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The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

Background: Gender dysphoria among transgender adolescents has predominantly been examined in relation to body dissatisfaction. While in adult transgender samples, body dissatisfaction is higher than in cisgender controls, this has so far rarely been investigated for adolescents. In the context of a cisnormative society, the impact of influences from the social environment on body dissatisfaction and gender dysphoria has been neglected in research. Therefore, this study aimed to (1) provide a detailed analysis of body dissatisfaction among young transgender people and (2) investigate whether body dissatisfaction and gender dysphoria are associated with experiences of minority stress such as trans hostility and poor peer relations (PPR). Methods: The paper presents a cross-sectional study among a sample of transgender adolescents, presenting at a specialized outpatient counseling clinic (N = 99; age M = 15.36, SD = 1.85). First, body dissatisfaction (assessed by the Body-Image-Scale; BIS), was explored and compared to data from a population-based control group of cisgender peers (N = 527; age M = 14.43, SD = 0.97). Second, within a clinic-referred transgender subsample (n = 74), associations between body dissatisfaction and gender dysphoria (measured by Utrecht Gender Dysphoria Scale; UGDS), PPR (measured by the Youth-Self-Report; YSR-R), and trans hostile experiences (assessed in clinical interview) were examined by correlations, t-tests and multivariate regression. Results: Transgender adolescents reported more body dissatisfaction than cisgender peers. The dissatisfaction with sex characteristics, non-hormonal reactive body regions and the total score for body dissatisfaction were positively related with gender dysphoria. The majority had experienced trans hostility in the present and/or past (54.1%) and PPR (63.5%). More body dissatisfaction was correlated with more PPR regarding visible body parts i.e., hair, overall appearance and muscles, whilst PPR and gender dysphoria were not associated. Transgender adolescents who experienced trans hostility showed higher gender dysphoria and PPR, but not more body dissatisfaction. In multiple regression, trans hostility predicted gender dysphoria, whilst age and PPR predicted body dissatisfaction. Discussion: Experiences of minority-stress differentially interact with body dissatisfaction and gender dysphoria among transgender adolescents. Social correlates of body dissatisfaction and gender dysphoria must be considered when working with young transgender people. [ABSTRACT FROM AUTHOR]

Background: As delays or disorders in early language and communication are the most prevalent symptom in children with disabilities, early screening is crucial to promote prevention, early diagnosis, and intervention. However, to the best of our knowledge, no screening tool is available for the joint assessment of early language and social communication skills in European Portuguese (EP)‐learning children, which is critical for screening, monitoring and enrolment in appropriate early intervention services. Aims: (1) To adapt and validate the EP version of the Communication and Symbolic Behaviour Scales Developmental Profile™ (CSBS DP™) Infant–Toddler Checklist, a parental report for the screening of early language and social communication skills. (2) To conduct a cross‐cultural comparison between the EP adaptation and the original US version. Methods & Procedures: A total of 611 EP‐learning children (ages 6–24 months) were assessed on the CSBS DP Infant–Toddler Checklist. Normative data, psychometric characteristics (i.e., internal consistency and test–retest reliability), and cross‐cultural comparison between the EP and the original version were explored. Outcomes & Results: Internal consistency ranged from good to excellent and the test–retest reliability was excellent. The performance of the EP and US samples matched on almost all scores. However, EP children performed significantly better than their American peers in the Social compositive at 22 months and in the Symbolic composite at 20 months. No further differences were found. Conclusions & Implications: These findings showed that the EP CSBS DP Infant–Toddler Checklist seems to be a reliable screening tool of communicative and symbolic behaviours for EP‐learning children, which can be particularly relevant for decision‐making in clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject: Early communication skills are known to be related to later language outcomes. Thus, screening tools for the early identification of children at risk for language and communication impairments, which may lead to monitoring and early intervention, have the potential to promote better outcomes. However, to the best of our knowledge, no screening tool is available for the assessment of early communication abilities in EP‐learning children. What this paper adds to existing knowledge: This study adapted and validated the EP CSBS DP Infant–Toddler Checklist, the first published parental report checklist for the assessment of early communication skills in EP. It described the psychometric characteristics of the adapted checklist, summarized the newly available normative data for EP‐learning infants and toddlers, and compared the performance of EP‐learning children with the original standardization sample reported for American English. The results demonstrated that this tool is a reliable instrument for the early screening of language, communicative and symbolic behaviours for EP‐learning children between 6 and 24 months of age. What are the potential or actual clinical implications of this work?: Given that early screening is crucial to promote prevention, early diagnosis and intervention, the availability of this tool is particularly relevant for children monitoring and their enrolment in appropriate early intervention services, helping decision‐making in clinical practice, in line with current guidelines regarding early monitoring and intervention to promote and support better outcomes. Thus, the tool and related normative data will be useful for paediatricians, family doctors, primary healthcare providers, developmental psychologists and speech–language therapists, among other professionals in the healthcare and educational fields, concerned with speech, language, and communication development and impairments. [ABSTRACT FROM AUTHOR]

Introduction: Vitiligo is a chronic skin condition caused by progressive cutaneous hypomelanosis. Aim: The aim of the study was to determine its epidemiology and clinical aspects. As considerable progress has been made in understanding of the pathogenesis of vitiligo and its classification as an autoimmune disease, the paper pays particular attention to coexisting autoimmune or atopic diseases. Material and methods: The study included 55 patients attending the Diagnostic and Treatment Center of Skin Diseases in Lodz. Data were collected during outpatient dermatological consultation. Results: The most common type of vitiligo was nonsegmental (85.5%) followed by segmental (12.7%) and unclassified (2.1%). The first skin lesions were mostly located on the hands (45.5%) and face (38.2%). Older patients with higher body mass index tended to demonstrate a higher body surface area. Of the patients, 63.6% demonstrated an autoimmune or atopic comorbidity, the most common of which were type 1 diabetes mellitus (18.2%), psoriasis (16.4%) or Hashimoto's thyroiditis (14.5%). Location on the face was associated with a significantly greater incidence of autoimmune or atopic co-morbidities. Conclusions: A facial location may serve as a predictive factor for other autoimmune or atopic diseases in vitiligo patients. Determining clinical factors in vitiligo patients which could be associated with a higher risk of autoimmune comorbidities may allow for their early diagnosis and suitable treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the impact, trends, and impact levels of factors affecting Pediculus capitis infestation in primary school students. Subject and methods: Among the papers reviewed, 226 were selected, as they contained information that suited the study objectives. Results: The factors whose trends have higher gradients have a higher impact on the infestation level. In order of impact, the gradients of hair washing frequency, health instructor involvement, bathing frequency, mother's and father's education, existence of bathing facility, family size, hairstyle, and family income trends are higher than hair length, and age and education trends. As a result, the factor impacts are diminished from the beginning to the end. The importance of the family size, father's and mother's education, bathing facility existence, health instructor involvement, and bathing and hair washing frequency factors, whose trends increased over time, is higher than family income, hairstyle and length, and age and education, whose trends remained constant or decreased. Based on the gradient of the factor level impact trends, it seems that hair washing frequency, father's and mother's education, and health instructor involvement are the factors with the greatest effects on infestation level, in that order. These are followed by the influence of family income and size, and hairstyle factors. The existence of bathing facilities, bathing frequency, hair length, and education factors have weaker effects. Conclusion: This work provides the importance and impact levels of factors affecting Pediculus capitis infestation levels in primary school students, which will help meet the needs of policymakers. [ABSTRACT FROM AUTHOR]

