Search

Online search involves multitasking and may demand better working‐memory capacities (WMC) and additional cognitive aids. Given the constraints of human cognition, we tested the effectiveness of note‐taking strategies on university students' online search performance. Also examined were the profile configurations of WMC tests in silence and in irrelevant speech as well as its interaction effects with note‐taking strategies on online search performance. Among the participants of 60 university students, we found a four‐group WMC profile composition that differed significantly across WMC scores in both silence and irrelevant speech. Results showed that WMC profiles, note‐taking groups and their interaction effect were significant factors on online search performance. Both Free Note and Matrix Note were beneficial for the students in low silent WMC profile groups. Study results have both theoretical and practical implications, advancing our understanding of the interrelationship of WMC under different conditions and informing instructional practice of online search performance. Lay Description: What is already known about this topicWorking memory capacity is fundamental to multitasking ability.Online search is a typical multitasking behavior that requires constant switching between different information sources.Students who take note perform better than those who do not while reading materials with seductive but irrelevant information.What this paper addsStudents working memory capacity is examined under silent and irrelevant speech conditions.Students exhibited different profile patterns in their working memory capacity under silent and irrelevant speech conditions.Taking note, either in matrix form or free form, can significantly improve students' online search performance for those with high WMC ONLY in irrelevant speech or for those with low WMC in both silent and irrelevant speech conditions.Implications for practiceNote‐taking as auxiliary support may facilitate students' integration and evaluation of the online information across multiple sources during their online search.Instructions on how to self‐construct matrix note are needed to help students develop advanced note‐taking skills for their learning involving online search. [ABSTRACT FROM AUTHOR]

Objective This paper describes the sociodemographic and health-related characteristics of people with chronic disease attending an interprofessional student-assisted clinic in regional Queensland. Design A retrospective review of data collected during the first 10 months of operation of the clinic was conducted. Setting, participants and outcome measures Data was collected on up to 378 patients during an intake appointment at the Capricornia Allied Health Partnership ( CAHP) community-based clinic and compared with normative reference groups where available. Sociodemographic characteristics included age, gender and education level; health-related characteristics included body mass index and hospitalisations in the previous 12 months; and risk factors included prescribed medications, smoking status and general practitioner-diagnosed medical conditions. Results Patients attending the CAHP clinic had a mean number of chronic conditions of 4.9 ± 2.1 per patient, and 97% of patients had multimorbidities. A high level of socioeconomic disadvantage was found in comparison with normative comparison groups based on employment, highest level of schooling completed and the index of social disadvantage. Patients predominantly lived in inner regional areas (76.7%). The most common diagnoses of patients attending the clinic for the first time were hypertension, osteoarthritis, high cholesterol, diabetes and chronic back pain. Conclusions The CAHP clinic offers a unique student-assisted service model for interprofessional management of patients who are socioeconomically disadvantaged, have multimorbid chronic disease and live in regional areas. The description of baseline data in this paper is important to refine clinic services, to guide other chronic disease clinics and to inform future research study designs. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Sufficient evidence suggests that health information technology (HIT) will soon become part of physician procedure. This paper poses that the outcome of using HIT is affected by the intentions of use. Note that ethical indoctrination is a crucial mechanism for monitoring physicians. Judicious and sufficient use of HIT is expected to be the prerequisite for deploying these technologies to help in delivering better care. This research paper, therefore, aims to define professional concerns and intent to use HIT, and identify their associations. Methods A survey study was conducted to collect data for developing a seven-dimensional eHealth success measure. This paper focuses on deriving a structural equation model that can explain the associations among professional concerns and intent to use HIT. Statistical analyses were, therefore, only performed on the Intent to Use and Physician Attributes constructs. Results The statistical results show that altruism, autonomy, physician-patient relationship and (subconscious) autonomy significantly associate with each other at least at P < 0.05. Only altruism shows to be a significant determinant of intent to use HIT (with P = 0.00005). Other professional concerns only associate with it indirectly through altruism. Conclusions Medicine has been a science-using and compassionate practice. Medical practice including HIT use may only be reliably assessed from a sociotechnical perspective. Professional concerns show to be associated with intent to use HIT is an expected result. This research direction may contribute to deriving policies to deploy HIT for delivering better care through implementing sufficient and judicious HIT use. [ABSTRACT FROM AUTHOR]

Emotions are critical to learning. However, the function of emotions in the emerging context of massive open online courses (MOOCs) has been under‐researched. The present study complemented this line of research by modelling the relation between learner emotions, engagement with videos, engagement with assignments, and self‐perceived achievement in a small private online course—a localized instance of an extended MOOC. The results suggested that whereas enjoyment, excitement, boredom, and annoyance were all significant predictors of video engagement, only excitement and annoyance were significant predictors of assignment engagement. Excitement, in particular, was the strongest or stronger predictor of both types of engagement. In addition, both types of engagement predicted self‐perceived achievement, but video engagement predicted self‐perceived achievement via the mediation of assignment engagement. Implications for designing more effective MOOCs were proposed. Lay Description: What is currently known about the subject Emotions predict engagement in learning settings other than MOOCs.Engagement predicts achievement in learning settings including MOOCs.Assignment engagement predicts achievement in MOOCs better than video engagement. What this paper adds The two types of engagement are predicted by different sets of emotions.Engagement predicts self‐perceived achievement in the SPOC.Video engagement predicts self‐perceived achievement via the mediation of assignment engagement.The majority of systematic reviews did not evaluate the quality of the primary papers which they examined. Implications for practitioners MOOC researchers should pay more attention to the design of assignments.MOOC developers should try to build more emotionally‐sound courses and platforms. [ABSTRACT FROM AUTHOR]

Breastfeeding is beneficial to both the mother and infant, yet many infants are either partially or fully fed with formula milk. Those parents feeding with formula receive less support from professional sources than those breastfeeding and may rely on more non‐professional sources for advice, and this contributes to negative emotional experiences such as guilt. This paper explores the sources of advice for formula feeding, factors associated with using professional or non‐professional sources and compares these sources with those used for breastfeeding advice. A secondary analysis of Australian survey data from 270 mothers was performed. Mothers of six‐month‐old infants participated in an online survey, providing information on advice they received or read about formula feeding and/or breastfeeding from professional and non‐professional sources. A fifth of mothers who were formula feeding did not receive any formula feeding advice from professional sources, and only a small fraction (4.5%) of mothers breastfeeding did not received any breastfeeding advice from professional sources. Compared with those mothers breastfeeding receiving breastfeeding advice, fewer mothers formula feeding receive formula feeding advice from both professional and non‐professional sources. The tin of formula was the most used source of formula advice. Mothers feeding with formula at six months were more likely to have received formula feeding advice from professional sources if they had been fully formula feeding before their infant was under the age of three months. Further research is needed to understand the specific barriers to accessing formula feeding advice and what other factors influence access to formula feeding advice. [ABSTRACT FROM AUTHOR]

Context: Exploring student intentions to practise in underserved areas (UAs) is necessary to inform the planning and training of the future medical workforce in order to increase effectiveness and fulfil societal needs. However, little is known about the motivational factors influencing these intentions. This paper explores medical students' intentions to practise in UAs and the motivational factors predicting these intentions. Methods: Eligible participants included graduating medical students from four of the five Swiss medical schools, who self‐reported specialty choice, intentions to practise in UAs, and motives that explained their career choices. Chi‐squared analysis was used to compare site, gender, specialty choice and UA practice intention. Motives were aggregated to obtain motivational factors using a principal component analysis with varimax rotation. Logistic regression was used to predict the effects of these motivational factors and of gender on UA practice intention. Results: Of 1749 students included in the study, 240 (13.7%) expressed an intention to practise in UAs (62.1% of whom intended to practise in rural areas) and 719 (41.1%) were undecided. In those who wished to practise in UAs, general practice (21.6%) was the most preferred specialty. Motivational factors influencing specialty choice were intellectual challenge, work variety, work conditions and enthusiasm (Kaiser‐Meyer‐Olkin index 0.79, P <.001, 49.0% of variance explained). Students motivated by work variety (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2‐1.7) and by work conditions (OR 1.3, 95% CI 1.1‐1.6) were more likely to choose UAs and those motivated by intellectual challenge (OR 0.4, 95% CI 0.3‐0.5) were less likely. Undecided students' motivations were very similar to those of students interested in working in UAs. Conclusions: The actual number of Swiss students interested in working in UAs is low and is probably insufficient to meet current societal needs. Work variety and work conditions appear to be factors that might attract interested and undecided students towards working in UAs. The authors showed that the actual number of Swiss students interested in working in underserved areas is insufficient to meet current societal needs. Work variety and work conditions seem to be targeting factors to attract interested and undecided students towards working in underserved areas. [ABSTRACT FROM AUTHOR]

Organizations are increasingly augmenting employee jobs with intelligent machines. Although this augmentation has a bright side, in terms of its ability to enhance employee performance, we think there is likely a dark side as well. Draw from self‐regulation theory, we theorize that dependence on intelligent machines is discrepancy‐reducing—enhancing work goal progress, which in turn boosts employees' task performance. On the other hand, such dependence may be discrepancy‐enlarging—threatening employee self‐esteem, which in turn detracts from employees' task performance. Drawing further from self‐regulation theory, we submit that employees' core self‐evaluation (CSE) may influence these effects of dependence on intelligent machines. Across an experience‐sampling field study conducted in India (Study 1) and a simulation‐based experiment conducted in the United States (Study 2), our results generally support a "mixed blessing" perspective of intelligent machines at work. We conclude by discussing the theoretical and practical implications of our work. [ABSTRACT FROM AUTHOR]

