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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]

Objective: The LittlEARS® Early Speech Production Questionnaire (LEESPQ) was developed to provide professionals with valuable information about children's earliest language development and has been successfully validated in several languages. This study aimed to validate the Serbian version of the LEESPQ in typically developing children and compare the results with validation studies in other languages. Methods: The English version of the LEESPQ was back‐translated into Serbian. Parents completed the questionnaire in paper or electronic form either during the visit to the paediatric clinic or through personal contact. A total of 206 completed questionnaires were collected. Standardized expected values were calculated using a second‐order polynomial model for children up to 18 months of age to create a norm curve for the Serbian language. The results were then used to determine confidence intervals, with the lower limit being the critical limit for typical speech‐language development. Finally, the results were compared with German and Canadian English developmental norms. Results: The Serbian LEESPQ version showed high homogeneity (r =.622) and internal consistency (α =.882), indicating that it almost exclusively measures speech production ability. No significant difference in total score was found between male and female infants (U = 4429.500, p =.090), so it can be considered a gender‐independent questionnaire. The results of the comparison between Serbian and German (U = 645.500, p =.673) and Serbian and English norm curves (U = 652.000, p =.725) show that the LEESPQ can be applied to different population groups, regardless of linguistic, cultural or sociological differences. Conclusion: The LEESPQ is a valid, age‐dependent and gender‐independent questionnaire suitable for assessing early speech development in children aged from birth to 18 months. [ABSTRACT FROM AUTHOR]

Objectives: We assessed the radiation dosages (Dmean) on implant regions to identify the threshold for implant loss in patients with an intraoral malignancy treated with dental implants to support a mandibular denture during ablative surgery before volumetric‐modulated arc therapy (VMAT). Materials and Methods: Data was collected prospectively from 28 patients treated surgically for an intraoral malignancy, followed by postoperative radiotherapy (VMAT) and analyzed retrospectively. Patients received 2 implants in the native mandible during ablative surgery. Implant‐specific Dmean values were retrieved from the patients' files. Radiographic bone loss was measured 1 year after implant placement and during the last follow‐up appointment. Implant survival was analyzed with the Kaplan–Meier method. Univariate logistic regression and Cox‐regression analyses were performed to investigate the effect of increasing implant‐specific radiation dosages on implant loss. Results: Five out of 56 placed implants were lost during follow‐up (median 36.0 months, IQR 39.0). Radiographically, peri‐implant bone loss occurred in implants with a Dmean > 40 Gy. Implant loss occurred only in implants with a Dmean > 50 Gy. Conclusion: An implant‐specific Dmean higher than 50 Gy is related to more peri‐implant bone loss and, eventually, implant loss. [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]

Limited information is available regarding the knowledge of Cardiovascular Disease (CVD) risk factors and the actual risk behaviors among African American (AA) older women living in rural areas of Alabama. A pilot study of needs assessment for CVD prevention behaviors was conducted to collect such data from rural AA women. This paper reports the quantitative part of the needs assessment of this pilot study. We recruited participants (N = 30) using convenience sampling. Data collection measures included: i) American Heart Association's CVD‐related knowledge questionnaire, ii) Five Times Sit to Stand Test to measure dynamic balance and iii) Six minute walk test (6MWT) to assess exercise endurance iv) standard weighing scale to measure body weight and v) standard measurements scale to measure height. Descriptive and inferential statistics were used to analyze the data. The majority (76%) of participants had hypertension (70%), diabetes (60%), poor balance (70%), and low exercise endurance (100%). Most of the participants had low knowledge related to CVD risk factors. This study demonstrated the need to conduct a large‐scale study to assess knowledge related to heart health and the actual needs and preferences of these individuals. Conducting such a study would lay the foundation for developing a need‐based program for these underserved individuals while incorporating their preferences and the strategies that would help engage them in a heart health intervention. [ABSTRACT FROM AUTHOR]

Background: The health‐related quality of life instrument with 8 items (HINT‐8) was developed to measure health‐related quality of life (HRQoL) in Korea. However, the HINT‐8 has not yet been validated among the family caregivers of people with dementia (PwD). Design: A cross‐sectional pilot study. Objective: The study aimed to examine the convergent and discriminant validity of the HINT‐8 among family caregivers of individuals with dementia. Sample: Forty‐seven family caregivers of PwD. Measurements: HINT‐8 was compared with the 5‐level EQ‐5D (EQ‐5D‐5L) to assess its convergent and discriminant validity. Additionally, the association between the two instruments assessing HRQoL was examined using the short‐form Bédard‐Zarit Burden Interview (SZBI). Results: The HINT‐8 was a promising and valid HRQoL instrument for family caregivers of PwD. There was a significantly high correlation between the overall HINT‐8 and EQ‐5D‐5L indices (r = 0.85, p <.001). The HINT‐8 had acceptable psychometric properties compared to the commonly used EQ‐5D‐5L, as indicated by the subdomains associated with family caregiversʼ burden measured by the SZBI. Conclusion: Future studies should compare the HINT‐8 with existing dementia carer‐specific QoL instruments among a larger study sample to enhance its statistical power and confirm its reliability and structural validity. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression is among the most common complications associated with child‐bearing having a period prevalence rate of 17%. Despite the prevalence of postpartum depression, recognition and treatment remains low. Methods: This paper examines the predictors of help‐seeking behavior among a sample (N = 326) of postpartum women. A cross‐sectional survey was deployed, and participants were recruited via social media through snowball and convenient sampling techniques. Results: Binary logistic regression was used to analyze the data. Results indicate the severity of depression and favorable attitudes toward help‐seeking were predictors of help‐seeking behavior among postpartum women in this sample. Discussion/conclusion: This study has implications for healthcare workers, including the allied health professions. Access to treatment is, in part, influenced by a woman's ability to ask for help from health professionals. Social workers and nurses have an opportunity to educate and discuss postpartum mental health and improve treatment seeking. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the job performance and predictability of job demands, job resources, personal resources, work engagement, job crafting, and the transformational leadership of nurse managers on this among nurses in Myanmar. Background: The ongoing crisis of nursing shortages along with heavy workloads combines to form a major challenge in Myanmar and these affected the job performance of nurses during the COVID‐19 pandemic. Methods: Utilizing a stratified random sample of 474 nurses from tertiary‐level general hospitals in the Republic of the Union of Myanmar, a descriptive predictive analysis was carried out. The Demographic Data Sheet, Job Performance Scale, Work Engagement Scale, Job Demands Scale, Job Resources Scale, Personal Resources Scale, Job Crafting Scale, and Global Transformational Leadership Scale were utilized to collect data. Results: The overall level of job performance was perceived to be high, considering various factors such as job demands, personal resources, work engagement, and job crafting were found as significant predictors of nurses' job performance, explaining 63.30% of the total variance. Discussion: These findings make a valuable contribution toward enhancing nurses' job performance by addressing job demands, fostering work engagement, and nurturing their job‐crafting capabilities. Self‐reporting data collection may not have accurately represented the actual level of study variable. Conclusion: This study highlighted factors that significantly affect nurses' job performance in general hospitals in Myanmar. Implications for nursing and health policy: The findings provide important evidence for nursing administrators and policymakers wishing to develop strategies to enhance the working environment and remain active in helping the performance of nurses. [ABSTRACT FROM AUTHOR]