This paper examines whether U.S./Mexico border residence in California is related to the prevalence of DSM-5 alcohol use disorder (AUD) among Whites and Hispanics. Household survey data were obtained from 1,209 adults (59.7% female) 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample, with data collected on the phone or online. Results show that AUD rates were not different between border and non-border location and between Whites and Hispanics. AUD was negatively associated with higher income ($20,000 to $60,000: AOR=.38; 95%CI=.17–.86; p<.01—more than $60,000: AOR=.27; 95%CI:.09–.81; p<.01) and poor risk perception (AOR=.86; 95%CI=.78–.94; p<.01). AUD was positively associated with continued volume of drinking (AOR = 1.05; 95%CI = 1.01–1.09; p<.01), drinking in Mexico (AOR = 4.28; 95%CI = 1.61–11.36; p<.01), marijuana use (AOR = 4.11; 95%CI = 1.73–9.77; p<.01), and impulsivity (AOR = 1.55; 95%CI = 1.23–1.94). Efforts to prevent AUD in the population in California, and especially among those who live close to the border with Mexico, should take into consideration factors such as impulsivity, marijuana use, border crossing to drink in Mexico, all of which increased risk of AUD. [ABSTRACT FROM AUTHOR]

Background: The impact of hearing impairment is typically studied in terms of its effects on speech perception, yet this fails to account for the interactive nature of communication. Recently, there has been a move towards studying the effects of age‐related hearing impairment on interaction, often using referential communication tasks; however, little is known about how interaction in these tasks compares to everyday communication. Aims: To investigate utterances and requests for clarification used in one‐to‐one conversations between older adults with hearing impairment and younger adults without hearing impairment, and between two younger adults without hearing impairment. Methods & Procedures: A total of 42 participants were recruited to the study and split into 21 pairs, 10 with two younger adults without hearing impairment and 11 with one younger adult without hearing impairment and one older participant with age‐related hearing impairment (hard of hearing). Results from three tasks—spontaneous conversation and two trials of a referential communication task—were compared. A total of 5 min of interaction in each of the three tasks was transcribed, and the frequency of requests for clarification, mean length of utterance and total utterances were calculated for individual participants and pairs. Outcomes & Results: When engaging in spontaneous conversation, participants made fewer requests for clarification than in the referential communication, regardless of hearing status/age (p ≤ 0.012). Participants who were hard of hearing made significantly more requests for clarification than their partners without hearing impairment in only the second trial of the referential communication task (U = 25, p = 0.019). Mean length of utterance was longer in spontaneous conversation than in the referential communication task in the pairs without hearing impairment (p ≤ 0.021), but not in the pairs including a person who was hard of hearing. However, participants who were hard of hearing used significantly longer utterances than their partners without hearing impairment in the spontaneous conversation (U = 8, p < 0.001) but not in the referential communication tasks. Conclusions & Implications: The findings suggest that patterns of interaction observed in referential communication tasks differ to those observed in spontaneous conversation. The results also suggest that fatigue may be an important consideration when planning studies of interaction that use multiple conditions of a communication task, particularly when participants are older or hard of hearing. WHAT THIS PAPER ADDS: What is already known on this subject: Age‐related hearing impairment is known to affect communication; however, the majority of studies have focused on its impact on speech perception in controlled conditions. This indicates little about the impact on everyday, interactive, communication. What this study adds to the existing knowledge: We investigated utterance length and requests for clarification in one‐to‐one conversations between pairs consisting of one older adult who is hard of hearing and one younger adult without hearing impairment, or two younger adults without hearing impairment. Results from three tasks (two trials of a referential communication task and spontaneous conversation) were compared. The findings demonstrated a significant effect of task type on requests for clarification in both groups. Furthermore, in spontaneous conversation, older adults who were hard of hearing used significantly longer utterances than their partners without hearing impairment. This pattern was not observed in the referential communication task. What are the potential or actual clinical implications of this work?: These findings have important implications for generalizing results from controlled communication tasks to more everyday conversation. Specifically, they suggest that the previously observed strategy of monopolizing conversation, possibly as an attempt to control it, may be more frequently used by older adults who are hard of hearing in natural conversation than in a more contrived communication task. [ABSTRACT FROM AUTHOR]

Background Non-pharmaceutical interventions (NPIs) decrease COVID-19 transmission. Reliability and validity of adherence to NPIs in accordance with normalization process theory (NPT) in coherent and convenient social subgroups using reflective measurement model assessment has not been evaluated. Methods In February 2021, a sample of medical students and people with substance use disorders in treatment as coherent (based on continuous probability distribution) vs. convenient groups (based on convenience, not equal probability) composed of travellers and COVID-19 suspected persons from Split-Dalmatia County (SDC) (n  = 656) in the Mediterranean completed self-administered surveys. Partial least squares structural equation modelling (PLS-SEM) was used to measure reflective model assessment of adherence to NPIs according to NPT. Results PLS-SEM reflective model assessment provided two-group specific factors in inverse relationships which determined adherence to NPIs with excellent goodness-of-fit [ χ 2 = 1.292, df = 1; P  = 0.297, CFI = 1, TLI = 0.997, RMSEA = 0.011 (90% CI 0–0.105), RMSEA P  = 0.604, SRMR = 0.008, Hoelter CN (α = 0.05) = 2322.757]. Significant negative factors covariance estimate (−0.716) revealed an inverse relationship between first (adherence to NPIs and internal locus of control (LoC) (0.640)) and second factor; young adulthood age (≤25) and highest level of education (1362). As the first factor increased the second tended to decrease. LoC is expected potential mechanism by which sex (MLsex = −0.017, SE = 0.007, P  < 0.016) and belonging to coherent subgroups (MLgroup = −0.008, SE = 0.003, P  = 0.015) can produce indirect effect of adherence to NPIs. Conclusions Coherent subgroups had a more pronounced tendency toward integration of NPIs in everyday life. Group factors that facilitate the normalization were higher educated younger adults with a tendency toward external LoC. [ABSTRACT FROM AUTHOR]

Background Consumption of alcohol is a risk factor for non-communicable and infectious diseases, mental health problems, and can lead injuries and violence. The aim of this study was to evaluate the prevalence of alcohol-involved deaths among decedents who died of external causes and underwent autopsy in Lithuania. Methods Study includes age persons of any age (from 0 to 110 years) who died and were autopsied in Lithuania from 1 January 2017 to 31 December 2020. Data were obtained from the Lithuanian State Register of Deaths and Their Causes. Results Among external causes of death, the presence of alcohol was detected in 55.0% of cases. Male decedents had a significantly higher number of positive BAC level recorded, at 46.6%, compared with female decedents (32.1%; P  < 0.001). The highest incidence of deaths where the alcohol was detected in the deceased's blood was found when the decedent was listed as being in the victims of assault group (71.5%, 95% CI 65.4–77.2). However, the highest median BAC score was found for those in the accidents group (59.7%, 95% CI: 58.2–61.2, BAC 2.42 ‰, IQR 1.86). Conclusions The findings of this study suggest that alcohol use may be a contributing factor in a wide range of fatal incidents, including accidents, injuries, and cases of violent intent. Inequalities between males and females were identified, with a higher proportion of males with alcohol detected in blood at the time of death. [ABSTRACT FROM AUTHOR]

