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Sleep is a biological necessity that is a critical determinant of mental and physical well‐being. Sleep may promote resilience by enhancing an individual's biological preparedness to resist, adapt and recover from a challenge or stressor. This report analyzes currently active National Institutes of Health (NIH) grants focussed on sleep and resilience, specifically examining the design of studies that explore sleep as a factor that promotes health maintenance, survivorship, or protective/preventive pathways. A search of NIH R01 and R21 research project grants that received funding in Fiscal Years (FY) 2016–2021 and focussed on sleep and resilience was conducted. A total of 16 active grants from six NIH institutes met the inclusion criteria. Most grants were funded in FY 2021 (68.8%), used the R01 mechanism (81.3%), were observational studies (75.0%), and measured resilience in the context of resisting a stressor/challenge (56.3%). Early adulthood and midlife were most commonly studied and over half of the grants focussed on underserved/underrepresented populations. NIH‐funded studies focussed on sleep and resilience, or the ways in which sleep can influence an individual's ability to resist, adapt, or recover from a challenging event. This analysis highlights an important gap and the need to expand research focussed on sleep as a promotor of molecular, physiological, and psychological resilience. [ABSTRACT FROM AUTHOR]

The objectives of this article are to introduce a conceptual framework for physical resilience in the context of ageing and to discuss key elements and challenges in the design of studies of physical resilience after health stressors. Advancing age is associated with increasing exposure to multiple stressors and declining capacity to respond to health stressors. Resilience is defined broadly as the ability to resist or recover well from the adverse effects of a health stressor. In ageing‐related study designs of physical resilience after a health stressor, this dynamic resilience response can be observed as changes in repeated measures of function or health status in various domains important to older adults. Methodologic issues in selecting the study population, defining the stressor, covariates, outcomes, and analytic strategies are highlighted in the context of an ongoing prospective cohort study of physical resilience after total knee replacement surgery. The article concludes with approaches to intervention development to optimize resilience. [ABSTRACT FROM AUTHOR]

Background and Aims: Guillain–Barré syndrome (GBS) is a rare, acute neuropathy characterized by ascending muscle weakness. Age, axonal GBS variants, and antecedent Campylobacter jejuni infection are associated with severe GBS, but the detailed mechanisms of nerve damage are only partly explored. Pro‐inflammatory myeloid cells express NADPH oxidases (NOX) that generate tissue‐toxic reactive oxygen species (ROS) that are implicated in neurodegenerative diseases. This study analyzed the impact of variants of the gene encoding the functional NOX subunit CYBA (p22phox) on acute severity, axonal damage, and recovery in adult GBS patients. Methods: Extracted DNA from 121 patients was genotyped for allelic variation at rs1049254 and rs4673 within CYBA using real‐time quantitative polymerase chain reaction. Serum neurofilament light chain was quantified by single molecule array. Patients were followed for severity and motor function recovery for up to 13 years. Results: CYBA genotypes linked to reduced formation of ROS, i.e. rs1049254/G and rs4673/A, were significantly associated with unassisted ventilation, shorter time to normalization of serum neurofilament light chain and shorter time to regained motor function. Residual disability at follow‐up was confined to patients carrying CYBA alleles associated with high formation of ROS. Interpretation: These findings implicate NOX‐derived ROS in GBS pathophysiology and CYBA alleles as biomarkers of severity. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the optimal range of quantitative ablation index (AI) value during superior vena cava (SVC) electrical isolation by radiofrequency catheter ablation (RFCA). Methods: First, in a development cohort of patients with atrial fibrillation (AF), the RFCA with 40 W was performed to complete SVC isolation guided by the conduction breakthrough point from the right atrium to SVC. Then, the range of AI value was calculated by offline analysis on different segments of SVC. Lastly, for the validation of AF patients, the safety and effectiveness of SVC isolation with the optimized target range of AI value were evaluated with an additional adenosine test. Results: A total of 101 patients with AF were included in the study (44 patients in the development cohort/57 in the validation cohort). The segmental ablation strategy was applied in 70% of the patients. According to the offline analysis of the AI values in the development cohort, the target AI value range was set as 350–400. The success rate of SVC isolation in the validation cohort was significantly higher than that in the exploration cohort (100% vs. 90.9%, p =.02), and no complications occurred in the exploration cohort. During the adenosine test, the recovery rate of electrical conduction in SVC was significantly lower than that in the pulmonary vein (3.5% vs. 17.5%). Conclusion: The target AI value with a range from 350 to 400 is safe and effective for high‐power RFCA to complete SVC isolation. [ABSTRACT FROM AUTHOR]

The article focuses on three topics. Firstly, it introduces the Wellness Recovery Action Plan as a self-management system for individuals coping with trauma and life challenges. Secondly, it discusses the prevalence of generalized anxiety disorder in people of African descent living in Australia during the COVID-19 pandemic and it explores nurses' motivations for entering mental health nursing, revealing personal and practice-related factors influencing their career choices.