Background: Quality of life (QOL) among older adults is a crucial aspect of geriatric care, particularly in the context of global demographic shifts toward ageing societies. Understanding the determinants of QOL in older adults is essential for developing effective interventions to promote well‐being in this population. Methods: This cross‐sectional study conducted in Greece aimed to investigate the complex relationship between depression, frailty, nutritional status, and QOL on 90 older adults (aged ≤65). Assessment instruments including the World Health Organization Quality of Life (WHOQoL)‐BREF questionnaire, Geriatric Depression Scale (GDS), Clinical Frailty Scale (CFS), and Mini Nutritional Assessment (MNA) were utilised to evaluate various dimensions of QOL, depressive symptoms, frailty, and nutritional status. Results: The study revealed significant negative correlations between depression and frailty with all domains of QOL (P < 0.05), indicating that higher levels of depressive symptoms and frailty were associated with lower QOL across physical, psychological, social, and environmental dimensions. Conversely, positive correlations were found between nutritional status and all QOL domains (P < 0.05), suggesting that better nutritional status was linked to higher QOL. Multivariate logistic regression analysis further demonstrated associations between nutritional status and participant characteristics, with females being more likely to be malnourished (odds ratio (OR) = 6.56, P = 0.013), while better health status (OR = 0.34, P = 0.486) and marital status (OR = 0.02, P = 0.019) were protective against malnutrition. Conclusion: These findings underscore the interconnectedness of depression, frailty, and nutritional status in shaping QOL among individuals. Holistic interventions targeting mental health, physical vulnerability, and nutritional well‐being are essential for promoting overall well‐being and functional outcomes in this population. [ABSTRACT FROM AUTHOR]

Background: Delirium commonly occurs in paediatric patients with acute critical illness and negatively affects clinical outcomes. Variations in delirium knowledge levels and its management have been noted among nurses. Aims: This study investigated nurses' experiences and knowledge levels regarding paediatric delirium. Additionally, we aimed to assess the gap between knowledge levels and practical experiences with paediatric delirium. Study Design: This cross‐sectional descriptive study conveniently sampled paediatric nurses from a university hospital in South Korea between September 2022 and March 2023. Nursing experiences with paediatric delirium and delirium knowledge levels were measured using structured survey questionnaires. Delirium knowledge was scored 0 to 47, and higher scores indicated higher levels of delirium‐related knowledge. Data were analysed using descriptive statistics and presented as mean, standard deviation, frequency and percentage. Results: A total of 127 paediatric nurses participated in this study; 40.2% had experience with 1–5 delirium cases in the previous year, and 86.6% (n = 110) had never used assessment tools for paediatric delirium assessment. The mean total delirium knowledge score was 34.45 ± 5.4; the mean scores of knowledge regarding aetiology, signs and symptoms and nursing management of delirium were 8.93 ± 1.31, 13.24 ± 2.81 and 12.3 ± 2.7, respectively. Interventions associated with a lower level of delirium‐related knowledge and a lower performance rate included avoiding restraint use and maintaining hydration and electrolyte levels. Interventions associated with a higher level of delirium‐related knowledge but a lower rate of performance comprised providing orientation, offering emotional support, allowing participants to stay with family members and administering medications to manage delirium. Conclusions: Although nurses working in paediatric units exhibited high rate of delirium nursing care, there was the gap between their delirium‐related knowledge and practice. Nurses need to be aware of the insufficient part of delirium care, and paediatric delirium education should be reinforced. Relevance to Clinical Practice: Preventing, assessing and systematically managing paediatric delirium is crucial, and considering the study results, delirium education among nurses is needed. [ABSTRACT FROM AUTHOR]

Background: Physical restraint is applied in pediatric intensive care units to carry out certain painful procedures and to ensure the maintenance and continuity of life support devices. There is a need to analyse the factors that influence the behaviour or intention to use physical restraint. Aim: To create and test psychometrically a paediatric version of the Physical Restraint‐Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. Study Design: A psychometric study. Five medical‐surgical Paeditric Intensive care Units from five hospitals in Spain. The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. Results: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. Conclusions: The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. Relevance for Clinical Practice: Having this instrument will help health centres move towards restraint‐free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs. [ABSTRACT FROM AUTHOR]

Background: Electrocardiographic (ECG) monitoring and recording are seen as the most commonly used non‐invasive diagnostic tool to identify cardiac arrhythmia and myocardial damage in the clinical setting. There is an expectation that critical care nurses are ideally trained to interpret abnormalities and morphology in the ECG more proficiently than nurses from general ward areas. However, the ability to interpret and recognise ECG abnormalities is dependent on which critical care area nurses are currently working in and their level of experience. Aim: The aim of this study was to investigate registered nurses' knowledge in being able to identify and interpret select electrocardiographic rhythms. Study Design: This was a cross‐sectional study that evaluated registered nurses' knowledge of electrocardiogram rhythm identification and interpretation. A convenience sample of 105 registered nurses currently enrolled in a 2‐year Master's programme leading to critical care specialism and advanced practice nurse award were recruited. A 20‐item multiple choice questionnaire that provided examples of electrocardiogram rhythm (n=14) abnormalities and rhythm abnormalities caused by electrolyte disturbances (n=6) Results: The study included registered nurses from critical care and general ward areas. The overall results were poor with only 55% of questions answered correctly. Coronary care nurses scored the highest in identifying ECG rhythms (12/20 ± 1.58; p <.001). When ECG abnormalities associated with electrolyte imbalances were analysed, both groups were unable to identify the effects of hypokalaemia and hypomagnesaemia effectively (p =.748). Length of time as a registered nurse (r = −0.304, p =.002) and length of time in current work environment were weakly correlated (r = −0.328, p =.001). Having a critical care background showed a positive relationship with nursing knowledge of ECG rhythm identification (r = 0.614, p <.001). Conclusion: The results of this study demonstrate that nurses have a poor knowledge of ECG rhythm identification and interpretation, a consistent finding from other work. A possible solution is a revamp of education and training associated with ECG recognition and morphology. Relevance to Clinical Practice: Monitoring and assessing ECG morphology provide important details about cardio‐electroconductive stability, especially with fluctuations in serum electrolyte levels seen in critical illness or trauma. For this, critical nurses must improve their proficiency through education/training or internal quality improvement activities in detecting abnormalities associated with ECG changes beyond those most easily recognizable rhythms such as atrial fibrillation or ventricular tachycardia. [ABSTRACT FROM AUTHOR]