Background: Limbic structures have recently garnered increased attention in Parkinson's disease (PD) research. This study aims to explore changes at the whole-brain level in the structural network, specifically the white matter fibres connecting the thalamus and limbic system, and their correlation with the clinical characteristics of patients with PD. Methods: Between December 2020 and November 2021, we prospectively enrolled 42 patients with PD and healthy controls at the movement disorder centre. All participants underwent diffusion tensor imaging (DTI), 3D T1- weighted imaging (3D-T1WI), and routine brain magnetic resonance imaging on a 3.0 T MR scanner. We employed the tract-based spatial statistical (TBSS) analytic approach, examined structural network properties, and conducted probabilistic fibre tractography to identify alterations in white matter pathways and the topological organisation associated with PD. Results: In patients with PD, significant changes were observed in the fibrous tracts of the prefrontal lobe, corpus callosum, and thalamus. Notably, the fibrous tracts in the prefrontal lobe and corpus callosum showed a moderate negative correlation with the Freezing of Gait Questionnaire (FOG-Q) scores (r = -0.423, p = 0.011). The hippocampus and orbitofrontal gyrus exhibited more fibre bundle parameter changes than other limbic structures. The mean streamline length between the thalamus and the orbitofrontal gyrus demonstrated a moderate negative correlation with Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III (r = -0.435, p = 0.006). Topological parameters, including characteristic path length (Lp), global efficiency (Eg), normalised shortest path length (λ) and nodal local efficiency (Nle), correlated moderately with the MDS-UPDRS, HAMA, MoCA, PDQ-39, and FOG-Q, respectively. Conclusion: DTI is a valuable tool for detecting changes in water molecule dispersion and the topological structure of the brain in patients with PD. The thalamus may play a significant role in the gait abnormalities observed in PD. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Determination of remaining growth potential of patients is the most important factor in orthodontic treatment. Purpose: This study aimed to assess the correlation of clivus length and angle with age, gender, sagittal growth pattern of the jaws, and skeletal maturation using lateral cephalometry. Materials and Method: This cross-sectional study was conducted on 390 lateral cephalograms (Vatech, paX-i3D Green, South Korea) of patients aged 6 to 25 years. The patients were assigned to three groups of skeletal class I, II, III (n=130) with equal gender distribution. The clivus length and angle, Welcher angle, maxillary and mandibular effective length, sella turcica to Nasion (SN), and the angles between SN and point A (SNA), between SN and point B (SNB), and between NA and NB (ANB )were measured. Correlations of variables with age and gender, and cervical vertebral maturation stage (CVMS) were analyzed using the Pearson and Spearman’s correlation tests, independent t-test, and one-way ANOVA at 0.05 level of significance. Results: Clivus length had a significant correlation with SNA (r= 0.103, p= 0.042), SNB (r= 0.108, p= 0.033), maxillary (r= 0.547, p< 0.001) and mandibular (r= 0.589, p< 0.001) effective lengths, SN length (r= 0.586, p< 0.001), and CVMS (r= 0.697, p< 0.001). Clivus angle had a significant correlation with SNA (r= 0.105, p= 0.039), SNB (r= 0.155, p= 0.002), maxillary (r= 0.507, p< 0.001) and mandibular (r= 0.596, p= 0.001) effective lengths, SN length (r= 0.566, p< 0.001), and CVMS (r= 0.699, p< 0.001). The mean clivus length (p= 0.006) and angle (p= 0.002) were significantly higher in males, and had a significant correlation with age (r= 0.636 and r= 0.718, p< 0.001). The mean clivus length and angle were not significantly different in class I, II, III (p> 0.05). Conclusion: All parameters were greater in males, and increased with age (except Welcher angle). Clivus length and angle had significant correlations with position of both jaws but not with sagittal relationship. [ABSTRACT FROM AUTHOR]

Background: Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators' job satisfaction and turnover intention. Methods: This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results: A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor's degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion: Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education. [ABSTRACT FROM AUTHOR]

Background: Despite significant changes in healthcare, work practices, and leisure activity, the proposed precipitating factors for abdominal wall hernias have remained largely unchanged for almost two centuries. We aimed to investigate if there have been shifts in these factors over time by examining patients' perception of precipitating factors for abdominal wall hernia development. This study was conducted in the Royal College of Surgeons In Ireland Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, where patients with abdominal wall hernias completed a questionnaire. Results: A total of 277 patients (mean age 55.7; 85.6% male) with abdominal wall hernia completed the questionnaire (66.1% inguinal; 10.8% umbilical; 6.9% paraumbilical; 10.5% epigastric; 3.2% incisional; 1.4% femoral, and 1.1% port-site). One hundred and twenty patients (43.3%) believed their hernia was due to lifting, 71 (25.6%) cited gym activity and 17 (6.1%) cited other sporting activities as the precipitating factor. Traditional factors – chronic cough and constipation - were cumulatively cited only by 11 patients (4.0%), while prostatic obstruction was not cited by any. Conclusion: This study suggests that fitness pursuits may be an increasing contributor to the development of abdominal wall hernia. Greater attention should be paid to the proper use of gym equipment to minimise the risk of hernia development. Key findings: Almost one quarter of patients attributed their hernia to gym activity which should be further explored in prospective studies. This potentially reflects changes in work practice and lifestyle. Traditional causes like chronic cough and constipation were rarely cited, probably reflecting improved healthcare and lifestyle practices. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess mental health nurses' empathy towards consumers with dual diagnosis in Australian mental health settings. The research question was What is mental health nurses' empathy towards consumers with co‐existing mental health and drug and alcohol problems? Design and Methods: A cross‐sectional survey was carried out to understand mental health nurses' empathy. The convenience sample included 96 mental health nurses from various mental health settings with experience working with consumers with dual diagnosis. We assessed empathy using the Toronto Empathy Questionnaire. We utilised SPSS™ software to analyse both the descriptive data and multiple‐regression. Results: The mean empathy score was 47.71 (SD 8.28). The analysis of the association between demographic variables and individual subscales showed an association between the clinical setting and empathy (p =.031) and sympathetic physiological arousal (p =.049). The work sector was associated with sympathetic physiological arousal (p =.045) and conspecific altruism (p =.008). Emotional contagion (β =.98, p <.001), emotional comprehension (β = 1.02, p <.001), sympathetic physiological arousal (β = 1.01, p <.001) and conspecific altruism (β = 10.23, p <.001) predicted mental health nurses' empathy. Conclusions: This study found that most mental health nurses showed empathy towards consumers with dual diagnosis. Mental health nurses who are more empathetic towards their consumers experience emotional contagion. They understand emotions better, show sympathetic physiological responses and exhibit kind behaviour towards consumers. Implications for the Profession and Patient Care: Further research is required to understand how mental health nurses adapt to consumers' emotional states in different mental health settings. This information can help clinicians make better decisions about care quality for consumers with dual diagnosis. Impact: This study addressed mental health nurses' empathy towards consumers with dual diagnosis. Mental health nurses showed increased empathy towards consumers with dual diagnosis. The empathy levels vary based on age, clinical setting, work sector and work experience. Mental health nurses' empathy levels were predicted by emotional contagion, emotion comprehension, sympathetic physiological arousal and conspecific altruism. Empathy enhancement among mental health nurses, particularly towards consumers with dual diagnosis, is crucial and should be regarded as a top priority by healthcare leaders and educators. Reporting Method: Outlined by the Consensus‐Based Checklist for Reporting of Survey Studies (CROSS). Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents. Methods: A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State–Trait Anxiety Inventory for Children—STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale. Results: The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001). Conclusions: This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity presents a significant public health concern globally, with implications for cardiovascular health and metabolic syndrome. In Portugal, approximately 31.6% of children are affected, highlighting the urgency for intervention strategies. This study aimed to assess the prevalence of overweight and obesity in Portuguese school-aged children, with a focus on sex and age differences. Methods: Anthropometric measurements were conducted on 1564 children aged 6–10 years, including weight, height, and skinfold thickness. Body Mass Index (BMI) and the percentage of body fat were calculated using established methods. Results: The results revealed significant differences in BMI (≤0.001) and body fat percentage (≤0.001) among different BMI categories, with a notable prevalence of overweight and obesity, particularly among boys. A total of 37% of the studied population is overweight or obese, among which 40.1% and 33.9% are boys and girls, respectively. Conclusions: This study highlights statistically significant differences in BMI and body fat percentage for both sexes in different BMI categories. A large proportion of the population is overweight or obese, with a greater prevalence in boys. In short, childhood obesity has a negative impact on body composition and is associated with significant differences in anthropometric parameters, emphasizing the importance of preventative and intervention strategies to address this health problem. [ABSTRACT FROM AUTHOR]