Background and Aims Behavioral economists assess alcohol consumption as a function of unit price. This method allows construction of demand curves and demand indices, which are thought to provide precise numerical estimates of risk for alcohol problems. One of the more commonly used behavioral economic measures is the Alcohol Purchase Task (APT). Although the APT has shown promise as a measure of risk for alcohol problems, the construct validity and incremental utility of the APT remain unclear. This paper presents a meta-analysis of the APT literature. Methods Sixteen studies were included in the meta-analysis. Studies were gathered via searches of the PsycInfo, PubMed, Web of Science and EconLit research databases. Random-effects meta-analyses with inverse variance weighting were used to calculate summary effect sizes for each demand index-drinking outcome relationship. Moderation of these effects by drinking status (regular versus heavy drinkers) was examined. Additionally, tests of the incremental utility of the APT indices in predicting drinking problems above and beyond measuring alcohol consumption were performed. Results The APT indices were correlated in the expected directions with drinking outcomes, although many effects were small in size. These effects were typically not moderated by the drinking status of the samples. Additionally, the intensity metric demonstrated incremental utility in predicting alcohol use disorder symptoms beyond measuring drinking. Conclusions The Alcohol Purchase Task appears to have good construct validity, but limited incremental utility in estimating risk for alcohol problems. [ABSTRACT FROM AUTHOR]

Background: Value chain interventions have become widespread throughout the international development sector over the last 20 years, and there is a need to evaluate their effectiveness in improving women's welfare across multiple dimensions. Agricultural value chains are influenced by socio‐cultural norms and gender dynamics that have an impact on the distribution of resources, benefits, and access to opportunities. While women play a critical role in agriculture, they are generally confined to the least‐valued parts of the value chain with the lowest economic returns, depending on the local, social and institutional contexts. Objectives: The review assesses the effectiveness of approaches, strategies and interventions focused on women's engagement in agricultural value chains that lead to women's economic empowerment in low‐ and middle‐income countries. It explores the contextual barriers and facilitators that determine women's participation in value chains and ultimately impact their effectiveness. Search Methods: We searched completed and on‐going studies from Scopus, Web of Science Core Collection (Social Sciences Citation Index [SSCI], Science Citation Index Expanded [SCI‐EXPANDED], Conference Proceedings Citation Index – Science [CPCI‐S], Conference Proceedings Citation Index – Social Science & Humanities [CPCI‐SSH], and Emerging Sources Citation Index [ESCI]), International Bibliography of the Social Sciences, EconLit, Business Source Premier, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane, Database of Systematic Reviews, CAB Abstracts and Sociological Abstracts. We also searched relevant websites such as Consortium of International Agricultural Research Centers (CGIAR); the International Fund for Agricultural Development (IFAD); AgriProFocus; the Bill & Melinda Gates Foundation (BMGF); Donor Committee for Enterprise Development; the UN Food and Agriculture Organisation (FAO); the International Labour Organisation (ILO); the Netherlands Development Organisation; USAID; the Swiss Agency for Development and Cooperation; the International Food Policy Research Institute; World Agroforestry; the International Livestock Research Institute; the Foreign, Commonwealth & Development Office; the British Library for Development Studies (BLDS); AGRIS; the IMMANA grant database; the 3ie impact evaluation database; Innovations for Poverty Action (IPA); The Abdul Latif Jameel Poverty Action Lab (J‐PAL); the World Bank IEG evaluations; the USAID Development Data Library; Experience Clearinghouse; the proceedings of the Agriculture, Nutrition and Health Academy conference; the proceedings of the Centre for the Study of African Economies (CSAE) Conference; the proceedings of the North East Universities Development Consortium (NEUDC) Conference; and the World Bank Economic Review. The database search was conducted in March 2022, and the website search was completed in August 2022. Selection Criteria: The review includes value chain interventions evaluating the economic empowerment outcomes. The review includes effectiveness studies (experimental and non‐experimental studies with a comparison group) and process evaluations. Data Collection and Analysis: Two review authors independently assessed studies for inclusion, extracted data, critically appraised the studies, and synthesised findings. Results: We found that value chain interventions are successful in improving the economic conditions of their intended beneficiaries. The interventions were found to improve women's economic outcomes such as income, assets holdings, productivity, and savings, but these effects were small in size and limited by low confidence in methodological quality. The meta‐analysis suggests that this occurs more via the acquisition of skills and improved inputs, rather than through improvement in access to profitable markets. The qualitative evidence on interventions points to the persistence of cultural barriers and other constraints. Those interventions implemented in Sub‐Saharan Africa and South Asia are consistently more successful for all outcomes considered, although there are few studies conducted in other areas of the world. Conclusions: The review concludes that value chain interventions empower women, but perhaps to a lesser extent than expected. Economic empowerment does not immediately translate into empowerment within families and communities. Interventions should either moderate their expectations of empowerment goals, or they should be implemented in a way that ensures higher rates of participation among women and the acquisition of greater decision‐making power. [ABSTRACT FROM AUTHOR]

Background: We assessed experiences of human papillomavirus (HPV) vaginal self‐sampling and future screening preferences in an ethnically and socio‐economically diverse group of women overdue for cervical screening. Setting and Participants: A postal questionnaire was embedded in the YouScreen self‐sampling trial in England: 32.5% (2712/8338) of kit completers returned the survey. Kit non‐completers were encouraged to return a questionnaire, but no responses were received. Participants were ethnically diverse (40.3% came from ethnic minority backgrounds), and 59.1% came from the two most deprived quintiles. Differences in confidence in kit completion, trust in the test results and intention to attend a follow‐up test if HPV‐positive were evaluated using Pearson's χ2 analyses. Binary logistic regression models explored predictors of a future screening choice and preferences for urine versus vaginal self‐sampling. Results: Most kit‐completers reported high confidence in self‐sampling (82.6%) and high trust in the results (79.9%), but experiences varied by ethnicity and screening status. Most free‐text comments were positive but some reported difficulties using the device, pain or discomfort. Most women would opt for self‐sampling in the future (71.3% vs. 10.4% for a clinician‐taken test) and it was more often preferred by ethnic minority groups, overdue screeners and never attenders. Urine self‐tests were preferred to vaginal tests (41.9% vs. 15.4%), especially among women from Asian, Black or Other Ethnic backgrounds. Conclusions: Kit‐completers were confident, found the test easy to complete, and trusted the self‐sample results. However, experiences varied by ethnic group and some women highlighted difficulties with the kit. Most women would prefer self‐sampling in the future, but it was not a universal preference, so offering a choice will be important. Patient or Public Contribution: We did not have direct patient and public involvement and engagement (PPIE) in the questionnaire design. However, patients and public representatives did input into the design of the YouScreen trial and reviewed the wider study materials (e.g. participant information sheet). Trial Registration: This questionnaire study was embedded in the YouScreen trial. The protocol for the YouScreen trial is available at https://www.isrctn.com/ISRCTN12759467. The National Institute for Health Research 43 Clinical Research Network (NIHR CRN) Central Portfolio Management System (CPMS) ID is 4441934. [ABSTRACT FROM AUTHOR]

This study examined affect during high school students' face‐to‐face collaborative inquiry learning in science, supported by the web‐based software Virtual Baltic Sea Explorer. Self‐reported affective states during the inquiry process in peer groups were related to evaluations of a group's collaboration and performance in three phases of interdisciplinary science inquiry (biology and chemistry). Results indicate that despite high cognitive demands, positive affect prevailed whereas negative affect was infrequent. Structural equation modelling was used to analyse the significance of affect on collaboration and group performance. The relationship between affect, collaboration, and the groups' productive outcome revealed that self‐assurance had a significant effect on collaboration and support, intertwined with scientific understanding and group performance. Furthermore, a cross‐lagged analysis showed a reciprocal relation between positive affect, scientific understanding, collaboration, and support. These outcomes contribute to the scarce literature on the nature and importance of affect in the process of face‐to‐face computer‐supported collaborative inquiry and learning in science. Lay Description: What is already known about this topic: Positive collaboration in groups promotes positive affect.Positive affect is crucial for attitudes and motivation towards science learning.Affect is an important factor in virtual learning environment design, but there is a lack of understanding on occurrence and influence of affect during face‐to‐face virtual learning.What this paper adds: Students report mainly positive affect during virtual science inquiry despite tough task demands and the level of productive group outcome.Positive activating affect prevails throughout collaborative inquiry, whereas negative deactivating affect is subordinate.Joviality and notably self‐assurance has a great impact on collaboration and support, and achievement, whereas feelings of displeasure and insecurity may have negative implications.Implications for practice and/or policy: Self‐assurance promotes collaboration and support and the aim at coconstruction of shared understanding during virtual science inquiry learning.Efforts should be made to enhance positive affect and especially self‐assurance in virtual learning. [ABSTRACT FROM AUTHOR]