Aim: The effects of statins on muscle health are not well established. Therefore, this study investigated the impact of statin use on muscle strength and mass recovery in patients with sarcopenia after stroke. Methods: This retrospective cohort study included stroke patients with sarcopenia hospitalized between 2015 and 2021 at a post‐acute rehabilitation hospital. Sarcopenia was diagnosed using handgrip strength and skeletal muscle mass index measured using bioelectrical impedance analysis according to the 2019 criteria of the Asian Working Group for Sarcopenia. The study outcomes included handgrip strength and skeletal muscle mass index at hospital discharge. We used multivariate analyses to examine whether statin use was independently associated with the outcomes. Statistical significance was set at P < 0.05. Results: Of the 586 patients enrolled, 241 (mean age 79.3 years, 44.4% men) presented with sarcopenia and were included in the analysis. Statin use was observed in 61 (25.3%) patients. Statin use was independently negatively associated with handgrip strength at discharge (β = −0.095, P = 0.032), but not with skeletal muscle mass index at discharge (β = 0.019, P = 0.692). Conclusions: Statin use was negatively associated with muscle strength recovery, but not with muscle mass in patients with sarcopenia who underwent rehabilitation after stroke. To maximize outcomes, sufficient consideration is needed for statin use in these patients. Geriatr Gerontol Int 2023; 23: 676–683. [ABSTRACT FROM AUTHOR]

Objectives: Self‐harm rates and clinical presentations differ by ethnicity. South Asian women are at risk of self‐harm. Previous research suggested investigating individuals' experiences with self‐harm with qualitative studies in developing self‐harm prevention strategies. This research aims to explore self‐harm experiences among South Asians in the United Kingdom. Design: Qualitative study. Methods: Participants were recruited via third‐sector organizations and online platforms. Semi‐structured interviews were conducted with 11 South Asian individuals with a history of self‐harm living in the United Kingdom. The data were analysed based on a reflective thematic analysis approach. Results: Results revealed four main themes: (1) reasons for self‐harm; (2) recovery journey; (3) culture and mental health; and (4) the transition to suicidal thoughts and behaviours. Reasons for self‐harm included negative life circumstances, social life difficulties, challenges faced during COVID‐19 and mental health problems. Participants described their recovery journey by acknowledging the role of professional help, self‐care, psychoeducation and personal growth, improving social relationships, and faith and spirituality. Cultural factors included generational differences and stigma. Culturally adapted psychological interventions were perceived as promising. The reported transition from self‐harm to suicidal behaviours was linked to experiencing major stressful life events and the use of severe methods of self‐harm. Conclusions: The findings suggest that socio‐cultural factors impact mental health and recovery processes among South Asians. Mental health services should consider improving culturally sensitive clinical practices in responding to self‐harm among South Asian communities. [ABSTRACT FROM AUTHOR]

Background: There is mixed evidence on whether living arrangements and social interactions are associated with poorer health outcomes after hip fracture repair. Distinct social profiles among male and female older adults may explain some of the differences. However, prior studies did not evaluate these differences by sex. This article aims to assess if the associations between living alone, social interaction, and physical performance differ by sex among hip fracture survivors. Methods: This prospective cohort study is part of the Baltimore Hip Studies seventh cohort, with 168 male and 171 female hip fracture patients assessed at baseline (≤22 days after hospitalization) and at 2, 6, and 12 months post admission. Living arrangements and interaction with children or siblings and others in the past 2 weeks were collected at all visits. Physical performance was measured in the follow‐up visits with the Short Physical Performance Battery (SPPB). Linear mixed models tested associations of living alone and social interaction with SPPB over time adjusted for age, education, comorbidities, physical functioning pre‐fracture, cognitive function, self‐rated health, and time. Results: For men only, living alone was associated with worse performance (0.7 points lower SPPB scores, p = 0.05). Higher social interaction was associated with 0.8 and 1.2 point higher SPPB scores for men and women, respectively (p < 0.05). Visiting with friends was significantly associated with better function among males, while visiting with children or siblings was associated with worse SPPB among females. Conclusions: Living arrangements and types of social interaction are differentially associated with physical function for older men and women. Screening for social isolation/integration and including interventions that promote social interaction and participation should be considered in healthcare programs for hip fracture survivors. [ABSTRACT FROM AUTHOR]