Background: As one of the world's biodiversity hotspots, Indonesia contains over 25,000 plant species, including unconventional food plants (UFPs). These plants are integral to the dietary practices of rural communities, providing essential nutrients often overlooked in modern diets. However, the use of UFP is declining, with both their dietary and cultural values being undermined. In rural West Java, this decline in UFP biodiversity coincides with public health challenges related to malnutrition. This study aims to document the diversity of UFPs used by local communities in rural West Java, assess their nutritional value, and explore their consumption practices. Methods: Data were collected using mixed methods, including interviews with 20 key informants and food frequency questionnaire administered to 107 women in three villages in the area. The nutritional compositions of documented UFPs were obtained from literature and analysis. Bivariate correlation was used to analyze the relationships between UFP consumption frequency and potential correlates. Results: The study documented 52 species of UFPs from 29 families, many of which are rich in nutritional value. About half of respondents (56%) consumed UFPs moderately (2–3 times a week). UFP consumption frequency had a strong correlation (r = 0.70) with associated knowledge (r = 0.70, p < 0.01) and a weak correlation with age (r = 0.240, p = 0.015), livestock possession (r = 0.260, p = 0.008), and family size (r = − 0.220, p = 0.02). Motivations for UFP consumption included availability as free food (33%), medicinal value (26%), nostalgic value (23%), and preferred taste (18%). Most respondents (92%) agreed that consumption has declined compared to the past, with perceived reduced availability and lack of knowledge cited as the primary reasons for the declining trend. Conclusions: UFP use is common in the study area, where local communities value these plants for their critical roles in diet, medicine, and culture. Given their significant potential to meet dietary needs, educating and raising awareness about UFPs can enhance their consumption and contribute to food and nutrition security. [ABSTRACT FROM AUTHOR]

Aim. This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses' work performance and well‐being. Background. Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries. Design. Cross‐sectional study. Methods. We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face‐to‐face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse‐level outcomes included self‐directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling. Results. The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses' self‐directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses' organizational commitment or work stress. Conclusion. This study demonstrates a high‐level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs' organizational learning and primary care nurses' well‐being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. Implications for Nursing Management. In China's evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses' self‐directed learning and improve the quality of care. [ABSTRACT FROM AUTHOR]

A healthy lifestyle is a key determinant of health, especially for people with chronic diseases such as diabetes or hypertension. The health behaviours which contribute to a healthy lifestyle include the following: regular physical activity, preventive examinations, maintaining a proper diet and avoiding the consumption of alcohol or cigarettes. They have a significant impact on the disease process, controlling symptoms and preventing complications. The aim of this study was to examine the health behaviours related to diet, physical activity and prevention among Polish primary health care patients and to identify predictors of health behaviours. For this reason, the standardized Health Behaviour Scale (HBS) questionnaire was used. The study was conducted among 269 patients (including 61.71% women) in primary health care facilities. The mean age of participants was 52.89 years (±17.76). The mean HBS score was 36.93 ± 9.66. A statistically significant association was found between HBS scores and such sociodemographic variables as education (p = 0.0061, r = 0.17), body mass index (p = 0.0018, r = −0.20, β = −0.36) and self-assessed economic status (p = 0.0094, r = 0.16). Women's health behaviours as measured by HBS were significantly better than men's (p < 0.001, β = −6.82). A special focus should be given to the groups manifesting poorer health behaviours (e.g., men, older people and persons with low socioeconomic status) by offering them tailored health-promoting interventions. [ABSTRACT FROM AUTHOR]

Aims: To (a) compare student nurses' health status and levels of ergonomics knowledge and awareness to those of first‐year nursing staff and (b) investigate the association between nurses' ergonomic compliance and health status with their educational preparedness. Design: This cohort study compared ergonomics awareness and knowledge, and health status of nurses when they were students and after their first‐year working in medical facilities. Methods: In total, 133 4th‐year student nurses completed a survey; 45 of them completed a second survey after working 1 year in a medical facility. Their health status was compared over time using repeated‐measures ANOVA. Correlation tests were used to analyse associations between ergonomics knowledge and awareness, health status, demographic variables and educational preparedness. Results: Respondents in both surveys displayed weak knowledge of ergonomic principles significantly associated with increased pain intensity and educational preparedness. Patient contribution: Ergonomics training should be expanded during nursing studies and first‐year training to prevent long‐term health disorders. [ABSTRACT FROM AUTHOR]

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

Aims: The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift‐related factors predispose nurses to higher levels of occupational stress and anxiety. Design: This is a cross‐sectional study. Methods: From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety. Results: The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non‐Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night‐shift frequency of 3–4 times per month, night‐shift durations of 9–12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift‐related factors that increased the levels of occupational stress and anxiety. Conclusion: The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety. Impact: By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well‐being and work schedules. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Purpose: This article explored Licensed Clinical Social Workers (LCSWs) beliefs, attitudes, and knowledge of Complementary and Alternative Interventions (CAI). Method: We utilized a cross-sectional online survey among a sample of 193 LCSWs. Results: Approximately 60% of LCSWs assessed for and utilized CAI professionally, and 90% personally utilized CAI. LCSWs had moderately positive beliefs, neutral attitudes, and high baseline knowledge of CAI. Age and years of practice were the only significant correlates, and the only significant predictor for assessment and utilization of CAI was positive attitudes. Discussion: As the largest group of mental health providers, we found that it is vital for LCSWs to have a solid understanding of CAI to provide effective and safe services to the clients they serve. It is hoped that the results of this study will serve as a starting point for future research on CAI among social workers, with the goal of enhancing client-centered practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to identify predictors of severe white matter hyperintensity (WMH) with obesity (SWO), and to build a prediction model for screening obese people with severe WMH without Nuclear Magnetic Resonance Imaging (MRI) examination. Patients subjects and methods: From September 2020 to October 2021, 650 patients with WMH were recruited consecutively. The subjects were divided into two groups, SWO group and non-SWO group. Univariate and Logistic regression analysis were was applied to explore the potential predictors of SWO. The Youden index method was adopted to determine the best cut-off value in the establishment of the prediction model of SWO. Each parameter had two options, low and high. The score table of the prediction model and nomogram based on the logistic regression were constructed. Of the 650 subjects, 487 subjects (75%) were randomly assigned to the training group and 163 subjects (25%) to the validation group. By resampling the area under the curve (AUC) of the subject's operating characteristics and calibration curves 1,000 times, nomogram performance was verified. A decision curve analysis (DCA) was used to evaluate the nomogram's clinical usefulness. By resampling the area under the curve (AUC) of the subject's operating characteristics and calibration curves 1,000 times, nomogram performance was verified. A decision curve analysis (DCA) was used to evaluate the nomogram's clinical usefulness. Results: Logistic regression demonstrated that hypertension, uric acid (UA), complement 3 (C3) and Interleukin 8 (IL-8) were independent risk factors for SWO. Hypertension, UA, C3, IL-8, folic acid (FA), fasting C-peptide (FCP) and eosinophil could be used to predict the occurrence of SWO in the prediction models, with a good diagnostic performance, Areas Under Curves (AUC) of Total score was 0.823 (95% CI: 0.760--0.885, p < 0.001), sensitivity of 60.0%, specificity of 91.4%. In the development group, the nomogram's AUC (C statistic) was 0.829 (95% CI: 0.760--0.899), while in the validation group, it was 0.835 (95% CI: 0.696, 0.975). In both the development and validation groups, the calibration curves following 1,000 bootstraps showed a satisfactory fit between the observed and predicted probabilities. DCA showed that the nomogram had great clinical utility. Conclusion: Hypertension, UA, C3, IL-8, FA, FCP and eosinophil models had the potential to predict the incidence of SWO. When the total score of the model exceeded 9 points, the risk of SWO would increase significantly, and the nomogram enabled visualization of the patient's WMH risk. The application prospect of our models mainly lied in the convenient screening of SWO without MRI examination in order to detect SWO and control the WMH hazards early. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a disease characterized by long-term and troublesome symptoms that affect the patient's life. This study aimed to assess and compare the health-related quality of life (HRQoL) of Polish CF patients and identify factors influencing it. The study group consisted of 79 patients (6 to 42 years old), who filled in an age-appropriate Cystic Fibrosis Questionnaire-Revised. Medical data were collected from each patient's medical records. The domains with the highest HRQoL median were eating problems (88.89), digestive symptoms (77.78) and physical functioning (75.00). The lowest-rated domain was social functioning (61.90). Age negatively correlated with eight domains, and most strongly with treatment burden (rho = −0.474). Physical functioning positively correlated with all spirometry parameters, and most strongly with FEV1% (rho = 0.588). Treatment burden, body image and respiratory symptoms were positively correlated with all spirometry parameters except PEF%. Present exacerbations reduced scores in almost all domains, and in the MANCOVA model they were a significant factor differentiating patients' HRQoL. The univariate analysis of MANCOVA showed the significant effects of both health condition (F = 8.32, p = 0.005) and the COVID-19 pandemic (F = 5.89, p = 0.018) on social functioning domain, and of the place of residence on body image (F = 5.60, p = 0.21). A decreasing HRQoL with increasing age and during exacerbations indicates that it is important to focus on these aspects of patients' lives and ensure they received the necessary support from their healthcare providers. [ABSTRACT FROM AUTHOR]