Are pregnancy and birth‐related parameters important risk factors in the development of urinary incontinence (UI)? The aim of this study is to examine the prevalence of UI and associated risk factors in Turkish women in the third postpartum month. Incontinence after childbirth is a common problem. A cross‐sectional study that included 370 women in third postpartum month in Çanakkale is presented in this paper. Wagner's quality of life scale questionnaire exploring the risk factors for UI was used as the principle data collection tool. All women gave consent prior to inclusion in the study. Chi‐square, t test, Mann‐Whitney U test and Binary logistic regression were used for comparison. The prevalence of self‐reported postpartum UI was 35.9%. In this study; age, educational level, parity, number of normal birth, nocturia and constipation were determined to be the associated risk factors for postpartum UI in univariate analysis. When examining these risk factors by using logistic regression, it was found that the number of birth being 2 increased UI 2.7 times (P = 0.002, 95% CI:1.434‐5.324), the number of birth being 3 or more increased UI 20.3 times (P = 0.001, 95% CI:7.130‐58.332) and nocturia being 3 times and more increased UI 2.6 times (P = 0.041, 95% CI:1.042‐6.790). Pregnancy and birth‐related parameters are important risk factors in development of UI. It would be useful to increase the awareness in women in pregnancy and the postpartum period, by providing health training and consultancy services about UI protection and the reduction of risk factors. [ABSTRACT FROM AUTHOR]

Aim The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials ( RCTs). Material and Methods A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences ( WMD) and 95% confidence intervals. Results After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD −0.217), modified gingival index ( n = 23, −0.415), gingivitis severity index ( n = 26, −14.939%) or bleeding index ( n = 23, −7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD −0.475), Silness & Löe ( n = 26, −0.109), and plaque severity ( n = 12, −23.4%) indices, with significant heterogeneity. Conclusion Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

Background: For parents who experience stillbirth, knowing the cause of their baby's death is important. A post mortem examination is the gold standard investigation, but little is known about what may influence parents' decisions to accept or decline. Aim: We aimed to identify factors influencing maternal decision‐making about post mortem examination after late stillbirth. Methods: In the New Zealand Multicentre Stillbirth Study, 169 women with singleton pregnancies, no known abnormality at recruitment, and late stillbirth (≥28weeks gestation), from seven health regions were interviewed within six weeks of birth. The purpose of this paper was to explore factors related to post mortem examination decision‐making and the reasons for declining. We asked women if they would make the same decision again. Results: Maternal decision to decline a post mortem (70/169, 41.4%) was more common among women of Māori (adjusted odds ratio (aOR) 4.99 95% confidence interval (CI) 1.70–14.64) and Pacific (aOR 3.94 95% CI 1.47–10.54) ethnicity compared to European, and parity two or more (aOR 2.95 95% CI 1.14–7.62) compared to primiparous. The main reason for declining was that women 'did not want baby to be cut'. Ten percent (7/70) who declined said they would not make this decision again. No woman who consented regretted her decision. Conclusion: Ethnic differences observed in women's post mortem decision‐making should be further explored in future studies. Providing information of the effect of post mortem on the baby's body and the possible emotional benefits of a post mortem may assist women faced with this decision in the future. [ABSTRACT FROM AUTHOR]

Aim: The prevalence of diabetes in older adults in residential aged care (RAC) is twice that of community dwelling older adults. Older adults with diabetes have been highlighted as being at high risk of frailty and malnutrition, particularly when managed on a therapeutic diet. However, assumptions may be based on clinical presentation of our oldest old which may be at conflict with the clinical presentation of younger older adults. The aim of this retrospective audit was to identify the characteristics of aged care residents with diabetes, their comorbidities and malnutrition risk. Methods: Residents' with diabetes paper‐based records were audited for demographic data, diet code, medical and medication history, malnutrition risk screening scores and anthropometric data. Results: A total of 295 residents with diabetes records were audited across 13 sites in South Australia. Younger older adults (65–74 years) were generally in a healthy weight range (23–30 kg/m2) or obese (>30 kg/m2) and had gained weight since admission to RAC; whereas the oldest old were more likely to have lost weight and had a lower body mass index range 22.6–28.9 kg/m2. An unexpected finding was the variability between RAC sites in dietary management of diabetes and potential inappropriate dietary management of malnutrition, as indicated by their food service diet codes. Conclusions: Findings suggest that younger older adults in RAC are more likely to be overweight which is maintained over a typical length of stay. Study findings indicate that diabetes management is inconsistent and highlights the need for mandated RAC menu guidelines. [ABSTRACT FROM AUTHOR]

Aims To assess the association between doctors' smoking status and the use of the '5 As' of smoking cessation. Methods A systematic search of 11 databases covering English and Spanish language publications since 1996 was undertaken. Studies were included if they reported doctors' smoking status (current, former or never smoker) and rates of practising any of the 5 As of smoking cessation ( Ask; Advise; Assess; Assist; and Arrange). Frequencies and proportions were extracted from individual papers and risk ratios ( RR) were calculated. A random-effects meta-analysis model was used to assess the effect of the doctor's personal smoking history. Covariate effects were explored using meta-regression for three pre-specified study characteristics: doctors' role, smoking prevalence of the sample and study quality. Results Twenty studies were included in this systematic review. The RR of always asking patients about their smoking was not associated significantly with doctors' smoking status [ RR = 0.98; 95% confidence interval ( CI) = 0.94-1.02; P = 0.378; I2 = 0.00%; 10 studies]. Meta-analysis suggested that doctors who were current smokers had a 17% increased risk of not advising their patients to quit compared with never-smokers ( RR = 0.83; 95% CI = 0.77-0.90; P < 0.000; I2 = 82.14%; 14 studies). However, high levels of heterogeneity were found that were not explained by the meta-regression. Regarding assisting patients to quit, never smokers were more likely to counsel than current smokers ( RR = 0.92; 95% CI = 0.85-0.99; P = 0.036; I2 = 0.00%; three studies) but less likely to make a referral ( RR = 1.40; 95% CI = 1.09-1.79; P = 0.009; I2 = 0.00%; five studies). No statistically significant differences were found in arranging future contact by smoking status ( RR = 0.80; 95% CI = 0.52-1.23; P = 0.315; I2 = 47.03%; four studies). Conclusions Smoking status of doctors may affect their delivery of smoking cessation treatments to patients, with smokers being less likely than non-smokers or ex-smokers to advise and counsel their patients to quit but more likely to refer them to smoking cessation programmes. [ABSTRACT FROM AUTHOR]

Abstract: Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU. Six NICUs across Sweden randomised a total of 493 mothers. We used regression and survival analyses to assess the risk factors for ceasing breastfeeding and the long‐term outcomes of the intervention. The results showed that 305 (64%) of the infants were breastfed at 6 months and 49 (21%) at 12 months. Partial breastfeeding at discharge, low maternal educational level, and longer length of stay in the NICU increased the risk for ceasing breastfeeding during the first 12 months. Furthermore, the Kaplan–Meier analysis showed that the proportion of mothers who ceased breastfeeding did not differ between the intervention (n = 231) and controls (n = 262) during the first 12 months (log‐rank test p = .68). No difference was found between groups on method of feeding. More than 85% of the infants were fed directly at the breast. These findings provide important insights for health professionals who are supporting mothers of preterm infants to breastfeed long term. Registered in www.clinicaltrials.gov (NCT01806480). [ABSTRACT FROM AUTHOR]

Abstract: Improving infant and young child feeding practices is critical for improving growth and reducing child mortality and morbidity. This paper aims to compare predictors of minimum dietary diversity, an important indicator of adequate complementary feeding practices, in Bangladesh in 2011 and 2014. The 2011 and 2014 Bangladesh Demographic and Health Survey were used to examine predictors of minimum dietary diversity among 6–23 months. An additional analysis was conducted for the 18–23‐month group, because a significant increase in meeting minimum dietary diversity recommendations was seen in this age group only. Factors found to be associated with practices were compared across time points. In 2011, minimum dietary diversity was 23.8% and increased to 28.8% in 2014. Among children 18–23 months, in 2011, minimum dietary diversity was 32.5% and increased to 42.8% in 2014. Among all children, wealth, education, exposure to media, and antenatal care were significant predictors of dietary diversity. In the 18–23‐month age group, significant predictors in 2011 were wealth and decision making. In 2014, significant predictors were education and exposure to media. Demographic trends indicated a significant increase in education and exposure to media between 2011 and 2014. As these were significant for minimum dietary diversity in 2014 overall and for 18–23 months, they might be important targets of future interventions, specifically utilizing media channels and tailoring special strategies for women with low education and limited exposure to media. [ABSTRACT FROM AUTHOR]

Parental substance misuse has a pervasive impact on family functioning, parenting, and, ultimately, child wellbeing and development. Subsequently, linkages with informal and formal support networks are crucial for ameliorating risk. To facilitate engagement with these families prior to identification in child protection systems, it is vital to understand the factors inhibiting and promoting engagement with informal and formal support. This paper examines how different factors influence informal and formal help‐seeking by alcohol‐misusing parents with regard to parenting and family concerns. Parents reporting alcohol problems in a clinical range (n = 322) were drawn from a representative parent sample (n = 1991). Alcohol‐misusing parents reported low help‐seeking for parenting‐focused support services. The findings particularly highlight the role of age, education, socioeconomic status, ethnicity, parenting stress, empowerment and trust in support services for predicting parents' help‐seeking. 'Examines how different factors influence informal and formal help‐seeking by alcohol‐misusing parents with regard to parenting and family concerns' Key Practitioner Messages: The role of practitioners working in family welfare and child protection services in identifying and facilitating support for alcohol-misusing families is described.Parenting‐focused support services need to be promoted, especially for vulnerable parent populations.Education of service providers along with the wider community is required to foster and increase trust and support uptake before alcohol-misusing families become involved with statutory systems. [ABSTRACT FROM AUTHOR]

