colorectal cancer were chosen randomly and were given ACT therapy at a 1:1 ratio. ACT was delivered in six sessions for 3 weeks, followed by 3 months follow‐up. Results: The table shows a statistically significant increase in the mean scores of the mental health and its flourishing level among the study group than those of the control group. Cognitive impairment was significantly decreased among the study group than for those in the control group. Conclusion: The ACT‐based interventions may be a promising approach for improving mental health and cognitive function in cancer patients, particularly those with advanced disease. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the characteristics of assistive device users and influencing factors among disabled elderly in China. Methods: A total of 13,510 disabled elderly in Sichuan Province were surveyed. Disability was assessed using the Barthel Activities of Daily Living Scale, mental status, sensory perception, and social engagement evaluation. Univariate analysis and logistic regression analysis were employed to identify the impact factors. Results: The prevalence of assistive device utilization among participants was 79.2% (10,700/13,510, 95% CI 78.5%–79.9%), with the wheelchair being the most commonly used device. Various factors were found to influence the usage of the device, including disability level, somatic disability, age, caregivers, income, caregiver fees, and living situation (p <.05). Additionally, several factors were identified associated with the frequency of device usage, such as somatic disability, education background, income, caregiver fees, living situation, access to acquire assistive devices, duration of assistive device usage, education on assistive devices, and satisfaction level (p <.05). Conclusions: The use of assistive devices among elderly individuals in China is prevalent. There are many factors that affect the use of assistive devices, which can provide a reference for the formulation of policies in the field of assistive devices. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the mode of school physical activity, the relationship with obesity, and participation willingness and behavior in the relationship between modes of school physical activity and BMI in students with overweight or obesity. Design: Cross‐sectional study. Sample: Data from the 2014 Physical Fitness and Health Surveillance of Chinese School Students was used, wherein physical measurements and questionnaires of 3476 middle school students were collected. Measurements: Physical measurements and questionnaires were completed. Latent profile analysis and mediated effects analysis were conducted using Mplus 8.3 and IBM SPSS 26.0 for data description and statistical analysis. Result: After latent profile analysis divided into poor (9.35%), medium (65.16%), and good (25.49%) groups of school physical activity, among junior middle school students, medium (OR = 0.428, 95% CI = 0.259–0.707, p =.001) and good (OR = 0.448, 95% CI = 0.255–0.718, p =.002) groups were positive for controlling overweight. Among students with overweight or obesity, participation willingness mediated the relationship between the mode of school physical activity and BMI, with effect coefficients of −0.120 (95% CI = −0.264 to −0.016) and −0.240 (95% CI = −0.426 to −0.099). Conclusions: School physical activity modes have a positive effect only on preventing and controlling overweight in junior middle school students. For middle school students with obesity, weight‐specific measures should be considered for their prevention and control. [ABSTRACT FROM AUTHOR]

The article presents a study which sought to automate Medication Regimen Complexity Index (MRCI) calculation in a database of people with mild cognitive impairment (MCI) or dementia and to examine contributions of specific MRCI components to overall complexity. Topics include calculation of MRCI scores, MRCI by patient characteristics, and possible impact of complex medications on the risk of poor health outcomes.

Over the last two decades, great efforts and investments have been made in Ethiopia to ensure that all children have equal access to nutrition services in health facilities. While quality health systems are a prerequisite for quality nutrition services, little attention has been given to the evaluation of the supply and delivery services. The purpose of the study was to evaluate the coverage and quality of the nutrition‐specific interventions delivered through the health system. Using an end‐user monitoring (EUM) system, we monitored the delivery of nutrition‐specific interventions in 500 districts, having 2514 health facilities distributed throughout Ethiopia. Data were collected through third‐party monitors between August 2020 and 2021. Roughly 90% of health facilities were performing severe acute malnutrition management in line with the national guideline/protocol, and 2/3 of the assessed facilities were delivering iron and folic acid, vitamin A supplementation and deworming. A third of the messages on AMIYCN were retained by beneficiaries. Warehouse conditions were good in 64.3% of the facilities, but only 22% had good recording practices and about half had problems related to the quality and availability of nutrition supplies. Most beneficiaries were satisfied with the nutrition supplies and service delivered at the health facility level. This study also suggests the relevance of an EUM system to assess the quality of nutrition service delivery and its related supply management, as well as to improve the implementation of nutrition interventions as a decision‐making tool. Key messages: The main bottleneck identified in supply management was the recording system, while roughly 65% of warehouses are in good condition to store nutrition supplies at the health facility level.Roughly 90% of health facilities were performing severe acute malnutrition management in line with the national guideline, while 2/3 of the health facilities are delivering iron and folic acid, vitamin A supplementation and deworming.The knowledge and practices of the HW were above average and only a third of the messages delivered were retained by beneficiariesAlthough messages are being well delivered once counselling is implemented, many opportunities (contact points) are missed to deliver nutrition counselling. [ABSTRACT FROM AUTHOR]

