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This paper highlights the tight relationship between the picking and packing processes in warehouse management and the need to consider them as an integrated problem. The study describes and models this integrated problem as a mixed-integer programming model, to optimise overall labour costs by determining the assignment of the subsets of orders, i.e. batches, for picking and packing. To address the issue of model complexity, the paper presents a statistical-based framework for generating approximate models and selecting the optimal one through examination. Based on the examination results, a pair-swapping heuristic is additionally proposed to be combined as a hybrid algorithm. Numerical experiments based on a real-world case demonstrate the effectiveness of the framework-proposed and selected hybrid algorithm by comparison with other framework-proposed approximate models, a solver, and existing heuristics. Our findings indicate that the combined usage of integrated picking and packing processes planning and the hybrid algorithm proposed and selected within the statistical-based framework can effectively reduce the cost of warehouse management. [ABSTRACT FROM AUTHOR]

This study aims to investigate the relationship between written and oral reasoning in an undergraduate chemistry laboratory course as part of an argument-based inquiry approach, which is also a generative learning environment, known as the Science Writing Heuristic (SWH). The study employed the data-transformation variant of convergent design of mixed-method research. Data sources included 180 laboratory reports from nine Pre-service Science Teachers (PSTs) and 20 video recordings across two semesters. Using Walton's argument schemes, PSTs' development, utilisation and correlation of written and oral reasoning and an argument cycle of premise-justification-conclusion were examined. A Friedman test and a Spearman-Brown correlation were conducted for statistical analysis. The results revealed that there is a positive correlation between written and oral reasoning. While the quality of PSTs' written reasoning significantly increased from the first time phase to the following time phases, this pattern was not observed in oral reasoning. An argument cycle of premise-justification-conclusion occurred in each phase of oral arguments. However, this cycle did not occur in every facet of the SWH process across all time phases in written arguments. The study suggests that pre-service science teachers should be provided with learning environments that will allow them to make external evaluations and engage in talking, reading and writing activities for learning purposes. [ABSTRACT FROM AUTHOR]

The aim of this study was to adapt the Facioscapulohumeral Muscular Dystrophy – Health Index (FSHD-HI) to an Italian population affected by FSHD by translating, validating, and testing this instrument in an Italian cohort. Italian FSHD patients were interviewed regarding the form and content of the translated instrument. Subsequently, forty FSHD patients were recruited to test the reliability (Intraclass Correlation Coefficient, ICC for test-retest; and Cronbach's Alpha for Internal consistency), known groups (Mann-Whitney U test and Area Under the Curve, AUC) and concurrent validity (Pearson's and Spearman's Rank Correlation Coefficient) of the instrument by serially completing the FSHD-HI and an extensive set of tests measuring the neuromotor, psychological and cognitive functions, and perceived quality of life (QoL) aspects. The Italian translation of the FSHD-HI and its subscales were highly relevant to patients, had a high internal consistency (Cronbach's Alpha = 0.90), optimal test-retest reliability (ICC= 0.95), and was significantly associated with motor function, respiratory function, and QoL assessments. Overall, the Italian FSHD-HI is a valid and well-suited measurement of the multi-dimensional aspects of disease burden in FSHD patients. Facioscapulohumeral muscular dystrophy (FSHD) negatively impacts the quality of life and increases the disease burden. It is important for the clinical community to have a valid instrument that can serially measure a patient's perception of their multifactorial disease burden in FSHD. The Facioscapulohumeral Muscular Dystrophy – Health Index (FSHD-HI) is a valid instrument that allows patients to provide their perspective regarding their current health state. FSHD-HI-IT provides a valid option for measuring multifactorial disease burden in Italian patients with FSHD during clinical trials. [ABSTRACT FROM AUTHOR]

Orthotic devices may be prescribed for the management of foot and ankle deformities caused by Charcot-Marie-Tooth disease (CMT). However, the actual use of these devices is variable. No studies have evaluated the impact of prescription, delivery and follow-up of orthotic devices on their use. We aimed to describe the relationship between the pathways followed by individuals with CMT and orthotic device use. Exploratory, cross-sectional, 35-item survey of orthotic device management. Individuals with CMT were recruited from CMT-France Association. Of the 940 respondents, 795 were included, mean age of 52.9 (SD 16.9) years. Rate of orthotic device use was 49.2% (391/795). The most frequent reason for non-use was a poor fit. Non-use was related to the orthotic device type, the health professionals consulted, and the severity of the CMT-related impairments. Follow-up visits (38.7%), re-evaluation of orthotic devices (25.3%) and consultations with the Physical and Rehabilitation Medicine physician were infrequent (28.3%). Orthotic devices are massively underused. Follow-up and re-evaluation are infrequent. Care pathways, prescription and delivery of orthotic devices must be optimized to meet the expectations of people with CMT. Device fitting, individual needs, and changes in the clinical state must be re-evaluated regularly by specialists to improve orthotic device use. Foot deformities and foot drop contribute to disability in people with Charcot Marie Tooth Disease but use of orthotic devices is poor. To improve orthotic device use, regular multidisciplinary consultations and regular re-evaluation of the device by specialists in neuro-orthopaedics are important. The device fit should be regularly re-evaluated by the prescribing doctor or the practitioner who made the device. Regular multimodal evaluation of foot deformity, including muscle strength and length, and the individual's needs and expectations is also important to improve orthotic device use. [ABSTRACT FROM AUTHOR]

The research investigates the validity of the complete quadratic combination (CQC) method. A new approach is proposed in order to consider the effect of modal correlation more accurately than the CQC method. Statistical analysis indicates that the error in the estimation of modal correlation could be reduced compared to the CQC method. This method is especially more accurate in higher frequency ratios where the role of interaction between modes in the seismic response is noticeable. Statistical analysis reveals that the proposed method is more precise, especially for far-field records. Meanwhile, the proposed method is not sensitive to different site classes. [ABSTRACT FROM AUTHOR]

Introductory undergraduate statistics courses widely focus on statistical concepts or software-based data analysis. Despite the fact that the analysis of real data has shown to enhance students' engagement, the step of data collection is often neglected. Once students know the challenges of data collection, they are more aware of potential imperfections, such as a lack of representativeness, during data analysis. In this paper, we present a course that closes the gap allowing Business and Economics students to conduct a full survey under realistic conditions including questionnaire design, sampling, and data analysis. It entangles theory and application by combining course-based research experiences with cooperative learning and a flipped classroom approach. Students do not only obtain competences in the field of statistics, they also gain experiences and self-confidence for future research projects because the lecturer acts as a mentor guiding the students throughout the project. Although statistics is usually an unpopular field for Business and Economics students, their motivation was high throughout the semester as they acted as researchers who analysed a specific research question. This is in agreement with student feedback, which highlights the promotion of research-related competences and self-efficacy within the course. [ABSTRACT FROM AUTHOR]

Based on the relevant statistical data of 30 Chinese provinces from 2007 to 2020, the spatial spillover effect of the impact of financial development on the capitalization of hog farming was analysed by establishing a spatial Durbin model based on the capitalization of hog farming in China.The results show that the level of regional financial development has a facilitating effect on the capitalization of hog farming.Meanwhile, the results of decomposition effects show that the regional financial development level has a negative spillover effect on capitalized farming of hogs.The reason for this negative externality may be the siphoning effect of the developed financial industry areas on the capital and non-fixed farming factors in the surrounding areas. [ABSTRACT FROM AUTHOR]