Background: Age-related decline in cognitive function is often linked to changed prefrontal cortex (PFC) activity and heart rate variability (HRV). Mild cognitive impairment (MCI), a transitional stage between normal aging and dementia, might have further degeneration beyond aging. This study aimed to investigate the differences between young and older adults with or without MCI in cognitive functions, task-induced PFC activation and HRV changes. Methods: Thirty-one healthy young adults (YA), 44 older adults (OA), and 28 older adults with MCI (OA-MCI) were enrolled and compared in this crosssectional study. Each participant received a one-time assessment including cognitive and executive functions, as well as the simultaneous recording of PFC activity and HRV during a cognitive task paradigm. Results: We observed age-related decrease in global cognitive functions, executive functions, HRV, and increase in PFC activity. The MCI further deteriorated the global cognitive and executive performances, but not the HRV or the prefrontal activation. Conclusion: Older people showed lower performances in general cognitive function and executive function, compensatory increase of PFC activity, and reduced HRV. Older people with MCI had further deterioration in cognitive performance, but not in PFC activation and HRV. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis is considered one of the most common chronic inflammatory autoimmune diseases that lead to affection of several joints, as well as extra-articular organ involvement. Rheumatoid arthritis women tend to menopause somewhat earlier. This was attributed to primary ovarian insufficiency because of autoimmune disorders. Anti-Müllerian hormone is a marker used for evaluating preantral follicle reserve. It provides a very sensitive way to reflect the ovarian reserve and has become a crucial factor in determining it. The study aimed to show the influence of rheumatoid arthritis and its activity on ovarian reserve assessed using anti-Müllerian hormone serum levels. Results: Our cross-sectional study involved 30 rheumatoid arthritis female patients with an age range between 25 and 35 years. The Disease Activity Score (DAS 28-ESR) was used to assess the degree of disease activity. Serum level of anti-Müllerian hormone was determined using quantitative enzyme-linked immunosorbent assay and the correlation with the disease activity as well as with the medications the patients were receiving was analyzed. A statistically significant relation was found amid the disease activity and the anti-Müllerian hormone level. Serum levels of anti-Müllerian hormone were found less in cases with high disease activity than in low to moderate cases. Different medications had no effect on anti-Müllerian hormone levels. Conclusions: Rheumatoid arthritis high disease activity was linked to a diminished level of serum anti-Müllerian hormone. [ABSTRACT FROM AUTHOR]

Aim: To assess the perceived health-related quality of life (HRQoL) in hospitalized patients with rheumatic diseases and to determine whether selected characteristics can affect their perceived quality of life. Design: A cross-sectional study. Methods: Data were collected between September 2022 and March 2023 using the standardized instrument to measure HRQoL, namely the RAND 36-Item Health Survey (SF-36). The sample consisted of 170 patients with rheumatic diseases hospitalized in a teaching hospital in the Czech Republic. Results: The average perceived HRQoL was 34.94 (SD = 17.06), indicating poor quality of life. The most highly rated subscale was 'emotional well-being' (56.02 ± 15.71), and the lowest rated subscale was 'role limitations due to physical health' (11.76 ± 28.54). The HRQoL subscales were significantly correlated with Mini-Mental State Examination (MMSE) score, self-care activities, pain severity, age of the patients, and length of hospitalization. Differences in HRQoL were identified based on education, social status, use of compensatory aids, attendance at social events, and history of falls in the past year (p < 0.05). Conclusion: The study contributes to the existing body of knowledge on the subject, but also underscores the importance of considering holistic factors when evaluating HRQoL in individuals with rheumatic diseases. [ABSTRACT FROM AUTHOR]

Background: Glenoid bone loss (GBL) is common in patients with shoulder instability and plays a major role in surgical decision-making. While a plethora of GBL estimation methods exist, all of which present specific challenges, recent studies have developed simple linear formulas estimating GBL based on glenoid height. Purpose: To assess the correlation between glenoid height and width, and to develop specific formulas based on age and sex to calculate the native glenoid width in the Lebanese population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Computed tomography scans for 202 normal shoulders were extracted from our database. The glenoids were reconstructed in 3 dimensions and their width and height were measured. Glenoid width and height were compared between male and female groups. Correlation analysis was also performed on the width, height, age, and body mass index. Formulas estimating glenoid width were developed using regression analysis including all variables significantly influencing the model. Results were then compared with the values calculated using previously published formulas to determine the external validity when using linear formulas to estimate GBL. Results: Significant differences were found between men and women. Regression analysis found that glenoid height and width strongly influenced the model, and that age showed a weak but significant correlation; therefore, the following 2 sex-specific formulas were developed: width (mm) = 6.1 + 0.51 × height + 0.03 × age, and width (mm) = 4.55 + 0.51 × height + 0.03 × age, in men and women, respectively. The values yielded from the formulas developed in this study and the true width significantly differed from those calculated from previous reports. Conclusion: A strong correlation was found between glenoid height and width in a the Lebanese population and demonstrated that glenoid width can be accurately calculated based on the glenoid height and patient's age and sex using the following simplified formulas: width (mm) = 6 + 0.5 × height + 0.03 × age, and width (mm) = 4.5 + 0.5 × height + 0.03 × age, in men and women, respectively. [ABSTRACT FROM AUTHOR]