Aim: Assessment of the fetal adrenal gland (FAG) size and middle adrenal artery (MAA) Doppler parameters in pregnancy recovered from Coronavirus Disease (COVID‐19) and comparison of the values with the healthy control group. Methods: Thirty‐eight pregnant women who had recovered from COVID‐19 infection and 76 healthy control group between 33 and 35 weeks of gestation were involved in this case–control study. Fetuses were examined for fetal biometry, fetal well‐being, adrenal gland dimensions, and Doppler parameters 4–6 weeks after the diagnosis of COVID 19 infection. FAG dimensions were measured in two planes and MAA blood flow velocity was evaluated with pulsed Doppler. Pregnant women with COVID‐19 infection were grouped according to the National Institutes of Health for the severity of the disease, and those with mild and moderate infections were examined in the study. Results: The total adrenal gland (TAG) height, fetal zone (FZ) length and width, and MAA‐Peak Systolic Velocity (MAA‐PSV) were significantly higher, and the MAA‐Pulsatility Index (MAA‐PI) was significantly lower in the COVID‐19 group (p < 0.05). The lower in MAA‐PI and the higher in MAA‐PSV, the width of the FZ, and width of the TAG were found to be significant in the moderate group compared to the mild groups (p < 0.05). Conclusion: COVID‐19 pregnancies might cause early maturation of the FAG and its vasculature depends on the intrauterine stress due to the hyper‐inflammation, so fetuses exposed to maternal COVID‐19 suggested to have an increase in blood flow to the adrenal gland and fetal adrenal size. [ABSTRACT FROM AUTHOR]

Background: Many critically ill patients report a change in their health‐related quality of life after intensive care unit (ICU) discharge. Patients who experience delirium during their ICU stay are perceived as a fragile group of ICU survivors, and the 'quality of life' phenomenon needs to be studied among these patients. Aim: To explore everyday life experiences of critically ill patients with delirium during the ICU stay, from ICU discharge until 1‐year follow‐up, focusing on their health‐related quality of life and cognitive function. Study Design: We used a descriptive qualitative research design and interviewed patients 1 year after ICU admission. The participants were recruited from a pre‐planned one‐year follow‐up study of 'Agents Intervening against Delirium for patients in the Intensive Care Unit trial'. Data were analysed using Framework Analysis Method and content analysis. Results: Nine women and eight men participated and reported a struggle when returning to everyday life or adapting to a new normality from hospital discharge to 1 year later. None of the participants had been aware of the challenges they would face after hospital discharge. They described a need for more information about these challenges to themselves and about primary care to better understand their situation and the struggles they experience during recovery. One overall theme emerged from the analysis 'From enduring to adapting' with three subthemes: 'Struggling to regain a functional life', 'Struggling to regain normal cognition' and 'Distressing manifestations from the ICU'. Conclusions: To improve recovery and the quality of rehabilitation for critically ill patients suffering from delirium, it is essential to understand the phenomenon of ICU survivorship and what this fragile group of patients is going through. It is necessary to bridge the gap between secondary and primary care so patients can receive optimal training and support when needed. Relevance to Clinical Practice: Bridging the gap between primary and secondary healthcare services is urgently needed to improve rehabilitation for ICU survivors after critical illness. [ABSTRACT FROM AUTHOR]

Background: Recovery from mental illness and mental health problems is relatively well‐researched among adults, but evidence that focuses on the recovery experiences of young people and what characterizes it is scarce. With this in mind, this article aims to map out the existing research in order to identify prevailing knowledge about the recovery of young people between the ages of 12 and 25. Method: Drawing on scoping review methodology, this article is based on an analysis of 33 articles conducted in the USA, Australia, and Europe. Results: Our findings reveal that young people express both similar and divergent lines of reasoning about recovery compared with adults. Our findings also indicate that young people often fluctuate in the way they view recovery, and that they thus tend to be ambivalent about what recovery means. Parents usually highlight the importance of professionals facilitating recovery, while care staff problematize the organizational frameworks available as aggravating circumstances for implementing personal recovery. Young people, parents, and care staff consistently describe recovery as a way to, despite lingering problems, enable a satisfying life. Conclusions: Through this review, we outline the need for a more distinct focus on agency and participation in young people's recovery processes, at the same time as family involvement needs to be further investigated and operationalized. [ABSTRACT FROM AUTHOR]