Background: The pulse oximeter is a simple, cost‐effective and reliable device for estimating arterial blood oxygen saturation. Nurses are required to be knowledgeable in pulse oximeter use. Little is known about nurses' knowledge of pulse oximetry in the Middle East region. Aim: To assess nurses' knowledge of pulse oximetry among emergency and critical care nurses and to explore predictors of nurses' knowledge of pulse oximetry. Study Design: This is the second part of data analysis that was first presented in the 'proficiency in ECG' study conducted in Jordan. The original data used for both parts of analysis included a questionnaire with two tests; a knowledge of pulse oximeter test and an ECG proficiency test. Participants were asked to take, alone without receiving assistance, both tests. In this study, the second part of analysis, the focus is on the pulse oximeter test. The test consisted of 21 items that emphasize knowledge of basic physiological principles as well as device limitations; whether technical or interpretation. The test administration procedure also included asking participants to provide socio‐demographic variables. In the original data collected in both parts of analysis, nurses working in the emergency department, cardiac care units or intensive care units from nine different hospitals (1 governmental, 6 private and 2 educational) and holding a bachelor degree or higher were asked to participate. Results: The total number of participating nurses was 210; out of 247 approached (response rate, 85%). The mean score in the nurses' knowledge of pulse oximetry test was 12.33 out of 21, corresponding to 58.7%. The clinical area currently working in predicted the knowledge of pulse oximetry test score after controlling for all other variables. Emergency department and intensive care unit nurses scored higher than cardiac care unit nurses by 1.86 and 1.63 points respectively (58.2% and 60% respectively). Conclusion: Nurses consistently report inadequate education and training concerning pulse oximeter use and interpretation. A revision to hospital in‐service education seminars and undergraduate nurses' curriculum to assure adequate preparation is needed. Relevance to Clinical Practice: Knowledge of pulse oximetry among emergency and critical care nurses is modest. This is a challenge worldwide. Predictors of nurses' knowledge of pulse oximetery are the clinical area currently working in (ICU and ED nurses are more knowledgeable than CCU nurses), proficiency in electrocardiography and taking an advanced cardiac life support course. [ABSTRACT FROM AUTHOR]

The prevalence of mental health issues among UK undergraduate students is growing, and poor diet quality appears to be a risk factor for poor mental health although with limited research in this area. Therefore, the objective of this study was to examine the cross‐sectional associations between diet quality and common mental disorders (CMD) such as depression and anxiety in UK undergraduate students. A cross‐sectional survey consisting of demographic information and validated questionnaires (the Short‐Form Food Frequency Questionnaire [SFFFQ] and the Hospital Anxiety and Depression Scale [HADS]) was conducted to measure diet quality and anxiety and depression in young adults in 44 UK‐based universities. Multiple regression analysis adjusting for confounding factors was used to assess the associations between them. Undergraduate university students (n = 202, 67% female) with a mean age of 20.9 ± 3.6 years and a mean body mass index (n = 170) of 22.6 ± 3.2 kg/m2 took part in the study. Prevalence of anxiety was high, with 40% of the sample having an anxiety score in the severe range (≥12 points) while the prevalence of depression was lower, with 6% of the population having a depression score in the severe range (≥12 points). Diet quality was significantly higher for females than males (p = 0.034) and was poor for 38% of the sample, being more common in males compared to females, although not significantly so (43% and 36%, respectively). Diet quality was inversely associated with anxiety (β = −0.427; p = 0.029) and was more likely to be associated with anxiety in females than males (β = 0.743; p = 0.043). No significant relationship between diet quality and depression was found. Better self‐reported health, father's qualification and smoking status were also associated with less anxiety and depression. This research supports other research suggesting that UK universities should explore whether the implementation of dietary interventions and improving the food environment would be a cost‐effective option to reduce the high prevalence of anxiety among students. [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]

Background: Autogenic training (AT) is a structured meditative‐style practice, consisting of a sequence of simple mental exercises intended to induce a relaxed state in patients. There is some emerging evidence to suggest that AT can be effective in treating certain chronic conditions, however, further evidence is required. A service evaluation of AT services at the Royal London Hospital for Integrated Medicine was conducted to evaluate the impact of AT on patients with chronic conditions. Methods: The service evaluation consisted of the completion of validated quantitative outcome measures pre and posttreatment to explore the impact of AT. AT patients were asked to complete the Measure Yourself Medical Outcomes Profile (MYMOP) and Perceived Stress Scale (PSS) at their first hospital appointment (baseline) and then again 8 weeks later following completion of their AT sessions. Pre‐ and posttreatment scores for each outcome measure were analysed in SPSS using the Wilcoxon signed‐rank test. Results: One hundred ninety‐nine patients completed both initial and follow‐up MYMOP forms and were included in the evaluation. The most common presenting complaints for MYMOP symptom 1 were prolonged anxiety/stress and depression (n = 70, 35.2%), chronic pain and migraine headache (n = 44, 22.1%), chronic insomnia and sleep problems (n = 42, 21.1%) and, long‐term exhaustion and fatigue (n = 18, 9%). The change in median score pre‐ and posttreatment for all MYMOP categories (symptoms, activity and well‐being) were statistically highly significant p < 0.001. Anxiety, stress, depression, pain and insomnia were the symptoms that had the largest statistically significant difference between the median score pre‐ and posttreatment. Fifty‐five patients completed the PSS questionnaire at two time points (pre‐ and posttreatment). It showed a highly statistically significant change in PSS median score in patients experiencing stress (p < 0.001). Discussion: The findings of the evaluation indicate that 8 weeks of AT appears to be effective in improving symptoms of concern to patients and enhancing patients' overall well‐being. In particular, AT was found to be beneficial for patients with symptoms of anxiety, stress, depression, pain and insomnia. [ABSTRACT FROM AUTHOR]

Objectives: Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case–control study was to explore the risk factors for NCCLs. Methods: Cone‐beam computed tomography was used to determine whether a wedge‐shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing‐related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self‐administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Results: Significant variables in the univariate analysis (i.e., p <.2) included frequency of carbonated beverage consumption, sella‐nasion‐point B angle (SNB) and Frankfort‐mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039–9.532), FMA (OR = 1.100; 95% CI, 1.004–1.204) and SNB (OR = 0.896; 95% CI, 0.813–0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607–0.792; p <.001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612–0.796; p <.001). Conclusions: The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue. [ABSTRACT FROM AUTHOR]

Objectives: Clinical associate psychologists (CAPs) train under the auspices of the apprenticeship programme and are a new addition to the psychological workforce. This project sought to evaluate whether a "personal reformulation" (PR) was helpful in terms of personal and professional development during the apprenticeship. Methods: A mixed methods evaluation containing a longitudinal quantitative element and a "Big Q" qualitative element with a single cohort of N = 18 CAPs. A PR consists of a 2‐hr one‐to‐one session and a follow‐up session with a cognitive analytic psychotherapist. During a PR, a sequential diagrammatic reformulation is produced to aid recognition and revision of potentially problematic relationship patterns at work. Two outcome measures concerning reflective capacity and professional quality of life were completed at the start of the apprenticeship, pre‐PR and at 3‐month PR follow‐up. The semi‐structured interviews (n = 11) conducted at the follow‐up were analysed using reflexive thematic analysis. Results: Quantitative changes were limited to significant increases to general confidence and 8/12 apprentices had a reliable increase in confidence in communication. Qualitatively, five overarching themes were found: (1) gaining insight, (2) wellbeing, (3) nature of the space, (4) being an apprentice, and (5) moving forward. Conclusions: PRs were generally found to be emotionally challenging, but relatively large amounts of insight are possible from a very brief intervention that can contribute to personal and professional development during clinical training. More controlled research needs to be conducted and wider applications and evaluations of PRs in different professions would be welcome. [ABSTRACT FROM AUTHOR]