Responsive feeding serves as an important protective factor for infant growth and overall health development. This study based on self‐determination theory (SDT) aimed to assess the effects of a responsive breastfeeding (RBF) intervention programme on maternal breastfeeding and infant growth and development. A total of 110 mother–infant pairs were recruited and randomly divided into an intervention group (n = 55) and a control group (n = 55). The primary outcomes were breastfeeding motivation score, breastfeeding self‐efficacy (BSE) and exclusive breastfeeding rate; the secondary outcomes were infant physical development at 6 weeks and 3 months. A repeated measures ANOVA indicated that the intervention group had significantly higher Enjoyment scores compared to the control group at three time points: at discharge (MD: 5.28; 95% CI: 3.68 to 6.89; p < 0.001), 6 weeks post‐partum (MD: 5.06; 95% CI: 3.80 to 6.31; p < 0.001) and 3 months post‐partum (MD: 5.24; 95% CI: 4.12 to 6.35; p < 0.001). Similarly, the intervention group reported significantly higher connection and mother's self‐perception scores at discharge (MD: 4.31; 95% CI: 3.07 to 5.56; p < 0.001), 6 weeks post‐partum (MD: 4.69; 95% CI: 3.71 to 5.68; p < 0.001) and 3 months post‐partum (MD: 4.93; 95% CI: 4.14 to 5.72; p < 0.001), compared to the control group. In contrast, the pressure from significant others scores were higher in the control group relative to the intervention group at discharge (MD: −2.09; 95% CI: −2.88 to −1.31; p < 0.001), 6 weeks post‐partum (MD: −4.35; 95% CI: −5.20 to −3.49; p < 0.001) and 3 months (MD: −4.89; 95% CI: −5.70 to −4.08; p < 0.001). Finally, the intervention group also reported higher Instrumental Needs scores at all three time points: at discharge (MD: 1.96; 95% CI: 1.35 to 2.58; p < 0.001), 6 weeks post‐partum (MD: 3.58; 95% CI: 3.05 to 4.11; p < 0.001) and 3 months post‐partum (MD: 1.18; 95% CI: 0.68 to 1.69; p < 0.001). BSE scores were significantly higher in the intervention group compared to the control group at discharge (MD: 14.29; 95% CI: 10.38 to 18.21; p < 0.001), 6 weeks post‐partum (MD: 14.04; 95% CI: 11.05 to 17.02; p < 0.001) and 3 months post‐partum (MD: 6.80; 95% CI: 4.66 to 8.94; p < 0.001). The rates of exclusive breastfeeding were higher in the intervention group than in the control group at each stage of the intervention (p < 0.01). At 6 weeks post‐partum, the intervention group's infants showed slower weight (t = −0.90, p = 0.371) and length (t = −0.69, p = 0.495) growth compared to the control group, though not significantly. By 3 months post‐partum, there was a significant difference in both weight (t = −3.46, p = 0.001) and length (t = −2.95, p = 0.004) between the groups. The findings in this study suggest that the RBF intervention programme based on SDT may be effective in improving mothers' motivation to breastfeed, building breastfeeding self‐confidence and increasing the rate of exclusive breastfeeding. The effects of the intervention on infant physical development will need to be verified with longer follow‐up in future research. Key messages: This study validated the application of responsive breastfeeding (RBF) intervention during the exclusive breastfeeding phase of Chinese infants.The RBF intervention may help to increase mothers' level of autonomous motivation for breastfeeding, enhance breastfeeding self‐efficacy and increase exclusive breastfeedingrates. The intervention had no significant effect on the weight and length of 6 week old infants but significantly impacted 3monthold infants, with slower growth observed in the intervention group compared to the control group.Future intervention programmes shouldinclude extended follow‐up periods to investigate the long‐term effects of RBF on infant growth and development. [ABSTRACT FROM AUTHOR]