This paper documents the development of a programme component within an alcohol and other drugs residential service. Designed to improve relational competence, this pilot component was designed to have multiple levels of function: from the specific, for example, stimulating residents to formulate and monitor relationally oriented goals, to the more pacific, for example, embedding relationally focused learning as an ongoing rehabilitative concern. Development of the component began with a literature review. After finalising a set of relationship types (friends, siblings, etc.), this review identified three domains: 'values', 'knowledge' and 'skills'. To create an initial draft, these categories were populated by items selected from a multi‐stage inspection of the relevant literature. This draft was then reviewed by multiple stakeholder groups. Feedback from these consultations resulted in substantial modifications to the initial draft. In addition to the component having a broad‐spectrum interventive purpose, the authors propose that this component could play a role in (i) pre‐admission assessment and (ii) programme evaluation insofar as data concerning individual residents are aggregated and analysed. [ABSTRACT FROM AUTHOR]

Background: Mental illness, such as depression, anxiety disorders, attention deficit hyperactivity disorder and different addictive diseases, has increased among young adults over the last decade. Mental illness is associated with distress and problems functioning in social activities. Healthcare centres, that is, primary care, serve as the first point of contact with healthcare professionals for those young adults and provide outpatient medical and nursing care covering both physical and mental illness. Objective: To explore experiences of primary care among young adults with mental illness. Methods: A systematic literature review was conducted that followed the method of Bettany–Saltikov and McSherry. A keyword search was performed in various databases, and after a quality assessment 23 articles were included in the review. Results: Young adults' experiences from primary care are described in four categories – Facing difficulties to accept help, relational preconditions, structural and organisational hindrances and satisfaction with youth‐focused mental health interventions. Young adults with mental illness experience many difficulties in accessing and receiving proper help from primary care. Further, they did not believe in recovery from mental illness, and they also expressed a lack of mental health literacy. Conclusion: While being the first contact with healthcare professionals, primary care needs to adjust its services to address the growing group of young adults suffering from mental illness. It is necessary to provide tailored guidelines and interventions in primary care for young adults with mental illness, and the Tidal Model may improve the contacts with young adults in primary care. [ABSTRACT FROM AUTHOR]

Objective: Fractures of the mandibular condyle are the most common jaw fractures. There are several treatment approaches. There is the non‐surgical and surgical approach. The purpose of this systematic literature review is to evaluate the indications and contraindications of either method to help the clinician make the best treatment choice. Methods: Pubmed, Web of Science and Lilacs were systematically searched until 20 May 2023. Clinical trials were selected to compare the two treatments for condyle fracture and evaluate indications and contraindications. Results: Out of 2515 papers, four studies were included. The surgical approach allows faster functional recovery and decreases patient discomfort. The study analyses under what circumstances a surgical procedure is more practical than a non‐surgical one. Conclusion: There is no evidence regarding the reliability of either method. Both have superimposable results. However, age, type of occlusion and other factors direct the clinician towards a surgical choice. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive analytic therapy (CAT) is used within UK mental health settings as a treatment for transdiagnostic complex psychological presentations. However, it is not routinely offered by the NHS Talking Therapies, for anxiety and depression (NHS Talking Therapies) programme which provides psychological treatments for common mental health difficulties. We aimed to evaluate the outcomes of providing CAT treatment to patients presenting with depression and/or anxiety, within the context of relational difficulties, adverse childhood experience or difficulty managing emotions, returning for further psychological treatment within NHS Talking Therapies. Methods: This was a pragmatic, real‐world evaluation, involving routinely collected self‐report measures of depression and anxiety, to examine the treatment outcomes of NHS Talking Therapies patients offered CAT over an 18‐month period. Quantitative validated measures of depression and anxiety were administered at the beginning and end of CAT treatment, and at follow up. Within‐group change in depression and anxiety scores were examined statistically, and rates of reliable improvement and recovery calculated. Results: Statistically significant decreases in depression and anxiety scores were observed during the CAT active treatment phase. The recovery rate was 46.4%, and 71.4% of patients showed a reliable improvement post‐treatment. Positive outcomes continued to be observed at follow‐up, with a recovery rate of 50% and a reliable improvement rate of 79.4%. Conclusions: CAT shows promise as a treatment option for NHS Talking Therapies patients re‐presenting with depression and/or anxiety. More research is required to determine if CAT should be offered more widely within NHS Talking Therapies services. [ABSTRACT FROM AUTHOR]