Competency-based medical education relies on a strong program of assessment, and quality comments play a vital role in ensuring its success. The goal of this study is to determine the effect of the timeliness of assessment completion on the quality of the feedback. Using the Quality of Assessment for Learning (QuAL) score 2478 assessments were evaluated. The assessments included those completed between July 2017 and December 2020 for 18 ophthalmology residents. Spearman correlation, Mann–Whitney U and Kruskal–Wallis tests were used to assess variations in QuAL scores based on the timeliness of assessment completion. The timeliness of assessment completion ranged from 0 to 299 d with the mean time for completion being 3 d. As the delay increased, the QuAL score decreased. Feedback provided 4, 5, and 14 d post-encounter demonstrated statistically significant differences in the QuAL score. Additionally, there was a significant difference in the timeliness of feedback when there is no written comment. This study demonstrates that the timeliness of assessment completion might have an effect on the quality of written feedback. Written feedback should be completed within 14 d of the encounter to optimize quantity and quality. [ABSTRACT FROM AUTHOR]

This study compared three ethnic/racial groups of informal cancer caregivers on social determinants of health and tested social determinants of health as predictors of psychological distress and caregiver burden. This study was a secondary analysis of baseline data of a sequential multiple assignment randomized trial (SMART) testing symptom management interventions with caregiver-survivor dyads. Caregivers completed baseline measures of social determinants of health (SDoH), functional limitations, psychological distress, and caregiver burden. Hispanic, non-Hispanic White, and non-Hispanic other races caregivers were compared on these variables. Multivariate tests of associations between SDoH and caregiver burden and psychological distress were conducted in structural equation modeling with caregiver burden and psychological distress as latent variables. Hispanic caregivers reported significantly higher caregiver burden, specifically for finances, family, and schedules. Caregiver burden was significantly predicted by having income barely or not meeting needs, being female, socially isolated, married, Hispanic, and having poor physical functioning. Significant predictors of caregivers' psychological distress: being female, being socially isolated, and having poor physical functioning. Hispanic caregivers experience significant challenges associated with caregiver burden, especially if they are female, socially isolated, and have poor physical functioning. Assessment of these SDoH is important in caregiver health to provide supportive care during caregiving. NCT03743415 . [ABSTRACT FROM AUTHOR]

Traffic enforcers are exposed to various occupational health and safety hazards, including noise pollution, which may lead to occupational hearing loss. This cross-sectional study aimed to estimate the prevalence of hearing loss and to assess the relationship between occupational noise exposure level (ONEL) and abnormalities in air conduction thresholds among Metropolitan Manila Development Authority (MMDA) employees along Epifanio delos Santos Avenue, Philippines. Eight-hour ONELs were measured among 108 participants working with greater than 5 years of service. Participants had hearing evaluations using pure tone audiometry (PTA) to calculate the prevalence of hearing loss. Generalized linear models with a Poisson distribution were fitted to estimate the association between ONEL and audiologic abnormalities, controlling for confounding factors. Approximately 16% of employees had hearing loss. The prevalence of hearing loss was higher with ONEL exposures greater than 85 A-weighted decibels (dBA), with traffic enforcers exposed to higher ONELs than office workers. ONELs greater than 85 dBA were related to audiologic abnormalities at different frequencies in PTA. The prevalence of audiologic abnormalities at 4000 Hz and 6000 Hz was 48% higher (adjusted prevalence ratio [aPR], 1.48; 95% CI, 1.12–1.96) and 25% higher (aPR, 1.25; 95% CI, 1.00–1.55), respectively, among participants with ONELs greater than 85 dBA than with ONELs less than or equal to 85 dBA. Participants exposed to ONELs greater than 85 dBA, more likely traffic enforcers, may have increased risk of audiologic abnormalities. Regular ONEL monitoring is warranted for occupational risk assessment of traffic enforcers. A hearing conservation program may need to be considered for this population. Additional studies are needed to determine trends in hearing deterioration among traffic enforcers. [ABSTRACT FROM AUTHOR]

The use of routinely collected electronic healthcare records (EHR) for outcome assessment in clinical trials has been described as a 'disruptive' new technique more than a decade ago. Despite this potential, significant methodological issues and regulatory barriers have hampered the progress in this area. This article discusses the key considerations that trialists should take into account when incorporating EHR into their trials. These include considerations of the clinical relevance of the outcome, data timeliness and quality, ethical and regulatory issues, and some practical considerations for clinical trials units. In addition, this article describes the benefits of using EHR which include cost, reduced trial burden for participants and staff, follow up efficiencies, and improved health economic evaluation procedures. We also describe the major regulatory and start up costs of using EHR in clinical trials. This article focuses on the UK specific EHR landscape in clinical trials and would help researchers and trials units considering the use of this method of outcome data collection in their next trial. If the issues described are mitigated, this method will be a formidable tool for conducting pragmatic clinical trials. [ABSTRACT FROM AUTHOR]

To evaluate differences in tinnitus impact, hyperacusis and hearing threshold level (HTL) between patients with unilateral and bilateral tinnitus. For patients with unilateral tinnitus, to compare audiological variables for the tinnitus ear and the non-tinnitus ear. To assess whether the presence of unilateral tinnitus increases the likelihood of interaural hearing asymmetry (relative to bilateral tinnitus) that warrants referral for an MRI scan. Retrospective cross-sectional. Data regarding HTLs and responses to self-report questionnaires were collected from the records of 311 patients attending a tinnitus clinic. 38.5% had unilateral tinnitus and the ears with tinnitus had higher HTLs and greater HTL slopes than the ears without tinnitus. There was no significant difference in tinnitus impact and hyperacusis between patients with unilateral and bilateral tinnitus. 40% of patients with unilateral tinnitus and 13% of patients with bilateral tinnitus had a between-ear difference in HTL ≥15 dB at two adjacent frequencies (2AF15 asymmetry). Unilateral tinnitus increased the risk of 2AF15 asymmetry by a factor of 4.4. Unilateral tinnitus increases the risk of having interaural asymmetry in HTLs that warrants referral for an MRI scan. [ABSTRACT FROM AUTHOR]