Background: No studies have evaluated the unique potential of nurse‐led silver diamine fluoride (SDF) application for children to bridge the gap in interprofessional collaboration. Aim: To investigate the attitudes, beliefs and perceptions of nurses regarding nurse‐led SDF application at the well‐child visit and identify possible barriers and make recommendations. Design: Mixed methods design involving a questionnaire and semi‐structured individual interviews were conducted. Results: All eligible nurses (n = 110) completed the questionnaire, and 16 were interviewed. Questionnaire responses highlighted that nurses were not confident in providing oral health services (score: <3 of 5) beyond oral hygiene advice (score: ≥3.9 of 5) but believed that they should be providing these services for individuals with difficulty accessing care. Interviews reflected that most nurses viewed oral health care as an important part of paediatric health but were limited by knowledge, time and manpower. Most were willing to expand their job scope to include SDF application with formal education and training, competency assessments and approaches to counter time limitations. Conclusion: Where nurses are already providing basic oral healthcare, nurse‐led SDF application could be the next step. Findings suggest that systemic changes should include strategies to empower and motivate nurses to apply SDF at the well‐child visit. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the most common chronic childhood disease. The recommended age for the first dental visit (FDV) is 1 year, yet a minority of children visit before the age of 3 years. Aim: The aim of the study was to estimate the patterns of and predictors for dental visits among a sample of children. Design: Parents of children between the ages of 6 months and 18 years, who attended the paediatric dentistry clinics and the well‐baby clinics, were recruited. A validated questionnaire was used to collect data. Logistic regression was utilized to assess the predictors of ever visiting a dentist. Results: The mean age at FDV was 5.8 ± 2.1 years. Parents' belief of not needing to see a dentist was the most common barrier to visiting a dentist (33%). Among the reasons for FDV, caries and pain were the most common (45% and 20%, respectively). Predictors of ever visiting a dentist were children who are not an only child and children of parents who visited a dentist themselves. Conclusion: Children visited the dentist at an age older than that recommended, and the reasons for FDV were mainly caries and its consequences. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are two gastrointestinal (GI) conditions known to be exacerbated by traumatic life experiences. One way in which these experiences might influence individuals' susceptibility to GI pathology, is by reducing their ability to deal with adversities effectively and predisposing them to passive coping styles that leave them vulnerable to the somatic effects of trauma. To validate this hypothesis, the present cross‐sectional study assessed the mediating effect of coping dispositions on the association between trauma and GI disease activity in an adult sample of 189 bowel patients (94 IBD, 95 IBS) and 92 controls. Results confirmed that GI patients exhibit significantly more cumulative trauma, pervasive feelings of uncontrollability and passive coping strategies than controls. Moreover, the use of passive coping styles was positively associated with the accumulation of trauma and the expression of GI symptoms. Using hierarchical regression and mediation analyses, we found support for the sequential model postulating passive coping styles as (partial) mediators of trauma‐induced (GI) disease manifestations. Specifically, out of all coping styles associated with cumulative trauma, behavioural disengagement most powerfully mediated the effect of trauma on GI symptom severity, accounting for 12% (IBD) to 14% (IBS) of its total effect. A somewhat smaller mediating role was observed for social support coping, the reduced reliance on which explained 7% (IBS) to 10% (IBD) of trauma's total effect. Finally, neuroticism acted as a channel through which past traumatization affected subjects' proneness to behavioural disengagement and, consequently, their GI disease activity. [ABSTRACT FROM AUTHOR]

Background: Understanding the prenatal origins of children's psychopathology is a fundamental goal in developmental and clinical science. Recent research suggests that inflammation during pregnancy can trigger a cascade of fetal programming changes that contribute to vulnerability for the emergence of psychopathology. Most studies, however, have focused on a handful of proinflammatory cytokines and have not explored a range of prenatal biological pathways that may be involved in increasing postnatal risk for emotional and behavioral difficulties. Methods: Using extreme gradient boosted machine learning models, we explored large‐scale proteomics, considering over 1,000 proteins from first trimester blood samples, to predict behavior in early childhood. Mothers reported on their 3‐ to 5‐year‐old children's (N = 89, 51% female) temperament (Child Behavior Questionnaire) and psychopathology (Child Behavior Checklist). Results: We found that machine learning models of prenatal proteomics predict 5%–10% of the variance in children's sadness, perceptual sensitivity, attention problems, and emotional reactivity. Enrichment analyses identified immune function, nervous system development, and cell signaling pathways as being particularly important in predicting children's outcomes. Conclusions: Our findings, though exploratory, suggest processes in early pregnancy that are related to functioning in early childhood. Predictive features included far more proteins than have been considered in prior work. Specifically, proteins implicated in inflammation, in the development of the central nervous system, and in key cell‐signaling pathways were enriched in relation to child temperament and psychopathology measures. [ABSTRACT FROM AUTHOR]

Background: Exposure to adversity early in life (ELA) has been associated with elevated risk for depression during adolescence, particularly for females; the mechanisms underlying this association, however, are poorly understood. One potential mechanism linking ELA and sex differences in depressive symptoms is sleep disturbances, which increase during adolescence and are more common in females. Here, we examined whether sleep disturbances mediate the association between ELA and increases in depressive symptoms during adolescence and whether this mediation differs by sex. Methods: 224 (N = 132 females) youth were recruited at age 9–13 years and assessed every 2 years across three timepoints. At the first timepoint, we conducted extensive interviews about stressful events participants experienced; participants provided subjective severity ratings of events and we objectively scored the severity of each event. Self‐reported sleep disturbances and depressive symptoms were assessed at all timepoints. We conducted linear mixed models to estimate both initial levels and changes in sleep disturbances and depressive symptoms, and moderated mediation analyses to test whether initial levels and/or changes in sleep disturbances mediated the association of ELA (objective and subjective) with increases in depressive symptoms across adolescence and whether the mediations differed by sex. Results: While higher initial levels and increases in sleep problems were uniquely associated with increases in depressive symptoms for males and females, they were related to ELA differently by sex. For females, greater ELA (both objectively and subjectively rated) was associated with higher initial levels of sleep problems, which in turn were associated with increases in depressive symptoms from early to late adolescence. In contrast, for males, ELA exposure was not associated with either initial levels of, or increases in, sleep problems. Conclusions: These findings highlight the role of sleep disturbances during the transition to adolescence in mediating sex differences in the effects of ELA on depressive symptoms. [ABSTRACT FROM AUTHOR]

The present study aims to explore and compare psychosocial risks and work overload among nursing professionals in the field mental health and psychiatry in Chile. Quantitative, observational and cross‐sectional research was designed for this purpose. Nurses from community, ambulatory, hospital and emergency units in mental health and psychiatry in Chile were recruited between January and May 2022. Instruments of psychosocial variables and an occupational psychosocial risk scale based on the Copenhagen Psychosocial Questionnaire were used. Descriptive and correlational statistics were used, as well as independent samples t‐tests, Factorial Anova and post‐hoc analysis with Bonferroni correction. As a result, 174 nursing professionals were recruited, 79.3% female, average age 33.9 years. One‐third belonged to the Metropolitan Region of Chile. The highest psychosocial risk was obtained by nurses over 30 years of age, from the Metropolitan Region, with more than 16 patients under their care, at the hospital or psychiatric emergency level. Significant differences were observed in work overload and psychosocial risks according to personal and work characteristics of the professionals, as well as of the users and health services. The levels of psychosocial risk and work overload of mental health and psychiatric nurses were reported, as well as the comparison of these according to personal, sociodemographic, and work characteristics. In order to improve the quality of work life of these professionals and the quality of these services, it is essential to develop interventions focused on the dimensions addressed, as well as to define norms and policies that ensure a workload in accordance with international standards. [ABSTRACT FROM AUTHOR]