Aims: In the present study, we aimed to determine how Health‐Related Quality of Life (HRQoL), recovery (function and capacity in daily life) and well‐being are followed up and characterised in persons ≥65 years of age who were being cared for in an intensive care unit (ICU). Design: A scoping review. Methods: CINAHL, MEDLINE (Ovid) and PsycINFO databases were searched in October 2021. 20 studies met the inclusion criteria. The scoping review followed the principles outlined by Arksey and O'Malley, and the Preferred Reporting Items for Systematic Review and Meta‐analyses (PRISMA) checklist and Joanna Briggs Institute (JBI) framework were used. Results: Results are presented under five subheadings: Study characteristics, Type of studies, Methods for follow‐up, health‐related quality of life, and Recovery. Time seems to be an important factor regarding HRQoL among older patients being cared for in an ICU, with most elderly survivors perceiving their HRQoL as acceptable after 1 year. Nevertheless, several studies showed patients' willingness to be readmitted to the ICU if necessary, indicating that life is worth fighting for. Patient or Public Contribution: Due to the design of the study, this study involves no patient or public contribution. [ABSTRACT FROM AUTHOR]

The study aimed to assess the functional and aesthetic outcomes of abdominal full‐thickness skin grafts (FTSGs) in paediatric postburn digital and palmar flexion contractures. The digital and palmar functions and aesthetics of 50 children who met the criteria were evaluated at pre‐operation, the 3rd‐ and 12th‐month post‐operation, respectively. In the evaluation, the Vancouver Scar Scale (VSS), total active movement (TAM), and Jebsen–Taylor Hand Function Test (JHFT) were used. The contralateral, unaffected hand served as the criteria for functional recovery. The complications of donor sites were observed, and the take rate of skin grafts was calculated. The VSS scores at the 3rd and 12th months post‐operation were lower than those before the operation. The TAM of each finger was improved at the 3rd and 12th months post‐operation, compared with that before the operation. There was a significant difference in the time to complete the JHFT between the affected hand and the unaffected at the 3rd month post‐operation, but no significant difference between them at the 12th month post‐operation. The excellent and good take rate of the skin grafts was 90.00%.No donor site complications were observed. The abdominal FTSGs are effective in repairing paediatric digital and palmar scar contractures, with satisfying functional and aesthetic results, especially in large defects after scar release and resection. [ABSTRACT FROM AUTHOR]

Background and Aims: The Opioid Use Disorder (OUD) Cascade of Care is a public health model that has been used to measure population‐level OUD risk, treatment engagement, retention, service and outcome indicators. However, no studies have examined its relevance for American Indian and Alaska Native (AI/AN) communities. Thus, we aimed to understand (1) the utility of existing stages and (2) the relative 'fit' of the OUD Cascade of Care from a tribal perspective. Design, Setting, Participants and Measurements: Qualitative analysis of in‐depth interviews with 20 individuals who were knowledgeable regarding the treatment of OUD in an Anishinaabe tribal setting in Minnesota, USA. Community member roles included clinicians, peer support specialists and cultural practitioners, among others. Thematic analysis was used to analyze the data. Findings: Participants identified the key transition points of prevention, assessment, inpatient/outpatient pathways and recovery as relevant to their community. They re‐imagined an Aanji'bide (Changing our Paths) model of opioid recovery and change that was non‐linear; included developmental stage and individual pathways; and demonstrated resilience through connection to culture/spirituality, community and others. Conclusions: Community members living/working in a rural tribal nation in Minnesota, USA identified non‐linearity and cultural connection as key elements to include in an Anishinaabe‐centered model of opioid recovery and change. [ABSTRACT FROM AUTHOR]

Problem: Art‐ and narrative‐based interventions are an integral component of pediatric inpatient psychiatric care. We describe a novel therapeutic comic book we developed for hospitalized children and young adolescents. Methods: A Hero's Journey is a 38‐page zine that can be freely downloaded and photocopied for distribution. The short booklet is intended to demystify and offer guidance throughout the experience of hospitalization, promote interaction and socialization, provide scaffolding for skill‐building, and prepare patients for moving forward after discharge. Findings: The underlying foundations of the booklet include: 1) Theoretical sources (Joseph Campbell's hero's journey; Donald Schön's reflective practice; and the principles of narrative medicine); and 2) Clinical sources (collaborative problem solving; cognitive‐behavioral therapy, and trauma‐informed care). We articulate how each page relates to the different components, and how individual pages can be used as worksheets for practice of specific skills. We next provide suggestions on how best to use the booklet: from arrival at the emergency room, through inpatient hospitalization, and toward discharge. We also propose ways for staff, caregivers, and any child‐facing adult to make use of this clinical resource in support of a patient's recovery and reintegration into their community. Conclusions: Even though not yet empirically tested, this therapeutic comic book is available for dissemination free of cost. We encourage leaders in nursing and therapeutic recreation to try using this resource in their emergency room and milieu settings. [ABSTRACT FROM AUTHOR]