Currently, the variety of speech recognition tests used to evaluate cochlear implant (CI) recipients makes it difficult to compare results, especially across languages. The Matrix Test limits contextual cues and is available in multiple languages, including American English. The current study investigated test format and noise type for the American English Matrix Test (AMT) and compared results to AzBio sentence scores in adult CI recipients. Fifteen experienced CI recipients were administered the AMT in fixed- and adaptive-level formats and AzBio sentences in a fixed-level format. Testing in noise used the AMT-specific noise and 4-talker babble. Ceiling effects were present for all AMT fixed-level conditions and AzBio sentences in quiet. Group mean AzBio scores were poorer than AMT scores. Noise type affected performance regardless of format; 4-talker babble was more challenging. The limited number of word choices in each category likely aided listeners performance for the AMT compared to AzBio sentences. The use of the AMT in the designed adaptive-level format would allow effective evaluation and comparison of CI performance internationally. A test battery with the AMT may also benefit from including AzBio sentences in 4-talker babble to reflect performance during listening challenges. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of environment-based intervention on participation outcomes and parent efficacy in autistic children. Twenty-one autistic children 6–10 years old and their parents were randomized to environment-based intervention (n = 11) or usual care (n = 10). The environment-based intervention targets individualized participation goals in leisure and community activities through changing environment and activity demands. The study outcomes were Canadian Occupational Performance Measure (COPM), Goal attainment scaling (GAS), and Parent Empowerment and Efficacy Measure (PEEM). Assessments included baseline, 12 weeks (post-test), and 24 weeks (follow-up). Mixed ANOVAs were used to examine within-group and between-group effects in outcome variables. The COPM performance and satisfaction scores and GAS T-scores increased after environment-based intervention from baseline to 12 weeks and 24 weeks (p < 0.001) but did not significantly differ from usual care. The medium to large effect sizes of COPM performance and GAS T-scores favored the environment-based intervention. For the PEEM scores, no significant differences were found. Environment-based intervention may support school-age autistic children to participate in self-chosen activities over time. The intervention effects on participation goals and parent efficacy, however, were inconclusive and need further research. Environmental barriers are important attributes to participation restriction in autistic children. Interventions focusing on modifying the task and environment is viable in supporting the participation of autistic children. The environment-based intervention appears to improve the participation goals in leisure and community-based activities over time. The environment-focused strategies may include providing social support, enabling access to a sensory-friendly environment, finding inclusive programs, adapting task demands, and managing routines. [ABSTRACT FROM AUTHOR]

This study aimed to compare stigma levels after acquired brain injury (ABI) and spinal cord injury (SCI) during the first 12-months post-discharge and investigate relationships between stigma, psychological distress and community integration. 110 adults with ABI (55%) or SCI (45%) were recruited from brain and spinal cord injury inpatient rehabilitation units of a tertiary healthcare facility. They were administered Neuro-QOL Stigma subscale and Depression Anxiety and Stress Scales (DASS-21) at discharge, 3-months and 12-months post-discharge, and Community Integration Measure at 12-months post-discharge. Stigma levels did not significantly differ between individuals with ABI and SCI. However, stigma significantly decreased between discharge and 12-months post-discharge for the total sample. Stigma was positively associated with psychological distress at discharge and 3-months post-discharge, but not at 12-months post-discharge. Lower functional status and power wheelchair use were associated with higher stigma at 12-months post-discharge. Stigma at 3-months post-discharge predicted community integration at 12-months post-discharge, controlling for psychological distress and functional status. Experience of stigma in the first few months post-discharge may negatively impact individuals' community reintegration. The early post-discharge period may be a pivotal time for supporting individuals to explore disability and injury-related appraisals and enhance connection to their community. Lower functional status and use of a power wheelchair after acquired neurological injury may increase the experience of stigma. Individuals with acquired brain injury or spinal cord injury who perceive high levels of stigma in the first few months post-discharge are more likely to experience poorer long-term community integration. The first few months post-discharge represent an important phase for health professionals to support individuals to explore their beliefs regarding disability and injury-related self-appraisals and enhance connection to their community. [ABSTRACT FROM AUTHOR]

To explore the effects of customized 3D-printed assistive technology (AT) on functional performance and feasibility in patients with neurological impairment. Patients with neurological impairment were recruited and randomized into customized 3D-printed assistive device group (group 1; n = 17) or standard device group (group 2; n = 14). The device was designed to assist their writing, spoon using, and typing. Each patient underwent 4-week intervention with the device (30 min per session, twice a week). We observed significant differences in shoulder abduction (p =.00), external rotation (p =.01), and internal rotation (p =.02) in group 1. And significant differences in abduction (p =.05) and external rotation (p =.05) between the 2 groups. Group 1 achieved significant improvements in writing without AT (p =.04) and with AT (p =.02), spoon use without AT (p =.02) and with AT (p =.03), and hemiplegia-side typing with AT (p =.00). Group 2 achieved significant improvements in writing without AT (p =.01), hemiplegia-side typing without AT (p =.01), and bil-side typing with AT (P =.05). Moreover, no significant differences were noted in other outcome measures. This study demonstrated that customized 3D-printed AT can improve shoulder active motion for patients with neurological impairment. A positive effect in functional hand tasks after AT intervention. Offering customized AT with specific training could enhance the efficacy of interventions. The feasibility of using 3D printing technology to produce customized AT, which has the potential to be cost-effective and efficient. 3D-printed assistive device incorporating a splint can improve shoulder active motion compared to conventional assistive device for patients with neurological impairment. A positive effect in functional hand tasks after assistive device intervention. [ABSTRACT FROM AUTHOR]

The IndieTrainer system, comprised of both a mobility device and gamified training modules, was developed to aid powered wheelchair (PWC) skills acquisition in children with cerebral palsy (CP). The aims of this small-scale study are to: explore use of the IndieTrainer system to improve PWC skills in children who have CP and document parental/caregiver perceptions of, and satisfaction with, the IndieTrainer system. This small-scale study is an open-label single-arm clinical trial involving a three-week PWC training intervention consisting of two 60-minute training sessions per week. A single session retention trial will be held four weeks after the completion of the intervention period. All research activities will take place in-person in a laboratory-based setting located within a university. Twenty-five child-parent/caregiver dyads will participate in the study. Each child participant will be 3 to 21 years of age and have a diagnosis of CP or other similar condition. The Assessment of Learning Powered mobility use will be the primary outcome measure. Secondary outcome measures will include the Wheelchair Skills Checklist, the Canadian Occupational Performance Measure, the Customer Satisfaction Questionnaire-8, and a qualitative interview. Data analyses will involve one-way repeated measures ANOVAs followed by paired samples t-tests with Bonferroni adjustments. The IndieTrainer system allows children to explore and use power mobility in their own manual wheelchair and was designed to meet the needs of power mobility learners across the continuum of learning. It is the first PWC training system to optimize learning for early learners who do not yet understand cause and effect concepts. The IndieTrainer system is designed to meet the needs of power mobility learners across the continuum of learning. This protocol outlines a novel means of providing progressive power mobility training. The IndieTrainer was designed to expand power mobility access to children with cerebral palsy, a previously underserved population. [ABSTRACT FROM AUTHOR]

To reduce the burden of Alzheimer's disease, the use of assistive technologies for patients and their informal caregivers is considered essential. However, these technologies are made as "one size fits all" instead of being tailored to accommodate people with varying degrees of cognitive impairment and those with diverse races/ethnicities. Thus, the aim of this survey was to determine whether the types of assistance needed most, and the technology used by those with cognitive impairment differed by race (White/non-Hispanics, Black or African Americans, and Hispanic/Latinos or Puerto Ricans) and severity of dementia (mild, moderate, severe). One hundred and eighty informal caregivers of people with different levels of severity of cognitive impairment and several different races/ethnicities filled out an online survey regarding assistance needed and technologies used. The results show that racial minorities considered the needs for assistance with Basic Activities of Daily Living as more important compared to White/non-Hispanics with mild dementia. Furthermore, Hispanic/Latinos or Puerto Ricans and White/non-Hispanics with severe dementia were shown to use technology that is designed to help with Instrumental Activities of Daily Living more than those with moderate dementia. Lastly, during COVID-19, devices to assist with walking, preparing meals and personal hygiene have been used significantly more by White/non-Hispanics with severe dementia compared to Hispanic/Latinos or Puerto Ricans. The results point to the need to design for those with severe dementia, regardless of race, and should focus on addressing needs related to both Instrumental and Basic Activities of Daily Living. Developers of assistive technology should consider designing technology that can accommodate all severity levels of cognitive impairment. More research is needed to determine the usability of assistive technology that is designed for those with cognitive impairments. [ABSTRACT FROM AUTHOR]