Behaviour change communication (BCC) can improve infant and young child nutrition (IYCN) knowledge, practices, and health outcomes. However, few studies have examined whether the improved knowledge persists after BCC activities end. This paper assesses the effect of nutrition sensitive social protection interventions on IYCN knowledge in rural Bangladesh, both during and after intervention activities. We use data from two, 2-year, cluster randomised control trials that included nutrition BCC in some treatment arms. These data were collected at intervention baseline, midline, and endline, and 6-10 months after the intervention ended. We analyse data on IYCN knowledge from the same 2,341 women over these 4 survey rounds. We construct a number correct score on 18 IYCN knowledge questions and assess whether the impact of the BCC changes over time for the different treatment groups. Effects are estimated using ordinary least squares accounting for the clustered design of the study. There are 3 main findings: First, the BCC improves IYCN knowledge substantially in the 1st year of the intervention; participants correctly answer 3.0-3.2 more questions (36% more) compared to the non-BCC groups. Second, the increase in knowledge between the 1st and 2nd year was smaller, an additional 0.7-0.9 correct answers. Third, knowledge persists; there are no significant decreases in IYCN knowledge 6-10 months after nutrition BCC activities ended. [ABSTRACT FROM AUTHOR]

Ethiopia faces a rising problem of overweight and obesity alongside a high prevalence of undernutrition; a double burden of malnutrition (DBM). This study aimed to quantify the magnitude and trends of household‐level DBM—defined as the coexistence of maternal overweight/obesity and child undernutrition (i.e., stunting or anaemia)—in Ethiopia between 2005, 2011 and 2016 and understand the potential drivers influencing DBM and the change in DBM over time. Data come from the Ethiopian Demographic and Health Surveys. National and regional prevalence estimates of the DBM were calculated (n = 13,107). Equiplots were produced to display inequalities in the distribution of DBM. Factors associated with DBM were explored using pooled multivariable logistic regression analyses for 2005, 2011 and 2016 (n = 9358). These were also included in a logistic regression decomposition analysis to understand their contribution to the change in DBM between 2005 and 2016 (n = 5285). The prevalence of household‐level DBM at the national level was low, with a modest increase from 2.4% in 2005% to 3.5% in 2016. This masks important within‐country variability, with substantially higher prevalence in Addis Ababa (22.8%). Factors positively associated with DBM were maternal age (odds ratio [OR] = 1.04 [1.02, 1.06]), urban residence (OR = 3.12 [2.24, 4.36]), wealth (OR = 1.14 [1.06, 1.24]) and the number of children <5 in the household (OR = 1.30 [1.12, 1.49]). Overall, 70.5% of the increase in DBM between 2005 and 2016 was attributed to increased wealth, urban residence and region. Double‐duty actions that address multiple forms of malnutrition are urgently needed in urban settings. Key messages: Despite a low national prevalence, household level DBM is significantly higher in urban areas, particularly in Addis Ababa where nearly a quarter of households are affected.Maternal age, urban residence, wealth and the number of children <5 in the household were positively associated with DBM.Increased wealth and urban residence were the main drivers associated with increases in DBM between 2005 and 2016.Double‐dutyactions addressing multiple forms of malnutrition are required in urban settings.Transforming food systems by regulating the promotion and distribution of unhealthy foods and promoting nutrient‐dense foods is critical. [ABSTRACT FROM AUTHOR]

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

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

Early childhood development (ECD) is crucial for better health and well‐being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem‐solving and personal–social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community‐based cross‐sectional survey design, 627 mother–child (12–36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ‐3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem‐solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non‐stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition. Key messages: Studies examining early childhood development (ECD) and child nutrition are scarce in Ethiopia, mainly due to lack of reliable and disaggregated ECD data.We estimated the prevalence of ECD delays and examined how different ECD domains were associated with child nutrition in urban Ethiopia using a direct ECD measure.Our study revealed that stunted and underweight children had a higher likelihood of ECD delays. To address these issues, we recommend coordinated efforts across key sectors, such as health, education, women's affairs and social protection, to promote and implement ECD interventions, such as nurturing care. [ABSTRACT FROM AUTHOR]

We aimed to describe how breastfeeding relates to adherence to complementary feeding (CF) recommendations, diet diversification and feeding skills development and whether sociodemographic factors explain any differences observed. The Scottish Maternal Infant and Nutrition Survey for infants aged 8–12 months collected breastfeeding history, CF practices, diet and sociodemographic data using a self‐completion questionnaire. Non‐healthful CF practices were starting CF < 6 months, any consumption of sugar‐sweetened beverages (SSBs), sweet or salty snacks (treats) or unmodified cow's milk and regular consumption of commercial baby foods. Diet diversification and feeding skills were assessed by amount of self‐feeding and number of food groups, meals and snacks eaten daily. Of the 2730 mothers, 20% were solely infant formula fed (IFF) and 48% continued breastfeeding ≥6 months. Compared to IFF babies, mothers who gave any breast milk ≥6 months were more likely to start CF ≥ 6 months compared to those IFF (66% vs. 37%) and less likely to give treats (15% vs. 45%), SSBs (11% vs. 20%) and commercial baby foods (31% vs. 53%). These associations remained highly significant (p < 0.001) even after sociodemographic factor adjustment. Despite starting CF later, infants breastfed ≥6 months ate the same number of food groups and meals as those IFF, were just as likely to self‐feed purees and more likely to self‐feed finger foods daily (87% vs. 81% p < 0.001). Mothers who breastfeed beyond 6 months adhere more to CF recommendations and start CF later compared to IFF, but their babies eat a similarly diverse diet and have similar feeding skills. Key messages: Adhering to breastfeeding recommendations is associated with delayed introduction of complementary foods, without influencing diet diversity or development of infant feeding skills.Breastfeeding duration is a predictor for healthful complementary feeding practices.These associations between breastfeeding duration and healthful complementary feeding practices are not explained by differences in maternal age or deprivation level. [ABSTRACT FROM AUTHOR]

Limited evidence exists on the long‐term effects of early feeding practices on child growth and development. We examined the relationships between infant feeding practices and child height and development at ages 2 and 6–7 years. We studied 885 mother–child dyads from a randomized controlled trial of preconception supplementation in Vietnam. Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding (BF) duration and minimum dietary diversity (MDD) were assessed using World Health Organization (WHO) guidelines. Child development was assessed by the Bayley Scales of Infant Development‐III at 2 years and the Wechsler Intelligence Scale for Children® – IV at 6–7 years. Child height‐for‐age z‐score (HAZ) was calculated from child height and age. Multivariable regression and structural equation models were used in analyses that controlled for confounding. EIBF and EBF at 6 months occurred in 52% and 62% of children, respectively. Mean breastfeeding duration was 18 months and 83% achieved MDD at 1 year. EIBF was associated with motor (β = 0.13, 95% confidence interval [CI]: 0.00, 0.28) and cognitive development at 2 years (β = 0.12, 95% CI: −0.01, 0.26), which in turn were positively associated with cognitive development at 6–7 years. EBF was directly associated with development at 6–7 years (β = 0.21, 95% CI:0.08, 0.34) whereas motor and cognitive development at 2 years explained 41%–75% of the relationship between EIBF and development at 6–7 years. HAZ at 2 years also mediated 70% of the association between MDD at 1 year and HAZ at 6–7 years. BF duration was not associated with child development and HAZ. Early infant feeding practices, especially EIBF and EBF, have important long‐term implications for optimizing child linear growth and cognition as they begin school. Key messages: Optimal breastfeeding practices during the first few months of life were positively associated with cognitive development in early childhood and school‐aged children.While exclusive breastfeeding was directly associated with child cognition at 6–7 years, cognitive development at 2 years mediated the association of early initiation of breastfeeding on cognition at 6–7 years. More research is needed to replicate these findings, explore mechanisms and evaluate the causal relationship.Child linear growth in early childhood mediated the association of minimum dietary diversity at 1 year on child height‐for‐age z‐score at 6–7 years. [ABSTRACT FROM AUTHOR]

To develop and validate the Insomnia in Response to Sports‐related Stress Test (IRSST) questionnaire, a new specific instrument with the goal of sensitively measuring vulnerability to sport‐specific stressful situations among elite athletes. Five hundred and thirty‐one competitive elite athletes (mean age = 17.6 ± 4.4 years) completed the Ford Insomnia Response to Stress Test (FIRST) questionnaire and the IRSST, a six‐item questionnaire developed to assess the level of sleep disturbance in response to the commonly experienced sport‐specific stressful situations. A development and validation process including substantive, structural, and external stages was used in the present study. One eigenvalue of the exploratory factor analyses was greater than 1.0 (i.e., 2.91, 48.52% of explained variance) whereas the scree test provided evidence for a one‐factor solution, with all the six items achieving a loading of 0.40 or higher on the factor. Cronbach alpha was 0.77 and provided evidence for the reliability of the IRSST score. The correlation between IRSST and FIRST scores was 0.47 (p < 0.001, moderate effect size). These results provide strong evidence for construct validity, indicating that the IRSST is a promising scale for assessing the likelihood of sleep disruption due to sports‐related stressful situations. The results of reliability and correlational analyses provided further evidence of the promising psychometric properties of the IRSST. We believe that the IRSST could provide to the sport and sleep science communities a sleep screening tool for use in this unique population. Highlights: The Insomnia in Response to Sports‐related Stress Test (IRSST) questionnaire is a promising new specific instrument for assessing the likelihood of sleep disruption due to sports‐related stressful situationsThe IRSST could provide to the sport and sleep science communities a sleep screening tool for use in the unique population of competitive elite athletesThe IRSST can be used to identify athletes with sleep difficulties related to sports‐specific stressful situations (e.g., training, competition, injury) [ABSTRACT FROM AUTHOR]