Typical measures of laboratory reactivity (i.e. difference between control and stress) and recovery (i.e. difference between stress and post‐stress) were compared with a conventional measure of daily‐life reactivity, best known as event‐related stress. Fifty‐three healthy individuals between 19 and 35 years of age took part in a laboratory session where stress was induced using the repeated Montreal Imaging Stress Task and 8 days of experience sampling method. Measures of negative affect, heart rate (HR), HR variability, and skin conductance level were collected. Findings show no strong associations between laboratory and daily life measures with the exception of laboratory affective recovery and daily life reactivity. Findings and their implications are discussed. [ABSTRACT FROM AUTHOR]

Uterine transplantation (UT) is an emerging medical treatment for women affected by absolute uterine factor infertility (AUFI). To date there have been over 90 documented cases of UT performed worldwide, with over 50 live births. UT allows women affected by AUFI the opportunity to carry and deliver a childd. The Royal Prince Alfred Hospital (RPAH) introduced a UT study in 2019; however, due to the impacts of the COVID pandemic the study was placed on hold for two years. In February 2023, RPAH performed the centre's first UT from a living unrelated donor to a 25‐year‐old woman with Mayer‐Rokitansky‐Küster‐Hauser syndrome. The donor and recipient surgeries were uncomplicated and both are recovering well in the early post‐operative period. [ABSTRACT FROM AUTHOR]

National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery‐oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery‐oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery‐oriented practice specifically. Therefore, this non‐participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery‐oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale‐v4 and The Recovery Attitudes Questionnaire inspired the development of a non‐participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery‐oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses. [ABSTRACT FROM AUTHOR]

Medication adherence and recovery rates are <50% among persons with schizophrenia; therefore, this health concern needs attention. Empowerment is a vital element for behavioural change, but previous studies have presented different results and lack specific connotations about empowerment. Therefore, this study systematically reviewed and meta‐analysed the effects of empowerment‐based illness management on the medication adherence and recovery of persons with schizophrenia. The databases searched included the PROSPERO registration network, Cochrane Library, PubMed, Embase, CINAHL, PsycAricle, and Airiti Library. The research steps were based on PRISMA. RoB 2.0 was used for article quality evaluation, the effect size was calculated using RevMan software, and the random‐effect model and standardized mean differences (SMD) were established. Eight randomized controlled trials (RCTs) involving 859 participants were used to investigate the effect of empowerment on medication adherence. The trials involved the use of effective strategies as inducing medication motivation, promoting self‐medication management, and providing support resources. A moderate effect was observed (SMD = 0.58, 95% CI 0.18–0.99). Ten RCTs involving 1473 participants were used to investigate the effect of empowerment on recovery. These trials involved the use of such effective strategies as using self‐strength, connecting external forces, understanding personal needs, and overcoming self‐stigma. A moderate effect was observed (SMD = 0.55, 95% CI 0.10–0.99). Empowerment in illness management can effectively promote the medication adherence and recovery of persons with schizophrenia. In the future, nurses can use self‐strength care to promote medication motivation and connect internal and external forces to assist a person's medication adherence and recovery. [ABSTRACT FROM AUTHOR]