To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition. Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology. Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies. Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use. Using mobile electronic devices (smartphones and tablets) is common after acquired brain injury (ABI) but is challenging for a significant proportion of individuals. After the ABI, close to 50% of individuals receive support in using their mobile device, mostly from family members and friends, but rarely from rehabilitation clinicians or technology specialists. In a sample of 50 adults with ABI, more frequent use of mobile devices to support cognition was associated with poorer subjective memory and executive functioning, greater use of memory strategies, more positive perception of the psychosocial impacts of technology, and younger age. [ABSTRACT FROM AUTHOR]

Current trends among college students include compromised mental health and wellness which have been exacerbated due to COVID-19. This pilot study examined the effectiveness of a brief, digital intervention focused on social wellness among college students on wellness-related outcomes including perceived wellness, life satisfaction, and happiness. A longitudinal, explanatory mixed-methods design was utilized. Quantitative data were collected from a total of 133 participants using questionnaires at baseline and one-week post-intervention. RM-ANOVA and post-hoc pairwise comparisons were employed to assess quantitative data. Qualitative data collection was obtained via semi-structured interviews at six weeks post-intervention and evaluated using Applied Thematic Analysis. A sub-sample (n = 23) from the participant pool (N = 133) completed the interviews. Results indicated intervention effectiveness as participants experienced significant positive change in perceived wellness, the primary outcome variable. Significant relationships were detected between wellness outcomes and goal attainment (e.g. I am confident in my ability to complete my goals) items. Qualitative analysis revealed themes related to accessibility and convenience of the intervention, increased self-awareness, and increased intentionality of participants. This study demonstrates the utility of a brief, digital intervention on wellness-related outcomes. Benefits were shown of a preventative, self-directed and solution-focused approach in enhancing wellness among college students. From a social work perspective, employing a salutogenic approach to support college students' wellbeing aligns with the field's core values. Specifically, this social wellness-focused intervention encourages self-determination, dignity and worth of the person, and emphasizes the importance of human relationships. [ABSTRACT FROM AUTHOR]

No known published empirical study in the social work literature has investigated goal-related feedback seeking's direct or indirect impact on human service case managers. Consequently, this field survey study sought to fill this gap in the extant literature using two different samples of county-based human service case managers across the state of New York. Four hundred and sixty-three public assistance and 349 child welfare case managers were surveyed in order to test goal-related feedback seeking's main and receiving goal-related feedback's mediating effect on internal work motivation. Data from each sample confirmed both types of effects. As the first to uncover these two sets of findings, this field survey study makes a unique contribution to the social work and feedback seeking literatures. [ABSTRACT FROM AUTHOR]

For users to adopt information systems, they must develop trust in such systems. Even though trust theories consistently define trust as dynamic, the development of trust over time has received little empirical attention. The present study examined the development of trust in a newly introduced information system and its association with antecedents related to the individual (e.g. disposition to trust), the information system (e.g. reliability), and the context (e.g. support) at different time points. We further assessed users' reliance, performance, and well-being as outcomes of trust. Employees (N = 313) of a German public university assessed a newly introduced invoice processing system on four occasions (before system launch, after initial use, five months after launch, ten months after launch). Results from latent growth curve modelling show a non-linear increase of trust in the information system over time with changing predictors: Person factors were stronger predictors of trust in early phases, whereas system characteristics were stronger predictors later in the process. Moreover, users' trust in the information system correlated positively with reliance, performance, and well-being. Our results highlight the central role of trust for the successful adoption of information systems at work, and offer specific suggestions for their building and maintenance. [ABSTRACT FROM AUTHOR]

Computer-supported collaborative learning (CSCL) seeks to improve students' learning with the support of technology. Although CSCL facilitates an enriching environment for cooperation, CSCL activities might be affected by asymmetrical participation. Group awareness tools have proven to enhance learners' interactions, balancing the levels of participation and increasing the learning outcomes. This study investigates the effect of a group awareness tool (GAT) on participation within synchronous CSCL activities in the context of extracurricular activities. We designed a quasi-experimental within-subject study (GAT exposure and control condition) and tested an ad hoc GAT in a web-based CSCL platform with high school students (N = 140). The measured variables included the effect of the GAT on students' participation and the quality of discussion. A complementary analysis evaluated students' perceptions of the tool. Results revealed that the implementation of a GAT encourages students to take part in CSCL discussions without explicitly hindering its quality. Even so, the balance of participation was not significantly affected. Students further reported that they found the GAT useful to regulate collaboration. The results from the study provide further knowledge of the functioning of group awareness tools in secondary education and share an insight into how students perceive them. [ABSTRACT FROM AUTHOR]

Physical activity levels are low in cancer survivors. Remotely delivered programs which harness wearable technology may potentially be beneficial. To evaluate the feasibility and preliminary efficacy of a remotely delivered, physical activity intervention which harnessed wearable technology. This single arm pre-post longitudinal study included cancer survivors who had completed treatment in the preceding 3 years. Participants were supplied with a Fitbit One® or Flex® for 12 weeks. Physical activity goals were discussed during support phone calls. Outcome measures, assessed at baseline (T1), 12 weeks (T2), and 24 weeks (T3), included feasibility (recruitment, adherence, safety, acceptability) and efficacy [physical activity (Godin leisure time Index, ActiGraph GT3X+), quality of life (functional assessment of cancer therapy – general, short form 36 physical functioning component), functional capacity (six-minute walk test)]. Forty-five participants completed T1 assessments (10 males, 35 females). Thirty-nine (86.6%) of those underwent assessment at T2 and 31 (68.8%) at T3. The intervention was perceived positively with no adverse effects. There were increases in functional capacity (six-minute walk test, p =.002) between T1-T3, an increase in quality of life [short form 36 physical functioning measure (p =.0035), functional assessment of cancer total score (p =.02)] and self-report physical activity levels (p =.000123) between T1-T2, although effect sizes were generally low (d = 0.180 to d = 0.418). Objectively measured physical activity did not change. A physical activity intervention including wearable technology was safe, feasible, and well received by cancer survivors. An intervention based on this proof of concept should be followed up in further studies. [ABSTRACT FROM AUTHOR]

The Osteoarthritis Research Society International has recommended a core set of performance-based tests of physical function for use in knee osteoarthritis (OA) patients. The core set includes 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40-m FPWT), and a stair climb test. This study aimed to evaluate responsiveness and minimal important changes (MICs) of these performance-based measures in knee OA patients following physiotherapy. Sixty patients with knee OA, undergoing 4-week physiotherapy performed 30-s CST, 40-m FPWT, and 4-step stair climb test (4-step SCT) at pre- and post-intervention. Patients also completed the 7-point global rating scale as an external anchor at post-intervention. Responsiveness was evaluated using receiver operating characteristics curve and correlation analysis. All three performance-based measures of physical function showed area under the curve > 0.70. Correlation analysis showed relationship of 30-s CST, 40-m FPWT, and 4-Step SCT with the external anchor fell within moderate to good range (Spearman = 0.43–0.63). Furthermore, MIC values reflecting improvement for 30-s CST, 40-m FPWT, and 4-Step SCT were 2.5, 0.21, and 3.21, respectively. Our findings demonstrated all three performance-based measures have good responsiveness to measure improvement in physical functions of knee OA patients following physiotherapy. The MIC reflecting improvement can help clinicians and researchers to make a decision based on the clinical significance of improvements in patients' functional status. [ABSTRACT FROM AUTHOR]