The 6‐hour (6‐h) time to wound closure was a controversial issue as studies have shown that time was not a substantial factor. Wounds in the face are often considered to have a lower infection risk. Despite this, the cause of injury was not extensively discussed in relation to this context. The primary objective was to investigate the association between the 6‐h time to wound closure and wound complications following emergency management of facial soft tissue injuries (STIs). Additionally, the secondary objective was to explore other factors contributing to wound complications. A retrospective record review was conducted in our hospital in Kuala Lumpur, Malaysia, from 1 January 2017 to 31 December 2021. Medical records of patients with facial STIs due to road traffic accidents were included. Simple random sampling was used to select records meeting inclusion criteria. Data on demographic, injury, and treatment characteristics were collected using a standardized proforma. Descriptive, univariate and multivariate analyses were performed, including chi‐square tests and binary logistic regression. A total of 295 patient records were included, with most patients being males (77.3%) and of Malay ethnicity (54.9%). The median age was 31.0 years. Majority of patients were treated within 6 h of injury (93.9%). Complications were documented in 6.1% of cases, including wound dehiscence and infection. Multivariate analysis revealed a significant association between 6‐h time to closure and wound complications (OR: 7.53, 95% CI: 1.90–29.81, p = 0.004). Grade of surgeon on duty (OR: 4.61, 95% CI: 1.25–16.95, p = 0.02) and diabetes mellitus (OR: 6.12, 95% CI: 1.23–30.38, p = 0.03) were also shown to have a statistically significant association with wound complications. A 6‐h time to wound closure, grade of surgeon on duty and diabetes mellitus were three major factors involved in facial wound complications following road traffic accidents. [ABSTRACT FROM AUTHOR]

Research acknowledges Sports‐Related Concussion (SRC) is acutely deleterious to academic ability, but no tool has been validated to measure the effect of SRC on academic ability. The sutdy aimed to establish if the Revised Perceived Academic Impact Tool (PAIT2) is reliable and valid for assessing academic impairment following an SRC. Non‐concussed, healthy student‐athletes in higher education were recruited to the control group and completed the PAIT2 at day 0, 2, 4, 8, 14 and 19. The concussed group consisted of higher education student‐athletes participating in rugby union. The concussed group completed the PAIT2 at baseline screening during pre‐season, day 2, 4, 8 and 14 following an SRC and at return‐to‐play. The PAIT2 asks participants to rate their perceived ability on 23 academic tasks on a statement scored on a 0–6 Likert scale. Repeated measurements from the healthy group (n = 25) demonstrated PAIT2 has good internal validity (χ2(25) = 2.128 and p = 0.712) and reliability (0.880 [95% CI: 0.785–0.941]). A change of 4.631 (80% CI) can be used to indicate if academic impairment is present following an SRC. PAIT2 identified 96% of concussed student‐athletes with academic impairment at day 2, 92% at day 4, 85.71% at day 8 and 92% at day 14 and 19. PAIT2 has good reliability and internal validity for detecting those with academic impairment following SRC. The use of this tool may be of assistance to clinicians when managing student‐athletes return to learn. Highlights: No previous studies have used an assessment tool to measure perceived academic ability during the acute phase of a Sports‐Related Concussion (SRC). The Revised Perceived Academic Impairment Tool (PAIT2) may fill this void but has not been validated or its reliability established.The concussed group had significantly worse self‐perceived academic performance at day 2, but not by day 4, indicating perceived academic ability recovers by 4 days following an SRC.The PAIT2 had good validity and reliability and was able to detect 96.00%, 92.00% and 85.71% of concussed student‐athletes with academic impairment at day 2, 4, 8 and 14 days post‐SRC.Other measures, such as academic time loss or the Immediate Post Concussion Test, were not superior for detecting academic impairment, but the use of this with PAIT2 was superior for ruling out academic impairment rather than just the PAIT2. [ABSTRACT FROM AUTHOR]

Caesarean section (C‐section) is the most performed major surgery worldwide. About 15% of births are delivered through C‐section in Rwanda. The post‐caesarean surgical section is one of the most frequent complications that follow a C‐section. The purpose of this systematic review and meta‐analysis is to estimate the pooled prevalence of surgical site infections following caesarean section deliveries in Rwanda. A comprehensive search was conducted across PubMed/MEDLINE, Google Scholar, DOAJ, AJOL and the Cochrane Library to identify primary studies on post‐caesarean surgical site infections in Rwanda. Studies meeting predetermined criteria were included, and their quality was assessed using the JBI Critical Appraisal Tools. Heterogeneity was evaluated using I2 statistics, while publication bias was examined via funnel plots and statistical tests. Pooled prevalence was calculated using Jamovi 2.3.28 software, with subgroup analysis conducted to identify sources of heterogeneity. Statistical significance was set at p < 0.05. From 139 articles initially searched from the databases, only 17 studies with 8, 082 individuals were finally included in the systematic review and meta‐analysis. Using the random‐effects model, the pooled estimate of post C‐section SSIs prevalence in Rwanda was 6.85% (95% CI 5.2, 8.5). Subgroup analysis based on publication year, sample size, hospital and study design showed no much difference in SSI prevalence. The current systematic review and meta‐analysis indicates that post‐caesarean surgical site infections are significant in Rwanda. A collaborative effort is required to lower post‐C‐section SSIs and provide the best surgical care in the country. [ABSTRACT FROM AUTHOR]

Background and Objective The aim of this study is to analyze the relationship between the subgingival colonization by Candida albicans and other yeasts with the severity of chronic periodontitis ( CP). Material and Methods After sample size calculation, 40 patients with CP and 20 healthy subjects ( HS) were included in the study. Cases of slight-moderate ( MCP, n = 23) and severe CP ( SCP, n = 17) were defined according to the Centers for Disease Control/American Association of Periodontology classification. Subgingival samples were acquired using sterile paper-points from the sulcus or the deepest periodontal pocket of each healthy and subject with CP, respectively, and were cultured aerobically on three selective media. Yeast colonies that grew on the surface of plates were later identified by biochemical reactions. Statistical tests were used to analyze the association between subgingival yeast colonization (number of yeast-positive individuals and colony forming units ( CFU) per subject) and periodontal disease status, considering statistical significance when P < 0.05. Results Although several yeast species were found ( C. parapisilosis, Rhodotorula sp., C. dubliniensis and C. tropicalis), only C. albicans was present in all the patients with yeast-positive CP. Twelve patients (30%) with CP presented yeasts in the subgingival biofilm while only three patients (15%) in the HS group were positive for these microorganisms. No statistical difference was found between the CP and HS groups ( P = 0.084). However, when the CP group was divided on the basis of severity, statistical differences were observed between the SCP and MCP groups (47% vs. 17%, P = 0.043), and between the SCP and HS groups (47% vs. 15%, P = 0.033). No statistical difference was observed between the MCP and HS groups (17% vs. 15%, P = 0.832). High densities of yeasts were found only in patients with MCP and SCP (mean and range 61.25 (0-100) CFU/plate and mean and range 51 (0-101) CFU/plate, respectively). Conclusion In this group of patients, subgingival colonization of some yeasts, especially C. albicans, was associated with the severity of CP. [ABSTRACT FROM AUTHOR]