Objectives: Cerebral palsy (CP) can cause motor, sensory, cognitive, and communicative problems and poor feeding performances in children. Feeding problems could be lifethreatening and negatively affect cognitive and physical growth. This study investigates the frequency of response to oral motor skills, the frequency and severity of feeding problems, and the relationship between age and oral motor skills with feeding problems in children with CP aged 2 to 7 years. Methods: This was an observational and cross-sectional study. The participants were 60 children (26 girls and 34 boys) with CP with a mean age of 4.76±1.71 years. The screening tool for eating problems and oral motor assessment scale assessed participants' feeding and oral motor skills. The Spearman test determined the correlation between age and oral motor dysfunctions with feeding problems. Results: The present study revealed that 80% of participants indicated feeding problems in the screening tool of the eating problems test. Problems with feeding skills (51.5%) were the most frequent. Furthermore, the most frequent response of participants to "closing the lips while feeding with a spoon" was 46.7%, and "sucking with straw," equaled 55.0%," which was passive. For other items, the most frequent response of the examinees was "functional." Finally, the results showed no significant correlation (P<0.05) between age and mean scores of frequency and severity of feeding problems. A significant negative correlation was found between mean scores of oral motor skill with frequency (P<0.001, r=-0.476) and severity (P=0.001, r=-0.424) of feeding problems. Discussion: The majority of children with CP have problems with feeding and oral motor skills. Some skills in the fields of feeding and oral motor should be noticed more by speechlanguage pathologists and included in their therapeutic program, especially "feeding skills," "closing the lips while feeding with a spoon," and "sucking with straw." [ABSTRACT FROM AUTHOR]

The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the BOT-2 SF in Korean school-age children. First, we verified that the BOT-2 SF reflects developmental changes in motor skills. Second, we compared the BOT-2 SF scores to those of the BOT-2 CF. A total of 283 Korean school-age children performed the BOT-2. The differences in the BOT-2 SF point according to age group (7 years, 8–9 years, and 10–12 years) were analyzed. A correlation analysis of the standard scores between the BOT-2 SF and CF was conducted. The sensitivity and specificity of the BOT-2 SF were calculated in reference to its CF. Overall, the BOT-2 SF point scores increased with age. The correlation between the total scores of the BOT-2 SF and CF was strong. The BOT-2 SF had a sensitivity of 83% and specificity of 92%. This study has demonstrated the validity of the BOT-2 SF in Korean school-age children. The BOT2 SF can be useful in screening Korean school-age children with motor skills problems. [ABSTRACT FROM AUTHOR]

Objectives. Current research aims to identify factors that affect the occupational safety climate in university laboratories despite their perception as low-risk areas compared to industrial environments. Methods. A safety climate survey was conducted in science laboratories across various engineering universities in Pakistan. The survey questionnaire was administered to 406 personnel, and a quantitative method for analysis was selected to examine the socio-demographic variables. A 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) was used to perceive responses from participants. Additionally, a scale reliability test was conducted, and multivariate analysis of variance was performed to determine the relationship between selected dependent and independent variables. Results. The study found an overall safety climate score of 3.16 ± 0.55, indicating a moderate to high perception of safety on a scale of 1–5. Parameters such as role in the laboratory, departments/disciplines, accident experience and safety training significantly affected the safety climate score, while gender, age group, duration in university and accident witnessing did not. Conclusion. Upper management involvement, safety communication and direct supervision are crucial for improving the safety climate of university laboratories. The study recommends the consideration of the identified significant safety climate dimensions in laboratory safety policy-making at academic institutes. [ABSTRACT FROM AUTHOR]

Background: Home mechanical ventilation (HMV) is a treatment method for patients with chronic respiratory failure. HMV is a challenge for both patients and their caregivers. Some studies have shown a higher risk of depression, job loss, or lifestyle disturbance in family members caring for HMV patients. The purpose of the study was to measure caregiver burden, perceived social support, and coping strategies. Methods: In the cross-sectional study, 58 caregivers (65.52% female) of HMV patients treated at five healthcare institutions were surveyed. The questionnaires including patient/caregiver demographic data, the type and duration of MV, the Caregiver Burden Scale (CBS), the Social Support Scale (SSS), and the Brief-COPE questionnaire were applied. For statistical analysis, the Mann‒Whitney U test, the Kruskal‒Wallis H test, Dunn's test, and Spearman correlations were used. Results: In the CBS, a high level of burden was observed mainly in the isolation and disappointment subscales. The female caregivers achieved a higher score for general strain than did the male caregivers (p = 0.023). Differences in the distribution of the isolation (p = 0.028) and disappointment (p = 0.03) variables between the financial situation groups were observed. The older the patient, the lower the burden in the domains of isolation (p = 0.015) and disappointment (p = 0.005) was elicited. Invasive MV was associated with greater burdens of general strain (p = 0.005), isolation (p = 0.001), and disappointment (p = 0.001). A medium total SSS score was shown (74.5 ± 7.56). Caregivers used various coping strategies. The most common were planning, acceptance, and active coping. Self-blame and denial were positively related to several CBS subscales, whereas acceptance of difficult situations and positive reframing were related to lower scores. Conclusions: Caregivers most frequently experienced a medium level of burden. Female caregivers were characterized by higher level of burden. Invasive ventilation increased the burden. Respondents who assessed their financial situations as good, had lower burden in the selected subscales. Using some positive coping strategies may reduce the level of burden. Interventions to ensure that caregivers overcome these burdens should be undertaken. [ABSTRACT FROM AUTHOR]

Introduction: This analysis examined changes in services received and service recovery one-year post-pandemic compared to pre-pandemic levels in children with ASD aged between 19 months and 17 years in various subgroups based on factors such as age, income, race/ethnicity, geographic location, and sex. Methods: An online, parent report survey was completed by the parents of children with ASD in the SPARK study cohort (N = 6,393). Descriptive statistics, chi-square analyses, and Spearman correlations were performed to study associations between various factors and service access, pre-pandemic and one-year, post-pandemic. Results: One year after pandemic, the lag in service recovery in children with ASD was greatest for PT/OT services followed by SLT. ABA services only recovered in half of the subgroups. In contrast, SES fully recovered and MH and MED services superseded pre-pandemic levels. Across majority of the timepoints, younger children received more SLT, PT/OT, and ABA services whereas older children received more SES, MH, and MED services. Higher income families accessed more SES, SLT, and ABA whereas lower income families received more MH services. White families received less SLT compared to non-white families. Hispanic families received more SLT services compared to non-Hispanic families. Compared to rural families, urban families received more ABA services at baseline which also recovered one year after the pandemic. Certain counterintuitive findings may be attributed to home/remote schooling leading to reduced access to related services. Conclusions: Future research and policy changes are needed to address the American healthcare vulnerabilities when serving children with ASD by enhancing the diversity of healthcare formats for continued service access during future pandemics and other similar crises. [ABSTRACT FROM AUTHOR]

Background: Parents of children suffering from congenital heart disease experience high levels of stress and negative emotions. Therefore, recognition of parents' emotional states and their ways of coping with it is becoming more and more important. Methods: The study group consisted of 154 parents of newborns and infants with cyanotic congenital heart disease, before and after cardiac surgery (partial or full). To assess parental negative emotions, the level of stress, and strategies of coping with it, standardized questionnaires, such as HADS-M, PSS-10, and COPE, were used. Results: Stress levels in parents were high and associated with negative emotions (anxiety, depression, irritability), as well as the choice of non-constructive coping strategies, which was observed especially in younger parents. Conclusions: Assessing parents' stress levels and ways of coping with stress can improve family functioning and provide better development conditions for the child. [ABSTRACT FROM AUTHOR]