Chronic lymphedema is a progressive and inflammatory disease caused by impaired lymphatic transport. This study evaluates the effects of complex decongestive therapy (CDT) and aquatic physiotherapy on markers of the inflammatory process and lower limb volumes in individuals with lymphedema. A randomized controlled clinical trial was carried out with three groups: patients with lymphedema submitted to CDT, patients with lymphedema submitted to aquatic physiotherapy, and control group of individuals without lymphedema. The evaluation was performed through blood count, CRP measurements, C3, C4 complement, measurement of serum levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukins 4 (IL-4), 6 (IL-6), and 10 (IL-10), and the volume of a lower limb using the volume formula of a truncated cone. The study was registered with the Brazilian Clinical Trials Registry (RBR-4tpkszn). Our work showed a reduction in the TNF-α levels of patients in the CDT group (p =.028). Significant differences were found between the control group and the CDT group for IL-10 (p =.049) and Monocytes (p =.039). No significant reduction in limb volume was found. Our results show that CDT was able to significantly reduce the inflammatory marker TNF-α in patients with lymphedema, suggesting an anti-inflammatory effect of the therapy. [ABSTRACT FROM AUTHOR]

Military personnel experience many stressors during deployments that can lead to symptoms of posttraumatic stress disorder (PTSD). However, not all military personnel who are exposed to deployment stressors develop PTSD symptoms. Recent research has explored factors that contribute to military personnel resilience, a multifaceted and multidetermined construct, as a means to mitigate and prevent PTSD symptoms. Much of this research has focused on the effects of individual-level factors (e.g., use of coping strategies like humor, the morale of individual unit members), with some research focusing on unit-level factors (e.g., the cohesiveness of a unit). However, there is little research exploring how these factors relate to each other in mitigating or reducing PTSD symptoms. In this study, we examined the association between deployment stressors, perceived unit cohesion, morale, humor, and PTSD symptoms in a sample of 20,901 active-duty military personnel using structural equation modeling. Results indicated that perceived unit cohesion, humor, and morale were positively associated with each other and negatively associated with PTSD symptoms over and above the effect of deployment stressors. These findings highlight the influence of resilience factors on PTSD symptoms beyond their substantial overlap and have implications for future research as well as the potential development of interventions for military personnel. [ABSTRACT FROM AUTHOR]

Obtaining good quality sleep is crucial to mental health. Social work students might be particularly vulnerable to mental health challenges and insufficient sleep, which can have important implications for self-care education. Examining social work students' sleep characteristics (i.e. sleep duration and sleep quality) and health knowledge gaps can provide an important context for promoting healthy sleep among social work students. Nonetheless, the empirical literature lacks such data. The purpose of this study was to employ a sample of undergraduate and graduate social work students to: 1. assess sleep duration and sleep quality; 2. quantitatively and qualitatively examine knowledge about sleep and healthy sleep behaviors; and 3. identify sleep health knowledge gaps. Twenty-five social work students completed validated assessments and participated in a semi-structured focus group. Quantitative and qualitative data highlight poor sleep duration, poor sleep quality, and sleep health knowledge gaps among this population. Data also reveal that while students recognize the importance of sleep, they have difficulty obtaining adequate sleep due to various contextual constraints. These data support the importance of including sleep health in self-care education among social work students and highlight sleep health knowledge gaps that could be integrated into self-care education. [ABSTRACT FROM AUTHOR]

To compare participation patterns, environmental supports, and barriers to community activities in adolescents with and without attention deficit hyperactivity disorder (ADHD) in Turkey. Participants were 94 adolescents with ADHD and 109 adolescents without ADHD ages 13-17 years (mean age 14.6, S.D 1.49 years) Participation frequency, involvement rate, mothers who desired change, and environmental supports and barriers in a community setting were assessed with the Participation and Environment Measure for Children and Youth (PEM-CY). Adolescents with ADHD participated 20.3% less frequently in socializing with peers in the community than adolescents without ADHD. With moderate to large effect sizes, the mean involvement rate in four community activities, including neighborhood outings, community events, socializing with peers in the community, and religious activities, was significantly lower for adolescents with ADHD than for adolescents without ADHD. Adolescents with ADHD participate less frequently and are less involved in socializing with peers in the community. Almost half of all ADHD adolescents never participate in community events. It was seen that cognitive difficulties, sensory qualities, and safety may prevent adolescents with ADHD from socializing with peers in the community. [ABSTRACT FROM AUTHOR]

Health warning labels have been found to increase awareness of the harmful effects of tobacco products. An eye tracking study was conducted to determine the optimal placement and type of a health warning label on tobacco waterpipes. Participants viewed images that contained one of (1) four waterpipes, (2) three different types of warning labels, (3) placed in three locations. Typically, statistical analysis of eye tracking data is conducted based on summary statistics such as total dwell time, duration score, and number of visits to an area of interest. However, these summary statistics fail to capture the complete variability in a participant's eye movement. Instead, we propose to estimate heat maps defined on the entire image domain using the raw two-dimensional coordinates of eye movement via kernel density estimation. For statistical analysis of heat maps, we adopt the Fisher–Rao Riemannian geometric framework, which enables computationally efficient comparisons of heat maps, statistical summarization and exploration of variability in a sample of heat maps, and metric-based hierarchical clustering. We apply this framework to eye tracking data from the tobacco waterpipe study and comment on the results in the context of the optimal placement and type of health warning labels on tobacco waterpipes. [ABSTRACT FROM AUTHOR]

To determine whether cognitive learning potential measured with the dynamic Wisconsin Card Sorting Test has added value in predicting rehabilitation outcome in elderly patients post-stroke after controlling for age, ADL independence at admission, global cognitive functioning and depressive symptoms. Participants were patients with stroke admitted to a geriatric rehabilitation unit. ADL independence (Barthel Index) at discharge was used as measure for rehabilitation outcome. Predictor variables included age, ADL independence at admission, global cognitive functioning (Montreal Cognitive Assessment), depressive symptoms (Geriatric Depression Scale) and cognitive learning potential measured with the dWCST. Thirty participants were included. Bivariate analyses showed that rehabilitation outcome was significantly correlated with ADL independence at admission (r = 0.443, p = 0.014) and global cognitive functioning (r = 0.491, p = 0.006). Regression analyses showed that the dWCST was not an independent predictor of rehabilitation outcome. ADL independence at admission was the only significant predictor of rehabilitation outcome (beta = 0.480, p = 0.007). Cognitive learning potential, measured with the dWCST has no added value in predicting rehabilitation outcome in elderly patients post-stroke. ADL independence at admission was the only significant predictor of rehabilitation outcome. Trial NL7947. [ABSTRACT FROM AUTHOR]