Background Central venous catheters (CVCs) facilitate the administration of intravenous drugs, fluids, blood products and parenteral nutrition to patients with either chronic disease or critical illness. Despite a pivotal role within medical management, a common complication associated with CVC use is occlusion of the CVC lumen(s). CVC occlusion can interrupt and cause serious delays in administration of treatment interventions. Objectives The primary objective of this review was to assess the efficacy and safety of different interventions used to restore patency of occluded CVC lumens, in adults and children. Search methods We identified trials by searching the Cochrane Central Register of Clinical Trials (CENTRAL) ( The Cochrane Library 2011, Issue 9); OvidSP MEDLINE (1950 to September 2011); OvidSP EMBASE (1980 to September 2011) and NHS Evidence CINAHL (1982 to September 2011). We also searched clinical trial registers, handsearched reference lists, contacted pharmaceutical companies and authors of publications that met the inclusion criteria to identify trials. Selection criteria We selected randomized controlled trials which investigated the efficacy of an intervention (chemical, surgical or drug) used to restore patency to an occluded CVC lumen, in either adults or children. Data collection and analysis Three authors independently assessed those studies that met the inclusion criteria for quality and extracted the relevant data using a standardized form. Main results No studies were found that investigated the efficacy and safety of either chemical or surgical interventions. Seven studies (eight papers) with a total of 632 participants were identified from the search. They investigated different comparisons, strengths of thrombolytic or anticoagulant drug interventions for treating CVC lumen occlusion thought to be caused by a thrombus. There was low quality evidence from a meta-analysis of two studies suggesting that urokinase (various strengths) was more effective than placebo for restoring patency to occluded CVC lumens in adults and children with underlying medical conditions (relative risk (RR) 2.09, 95% confidence interval (CI) 1.47 to 2.95), with a number needed to treat of 4 (95% CI 2 to 8). There was insufficient evidence to draw conclusions on the safety of urokinase. The overall quality of the evidence provided by these studies was low to very low due to one or more domains being assessed as either at 'unclear risk of bias' or 'high risk of bias'. Furthermore, the total number of participants in these studies was small and consequently may lead to spurious results. Authors' conclusions There is inadequate evidence to draw strong conclusions on the efficacy or safety of the drug interventions included in this review. There is some low quality evidence from a meta-analysis of two studies investigating urokinase (various strengths) and some very low evidence from two single studies investigating alteplase 2 mg/2 mL that suggest that these two drug interventions may be effective in treating withdrawal or total occlusion of CVC lumens caused by thrombosis. Further high quality, sufficiently powered research is still required to look at the efficacy and safety of urokinase, alteplase and other chemical, surgical and drug interventions for treating CVC lumen occlusion. Research studies which exclusively include child participants are especially warranted. Plain Language Summary Interventions for restoring patency of occluded central venous catheter lumens A central venous catheter is a small, hollow tube that is inserted into a large vein in either the chest, neck or groin. Central venous catheters enable healthcare professionals to administer drugs and other fluids directly into the blood stream, in order to treat critically ill patients or those patients with a long-term condition. In certain chronic conditions, patients or their carers may also be involved with the administration of treatment interventions via the central venous catheter. Occasionally, the catheter lumens can become blocked with either a blood clot or a treatment intervention solidifying in the tube, or due to the position of the tube inside the vein. If the catheter does become blocked it may mean that the patient has to undergo further surgery to remove and replace the blocked catheter. No studies were found investigating the efficacy and safety of surgical interventions (brush, snare or guidewire exchange) or chemical interventions (hydrochloric acid, sodium bicarbonate, 70% ethanol solution) to unblock the catheter. Our search identified seven studies (eight papers), with a total of 632 participants, that investigated different drug comparisons or compared different strengths of drug therapies for treating catheters that were either completely or partially blocked with a blood clot. This review has found low to very low quality evidence suggesting that thrombolytic drugs (urokinase and alteplase) could be effective in unblocking central venous catheter lumens blocked by blood clots. However, the total number of participants included in these trials was small and consequently the results of the analysis may well be over exaggerated. There were also issues with the way the studies were conducted that could possibly have introduced bias. In conclusion, more research is required to establish the efficacy and safety of different treatment interventions used to unblock occluded central venous catheter lumens. Particularly, there is a need for studies exclusively in children. [ABSTRACT FROM AUTHOR]

What is already known about this subject There is an association between adiposity levels and physical activity guidelines for adolescents., Achieving physical activity recommendations helps adolescents to prevent obesity status., What this study adds This paper presents an association between physical activity levels and obesity status., This paper supports physical activity recommendations to avoid children's obesity levels., This paper emphasizes vigorous physical activity for this matter., Background There is no information about physical activity (PA) recommendations to avoid children's obesity levels and how much of vigorous PA (VPA) is included into the '60 minutes of MVPA 5 days a week' recommendation for children. Objective The aim of this study was to examine the association between PA and adiposity in children and to examine whether the current PA guidelines are associated with a low risk of having excess of body fat in children, with special focus on sex differences, and PA intensity. Methods A sample of 439 Spanish children aged 8-10 years from the European Youth Heart Study participated in the study. The variables measured were anthropometric characteristics (height, weight, body mass index [ BMI], skin-folds and waist circumference) and PA was measured during 6 consecutive days using the GT1M accelerometer. Results Receiver operating characteristic analysis showed significant cut-off points associated with non-overweight: 45 min d−1 of VPA and 67 min d−1 of moderate-to-vigorous physical activity ( MVPA) (using BMI categories); and non-fat: 41 min d−1 of VPA and 67 min d−1 of MVPA (using percentage of body fat) and 38 min d−1 of VPA and 47 min d−1 of MVPA (using waist circumference categories) for boys. For girls, the optimal cut-offs of moderate-to-vigorous activity and MVPA associated with non-overweight were 24 and 57 min d−1, respectively ( BMI). Boys who did not meet 67 min in MVPA had an increased risk of being overweight + obese and overfat + obese (odds ratio [ OR] = 2.48, 95% confidence interval [ CI] = 1.36, 4.53, and OR = 2.56, 95% CI = 1.12, 5.82). Conclusions The findings support current PA recommendations (60 min d−1 of MVPA) to avoid excess of body fat in Spanish children. However, VPA appears to be an important component for the prevention of obesity, and our findings suggest that PA recommendations should specify the dose of VPA required for optimal health. Therefore, public health PA recommendations should incorporate specifically a greater dose of VPA into the total amount of MVPA in 8- to 10-year-old boys. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 267-276 Objectives We reviewed papers describing the development of instruments for assessing clinical communication in undergraduate medical students. The instruments had important limitations: most lacked a theoretical basis, and their psychometric properties were often poor or inadequately investigated and reported. We therefore describe the development of a new instrument, the Liverpool Undergraduate Communication Assessment Scale (LUCAS), which is intended to overcome some of these limitations. We designed LUCAS to reflect the theory that communication is contextually dependent, inherently creative and cannot be fully described within a conceptual framework of discrete skills. Methods We investigated the preliminary psychometric properties of LUCAS in two studies. To assess construct and external validity, we examined correlations between examiners' LUCAS ratings and simulated patients' ratings of their relationships with students in Year 1 formative ( n = 384) and summative ( n = 347) objective structured clinical examination (OSCE) samples. Item-total correlations and item difficulty analyses were also performed. The dimensionality of LUCAS was examined by confirmatory factor analysis. We also assessed inter-rater reliability; four raters used LUCAS to rate 40 video-recorded encounters between Year 1 students and simulated patients. Results Simulated patient ratings correlated with examiner ratings across two OSCE datasets. All items correlated with the total score. Item difficulty showed LUCAS was able to discriminate between student performances. LUCAS had a two-dimensional factor structure: we labelled Factor 1 creative communication and Factor 2 procedural communication. The intraclass correlation coefficient was 0.73 (95% confidence interval 0.54-0.85), indicating acceptable reliability. Conclusions We designed LUCAS to move the primary focus of examiners away from an assessment of students' enactment of behavioural skills to a judgement of how well students' communication met patients' needs. LUCAS demonstrated adequate reliability and validity. The instrument can be administered easily and efficiently and is therefore suitable for use in medical school examinations. [ABSTRACT FROM AUTHOR]

Ĉpk is used as an estimate of process capability and can reflect performance degradation due to both shifts in the process mean and variability. Exact upper and lower confidence limits for the actual parameter value are elusive. Objections to existing estimators focus on two areas: the difficulty of executing the needed computations and the excessive widths of those confidence bounds. The CPE estimator (so called since it relies on Ĉp ) which we derive in this paper is formed by simply multiplying Ĉpk by a value from the inverse chi-square distribution. A PASCAL computer program is supplied which generates those percentiles. Our CPE is compared via simulation to other estimators and is shown to be the preferred selection in most cases by providing the requisite probability coverage and narrow interval widths. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective Despite increases in Commonwealth funded general practice (GP) Registrar training positions, workforce trends continue to show geographical maldistribution. This study aimed to identify Registrar attributes which describe a cohort choosing to work in rural practice. Design Cross-sectional self-report questionnaire for socio-demographics, prior training, current training pathway, measures of personality and resilience. Participants and Setting GP Registrars ( N = 452) training in either the general or rural pathways of three Registered Training Providers in three states, or training through the Australian College of Rural and Remote Medicine's independent pathway. Main outcome measure Ordinal logistic regression tested the impact of key variables on the likelihood that Registrars would settle in rural practice. Univariate analysis explored differences between groups and effects of variables. Results A significantly increased interest in rural practice was to found to exist among registrars who were male, identified themselves as being rural, had a partner who identified as being rural, were enrolled in a rural training pathway and had high levels of Cooperativeness. Conclusion We present a discriminating model combining socio-demographics, prior training and personality variables which challenges Australia to rethink Registrar attributes when training for rural general practice. With significant changes about to occur to GP training in Australia, this paper highlights the need for a more holistic approach which considers personal attributes such as Cooperativeness, rural identity and provision of geographically focused rural training pipelines to encourage Registrars to bond to individual rural communities and further develop their personal connectedness to country life and rural medical practice. [ABSTRACT FROM AUTHOR]

Background and aims Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug-related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly funded treatment for OUD to compare total costs of crime during a hypothetical 6-month period following initiation of opioid agonist treatment (OAT) versus detoxification. Design Retrospective, administrative data-based cohort study with comprehensive information on drug treatment and criminal justice systems interactions. Setting Publicly funded drug treatment facilities in California, USA (2006-10). Participants A total of 31 659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women and 37.1% primarily used prescription opioids. Measurements Daily costs of crime (US$2014) were calculated from a societal perspective and were composed of the costs of policing, court, corrections and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time-varying confounders, including drug use and criminal justice system involvement prior to treatment initiation. Findings Daily costs of crime during treatment compared with after treatment were $126 lower for OAT [95% confidence interval (CI) = $116, $136] and $144 lower for detoxification (95% CI = $135, $154). Summing the costs of crime during and after treatment over a hypothetical 6-month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17 550 ($16 840, $18 383). Conclusions In publicly funded drug treatment facilities in California, USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the 6 months following initiation of treatment, and the economic benefits were far greater for individuals receiving time-unlimited treatment. [ABSTRACT FROM AUTHOR]