Remote monitoring of cognition holds the promise to facilitate case-finding in clinical care and the individual detection of cognitive impairment in clinical and research settings. In the context of Alzheimer's disease, this is particularly relevant for patients who seek medical advice due to memory problems. Here, we develop a remote digital memory composite (RDMC) score from an unsupervised remote cognitive assessment battery focused on episodic memory and long-term recall and assess its construct validity, retest reliability, and diagnostic accuracy when predicting MCI-grade impairment in a memory clinic sample and healthy controls. A total of 199 participants were recruited from three cohorts and included as healthy controls (n = 97), individuals with subjective cognitive decline (n = 59), or patients with mild cognitive impairment (n = 43). Participants performed cognitive assessments in a fully remote and unsupervised setting via a smartphone app. The derived RDMC score is significantly correlated with the PACC5 score across participants and demonstrates good retest reliability. Diagnostic accuracy for discriminating memory impairment from no impairment is high (cross-validated AUC = 0.83, 95% CI [0.66, 0.99]) with a sensitivity of 0.82 and a specificity of 0.72. Thus, unsupervised remote cognitive assessments implemented in the neotiv digital platform show good discrimination between cognitively impaired and unimpaired individuals, further demonstrating that it is feasible to complement the neuropsychological assessment of episodic memory with unsupervised and remote assessments on mobile devices. This contributes to recent efforts to implement remote assessment of episodic memory for case-finding and monitoring in large research studies and clinical care. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: To assess the utility of the computerized cognitive function assessment tool, CogEvo, as a screening tool for mild cognitive impairment in primary care, we explored the relationship between CogEvo performance, age, and the severity of cognitive dysfunction evaluated by the Mini-Mental State Examination (MMSE). Methods: The observational cross-sectional study included 209 individuals' data (mean age 79.4 ± 8.9 years). We conducted a correlation analysis between CogEvo and MMSE scores, compared the performance among the 3 cognitive function groups (MMSE ≥ 28 group; MMSE24-27 group; MMSE ≤ 23 group) using the MMSE cut-off, and evaluated CogEvo's predictive accuracy for cognitive dysfunction through ROC analysis. Results: Both total CogEvo and MMSE scores significantly decreased with age. A significant positive correlation was observed between total CogEvo and MMSE scores, but a ceiling effect was detected in MMSE performance. Significant differences were observed in the total CogEvo score, including orientation and spatial cognitive function scores, among the 3 groups. CogEvo showed no educational bias. ROC analyses indicated moderate discrimination between the MMSE ≥ 28 group and the MMSE24-27 and MMSE ≤ 23 groups. Conclusions: The computer-administered CogEvo has the advantage of not exhibiting ceiling effects or educational bias like the MMSE, and was found to be able to detect age-related cognitive decline and impairment. [ABSTRACT FROM AUTHOR]

Background: There are multiple recommended protocols for Vitamin D (VitD) supplementation in elderly; however, only a few studies achieved to examine the role of VitD supplements before intertrochanteric fracture surgery on mortality and complications after surgery. Methods: This single-center block-randomized double-blinded trial was conducted on 80 patients with intertrochanteric fractures and a sufficient level of 25 (OH) VitD. The intervention group received an intramuscular 300,000 IU VitD ampule before surgery. The primary outcome was a 6-month mortality rate, and the secondary outcomes were 1- and 2-year mortality rates and Harris Hip Score (HHS) in 6, 12, and 24 months after surgery. Chi-square, t-test, repeated measure ANOVA, and Cox regression survival model was used for statistical analysis. Results: 40 patients were allocated to each group. Demographic, clinical characteristics, and preoperative evaluations were not significantly different between the groups. Mortality rate 6-month after the surgery was 7.5% and 10% for the intervention and placebo groups respectively (P value =.71), 15% and 12.5% at 1-year (P value =.83), and 25% and 27.5% at 2-year (P value =.98). Based on the Cox regression model, only age was significantly associated with mortality (HR = 1.229, P value <.001). Significant HHS changes from baseline through 24 months after surgery were observed within both groups; however, mean differences were not significantly different between groups. Conclusions: A single preoperative 300,000 IU VitD did not significantly impact 2-year survival and HHS in patients with intertrochanteric fractures and sufficient serum VitD level. [ABSTRACT FROM AUTHOR]

Purpose: Skilled nursing facility (SNF) care has historically been influenced by systemic issues that could impact speech-language pathology (SLP) service provision. However, there has been little study specifically on factors associated with SLP service provision in SNFs. Large administrative data sets are rarely analyzed in SLP research but can be used to understand real-world SLP services. This study investigated associations between patient and facility characteristics and SLP services. Method: Mixed-effects logistic regression models were used to evaluate factors associated with SLP service provision in 2018 Medicare administrative data representing 833,653 beneficiaries. Results: Beneficiaries had higher odds of receiving SLP services when they had neurologic diagnosis (odds ratio [OR] = 3.32), had SLP-related functional impairments (ORs = 1.19-3.41), and received other rehabilitative services (ORs = 3.11- 3.78). Beneficiaries had lower odds of receiving SLP services when they received care from SNFs located in hospitals versus freestanding (OR = 0.45), with need for interpreter services (OR = 0.76) and with thresholding (OR = 0.68), a financially motivated practice. Direction of association varied across racial and ethnic groups and measures of location. Odds of being provided SLP services decreased with increasing communication impairment severity. Conclusions: The results suggest that clinicians are identifying patients with diagnoses most likely to warrant SLP services. However, association disparities and weakening association of service provision with increasing impairment severity have concerning clinical implications. Health services research methods can be used to further explore SLP practices in SNFs to support equitable service provision. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study was conducted to examine the possible aetiology of nocturia in patients with long‐term COVID‐19. Background: Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID‐19, 10–14 weeks after the illness. Design: A descriptive design. Methods: The study consisted of 70 patients who had experienced COVID‐19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist. Results: When the nocturia effects of long‐term COVID‐19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p <.05). According to post‐hoc analysis, the mean age of patients with a dominant cardio‐metabolic factor was found to be significantly younger (p <.05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p <.05). Conclusions: It was found that the urinary tract aetiological factor was dominant in patients with long‐term COVID‐19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor. Relevance to Clinical Practice: Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post‐COVID‐19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia. Patient or Public Contribution: The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID‐19 infection. [ABSTRACT FROM AUTHOR]

This document analyzes a survey conducted in three geographical areas in Spain, focusing on centers for individuals with cerebral palsy (CP). The study aims to determine the adherence rate to recommended physical activity guidelines, assess if there is a decline in interest in physical activity over time, identify the stage at which this decline occurs, and explore potential mechanisms, tools, or strategies to sustain long-term engagement in regular physical activity for this population. The 36-item questionnaire comprises multiple-choice, open-ended, and Likert scale-type questions. Data were collected on physical activity frequency and duration, daily living activities, and demographics. Statistical analysis identified patterns and relationships between variables. Findings reveal that only a 17.6% meets the World Health Organization (WHO) recommendations regarding regular physical activity (RPA), decreasing in frequency or number of days a week, (3.7 d/w to 2.9 d/w; p < 0.01) and duration (50.5 min/d to 45.2 min/d; p < 0.001) with age, especially for those with higher Gross Motor Function Classification System (GMFCS) mobility levels. Obesity slightly correlates with session duration (ρ = −0.207; p < 0.05), not mobility limitations. Gender has no significant impact on mobility, communication, or physical activity, while age affects variables such as body mass index (BMI) and engagement (p < 0.01). A substantial proportion follows regular physical activities based on health professionals' advice, with interest decreasing with age. To improve adherence, focusing on sports-oriented goals, group sessions, and games is recommended. These findings emphasize the importance of personalized programs, particularly for older individuals and those with greater mobility limitations. [ABSTRACT FROM AUTHOR]