Acute malnutrition affects not only the growth and development but also the body composition of children. However, its specific effects have not yet been characterized. This study aims to compare the body composition of 5–7‐year‐old children with moderate acute malnutrition (MAM) to that of their well‐nourished (WN) peers and identify associated factors. A school‐based comparative cross‐sectional study was conducted from June to July 2022 in Jimma town, southwest Ethiopia. The study participants were selected from eight kindergartens and eight primary schools using a simple random sampling technique based on the proportional allocation of the sample to the size of the population in the respective school. Descriptive statistics and multivariable linear regression analyses were used to assess the mean differences and associations between variables and isolate independent predictors of body composition, respectively. The statistical significance was determined using ß‐coefficients with 95% confidence intervals and a p value of ≤ 0.05. Data were captured from 388 (194 MAM and 194 WN) children with a response rate of 97.9%. The mean fat‐free mass of WN children was significantly higher compared with those with MAM (p < 0.001). The mean (SD) of fat mass of MAM children was 4.23 ± 0.72 kg, 4.36 ± 0.88 kg and 4.08 ± 0.89 kg for 5, 6 and 7‐year‐olds, respectively. For WN children, the mean (SD) of fat mass was 4.92 ± 0.88 kg for 5 years old, 5.64 ± 1.01 kg for 6 years old and 5.75 ± 1.26 kg for 7 years old (p < 0.001). On the multivariable linear regression analysis after controlling for background variables, WN children exhibited 1.51 times higher fat‐free mass compared with MAM children (β = 1.51, p = 0.003). A unit increase in age of the study participants was associated with a 1.37 increment in fat‐free mass (β = 1.37, p < 0.001). WN children had 1.07 times higher fat mass compared with children with MAM (β = 1.07, p < 0.001). A unit increase in the age of the child resulted in 0.15 times increment in fat mass (β = 0.15, p = 0.020), and being female was associated with a 0.37 increase in fat mass (β = 0.37, p < 0.001). The results showed that the mean fat mass and fat‐free mass were significantly lower among moderately acute malnourished children than in WN children showing the loss of both body compartments due to malnutrition. The body mass index for age, age of the child and sex of the child were significantly linked to both fat‐free mass and fat mass. Key messages: This study demonstrated that children aged 5–7 years suffering from moderate acute malnutrition (MAM) have lower mean body fat mass (FM) and fat‐free mass (FFM) as compared with well‐nourished (WN) children.The substantial difference observed between MAM and WN children in body FM and FFM calls for the integration of MAM treatment into the routine health services to prevent their sliding down to SAM and associated mortality. [ABSTRACT FROM AUTHOR]

Poor diet quality (diet diversity and animal‐source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school‐age children compared to children <5 years of age, especially in low/middle‐income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school‐age children is needed. A 36‐month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school‐age children (5–8 years at baseline) in these households; the present study analysed findings in the cohort of school‐age children seen at all five study visits (n = 341). Diet quality improved more in the full package school‐age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z‐scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi‐sectoral community development intervention was associated with improvements in diet and growth of school‐age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school‐age children can be favourably influenced by community‐level interventions, even indirectly. Key messages: Relatively less is known about the factors that influence diet quality and growth in school‐age children compared to younger children, especially in low‐ and middle‐income countries.Better diet quality and growth were found among school‐age children whose families participated in an impact study multi‐sectoral intervention compared to children in control families or those whose families only received nutrition training.Diet and growth of school‐age children can be favourably influenced by community‐level interventions. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate whether regular follow‐up of oral leukoplakia (OL) resulted in early detection of malignant transformation (MT). Method: Two hundred and twenty‐two consecutive patients with OL (147 females, 75 males); median follow‐up period of 64 months (range: 12–300). Three groups were distinguished: group A (n = 92) follow‐up at the hospital; group B (n = 84) follow‐up by their dentist; group C (n = 46) lost to follow‐up. Results: OLs in group B compared to group A, were smaller in size (<2 cm; p < 0.001), showed more hyperkeratosis (p < 0.001) and less moderate/severe dysplasia (p < 0.001). MT occurred in 45 (20%) patients: 32 (35%) in group A, five (6%) in group B and eight (17%) in group C. There was no significant difference in clinical tumour size between group A (median: 15 mm, range: 1–40) and group B (median: 10 mm, range: 3–25; p = 0.496). Tumour size was smaller for patients in groups A and B (median: 10 mm, range 1–40) compared to group C (median: 33 mm, range: 3–100; p = 0.003). There was a positive correlation between tumour size and interval between the last visit in all patients (p = 0.022). Conclusion: Regular follow‐up of OL resulted in early detection of MT. If properly selected, follow‐up of OL performed by the dentist seems feasible. [ABSTRACT FROM AUTHOR]