The main aim of the Swedish physical activity and fitness cohort study ( SPAF-1958) was to describe physical fitness, physical activity, health, and lifestyle across part of the lifespan, and to assess the influences on these factors from the environment, personal factors, and genetics. There is inevitable dropout from longitudinal studies, and it may be systematic. The aim of this first paper of the second follow-up of SPAF-1958 was to provide a dropout analysis to consider to what extent the participants, at 52 years of age, remain a representative sample of the original adolescent study population. Additional aims were to provide an overview of the study protocol and the ongoing study population. Ongoing study participants in SPAF born in 1958 were, at the second follow-up at the age of 52, still representative of the study cohort in terms of sex, adolescent geographical area, upper secondary school program, adolescent body composition, muscular strength, and muscular endurance. However, a higher physical activity and, among women, a higher aerobic capacity in adolescence decreased the risk for dropout. It is important when interpreting results from longitudinal studies to adjust for the systematic dropout that could bias the conclusions drawn from the results. [ABSTRACT FROM AUTHOR]

Background Menstrual migraine is a highly prevalent disorder among adult women, resulting in disability and loss of quality of life. Some studies have reported menstrual cycle synchrony among women living together. No study has reported whether there may also be a higher prevalence of menstrual migraine among these women. Thus, they reported here the prevalence of menstrual migraine in a group of women living together compared with a control group of women living alone, and discussed the possible factors involved. Methods The study was conducted on female university students aged 18-30 years with a diagnosis of migraine according to the criteria of the International Classification of Headache Disorders III, beta appendix criteria. The subjects were divided into a group of women who lived together with two or more other students and a control group of age-matched students who lived alone, interviewed with a specific questionnaire and assessed for 3 months by means of a paper pain diary. The data evaluated included frequency of headache, presence of menstrual migraine, intensity of headache, medications used including contraceptives, and triggering factors such as diet, sleep deprivation, and stress. The menstrual data and data related to migraine were also investigated in the roommates. Results A higher occurrence of menstrual migraine among women living together (9, 50%) compared with women living alone (3, 16.7%) ( P = .03) was detected. After binary logistic regression analysis, this finding was not related to the main influencing factors detected, that is, use of a contraceptive, test stress, or sleep deprivation ( P = .03, adjusted odds ratio: 7.87; 1.23-50.36). These women also showed menstrual cycle synchrony with their roommates (8, 44.4%) and the presence of headache crises during the menstruation of their colleagues (11, 61.1%). Conclusion The present study detected a higher occurrence of menstrual migraine among women who lived together. Since there was no previous description of this topic in the literature, it was believed that the present study could represent a step toward more elaborate investigations of this complex topic. [ABSTRACT FROM AUTHOR]

Background Besides the right to freedom, human rights can be seen as a basic requirement also for the maintenance of human dignity and the opportunity to thrive - particularly in the case of children with disabilities. It is imperative to explore primary caregivers' awareness of the human rights of their children with intellectual disabilities in view of the role they may play in either facilitating or restricting these rights. This paper explores the awareness of 219 primary caregivers of the human rights of their children with intellectual disabilities. Method A descriptive survey design was used with a custom-designed questionnaire that employed a deductive content analysis based on the articles of the United Nations Convention on the Rights of a Child. Comparisons were drawn between the awareness of primary caregivers from urban and those from rural areas. Results The majority (85.5%) of participants agreed that their child with intellectual disability had rights. Three broad kinds of right were mentioned (in descending order): provision rights, protection rights and participation rights. Participants from both urban and rural areas mentioned education (a provision right) most frequently. However, participants from urban areas were more aware of the different rights that existed than were their counterparts from rural areas. Conclusion Primary caregivers in both rural and urban areas are aware of the rights of their children with disabilities, although there are significant differences between them. [ABSTRACT FROM AUTHOR]

Previous evaluation studies have rarely used authentic online texts and investigated upper secondary school students' use of evaluation criteria and deep reasoning. The associations between internet‐specific epistemic justifications for knowing and credibility evaluation of online texts are not yet fully understood among adolescents. This study investigated upper secondary school students' (N = 372) abilities to evaluate self‐selected authentic online texts and the role of internet‐specific epistemic justifications in students' evaluation performance when solving a health‐related information problem. Students selected three texts with Google Custom Search Engine and evaluated their credibility. Students' evaluation performance across the three texts was determined according to the different aspects evaluated (author, venue, intentions, evidence and corroboration) and the depth of their evaluations. Students also filled in the Internet‐Specific Epistemic Justifications (ISEJ) inventory previously validated with pre‐service teachers. The results revealed considerable differences in students' abilities to evaluate online texts. Students' beliefs in justification by authority and justification by multiple sources positively predicted their evaluation performance similarly in both topics. The findings suggest that the ISEJ inventory is also valid for upper secondary school students. Students should be explicitly taught to evaluate different credibility aspects and scaffolded to deeply engage with online information. Lay Description: What is currently known about the subject matter: Evaluation of online texts is challenging for adolescents.Students' abilities to evaluate the credibility of online texts vary considerably.Beliefs in justifications for knowing may contribute to the evaluation of online information.Three‐dimensional knowing construct has been found in the Internet context. What the paper adds: Students' evaluations of online texts reflected different credibility aspects and depth in reasoning.Students used more frequently venue, evidence and author than intentions and corroboration as evaluation criteria.Students' beliefs in justification by authority and justification by multiple sources predicted their evaluation performance.Personal justification did not predict students' evaluation performance. The implications of study findings for practitioners: Students should be instructed to evaluate various aspects of credibility and engage in deep reasoning.Students would benefit from learning how to use corroboration with multiple texts as an evaluation strategy.Personal feedback may promote advanced justifications for knowing. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship among emotional intelligence (EI), resilience and academic procrastination (AP), and provide suggestions for the development of targeted intervention strategies and lowering of AP level of nursing undergraduates. Design: A cross‐sectional study. Methods: Three provincial universities offering nursing courses in China were investigated in this study. A convenience sample of 256 nursing undergraduates from May 2021 to September 2021 were recruited, with a response rate of 91.4%. Data were collected using face‐to‐face interviews. The survey tools included the General Information Questionnaire, Academic Procrastination Scale, Emotional Intelligence Scale and Resilience Scale. IBM SPSS v19.0 and Amos 22.0 were used for data analysis. Results: The AP of sampled nursing undergraduates was at the middle level (54.4 ± 21.5). The AP of nursing undergraduates was negatively correlated with EI and resilience. Moreover, the analysis on the mediating role of resilience via structural equation model showed a good fit, with χ2/df = 2.34, RMSEA = 0.07, CFI = 0.99, GFI = 0.95, TLI = 0.98. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

A meta‐analysis was conducted to evaluate the effects of loose combined cutting seton surgery on wound healing and pain in patients with high anal fistula, aiming to provide evidence‐based medical evidence for surgical method selection for these patients. A comprehensive computerized search of PubMed, Cochrane Library, EMBASE, Wanfang and China National Knowledge Infrastructure databases was conducted to collect all relevant studies published up to November 2023, evaluating the effects of loose combined cutting seton surgery in treating patients with high anal fistulas. Two researchers independently screened, extracted data, and assessed the quality of the identified studies. RevMan 5.4 software was employed for data analysis. Overall, 16 articles were included, comprising 1124 patients, with 567 undergoing loose combined cutting seton surgery and 557 undergoing simple cutting seton surgery. The analysis revealed patients undergoing loose combined cutting seton surgery had a higher rate of postoperative wound healing (97.44% vs. 81.69%, odds ratio [OR]: 7.49, 95% confidence interval [CI]: 4.29–13.10, p < 0.00001), shorter wound healing time (standardized mean differences [SMD]: −1.48, 95% CI: −1.89 to −1.08, p < 0.00001), lower postoperative wound pain scores (SMD: −2.51, 95% CI: −3.51 to −1.51, p < 0.00001), and a lower rate of postoperative complications (3.43% vs. 20.83%, OR: 0.13, 95% CI: 0.05–0.31, p < 0.00001). The current evidence suggests that compared to simple cutting seton surgery, loose combined cutting seton surgery in treating high anal fistulas can promote postoperative wound healing, shorten wound healing time, alleviate pain, and reduce the incidence of postoperative complications, making it a worthy clinical practice for widespread application. [ABSTRACT FROM AUTHOR]