Although occupational therapists engage as part of interprofessional healthcare teams, explicit investigation into their experiences of interprofessional collaborative practice (IPCP) has not been explored. This study evaluated occupational therapists in the United States experiences of IPCP with additional inquiry into which healthcare professionals occupational therapy practitioners interact with and how they engage in collaboration, during IPCP. An exploratory cross-sectional study was conducted using an online survey; 142 occupational therapy practitioners responded. Quantitative data were analyzed using descriptive and bivariate analyses; open-ended responses underwent consensual qualitative analysis. Participants reported most often engaging in IPCP with physical therapists, speech-language pathologists, nurses, physicians, and case managers, although variations in the top five professions were evident between practice settings. In addition, 82% of the respondents reported either feeling prepared or very prepared for IPCP after completing their pre-licensed educational programs. Two qualitative themes have emerged to describe key education-oriented and practice-oriented interprofessional experiences. To further enhance engagement in and preparedness for IPCP, occupational therapy professionals, and students may benefit from interprofessional training that involves the professions most often encountered during clinical practice. This type of learning could foster an understanding of communication and teamwork, thus enhancing readiness to participate in the IPCP team upon transition to practice. [ABSTRACT FROM AUTHOR]

In sport medicine, epidemiology of sport-related injury provides the foundation for understanding what types of injuries and illnesses occur and who is at the highest risk. Thus, accurate and transparent reporting and interpretation of risk metrics is essential to sports epidemiology. Odds ratios (OR) and risk ratios (RR) are two statistics used to quantify the association between exposure and outcome and are frequently seen in sports medicine literature. While similarities exist, there are optimal ways to use and interpret OR and RR based on the study design and outcome incidence in the target population. In this short communication, we will present common study designs (e.g. prospective cohort, case-control, cross-sectional) along with recommendations for the use and interpretation of OR and RR. This will ultimately assist practitioners in choosing and interpreting these frequently confused measures of association and also help journal reviewers better understand the appropriate use of these measures when evaluating a manuscript. [ABSTRACT FROM AUTHOR]

This study aimed to investigate an acute effect of foam rolling and tissue flossing of the Triceps Surae muscle on Achilles tendon stiffness, jump height and sprint performance at different time points. The participants were academic athletes (n = 32) aged between 22 and 24 years; randomly allocated into two groups: foam rolling (ROLL) and tissue flossing (FLOSS). The participants were tested at baseline and 5-min, 15-min, 30-min, 45-min, and 60-min after ROLL and FLOSS for Achilles tendon stiffness (ATstiffeness) at three reference locations: (1) tendon's origin, (2) ankle joint height and (3) intermuscular septum of the gastronomies muscle; countermovement jump (CMJ); and sprint performance at 15-m (SPRINT15 m). The analysis of stiffness revealed a significant decrease in ATstiffness from baseline to Post-60 (p ≤ 0.001) for three locations in the FLOSS group (p ≤ 0.001). In FLOSS, a significant increase was observed from Post-15 to Post-60 (all p≤0.001) in CMJ. We found also a significant decrease in SPRINT15 m in FLOSS in all-time points (p ≤ 0.001), however, SPRINT15 m decreased in Post-5 min, Post-15 min, and Post-30 min (p ≤ 0.001 for all) in ROLL. The current study suggested that both groups enhanced performance up to 60 min after the intervention, caused by mitigating excessive stiffness. [ABSTRACT FROM AUTHOR]

The objectives of the study were to examine the incident rate (IR), characteristics, and mechanisms of muscle injuries of 121 men amateur soccer players that voluntarily participated in this project. Sixty-five muscle injuries with an overall IR of 3.62/1000 h, 95% CI 2.7–4.5, were reported. The most frequently injured muscle groups were the hamstrings (IR 1.78/1000 h, 95% CI 1.1–2.3), followed by the adductors (IR 1.5/1000 h, 95% CI 0.93–2.06). Most muscle injuries were characterized as mild (IR 2.3/1000 h, 95% CI 1.53–2.92) or minimal (IR 1.28/1000 h, 95% CI 1.16–2.39. Higher incidence of injury sustained during matches (IR 14.09 injuries/1000 h, 95% CI 9.49–18.7), than in training (IR 1.88 injuries/1000 h, 95% CI 1.19–2.56). The most frequent injury mechanisms were high-speed running (84.4%) and change of direction (44.4%), for hamstring and adductors-related groin injuries, respectively. Players aged over 24 years had a 7-fold increased risk to sustain a hamstring injury but a lower risk to sustain an adductor-related groin injury. Injury prevention and rehabilitation management strategies may reduce muscle injury rates in amateur soccer. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of a multi-day mountain bike race on amateur master athlete cyclists (AMA). AMA (50±5 years) completed 2 stages of a mountain bike race. Six weeks before racing, echocardiography, blood and maximal cardiopulmonary exercise tests (CPET) were performed. One hour after completion of each race stage, echocardiography measurements were taken and blood was sampled for stress, inflammatory and cardiac biomarkers. Main outcomes of the CPET were maximal oxygen consumption (VO2max) 50.7±6.5 ml/kg/min; maximal power 328±45 Watt and ventilatory threshold of 86%VO2max. Participants completed 95.7km with an elevation of 1650m on the first day, and 92.5km with an elevation of 1410m on the second day, with completion times of 357±42 and 390 ±43 minutes, respectively. After racing, increases in Creatine Phosphokinase and C-reactive protein (3-6 fold) (p<0.001), Troponin I (4-fold) (p<0.001) and N-terminal pro-brain natriuretic peptide (NT-Pro BNP) (4-7-fold) (p<0.001) were noted, with a reduction in the myocardial global work index of 17-24% (p<0.001). No correlations were found between Troponin I or NT-Pro BNP and myocardial global work index. Highly aerobically fit AMA participating in demanding endurance events demonstrated elevated stress, inflammatory, muscle damage and cardiac biomarkers. However, these changes did not significantly correlate with altered cardiac function. In addition, consecutive days of demanding prolonged cycling exercise did not have cumulative effects on the measured myocardial parameters. [ABSTRACT FROM AUTHOR]

We propose using the single-leg squat-and-hold (SLSH) task with kinematic analysis to objectively measure dynamic knee stability after anterior cruciate ligament (ACL) injury. There are three objectives of this study: to compare the knee kinematics of ACL-deficient patients and healthy controls by capturing knee wobbling during the SLSH task, to detect kinematic changes after ACL reconstruction, and to correlate the kinematic variables with self-reported knee function. Twenty-five ACL-deficient participants and 18 healthy matched participants were recruited. The knee kinematics involving both the magnitudes and frequency of motion fluctuation was captured during SLSH by 3D motion analysis system (Vicon). Compared to the limbs of the control participants, the ACL involved limbs exhibited a greater range of flexion-extension (4.33 ± 1.96 vs. 2.73 ± 1.15; p = 0.005) and varus-valgus (2.52 ± 0.99 vs. 1.36 ± 0.42; p < 0.001). It also inhibited higher frequency of flexion-extension (4.87 ± 2.55 vs. 2.68 ± 1.23; p = 0.003) and varus-valgus (3.83 ± 2.59 vs. 1.42 ± 0.55; p < 0.001). The range of flexion-extension (4.50 ± 2.24 vs. 2.90 ± 1.01; p = 0.018), frequency of flexion-extension (4.58 ± 2.53 vs. 3.05 ± 1.80; p = 0.038) and varus-valgus (3.46 ± 2.11 vs. 1.80 ± 1.23; p = 0.022) was reduced after ACL reconstruction. Increased frequency of knee varus-valgus was correlated with lower IKDC score (r = −0.328; p = 0.034). Knee wobbling was more prominent in ACL-deficient patients, which was associated with poor knee function. SLSH task with kinematic analysis appears to be a potential assessment method for monitoring dynamic knee stability after ACL injury. [ABSTRACT FROM AUTHOR]