Background: The long‐term effects on people who have had COVID‐19 affect nutrition and can be influenced by diet conversely. Specific nutritional guidelines, however, were scarce at the beginning of 2020, and empirical literature was also lacking. Conventional research methodologies needed to be adapted to review the available literature that could be relevant to the United Kingdom and policy documents as well as collect the views of health and care staff. The aim of this paper is to describe the method to develop consensus statements from experts to address the necessary nutritional support and what emerged from this. Methods: A nominal group technique (NGT) was adapted to the virtual world; we purposefully selected a range of professionals (dietitians, nurses, occupational therapists, etc.) and patients with long‐term effects of COVID to present them with the most updated evidence and aim to reach key guidelines to address COVID‐19 recovery. Results: We were able to reach consensus statements that were developed and reviewed by relevant healthcare staff at the front line to address the nutritional needs of patients recovering from COVID‐19 and those suffering from its long‐term effects. This adapted NGT process led us to understand that a virtual repository of concise guidelines and recommendations was needed. This was developed to be freely accessed by both patients recovering from COVID‐19 and health professionals who manage them. Conclusions: We successfully obtained key consensus statements from the adapted NGT, which showed the need for the nutrition and COVID‐19 knowledge hub. This hub has been developed, updated, reviewed, endorsed and improved across the subsequent 2 years. Highlights: It is feasible to use a nominal group technique in a virtual environment with a wide range of stakeholder groups.Consensus statements are useful in the development of recommendations for nutritional support for COVID‐19 recovery.The online adapted technique enabled successful engagement with patients suffering from symptoms of long COVID (e.g., fatigue, brain fog). [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of full marathon running on intrinsic and extrinsic foot muscle damage and to determine the relationship with the height change of the longitudinal foot arch following full marathon completion. Methods: Magnetic resonance imaging‐measured transverse relaxation time (T2) of the abductor hallucis (ABH), flexor digitorum brevis (FDB) and quadratus plantae (QP), flexor digitorum longus (FDL), tibialis posterior (TP), and flexor hallucis longus (FHL) from 22 collegiate runners were assessed before and 1, 3, and 8 days after full marathon running. The three‐dimensional foot posture of 10 of the 22 runners was further obtained using a foot scanner system before and 1, 3, and 8 days after the marathon. Results: Marathon‐induced increases in T2 were observed in the QP, FDL, TP, and FHL 1 day after the marathon (+7.5%, +4.7%, +6.7%, and +5.9%, respectively), with the increased T2 of TP persisting until 3 days after the marathon (+4.6%). T2 changes of FDL and FHL from pre‐marathon to DAY 1 showed direct correlations with the corresponding change in the arch height ratio (r = 0.823, p = 0.003, and r = 0.658, p = 0.038). Conclusion: The damage and recovery response from a full marathon differed among muscles; QP, FDL, TP, and FHL increased T2 after the marathon, whereas ABH and FDB did not. In addition, T2 changes in FDL and FHL and the arch height ratio change were correlated. Our results suggest that the extrinsic foot muscles could be more susceptible to damage than the intrinsic during marathon running. [ABSTRACT FROM AUTHOR]

We aimed to investigate the influence of 4-wk of fish oil (FO) supplementation on markers of muscle damage, inflammation, muscle soreness, and muscle function during acute recovery from eccentric exercise in moderately trained males. Sixteen moderately-trained males ingested 5 g/d of FO (n = 8) or soybean oil (placebo) capsules (n = 8) for 4-wk prior to- and 3-d following an acute eccentric exercise bout. Eccentric exercise consisted of 12 sets of isokinetic knee extension and knee flexion. Indices of muscle damage, soreness, function and inflammation were measured at baseline and during exercise recovery. Eccentric exercise elicited an increase in muscle soreness (p < 0.010) and thigh volume (p < 0.001), and reduced peak isometric torque by 31.7 ± 6.9%, (p < 0.05, 95% CI 10.6–52.8) during 3-d of recovery. Blood omega-3 polyunsaturated fatty acid concentration was 14.9 ± 2.4% higher in FO than PLA (p < 0.01, 95% CI 9.8–20.1). However, FO did not ameliorate the cumulative creatine kinase response (expressed as AUC; p = 0.368), inflammation (p = 0.400), muscle soreness (p > 0.140), or muscle function (p > 0.249) following eccentric exercise. FO supplementation confers no clear benefit in terms of ameliorating the degree of muscle damage, or facilitating the muscle repair process, during acute eccentric exercise recovery. These data suggest that FO supplementation does not provide an effective nutritional strategy to promote exercise recovery, at least in moderately-trained young men. Abbreviations: ANOVA: Analysis of variance; AUC: Area under curve; CI: Confidence interval; CK: Creatine kinase; CMJ: Countermovement jump; COX: Cyclooxygenase; CRP: C-reactive protein; DHA: Docosahexaenoic acid; DOMS: Delayed-onset muscle soreness; EIMD: Exercise-induced muscle damage; En%: Energy percent; EPA: Eicosapentaenoic acid; FO: Fish oil; IL-6: Interleukin-6; LDH: Lactate dehydrogenase; LOX: Lipoxygenase; Mb: Myoglobin; mTOR: Mechanistic target of rapamycin; PLA: Placebo; ROM: Range of motion; ROS: Reactive oxygen species; SD: Standard deviation; SEM: Standard error of the mean; TNF-α: Tumour necrosis factor alpha; VAS: Visual analogue scale; Ω3-PUFA: Omega-3 polyunsaturated fatty acids; Ω6-PUFA: Omega-6 polyunsaturated fatty acids Highlights The anti-inflammatory properties of omega-3 polyunsaturated fatty acids, alongside their propensity to incorporate into the muscle phospholipid membrane underpins the idea that fish oil supplementation may attenuate muscle damage and promote muscle repair following eccentric-based exercise. Four weeks of high-dose (5 g/d) fish oil supplementation prior to eccentric exercise failed to attenuate the rise in creatine kinase concentration and muscle soreness during acute exercise recovery in physically-active young men. Future studies are warranted to investigate the efficacy of combining omega-3 polyunsaturated fatty acids with other nutrients (i.e. protein/amino acids) for the promotion of muscle recovery following eccentric-based damaging exercise. [ABSTRACT FROM AUTHOR]