Background: This survey described the compensation of neonatal intensive care unit (NICU) registered dietitian nutritionists (RDNs) in the United States and examined correlates of higher salaries within this group. Methods: A cross‐sectional online survey was completed in 2021 by 143 NICU RDNs from 127 US hospitals who reported hourly wage in US dollars (USD). We used initial bivariate analyses to assess the relationship of selected institution‐level and individual‐level variables to hourly wage; the rank‐sum test for binary variables; bivariate regression and Pearson correlation coefficients for continuous variables; the Kruskal–Wallis test for categorical variables. Variables with a compelling relationship to the hourly wage outcome were considered in model creation. Final model selection was based on comparisons of model fit. Results: Median hourly compensation was USD 33.24 (interquartile range [IQR] 29.81, 38.49). Seven variables had a compelling bivariate relationship with hourly wage: cost of living, employer facility with a paediatric residency, employer facility with a neonatal fellowship, NICU bed: full‐time equivalents (FTE) RDN ratio, years in neonatal nutrition, having a certification and order writing privileges. In the final adjusted model (R2 = 0.42), three variables remained associated with increased hourly wage: higher cost of living, longer length of career in neonatal nutrition and fewer NICU beds per NICU RDN FTE. Conclusions: US NICU RDNs earn similar or slightly higher wages than other US paediatric RDNs; they earn substantially less than other NICU healthcare team members. Employers need to improve compensation for NICU RDNs to incentivise their retention and recognise their additional non‐clinical responsibilities. Key points: Median hourly compensation for US neonatal intensive care unit (NICU) registered dietitian nutritionists (RDNs) was US dollars (USD) 33.24 in 2021.Higher cost of living, longer length of career in neonatal nutrition and fewer NICU beds per full‐time equivalent (FTE) RDN together only explained 42% of variation in salary.NICU RDNs are not compensated better than other RDNs despite their specialisation, and they earn less than other NICU healthcare team members. [ABSTRACT FROM AUTHOR]

The present study aims to test a model in which basic psychological needs (BPN) satisfaction in physical‐sport activity contexts is associated with self‐determined motivation, which, in turn, would predict the social inclusion of people with intellectual disabilities. A total of 286 people with intellectual disabilities (53.5% men) who reported engaging in physical‐sport activities responded to a validated questionnaire about the satisfaction of their BPN, motivation (using the Self‐determination index [SDI]), and social inclusion. A Pearson's bivariate correlation and structural equation modeling were conducted. The resulting model was reanalyzed in a multigroup analysis to test its invariance across self and proxy reports. Positive associations were found between the satisfaction of the BPN and the SDI. However, the SDI and social inclusion were positively associated only in proxy reports (βself = 0.07 vs. βproxy = 0.30). The tested model established positive relationships between the BPN and SDI in autonomy (βself = 0.21 vs. βproxy = 0.18), competence (βself = 0.47 vs. βproxy = 0.53), and relatedness (βself = 0.21 vs. βproxy = 0.23). Further research is needed to understand the factors leading to discrepancies between participants and proxies when relating the SDI to social inclusion in the context of physical‐sport activity. However, the results obtained suggest that it would be optimal to develop contexts of practice for people with intellectual disabilities in which the satisfaction of their BPN is favored and that this has a positive impact on their motivation and social inclusion. Highlights: In the context of physical‐sport activity practice, the satisfaction of basic psychological needs in people with intellectual disabilities seems to be associated with developing more self‐determined motivation, with a strong association found between competence satisfaction and self‐determined motivation.Self‐determination index appears to have a positive relationship with the social inclusion of people with intellectual disabilities in physical‐sport activity contexts.Discrepancies have been found between the perceptions of people with intellectual disabilities and proxies regarding the terms of this relationship, necessitating research to understand better the factors that may be generating such discrepancies. [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: The objective of this study is to evaluate the Respect YOU program's impact on students' eating expectancies, body image satisfaction levels, self‐efficacy, and knowledge. A total of 444 (intervention cohort n = 348, control cohort n = 96) underclassmen enrolled in health or physical education courses from 7 high schools in the Midwest participated in the study. METHODS: A repeated measure research design was utilized to assess students' eating expectancies, body image satisfaction levels, self‐efficacy, and knowledge. More specifically, paired t‐tests were conducted to compare outcome measurements to evaluate the efficacy of the intervention. RESULTS: Among the students who received the intervention (n = 348), there was a statistically significant change in scores for eating expectancies (Z = −14.403, p <.001), body image satisfaction levels (Z = −14.114, p <.001), social media self‐efficacy (Z = 14.868, p <.001), and knowledge scales (Z = −16.100, p <.001) at post‐intervention and compared to the control group. CONCLUSIONS: Results indicate that the Respect YOU program was effective in improving body image scores, eating expectancies, self‐esteem, and knowledge‐related outcomes among students post‐intervention. These results can be used to further develop educational programming to address body image concerns and disordered eating among adolescents. [ABSTRACT FROM AUTHOR]

Objectives: To identify sexual/sex‐associated risk factors for hepatitis C transmission among men who have sex with men (MSM) and visualise behavioural trajectories from 2019 to 2021. Methods: We linked a behavioural survey to a hepatitis C cohort study (NoCo), established in 2019 across six German HIV/hepatitis C virus (HCV) treatment centres, and performed a case–control analysis. Cases were MSM with recent HCV infection, and controls were matched for HIV status (model 1) or proportions of sexual partners with HIV (model 2). We conducted conditional univariable and multivariable regression analyses. Results: In all, 197 cases and 314 controls completed the baseline questionnaire and could be matched with clinical data. For regression models, we restricted cases to those with HCV diagnosed since 2018 (N = 100). Factors independently associated with case status included sex‐associated rectal bleeding, shared fisting lubricant, anal douching, chemsex, intravenous and intracavernosal injections, with population‐attributable fractions of 88% (model 1) and 85% (model 2). These factors remained stable over time among cases, while sexual partner numbers and group sex decreased during COVID‐19 measures. Conclusions: Sexual/sex‐associated practices leading to blood exposure are key factors in HCV transmission in MSM. Public health interventions should emphasize the importance of blood safety in sexual encounters. Micro‐elimination efforts were temporarily aided by reduced opportunities for sexual encounters during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Bereavement of one or both parents is known to cause many kinds of internalizing and externalizing problems in adolescents. However, less is known about factors that are protective of the mental health of orphaned adolescents and differences by their gender and orphanhood type. To fill these gaps, the current study used a sample from southwestern China to test the association between types of orphans, life satisfaction, adolescents' psychological distress and problem behaviours. The results showed that orphan girls were prone to have lower levels of problem behaviours but higher levels of psychological distress than orphan boys. Female paternal orphans tended to have the highest psychological distress, while male paternal orphans tended to have the lowest psychological distress. In addition, school satisfaction had a stronger association with problem behaviour, and self‐satisfaction had a stronger association with psychological distress. Interventions and preventive measures aimed at reducing the psychological distress of orphans could benefit from the findings regarding the correlates of psychological distress and the most vulnerable group among orphans. [ABSTRACT FROM AUTHOR]