The aim was to examine the directionality of global training effects in middle-aged women after unilateral training. Thirty-nine middle-aged female volunteers (59.4 ± 5.4 years) were randomly assigned to one of three groups: 1. Unilateral Dominant Lower Limb Training (UDLT); 2. Unilateral Non-Dominant Lower Limb Training (UNDLT) or 3. Control group. Outcome measures assessing isometric strength, static and dynamic balance were recorded at baseline, and 1 week after 12 weeks (post-test) of training or no-intervention. The net cross education adaptation changes of the contralateral quadriceps isometric maximum voluntary (MVC) force (F2,34 = 4.33; p = 0.022), Stork balance score (F2,34 = 4.26; p = 0.023) and the Star Excursion Balance test score (F2,34 = 11.80; p = 0.001) were asymmetrical in the UNDLT group and on average, exceeded the UDLT group. The results demonstrated asymmetrical cross education training adaptations with unilateral training of non-dominant leg (UNDLT) to contralateral homologous and heterologous muscles, with the exception of knee flexor MVC. The results of this study provide a novel exercise or rehabilitation strategy that can be employed when one of the limbs is affected. [ABSTRACT FROM AUTHOR]

Practitioners who work with children and young people such as educators, psychologists, and social workers, are required to understand and respond to various sexual behaviours in children and young people. However, there is a dearth of training programmes dealing with sexual development. To reduce over- and under-reporting of risk, which can have serious adverse outcomes, it is essential to educate practitioners in understanding and responding appropriately to sexual behaviours. This study evaluated Traffic Lights® professional development training programme – a one-day programme offered across Queensland, Australia, with the goal of educating practitioners and promoting safe and respectful sexual health among children and young people. Thirty postgraduate psychology students working with/interested in working with children and young people received Traffic Lights® training, and accuracy of understanding and responding to sexual behaviours presented in scenarios was assessed pre- and post-training. Participant responses were scored using criteria developed by a local sexual health organisation's research specialists. Findings revealed no significant improvement in understanding and responding to sexual behaviours in children and young people. Implications of this study include recommendations for small-scale evaluations with sexual health experts and follow-up research, which is critical given the need for evidence-based practice in this area. [ABSTRACT FROM AUTHOR]

As adolescents turn to online resources for health information, obstetricians and gynaecologists can play an active role in creating evidence-based resources for sexual health education. The purpose of this study was to assess the effect of a sexual health education website on adolescent girls' reproductive health knowledge and self-efficacy. It took the form of a prospective study among girls aged 14–18 in a rural area of the USA. Informed consent and parental consent were obtained. Participants completed a pre-test survey containing a 20 question validated Reproductive Health Knowledge Index (RHKI) and six self-efficacy questions. They then completed the website curriculum (), followed by a post-test survey containing RHKI and same self-efficacy questions. Thirty-three girls completed the study with an average age of 16.42 (SD 1.09). Ten (30.3%) reported never having received sexual health education in school. Overall mean RHKI score improved from pre-test to post-test (87.67 SD 6.35 vs 90.82 SD 7.45, p = 0.012). Change in knowledge score ranged from −16.25 to+19.17 with a mean increase of+3.14 (SD 6.77). A greater proportion of participants reported improved confidence in obtaining birth control, recognising an unhealthy relationship, and getting tested for STIs. [ABSTRACT FROM AUTHOR]

This study examined how young adults' likelihood to engage in protective behavioral strategies (PBS) to reduce alcohol harms varies across physical and social contexts for drinking. We conducted an online survey with 514 heavy drinking young adults (Mage = 22.4 years, 52% women, 30% Hispanic/Latin(x), 40% non-White). Participants were asked to rate their likelihood to engage in 26 PBS generally, and specifically in six physical contexts (e.g., bar/club), and six social contexts (e.g., in a large group). We conducted regression analyses to examine the overall effect of context on the likelihood to engage in each PBS and post-hoc Tukey tests to assess pairwise comparisons of the differences in likelihood to engage in each PBS across response options for physical and social context. Analyses were conducted using the full sample, and for men and women separately. There were significant differences in six strategies across physical contexts; likelihood to engage in PBS varied across public and private spaces for different strategies. We also found significant differences in five strategies across social contexts; participants were more likely to engage in PBS among larger numbers of people and those who are intoxicated. There were numerous differences in pairwise comparisons of PBS engagement across physical and social contexts for women, while men demonstrated only two differences in PBS across physical context. Results suggest that alcohol interventions for young adults that include PBS should consider tailoring strategies to the individual and the specific context of the drinking event. [ABSTRACT FROM AUTHOR]

Background: During the past two decades of cannabis legalization, the prevalence of medical cannabis (MC) use has increased and there has also been an upward trend in alcohol consumption. As less restricted cannabis laws generate more adult cannabis users, there is concern that more individuals may be simultaneously using medical cannabis with alcohol. A few studies have examined simultaneous use of medical cannabis with alcohol, but none of those studies also assessed patients' current or previous non-medical cannabis use. This paper explores simultaneous alcohol and medical cannabis use among medical cannabis patients with a specific focus on previous history of cannabis use and current non-medical cannabis use. Methods: A retrospective cohort study of MC patients (N = 319) from four dispensaries located in New York. Bivariate chi-square tests and multivariable logistic regression are used to estimate the extent to which sociodemographic and other factors were associated with simultaneous use. Results: Approximately 29% of the sample engaged in simultaneous use and a large share of these users report previous (44%) or current (66%) use of cannabis for non-medical purposes. MC patients who either previously or currently use cannabis non-medicinally, men, and patients using MC to treat a pain-related condition, were significantly more likely to report simultaneous alcohol/MC use. Conclusions: Findings indicate that there may be differential risks related to alcohol/MC use, which should be considered by cannabis regulatory policies and prevention/treatment programs. If patients are using cannabis and/or alcohol to manage pain, clinicians should screen for both alcohol and cannabis use risk factors. [ABSTRACT FROM AUTHOR]

From an individual's perspective, social frailty may act as a key determinant of social capital, which is essential for meeting social needs and improvement of overall wellbeing. The present study aimed to understand the social frailty and its determining factors among Indian older adults. Data from the Longitudinal Ageing Study in India (LASI)-wave 1 was used. For the assessment of social frailty the study proposed a multidimensional Social Frailty Index (SFI) score ranging between 0 and 100 using 17 indicators. Bivariate analysis and quantile regression models were applied. The study results indicated that on average female older adults (mean SFI = 63.7) are relatively more socially frail than male older adults (mean SFI = 59.0). Further, the quantile regression analysis revealed that at the 10th, 25th, 50th, and 75th percentiles, female older adults were significantly more likely to be socially frail than male older adults (β = 3.80, p <.01; β = 2.82, p <.01; β = 1.72, p <.01; and β = 2.62, p <.01, respectively). Educational attainment and better economic condition showed a protective effect against social frailty. Investment to improve geriatric health status and socioeconomic conditions shall be a key focus to reduce social frailty prevalence among the older adults. A specific consideration is needed for addressing social frailty among female older adults. [ABSTRACT FROM AUTHOR]