Background: No previous study has examined the direct effect of occupational fatigue, inter-shift recovery and compassion competence on caring behaviours, including assurance, knowledge-skill, respect and commitment in intensive care nurses. Aim: We studied the direct effect of participating nurses' occupational fatigue, inter-shift recovery and compassion competence levels on their caring behaviours and the relationship among these variables. Study Design: This was a descriptive correlational study. All nurses who were registered members of the Turkish Intensive Care Nurses Association were invited to participate in this online survey. This study was conducted with 315 intensive care nurses using convenience sampling between April and July 2022. The data were collected using the Occupational Fatigue Exhaustion/Recovery Scale, which consists of three subscales: acute fatigue, chronic fatigue and inter-shift recovery; the Compassion Competence Scale, including communication, sensitivity and insight subscales; and the Caring Behaviours Inventory-24. In addition, a structural equation model was established using variables correlating with caring behaviours. Independent variables were occupational fatigue, inter-ship recovery and compassion competence; and the dependent variable was caring behaviours in this hypothesized model. Results: Three hundred and fifteen nurses completed the survey (315/1000) with a response rate of 31.5%. The increase in the inter-shift recovery levels of participants was statistically and positively associated with caring behaviours (95% confidence interval [CI]: 0.001-0.011, β = .154 [moderate effect size], p < .05). The sub-dimensions of the Compassion Competence Scale, that is, communication (95% CI: 0.110-0.443, β = .251 [moderate effect size]) and sensitivity (95% CI: 0.084-0.427, β =.241 [moderate effect size]), were statistically and positively associated with the caring behaviours of participants (p < .05). In addition, independent variables accounted for 35% (large effect size) of the total change in caring behaviours (R² = 0.350). Conclusions: This study suggests that the high inter-shift recovery and compassion competence levels of intensive care nurses are positively associated with their caring behaviours. Relevance to Clinical Practice: Nursing managers should consider the direct effect of occupational fatigue, inter-shift recovery and the compassion competence levels of intensive care nurses on their caring behaviours to provide high-quality care. [ABSTRACT FROM AUTHOR]

Background: Postintensive care syndrome (PICS) has adverse multidimensional effects on nearly half of the patients discharged from ICU. Mental disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are the most common psychological problems for patients with PICS with harmful complications. However, developing prediction models for mental disorders in post-ICU patients is an understudied problem. Aims: To explore the risk factors of PICS mental disorders, establish the prediction model and verify its prediction efficiency. Study Design: In this cohort study, data were collected from 393 patients hospitalized in the ICU of a tertiary hospital from April to September 2022. Participants were randomly assigned to modelling and validation groups using a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was performed to select the predictors, multiple logistic regression analysis was used to establish the risk prediction model, and a dynamic nomogram was developed. The Hosmer-Lemeshow (HL) test was performed to determine the model's goodness of fit. The area under the receiver operating characteristic (ROC) curve was used to evaluate the model's prediction efficiency. Results: The risk factors of mental disorders were Sepsis-related organ failure assessment (SOFA) score, Charlson comorbidity index (CCI), delirium duration, ICU depression score and ICU sleep score. The HL test revealed that p = .249, the area under the ROC curve = 0.860, and the corresponding sensitivity and specificity were 84.8% and 71.0%, respectively. The area under the ROC curve of the verification group was 0.848. A mental disorders dynamic nomogram for post-ICU patients was developed based on the regression model. Conclusions: The prediction model provides a reference for clinically screening patients at high risk of developing post-ICU mental disorders, to enable the implementation of timely preventive management measures. Relevance to Clinical Practice: The dynamic nomogram can be used to systematically monitor various factors associated with mental disorders. Furthermore, nurses need to develop and apply accurate nursing interventions that consider all relevant variables. [ABSTRACT FROM AUTHOR]