The progression from crawling to walking in infancy is associated with changes in infant language development. One possible explanation for such change is the infant's language environment. Prior research indicates that caregivers use more action directives with walking infants compared to crawling infants, but the relations of such parental speech with infant vocabulary is unknown. Here, we present findings from day‐long home audio recordings (Study 1) and laboratory observations (Study 2) of same‐aged crawling and walking infants to explore how caregiver language, specifically action directives, were associated with parent reported infant vocabulary size. Findings in both studies indicated that caregiver action directives were associated with crawling, but not walking infants' receptive vocabulary sizes. Specifically, action directives about objects occurring when the infant and caregiver were not jointly engaged were associated with higher receptive vocabulary scores for crawling infants, but no such pattern was found for walking infants. The replication of results in distinct samples with different research methodologies strengthens the findings. Taken together, these studies demonstrate that caregiver social engagement specific to infant motoric development is related with infant language learning. [ABSTRACT FROM AUTHOR]

Resilience, the ability to bounce back from difficult events, is critical for an individual to negotiate stressors and adversity. Despite being widely studied, little is known about the processes involved in the development of resilience. The goal of the studies are to investigate the relationship between motivation orientation, emotional intelligence, cognitive appraisals, and psychological resilience. Two studies, using self‐report questionnaires were conducted with employed young adults also enrolled in post‐secondary studies (pre‐ and during the pandemic) to test the tenability of our proposed models. Study 1 and Study 2 showed that emotional intelligence and challenge appraisals were mediators of autonomous motivation and resilience. Study 2 revealed statistically significant differences in mean scores of autonomous motivation and emotional intelligence between non‐pandemic students and pandemic students. Based on the findings, it is suggested that autonomous motivation, emotional intelligence, and challenge appraisals are important aptitudes for the development of resilience. Furthermore, findings suggest that social isolation caused by the pandemic may have affected levels of emotional intelligence. Ultimately, the research expands the literature on both self‐determination theory and resilience by offering a unique multiple mediation model for predicting the development of resilience within the employed undergraduate population. [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: Participation in organised and non‐organised physical activities among adolescents and young adults with Down syndrome is underexplored. This study aimed to examine differences between organised and non‐organised physical activities among adolescents and young adults with Down syndrome. Methods: Forty participants with Down syndrome (27 woman; mean age 21.4 ± 4.9 years) were recruited. Data on physical activity participation were collected by self‐ or proxy‐reported questionnaires about attendance, involvement and type of physical activity. Results: Adolescents and young adults with Down syndrome participated in more organised than non‐organised activities (P < 0.05), more often (P < 0.05), but there was no difference in the total time spent participating in these activities overall. Participants spent more time in vigorous physical activity during organised activities (P < 0.05) and spent more time in light physical activity during non‐organised physical activities (P < 0.05). Dancing (organised activity) and walking (non‐organised activity) were the most reported activities. Conclusions: Participation in both organised and non‐organised physical activities is important to increase overall physical activity levels of adolescents and young adults with Down syndrome. Future research exploring physical activity preferences may help guide the planning and adaption of community programmes for this group. [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: Some studies have researched the correlation between flipped learning and cognitive learning outcomes; however, there is a paucity of research elaborating on the effects of flipped language learning on cognitive load (CL). Objectives: This study investigates the effects of using flipped learning designs (student‐led, teacher‐led and collaboration‐led) on learning outcomes and CL management during out‐of‐class activities versus during‐class activities. Methods: A mixed methods research was used to concurrently triangulate different strands of data on the effects of flipped learning designs on English as foreign language (EFL) learners' learning outcomes and CL. A total of 122 EFL learners were randomly assigned to either the control or experimental group and participated in the study. The interpretations were made based on running one‐way analysis of variance between four groups. Results and Conclusion: This study evidenced the efficacy of the interactive use of collaboration‐led flipped learning design over student‐led and teacher‐led designs for improving learning outcomes and lowering CL during computer‐assisted language learning (CALL) course. Pedagogically, CALL practitioners need to develop and integrate a well‐organized combination of student‐led and teacher‐led flipped learning activities for during‐class and out‐of‐class phases with respect to the CL and learning material complexity, while also considering the specific contexts and goals of their instructional settings. Theoretically, the results indicate the necessity of merging active learning and sociocultural theories into an instructional design to take advantage of the identified affordances of flipped language learning approach in terms of psychological effects (CL management) and learning effects (CALL outcomes). Lay Description: What is already known about this topic: The flipped language learning approach involves receiving online instruction outside the classroom and is a learner‐centered pedagogy. What this paper adds: This study contributes by triangulating different strands of data on the effects of flipped learning designs on learning outcomes and cognitive load.The findings highlight the effectiveness of collaboration‐led design for flipped language learning, facilitating engagement in both out‐of‐class and during‐class activities. Implications for practice: The findings emphasize the importance of designing and implementing instructional designs that align with emerging educational technologies.Teachers should consider the flexibility, fluency and novelty of the learning material when designing flipped learning activities. [ABSTRACT FROM AUTHOR]

Background: Research on cognitive effects of educational games in general shows promising results. However, there are large variations in learning outcomes between individual educational games. Research on the design process and different design elements of educational games has led to some interesting directions, but some design aspects remain unclear. Objectives: We examined how an educational game designed on the basis of intrinsic integration theory, based on a strong alignment between game and learning goals, supports the learning of Newtonian mechanics. Methods: This study applied a mixed‐methods approach (N = 223). A pre‐ and post‐test design was used to examine possible learning and transfer effects fostered by playing the educational game, Newton's Race. To examine how players played the game, log data for each player were digitally recorded during gameplay. Results and Conclusions: Our findings demonstrated a significant positive learning effect of Newton's Race (p = 0.003, d = 0.201). This can be explained through the acquired log data. Log data show that players' gameplay mostly matched expected learning during the game, with physically correct game settings occurring more and more as gameplay progressed. The ability to transfer learned knowledge to other situations was shown to be limited to situations closely resembling the game environment. Implications: Similarly, designed intrinsically integrated games on different (physics) subjects could also foster learning in a relative short time. To foster transfer to other situations we propose embedding the game within other instructional activities. Lay Description: What is already known about this topic?: Research on cognitive effects of educational games in general shows promising results.There are large variations in learning outcomes between individual educational games.Some design aspects remain unclear on the design process and different design elements of educational games.Attempting to integrate learning with gameplay, without affecting the enjoyability of the game, is not easily achieved. What this paper adds?: The current study fits within the research body that emphasizes the importance of aligning gameplay with learning in educational games (i.e., intrinsic integration).Evidence for intrinsic integration as a key element in the design process, found by examining players' log data.A better understanding of how an intrinsically integrated game supports the learning of Newtonian mechanics. Implications for practice and/or policy: Similarly, designed intrinsically integrated games on different (physics) subjects could also foster learning in a relative short time.To foster transfer to other situations we propose embedding the game within other instructional activities. [ABSTRACT FROM AUTHOR]