This article introduces a collection of four datasets, similar to Anscombe's quartet, that aim to highlight the challenges involved when estimating causal effects. Each of the four datasets is generated based on a distinct causal mechanism: the first involves a collider, the second involves a confounder, the third involves a mediator, and the fourth involves the induction of M-Bias by an included factor. The article includes a mathematical summary of each dataset, as well as directed acyclic graphs that depict the relationships between the variables. Despite the fact that the statistical summaries and visualizations for each dataset are identical, the true causal effect differs, and estimating it correctly requires knowledge of the data-generating mechanism. These example datasets can help practitioners gain a better understanding of the assumptions underlying causal inference methods and emphasize the importance of gathering more information beyond what can be obtained from statistical tools alone. The article also includes R code for reproducing all figures and provides access to the datasets themselves through an R package named "quartets." for this article are available online. [ABSTRACT FROM AUTHOR]

Meaning making efforts, such as perceiving posttraumatic growth (PPTG), may relate to mental health (MH), especially when creating meaning in life (MIL). We tested this assertion using mediation analyses to see whether PPTG leads to subsequent MH through MIL and if PPTG leads to increased MIL, which predicts increased MH. 402 Post-9/11 military veterans were assessed at baseline, 6 months (T2), and 12 months (T3) later. PPTG predicted subsequent MH, effects entirely mediated by T2 MIL. PPTG also predicted increased T2 MIL but not increased T3 MH, although increased T2 MIL led to increased T3 MH. Findings suggest a stable association between PPTG and MH, an effect fully mediated by MIL. Further, PPTG relates to subsequent MH only when resulting in increased MIL. Future research examining meaning making in studies of PPTG is needed to better understand the conditions under which PPTG is adaptive. [ABSTRACT FROM AUTHOR]

The Personality Assessment Inventory (PAI) is among the most commonly used broadband inventories of psychological functioning. For the purposes of assessing trauma specifically, the most relevant aspect of the PAI is the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T), which measures the degree to which a person feels wounded by something in their past. Research suggests that ARD-T is associated with exposure to a variety of different traumatic stressors. However, there is little research on the degree to which traumatic stressors that entail a component of interpersonal betrayal (i.e. betrayal trauma) are associated with higher scores on ARD-T relative to other stressors. In this study, we evaluated the relative associations between traumas with varying degrees of betrayal and scores on ARD-T in a secondary analysis of two non-clinical samples (college sample N = 494; crowdsourced sample N = 364) using a Bayesian approach to multiple regression. In both samples, traumas with both high and medium (but not low) degrees of betrayal were associated with elevated ARD-T scores. Findings suggest that ARD-T scores are associated with interpersonal trauma regardless of betrayal, which has implications for interpretation of the ARD-T scale in practice. [ABSTRACT FROM AUTHOR]

Malnutrition significantly impacts the post-operative process of gynecological cancer patients. A prominent variable for determining perioperative morbidity is the Prognostic Nutritional Index (PNI). To investigate PNI's predictive value on the risk of post-operative infections, we conducted a prospective cohort study involving women who underwent surgery for gynecological malignancies. Out of the 208 patients enrolled, 28 (13.5%) were malnourished and post-operative infections occurred in 43 patients. Notably, there was a significant difference in PNI between patients who developed infections and those who did not (p = 0.027), as well as between malnourished patients and those with normal nutritional status (p = 0.043). Univariate analysis showed that preoperative PNI predicts the risk of post-operative infections better than post-operative white blood cell count (AUC of 0.562 vs 0.375). However, the most accurate diagnostic results in the multivariate analysis were obtained from random forest and classification tree models (AUC of 0.987 and 0.977, respectively). Essentially, PNI and post-operative white blood cell count provided the best information gain according to rank probabilities. In conclusion, PNI appears to be a critical parameter that merits further investigation during the preoperative evaluation of gynecological malignancies. [ABSTRACT FROM AUTHOR]

Esophageal carcinoma (EC) and nutritional status are strongly linked due to swallowing disruptions and treatment-related toxicities. Therefore, malnutrition and weight loss (WL) occur in 85% and 79% of EC patients, respectively. WL is frequently associated with worse EC patient outcomes, however, WL during radiation therapy (RT) and EC patient outcomes have not been well established. The purpose of this study is to retrospectively review the association of WL during RT treatment of EC with clinical outcomes. Non-metastatic EC patients from our institution treated between 2010 and 2018, receiving total prescribed dose >40 Gy and aged >18 years, were included. Patients were analyzed by WL during RT, with categories of ≥5% vs. <5% and ≥10% vs. <10%. Patient characteristics and treatment regimens were similar across all WL groups. In univariate analysis, ≥5% and ≥10% WL were significantly associated with both worse overall survival (OS) and progression-free survival (PFS), and ≥10% WL was significantly associated with increased local recurrence. In multivariate analysis, ≥5% WL was significantly associated with OS and PFS. With both ≥5% and ≥10% WL throughout the radiation treatment being detrimental to OS and PFS. The importance of nutritional support in EC patients receiving radiotherapy is further validated. [ABSTRACT FROM AUTHOR]

Malnutrition is prevalent in hepatocellular carcinoma (HCC) patients, linked to poor outcomes, necessitating early intervention. This study aimed to investigate malnutrition in HCC patients, assess Nutrition Risk Screening 2002 (NRS-2002) and Patient-Generated Subjective Global Assessment (PG-SGA) vs. Global Leadership Initiative on Malnutrition (GLIM) criteria, and identify independent risk factors. A cross-sectional retrospective study was conducted on 207 patients with HCC. Nutritional screening/assessment results and blood samples were collected within 72 h of admission. This study assessed the prevalence of malnutrition using the NRS-2002 and PG-SGA and retrospectively using the GLIM criteria. The performance of the screening tools was evaluated using kappa (K) values. Logistic regression analyses were performed to determine whether laboratory parameters were associated with malnutrition as identified by the GLIM criteria. Of the participants, 30.4% were at risk of malnutrition according to NRS-2002. The agreement between the NRS-2002 and GLIM criteria was substantial. The GLIM criteria and PG-SGA diagnosed malnutrition in 43 and 54.6% of the participants, respectively. Age, anemia, and ascites correlated with malnutrition in regression. The GLIM criteria, along with NRS-2002 and PG-SGA, aid in diagnosing malnutrition in HCC patients. Recognizing risk factors improves accuracy, enabling timely interventions for better outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of an animated Patient Decision Aid (PtDA) about dietary choices on decisional conflict and decision regret. A prospective, observational, two-group comparative effectiveness study was conducted with patients (n = 90) from a southern Taiwan oncology inpatient unit. Data included the Malnutrition Universal Screening Tool (MUST), laboratory results, 16-item Decisional Conflict Scale (sf-DCS), and 5-item Decision Regret Scale (DRSc). Data were collected at admission (T0), after the first-cycle of chemotherapy but before discharge (T1), and after the six-cycle chemotherapy protocol (T2) (around 3 months). Group A received standardized nutrition education and a printed brochure, while Group B watched a 10-minute information video during a one-on-one inpatient consultation and engaged in a values clarification exercise between T0 and T1. The percentage of women with a MUST score ≧1 in Group A sharply increased over time, but not in Group B. Decision aid usage significantly increased patients' hemoglobin and lymphocyte values over time (p < 0.05). The digital PtDA contributed to less decisional conflict and decision regret in at-risk patients and improved their nutritional well-being. Decision-aids help patients make healthcare decisions in line with their values, and are sustainable for use by busy clinicians. [ABSTRACT FROM AUTHOR]