Background: Current classification systems for intra-articular pathology intraoperatively have been described for patients with femoroacetabular impingement rather than dysplasia. Purpose: To (1) describe intra-articular findings in dysplastic hips undergoing combined hip arthroscopy and periacetabular osteotomy (PAO); (2) propose a new chondrolabral classification system for dysplastic hips based on these findings; and (3) correlate patient-reported outcome measures (PROM) with the newly proposed classification. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 hips underwent combined hip arthroscopy and PAO at our institution between September 2013 and December 2014, irrespective of symptoms or radiographic findings. PROMs were evaluated preoperatively and at 2 years postoperatively. At the time of hip arthroscopy, the chondrolabral junction was classified as normal without tear (1 hip, type 1); hypertrophic labrum without chondrolabral disruption (19 hips, type 2); chondrolabral disruption on the articular side, not extending into the capsular side (16 hips, type 3A); chondrolabral disruption extending through the capsular side (3 hips, type 3B); and exposed acetabular subchondral bone (7 hips, type 4). Results: There was a significant difference in postoperative modified Harris Hip Score (mHHS) (P =.020), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores (P =.037), and WOMAC total scores (P =.049) between chondrolabral junction types. Post hoc analyses demonstrated significant differences between type 2 (84.9 ± 12.9) and type 3A (67.8 ± 20.7; P =.198), and between type 2 and type 4 (59.3 ± 24.3; P =.011) in postoperative mHHS scores; and between type 2 (83.9 ± 12.9) and type 3A (68.9 ± 23.7; P =.045) in postoperative WOMAC total scores. In multivariate analysis, chondrolabral type 3 or type 4, age >35 years, and previous surgery were significantly correlated with worse mHHS scores at 2 years. Conclusion: This new chondrolabral classification is proposed to describe intra-articular pathology seen during combined hip arthroscopy and PAO, specifically in dysplastic hips. More advanced chondrolabral disease was associated with worse PROMs at 2 years. [ABSTRACT FROM AUTHOR]

BACKGROUND: Polypharmacy, or the use of 5 or more daily medications, is common in adults with multiple sclerosis (MS), and is often due to various physical, cognitive, and emotional symptoms. However, research regarding the association between polypharmacy and cognitive outcomes in MS is sparse. Furthermore, individuals with MS often use medications with anticholinergic properties, which are commonly associated with cognitive impairment and other central nervous system adverse effects. Currently, the utility of scales measuring anticholinergic burden in MS is unknown. This study aims to investigate the relationship between polypharmacy, anticholinergic burden, and objective cognitive performance in MS. METHODS: We recruited 90 individuals with MS during routine visits at an MS specialty clinic in Kansas City. Participants completed a brief, virtual cognitive assessment and answered questions about their health. Participants provided their medication lists from which we determined polypharmacy and scores on several anticholinergic burden scales. Statistical analyses included Spearman correlations and linear regression models. RESULTS: Approximately 44% of the individuals surveyed met the criteria for polypharmacy. The number of daily medications was negatively correlated with cognitive performance (rs = -0.45, P < .001). Further, the Drug Burden Index accounted for additional variance in cognitive performance beyond that explained by age, education, MS disease duration, and comorbidities [ΔR2 = .12, F(5, 84) = 7.84, P < .001.] CONCLUSIONS: Clinicians should consider the possible negative consequences of polypharmacy when addressing cognitive concerns in MS. Anticholinergic burden scales may be valuable in this regard. Future investigations could explore behavioral and pharmacological interventions aimed at reducing polypharmacy in MS [ABSTRACT FROM AUTHOR]

(1) Background: this study aimed to assess the physical activity of obese pediatric patients under specialized outpatient care and its potential determinants. (2) Methods: A total of 83 subjects aged 7–18 years with simple obesity and their parents were enrolled. Data were collected with the use of physical activity questionnaires (PAQs) for children and adolescents and additional questions concerning selected socio-demographic characteristics. (3) Results: The mean final PAQ score was 2.09 ± 0.69. The most frequently chosen types of physical activity included walking, gymnastics, and jogging or running. We found a weak correlation inversely proportional between the child's age and mean final PAQ score (r = −0.25; p = 0.02). Younger children were more active during lunchtime at school and after school compared to adolescents (p = 0.03 and p = 0.04). The final PAQ score differed according to the place of residence; the lowest score was obtained by subjects living in cities >100,000 inhabitants (p = 0.025). We found a positive correlation between PAQ-Ch score and the father's physical activity, and between PAQ-A score and the mother's education. (4) Conclusions: The physical activity of obese pediatric patients is low, particularly in adolescents. It seems that age and place of residence have an impact on the physical activity of obese children and adolescents. The PAQs used in this study are useful in physical activity assessment and identification of time segments during the day in which activity might be improved. However, this requires confirmation in a larger group of pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Urban slum dwellers face significant challenges, including overcrowded living conditions, inadequate access to basic necessities, and limited socio-economic opportunities, which adversely affect their mental health. Despite the high prevalence of mental health issues in slum populations, there is a dearth of research addressing this aspect of well-being. Aim: This study aimed to investigate the social determinants and predictors of mental health among urban slum dwellers in Rohtak, Haryana, India. Material and Methods: The study employed a cross-sectional design to examine mental health status and predictors among urban slum dwellers in District Rohtak, Haryana. Using simple random sampling, 301 subjects from the slum area were selected, ensuring demographic representation. A socio-demographic data sheet, the Modified Kuppuswamy scale, and the Mithila Mental Health Status Inventory were administered. Results: The findings revealed a moderate level of mental health challenges among urban slum dwellers, with age, gender, education, occupation, family income, and socioeconomic status identified as the strongest predictors of mental health (F = 7.69, p < .001), accounting for 29.9% of the variance. The remaining variance is attributed to variables not included in the study. Conclusion: This study sheds light on the social determinants and predictors of mental health among urban slum dwellers in Rohtak, Haryana, India. The findings underscore the significant impact of socio-demographic factors such as age, gender, education, occupation, family income, and socioeconomic status on mental health status. [ABSTRACT FROM AUTHOR]

The use of single-item measures of self-rated mental health (SRMH) has been increasingly valued in epidemiologic research. However, little is known about the reliability and mental health correlates of SRMH in Chinese populations. This study examined the reliability and mental health correlates of SRMH in three Chinese samples. We analyzed data collected from two convenience samples of Chinese adults from Hong Kong and/or Taiwan (Sample 1: N = 205; Sample 2: N = 377), and a random sample of Taiwan psychiatric inpatients (Sample 3: N = 100). Our results showed that the single-item measure of SRMH had moderate to good test–retest reliability (intraclass correlation [ICC] = 0.75) in Sample 1 and acceptable reliability between the self-report and interviewer-administered versions (ICC = 0.58) in Sample 3. It had a high positive correlation with self-esteem and a moderately high negative correlation with depression. It also had a consistently negative correlation with borderline personality disorder symptoms and post-traumatic stress disorder symptoms. The SRMH score was also associated with psychiatric service usage. These findings contribute to the body of knowledge regarding the use of a single-item measure of SRMH to assess overall self-perceived mental health in Chinese communities. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic. Methods: In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n = 30) and experimental (n = 30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training. Results: There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index. Conclusion: Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The current study aimed to examine internalized stigma and its psychosocial factors among people with severe mental illness in China. A cross-sectional study was performed with 202 adults diagnosed with schizophrenia, bipolar disorder, or schizoaffective disorder in Beijing, China. Participants were evaluated using the Chinese version of the Internalized Stigma of Mental Illness (ISMI) scale, Perceived Devaluation and Discrimination scale, and the Medical Outcomes Study Social Support Survey. Correlation analysis and multiple linear regression analysis demonstrated that 19.8% of participants had moderate-to-high ISMI scores, whereas the sample as a whole indicated a mild level of internalized stigma. A higher level of internalized stigma was associated with greater perceived discrimination, lower social support, lower family income, older age, and distancing coping. These factors may be important to consider for developing tailored interventions in the future. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 37–44.] [ABSTRACT FROM AUTHOR]