Background: The Positive Drinking Consequences Questionnaire (PDCQ) was developed to measure positive consequences of alcohol use endorsed by college drinkers. Efforts to assess positive drinking consequences experienced by adolescents have been much more limited. The aim of the present study was to advance the psychometric testing and evaluation of the factor structure of the PDCQ in adolescents. Methods: The current sample consisted of 173 adolescents at T1 (mean age = 15 years, range = 13–17; 61% female) who reported alcohol use in the past 12 months. Data were collected at two time points over a 12‐month interval in the United States. Confirmatory factor analyses, internal consistency, test–retest reliability, and discriminant, concurrent, predictive, and incremental validity were tested. Results: Our analyses supported four factors of positive alcohol‐related consequences: sociability, liquid courage, sexual enhancement, and tension reduction. Internal consistency was moderate to high (α = 0.78–0.94, ω = 0.86–0.91 at T1; α = 0.59–0.93, ω = 0.85–0.93 at T2). Test–retest reliability was fair to good (ICC = 0.46–0.55). The PDCQ total and subscale factor scores demonstrated discriminant validity from negative alcohol expectancy. PDCQ total and subscale factor scores were positively associated with current alcohol consumption (ρs = 0.19–0.50 at T1; ρs = 0.17–0.46 at T2), indicating concurrent validity. Predictive validity analyses showed that the overall PDCQ scale score and the sociability subscale positively predicted maximum drinks 1 year later (ρs = 0.18–0.22). However, the sexual enhancement subscale was negatively predictive of typical drinking frequency 1 year later. Finally, the PDCQ showed incremental validity for concurrent alcohol consumption beyond that for alcohol expectancies and drinking motives. Conclusion: The present findings support for the reliability and validity of PDCQ for use in adolescents where it may have utility as an assessment tool for characterizing various aspects of positive drinking. [ABSTRACT FROM AUTHOR]

Background: The safety of medication use among older adults is a growing concern, given the aging population. Despite widespread attention, the exploration of medication literacy in older adults, particularly from the perspective of information literacy, is in its nascent stages. Methods: This study utilized the existing literature to define medication information literacy (MIL) as a theoretical framework. A two‐round Delphi survey was conducted to identify the essential components of a MIL indicator system for older adults. The analytic hierarchy process (AHP) was then used to assign weights to each indicator. Results: The study observed relatively high response rates in both rounds of the questionnaire, which, along with expert authority coefficients (Cr) of 0.86 and 0.89, underscores the credibility and expertise of the panellists. Additionally, Kendall's coefficient of concordance (Kendall's W) ranging from 0.157 to 0.33 (p < 0.05) indicates a consensus among experts on the identified indicators. Utilizing the Delphi process, a MIL indicator system for older adults was developed, comprising five primary and 23 secondary indicators. These indicators were weighted, with medication information cognition and acquisition emerging as pivotal factors in enhancing medication literacy among older adults. Conclusions: This study developed a MIL indicator system tailored for older adults using the Delphi approach. The findings can inform healthcare professionals in providing customized medication guidance and assist policymakers in crafting policies to enhance medication safety among older adults. Patient or Public Contribution: Patient and public engagement played a pivotal role in the development of our medication information literacy indicator system for older adults. Their involvement contributed to shaping research questions, facilitating study participation, and enriching evidence interpretation. Collaborations with experts in geriatric nursing, medicine, and public health, along with discussions with caregivers and individuals with lived experience, provided invaluable insights into medication management among older adults. Their input guided our research direction and ensured the relevance and comprehensiveness of our findings. [ABSTRACT FROM AUTHOR]

Background: Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied. Objective: The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively. Methods: The Symptom Checklist 90 (SCL‐90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age‐ and gender‐matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons. Results: 100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001). Conclusions: Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment. [ABSTRACT FROM AUTHOR]

Background: Tooth loss has been associated with cognitive decline, but the underlying mechanisms involving speech and psychosocial impairment remain unclear. Objectives: To investigate the impact of tooth loss‐related speech and psychosocial impairment on cognitive function in Hong Kong's older population. Methods: Seventy‐six Cantonese‐speaking participants between the ages of 51–92 were classified into three groups: patients with complete dentures (CD), partially edentulous patients with less than 10 occluding tooth pairs (OU <10), and at least 10 occluding tooth pairs (OU ≥10). Cognitive function was assessed using the Montreal Cognitive Assessment Hong Kong Version, One‐minute Verbal Fluency Task and Hayling Sentence Completion Test. Objective and subjective speech assessments were carried out using artificial intelligence speech recognition algorithm and a self‐designed speech questionnaire. The impact of tooth loss on psychosocial condition was evaluated by the Reading the Mind in the Eyes Test and a self‐designed questionnaire. Statistical analyses (one‐way ANOVA, ANCOVA, Kruskal–Wallis test, Spearman correlation test) were performed. Results: Tooth loss was significantly associated with lower cognitive function (p =.008), speech accuracy (p =.018) and verbal fluency (p =.001). Correlations were found between cognitive function and speech accuracy (p <.0001). No significant difference in tooth loss‐related psychosocial impact was found between the three groups. Conclusion: While warranting larger sample sizes, this pilot study highlights the need for further research on the role of speech in the association between tooth loss and cognitive function. The potential cognitive impact of tooth retention, together with its known biological and proprioceptive benefits, supports the preservation of the natural dentition. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to conceptualise Temporomandibular disorder (TMD) symptom burden and severity and explored their interrelationships with somatic symptoms and psychological distress. Methods: Participants were recruited from a local polytechnic. The quintessential five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) were appraised and extended to evaluate the duration, frequency, intensity and interference of discrete TMD symptoms. Global TMD severity (GS) was computed by totaling the points for all TMD symptoms and dimensions. TMD (TS) and somatic symptom (SS) burden were assessed based on the Somatic Symptoms Scale‐8, while psychological distress was measured with the Depression, Anxiety and Stress Scales‐21. Statistical analyses were performed using Kruskal–Wallis/Dunn tests and Spearman's correlation (α =.05). Result: Of the 366 eligible participants (mean age 19.1 ± 2.3 years), 51.4% were 5Ts‐negative and 48.6% were 5Ts‐positive. Among the 5Ts‐positive individuals, 25.3%/64.0% were 'bothered a little' whereas 4.5%/10.7% were 'bothered a lot' by TMD pain/headache. Correspondingly, 32.6%/12.4%/5.1% were 'bothered a little' while 2.8%/2.8%/1.1% were 'bothered a lot' by TMJ sounds/closed/open locking. TS burden was moderate‐to‐strongly correlated to aggregate symptom duration, frequency, intensity, interference, GS and SS burden (rs =.50–.88). While TS burden and GS were weakly associated with psychological distress (rs =.18–.36), SS burden was moderately related to depression, anxiety and stress (rs =.47–.53). Conclusions: TS burden can serve as a proxy for global TMD severity and may be more meaningful than the mere presence of TMD symptoms in clinical and research settings. [ABSTRACT FROM AUTHOR]

Background: Extrinsic factors for erosive tooth wear (ETW) have been widely reported, but the intrinsic factors for wear remain unclear. Objectives: The aim of this study was to evaluate the factors associated with the prevalence of ETW in patients with reflux oesophagitis (RO). To prevent severe ETW with RO, factors associated with severity of ETW were also evaluated. Methods: A total of 270 patients with RO were recruited. A modified tooth wear index was used to evaluate the prevalence and severity of ETW. Salivary secretion and buffering capacity were assessed prior to endoscopy. Subjects were asked to complete a medical condition and oral self‐care questionnaire. Univariate and multivariate analyses were employed to identify factors collectively associated with the prevalence and severity of ETW. Results: A total of 212 cases were categorized as patients with ETW (148 with mild ETW and 64 with severe ETW). Multivariate analyses indicated that saliva secretion, severity of RO and proton pump inhibitor (PPI) resistance were associated with the prevalence of ETW, whereas age, BMI and severity of RO were associated with the severity of ETW. The odds ratio of saliva secretion and BMI were less than 1, meaning that higher saliva secretion resulted in a lower prevalence of ETW and lower BMI was associated with severe ETW. Conclusion: Saliva secretion, severity of RO and PPI resistance were associated with the prevalence of ETW, whereas age, BMI and severity of RO were associated with the severity of ETW. Lower saliva secretion and BMI were significant factors for ETW. [ABSTRACT FROM AUTHOR]