There has been controversy over the use of neoadjuvant chemotherapy or surgery in the treatment of ovarian cancer. The purpose of this meta‐analysis is to assess the hazard evaluation of the effect of adjuvant chemotherapy over primary debulking surgery (PDS) on the incidence of wound infection in women with ovarian carcinoma. In this research, we looked at PubMed, Embase and Cochrane Library to evaluate the impact of PDS and chemotherapy on the incidence of wound infections in women with ovarian cancer. Based on the keywords of 'Ovary Cancer', 'Surgical' and 'Chemotherapy', we looked up the data in the digital database, and at last, we selected six of them from 1453 studies. There was no time limitation in the studies. The meta‐analyses included studies that described the risk factors of wound infection in ovarian carcinoma patients, particularly those who reported OR value. The Chi‐square method was employed to perform statistical analysis of the inter‐study heterogeneity, with additional analyses dependent on I2. A sensitivity analysis was conducted, and a possible publication bias was evaluated. The findings suggest that there is a significant reduction in the rate of wound infections among patients with ovarian cancer treated with primary chemotherapy than with PDS (OR, 2.80; 95% CI, 1.79, 4.39, p < 0.0001). There was a significant reduction in the incidence of thrombus in patients with ovarian cancer who were treated with primary chemotherapy than in those who did have prior surgical intervention (OR, 2.77; 95% CI, 1.34, 5.74, p = 0.006). Our findings indicate that early chemotherapy in ovarian cancer patients may lower their chances of developing wound infection. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the impact of hip arthroscopy group and open surgical dislocation group as treatments for femoroacetabular impingement (FAI) in young athletes, specifically in relation to early hip osteoarthritis. A systematic search was conducted across four databases to identify controlled trials comparing hip arthroscopy and open surgical dislocation for FAI treatment. The selected studies (9 in total) underwent rigorous literature assessment and data analysis using Review Manager (RevMan) 5.3 software. The meta‐ analysis revealed that there was no statistically significant difference between hip arthroscopy group (the test group) and the open surgical dislocation group (the control group) concerning the improvement of the alpha angle (Standardized Mean Difference [SMD]: ‐5.54; 95% Confidence Interval [CI]: ‐ 12.45,1.38; p = 0.117), the Modified Harris Hip Score (mHHS) after a 12‐ month follow‐ up (SMD:0.94; 95% CI:‐ 2.87,4.75; p = 0.629) and the complication rate (OR: 0.66; 95% CI: 0.26,1.65; p = 0.372). However, the meta‐ analysis revealed that the Nonarthritic Hip Score (NAHS) after a 12‐ month follow‐ up of the test group was significantly higher than that of the control group (SMD: 6.31; 95% CI: 0.53, 12.09; p = 0.032). In terms of the reoperation rate, it demonstrated a significantly lower rate in the test group compared to the control group (OR: 0.48; 95% CI: 0.29, 0.82; p < 0.01). These findings suggest that hip arthroscopy may have better outcomes for patients with FAI, as it is associated with improvements in hip function and a lower reoperation rate. However, these conclusions should be validated by further high‐ quality studies. [ABSTRACT FROM AUTHOR]

Whether prophylactic abdominal drainage tube is routinely placed in patients after hepatobiliary surgery remains controversial. To evaluate the effect of prophylactic abdominal drainage tube placement after hepatobiliary surgery on postoperative infection. Randomized controlled trials on the placement of prophylactic abdominal drainage tube after hepatobiliary surgery were collected through a computerized search of PubMed, Embase, Conchrane Library and Web of Science databases, with a time range from the establishment of the database to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies. Finally, 13 studies were included, including 3620 patients, and the results showed that there was no statistically significant difference in postoperative infection rate between the drainage group (1840 patients and the non‐drainage group [1783 patients] [relative risk, RR = 1.17, 95% confidence interval, CI: 0.94–1.47, p = 0.16]. Compared with the drainage group, the incidence of infectious abdominal fluid in the non‐drainage group was lower (RR = 2.09, 95% CI: 1.57–2.80, p < 0.00001), and the incidence of postoperative bile leakage was lower (RR = 1.77, 95% CI: 1.27–2.47, p < 0.001) and shorter hospital stays after surgery (mean difference = 1.27, 95% CI: 0.32–2.22, p = 0.009). In conclusion, placing a prophylactic abdominal drainage tube after hepatobiliary surgery does not reduce postoperative infection rates compared with no drainage. [ABSTRACT FROM AUTHOR]

This retrospective cohort study aims to assess whether the implementation of a multidisciplinary approach in the Gosford Hospital High‐Risk Foot Clinic improved outcomes of diabetic foot ulcers. Ulceration is a common foot complication of diabetes mellitus and greatly increases patient morbidity and mortality. Patients who attended at least one appointment at the Gosford Hospital High‐Risk Foot Clinic in 2017 or 2019 were identified through the Gosford Hospital Podiatry department's records. The 2017 and 2019 cohorts were compared on measures of ulcer healing, incidence of amputation, incidence of vascular intervention and surgical debridement, percentage of patients admitted to hospital due to complications and use of systemic antibiotic therapy. Sixty‐one patients in 2017 and 59 patients in 2019 met inclusion criteria, and from them, 207 ulcers were included. Between 2017 and 2019, there was a 6.2‐week reduction in time to 100% ulcer healing in 2019 (p = 0.021), and 10.1% more ulcers healed within 52 weeks (p = 0.22, 95% confidence interval [CI] [−5.9%, 25.5%]). Whilst there was no significant difference in incidence of patients receiving amputation, there was an increased absolute number of amputations in 2019. Implementation of a multidisciplinary approach at the Gosford Hospital High‐Risk Foot Clinic led to improvements in diabetic foot ulcer healing. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) post‐surgery impact patient health and raise healthcare costs. This meta‐analysis examines the efficacy of antiseptics, chlorhexidine and povidone–iodine, in reducing SSIs, including various types, to settle ongoing debates on their comparative effectiveness. A systematic literature search conforming to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines was executed on four established databases without temporal restrictions. Only randomized controlled trials (RCTs) including patients aged 18 years or older undergoing clean or potentially contaminated surgeries were included. Two independent evaluators carried out study selection, data extraction and quality assessment, adhering to Cochrane Collaboration's risk of bias tool. Statistical analyses were performed using chi‐square tests and the I2 index to evaluate heterogeneity, and meta‐analyses were conducted employing either fixed‐effects or random‐effects models as warranted by the heterogeneity assessments. A total of 16 RCTs were included after rigorous selection from an initial pool of 1742 articles. The studies demonstrated low levels of heterogeneity, supporting the use of a fixed‐effects model. Chlorhexidine exhibited statistically lower rates of overall SSIs (RR 0.75; 95% CI 0.64–0.88; p < 0.001), superficial SSIs (RR 0.62; 95% CI 0.47–0.82; p < 0.001) and deep SSIs compared to povidone–iodine. The study furnishes compelling evidence in favour of chlorhexidine as a more efficacious antiseptic agent over povidone–iodine in minimizing the risk of various types of SSIs. [ABSTRACT FROM AUTHOR]

Prostate cancer is one of the most common malignancies worldwide and the fifth leading cause of cancer deaths in men. With the rapidly increasing surgical rate of minimally invasive radical prostatectomy, there is still controversy about how to use a urinary catheter post‐operatively. Thus, we attempted to compare the post‐operative wound‐related outcomes through a meta‐analysis of urethral catheterisation (UC) versus suprapubic catheterisation (SPC) after minimally invasive radical prostatectomy. As of August 2023, the authors conducted systematic searches in databases such as PubMed, Embase, Web of Science and the Cochrane Library. The authors reviewed the relevant literature separately to determine comparisons between SPC and UC treatment after radical prostatectomy. A total of 395 subjects were enrolled in the five trials, met the eligibility criteria and were included in the meta‐analysis. Data collection and analysis revealed significant differences in catheter bother to patients for surgical trauma (MD, 0.98; 95% CI, 0.48, 1.48 p = 0.0001), with SPC causing less catheter bother to patients post‐operatively; post‐operative catheter‐related problems (OR, 3.3; 95% CI, 0.03, 326.1 p = 0.61), the POD1 of the post‐operative period (MD, − 0.09; 95% CI, −0.75, 0.94 p = 0.83) and the POD3 of the post‐operative period (MD, −0.49; 95% CI, −0.99, 0.01 p = 0.06); there was no statistically significant difference in wound pain. Compared with UC, SPC patients had less post‐operative catheter distress. Thus, SPC is more beneficial in reducing post‐operative wound discomfort in patients. The validity of the results remains to be tested in more and better studies. [ABSTRACT FROM AUTHOR]

Objective To examine urban-rural differences and individual risk factors for a late stage of breast cancer at diagnosis in Australian women. Design Individual-level longitudinal data were linked with cancer registry data from New South Wales (New South Wales Cancer Registry linked by the Centre for Health Record Linkage (CHeReL)), Queensland (Queensland Cancer Registry) and Victoria (The Cancer Council Victoria). Setting Participants were drawn from the Australian Longitudinal Study on Women's Health 1946-1951 cohort (n = 13 715). Participants The sample included 195 women identified from the linked cancer registry data with a breast cancer diagnosis. Interventions Rural or urban residence was measured using Accessibility/Remoteness Index of Australia Plus (ARIA+). Individual characteristics and socio-demographic variables examined included survey year, menopausal status, country of birth, education and marital status. Main outcome measures A late stage of breast cancer at diagnosis was defined based on the TNM Classification of Malignant Tumours. Results A late stage of breast cancer diagnosis was observed in 36% of women residing in urban areas and 40% of women residing in rural areas. After adjusting for individual characteristics, we found that obesity was the strongest risk factor for a late stage of breast cancer at diagnosis. Conclusions Given that women are becoming increasingly obese, and that the rate of obesity is higher in the Australian rural population, this paper provides further evidence for targeting interventions for obesity, particularly in rural Australia, as a public health priority. [ABSTRACT FROM AUTHOR]