Parenting a child with anorexia nervosa (AN) is highly stressful, and the struggles around eating have a large impact on family functioning. Parents get involved in conflicts with their child and/or accommodate to the eating disorder symptoms. Non‐violent resistance (NVR) offers an additional treatment option for these families. NVR aims at helping parents effectively deal with their child's (self‐)destructive behaviour and their own helplessness, by non‐violent and non‐escalating means. In our pilot, we examined whether NVR was helpful in reducing stress and improve parent–child interaction. In six parents, it was found that parenting stress was significantly reduced at post‐assessment and at 3‐month follow‐up. For parent–child interaction, a non‐significant trend was found for improvement. Change in body mass index of the adolescents was not associated with the decrease in parenting stress. Although preliminary, the results of this pilot suggest that NVR can be a feasible treatment alternative for families of adolescents with AN. [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]

Aim: This study aimed to investigate personal preparedness among patients on haemodialysis (HD) and to examine the relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours during natural disaster incidents. Design: A cross‐sectional survey was conducted. Methods: A convenience sampling method was used. A total of 446 participants from six areas of Sichuan province completed the online questionnaire study from February 27 to March 13, 2022. Sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were measured. Descriptive statistics were used to analyse sociodemographic characteristics and attitudes toward disaster preparedness. The relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were assessed using ordinal regression. Statistical significance was defined as p < 0.05. Results: A total of 446 participants completed the survey. Of these, 42.15% (N = 188) were poorly prepared, 26.23% (N = 117) were moderately prepared and 31.61% (N = 141) were highly prepared. Ordinal regression showed that knowing about disaster preparedness (Odds Ratio (OR) = 1.691, 95% Confidence Interval (CI) = 1.081–2.644, p = 0.021), participating in disaster evacuation exercises (OR = 2.519, 95% CI = 1.595–3.977, p < 0.001) and learning about disaster preparedness (OR = 2.421, 95% CI = 1.542–3.802, p < 0.001) were associated with high preparedness. Compared to patients with a university degree or higher, patients with a junior high school education or lower (OR = 3.491, 95% CI = 1.760–6.925, p < 0.001) and senior high school degree (OR = 2.052, 95% CI = 1.038–4.057, p = 0.039) were associated with high preparedness. Patients who felt very confident and could deal with all their needs (OR = 3.878, 95% CI = 2.904–7.181, p < 0.001) or patients who felt confident and could meet some of their needs (OR = 1.949, 95% CI = 1.124–3.379, p = 0.017) had higher preparedness than those who felt less confident and were not well prepared to take care of their needs. Patient or Public Contribution: After obtaining each participant's consent, they filled out the online questionnaire using their own or a relative's cell phone while undergoing HD. Implication for Practice: It is essential that patients should be educated not only on medical specialty topics, but also on general disaster preparedness. Medical institutions should improve and reinforce preparation training among targeted populations. The low level of preparedness is partly due to the lack of participation of patients in disaster preparedness programs. Dialysis center managers should be urged to implement such programs at their centers. [ABSTRACT FROM AUTHOR]

Aim: To explore the correlations between examination tolerance and anxiety, knowledge needs and examination cooperation in sedation‐free gastroscopy examinees. Design: Cross‐sectional survey using convenience sampling. Methods: A total of 170 healthy adults who underwent sedation‐free gastroenteroscopy were asked to complete a visual analogue scale (VAS) to rate their examination tolerance, the state anxiety questionnaire (S‐AI), a newly designed knowledge needs questionnaire and a cooperation questionnaire. Results: The VAS score was 4.47 ± 1.96, the state anxiety score was 39.46 ± 9.81, the total score for knowledge needs was 44.89 ± 11.02, and the average cooperation score was 2.47 ± 0.38. The VAS score during the examination positively correlated with the pretest state anxiety score and pretest knowledge needs score and negatively correlated with the examination cooperation score. The results of multiple linear regression analysis showed that after undergoing the examination for the first time, anxiety, body position and swallowing control were the main factors influencing the examination tolerance of sedation‐free gastroscopy examinees. Patient or Public Contribution: We would like to thank the staff and patients of the participating hospital for their assistance and cooperation in performing the current study. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships among communication competence, professional autonomy and clinical reasoning and to identify the factors that influence clinical reasoning competence in oncology nurses. Design: Cross‐sectional descriptive design. Methods: Participants included 147 oncology nurses with more than a year of clinical experience in cancer wards. The Global Interpersonal Communication Competence Scale, Schutzenhofer Professional Autonomy Scale and Nurses Clinical Reasoning Scale (NCRS) were used to collect data. Data were analysed using descriptive statistics, independent t‐test, one‐way ANOVA, Pearson correlation analysis and hierarchical multiple regression analysis. Results: Communication competence (r = 0.59) and professional autonomy (r = 0.46) showed significant positive relationships with clinical reasoning competence. Clinical experience, communication competence, age and professional autonomy were statistically significant predictors and explained 48.6% of clinical reasoning competence. Conclusions: The clinical reasoning competence of oncology nurses increases proportionally with their communication competence and professional autonomy. Therefore, oncology nurses must reinforce their communication competence and professional autonomy to enhance their clinical reasoning competence. Implications for the Profession and/or Patient Care: The reinforcement of communication competence and professional autonomy is necessary for oncology nurses to enhance their clinical reasoning competence. In order to improve nurses' communication competence, practical‐focused communication education programmes must be designed and deployed systematically and periodically. In addition, to increase nurses' professional autonomy, it is necessary to expand their clinical experiences through the regular rotation of working units and to make institutional efforts to retain experienced nurses. Reporting Method: We have adhered to STROBE checklist. Patient or Public Contribution: Participants in the study were recruited online. They were informed of the study's purpose, method and usability and the survey could only be conducted if they consented to participate voluntarily. [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]

Aim: Internationalization at Home (IaH) strategies play an important role in nursing curricula to enhance nursing students' cultural awareness in the globalized world. The Community of Inquiry (CoI) is a theoretical framework for the optimal design of online learning environments to support critical inquiry and discourse among students and teachers. To optimise nursing students' online cultural awareness learning experiences, it was timely to develop online IaH strategies based on a sound theoretical model. This study aimed to examine the effectiveness of CoI‐guided online IaH strategies on enhancing the cultural awareness of nursing undergraduates who enrolled in a community nursing course. Design: This was an interventional pre‐test post‐test study. Method: One hundred and six nursing undergraduates who enrolled in the course participated in the study. The online IaH strategies were developed focusing on the interactions of teaching presence, cognitive presence and social presence of CoI framework and they were integrated into the course. A previously validated Cultural Awareness Scale was adopted for pre‐post evaluation. Higher scores indicate greater cultural awareness. Results: The results showed that there was a significantly higher total score of cultural awareness of participating students at post‐online IaH strategies. To be effective, aligning CoI‐guided online IaH strategies with course content, pedagogy and assessment was shown to be significant. The inclusion of technological elements in related strategies was also critical to engage student learning. The positive change on the total score of cultural awareness suggested the effectiveness of the deployed strategies. In this ever‐changing educational landscape, it may provide insights to educators regarding considering online IaH strategies with theoretical underpinning for curriculum planning and design. [ABSTRACT FROM AUTHOR]