The present study investigated the effects of a far-infrared radiation (FIR) lamp therapy on changes in muscle damage and proprioception markers after maximal eccentric exercise of the elbow flexors (EF: Study 1) and the knee flexors (KF: Study 2) in comparison to a sham treatment condition. In each study, 24 healthy sedentary women were assigned to a FIR or a sham treatment group (n = 12/group). They performed 72 maximal EF eccentric contractions (Study 1) or 100 maximal KF eccentric contractions (Study 2) with their non-dominant limbs. They received a 30-min FIR (wavelength: 8–14 µm) or sham treatment at 1, 25, 49, 73 and 97 h post-exercise to the exercised muscles. Maximum voluntary isometric contraction (MVC) torque, muscle soreness, plasma creatine kinase activity, and proprioception assessed by position sense, joint reaction angle, and force match were measured before, and 0.5, 24, 48, 72, 96 and 120 h post-exercise. The outcome measures showed significant changes (P < 0.05) at 0.5-hour post-exercise (before treatment) similarly (P > 0.05) between the conditions in both studies. However, changes in all measures at 24–120 h post-exercise were smaller (P < 0.05) for the FIR than sham condition in both studies. For example, MVC torque returned to the baseline by 72 h post-exercise for the FIR condition in both studies, but was still 19 ± 6% (Study 1) or 17 ± 12% (Study 2) lower than the baseline at 120 h post-exercise for the sham condition. These results suggested that the FIR lamp therapy was effective for accelerating recovery from muscle damage. FIR lamp therapy was effective for recovering muscle strength and proprioception 1–3 days faster to the baseline. FIR lamp therapy was effective for attenuating muscle soreness by 55–60%, and reducing peak plasma CK activity by 45–89%. The effects of the FIR lamp therapy appear to be greater than other therapeutic interventions for eccentric exercise-induced muscle damage that have been investigated previously. [ABSTRACT FROM AUTHOR]

To assess the effect of active and passive intra-interval recovery modes in time-efficient high-intensity interval training (HIT) on cardiorespiratory fitness, autonomic function, and endothelial function in sedentary middle-aged men. Participants (n = 62; age: 49.5 ± 5.8 y; BMI: 29.7 ± 3.7 kg·m−2) completed the assessments of cardiorespiratory fitness, flow-mediated dilation (FMD) and heart rate variability before being randomly allocated to control (CON; n = 14), moderate intensity continuous training (MICT; n = 15), HIT with passive (P-HIT; n-15), or active recovery (A-HIT; n = 15). Participants performed thrice weekly exercise sessions for 12 weeks. MICT completed 50–60 min of continuous cycling at 60–70% heart rate (HR) maximum. HIT completed 30-s work intervals (∼85% HR) interspaced with 2.5 min of active or passive recovery. All exercise modalities increased oxygen uptake (V̇O2) (MD: ≥ 3.1 ml·kg−1·min−1, 95%CI: 1.5–4.7 ml·kg−1·min−1; P < 0.001), power output (MD: ≥ 26 W, 95%CI: 15–37 W; P < 0.001) and cycle duration (MD: ≥ 62 s, 95%CI: 36–88 s; P < 0.001) at 85% HRM. Significant pre-to-post differences were observed among all exercise groups for FMD (MD: ≥ 3.4%, 95%CI: 0.3–6.5%; P < 0.05), while MICT and P-HIT significantly increased the standard deviation of all NN intervals (SDNN) pre-to-post intervention (MD: ≥ 7 ms, 2–13 ms; P ≤ 0.05). Time-efficient HIT elicits significant improvements in cardiorespiratory fitness, FMD and autonomic modulation following a thrice weekly 12-week exercise intervention among sedentary middle-aged men. Active recovery between successive high-intensity intervals provided no additional benefit among this deconditioned cohort. [ABSTRACT FROM AUTHOR]

Background: Orthognathic surgery has been performed with increasing frequency for the treatment of severe malocclusion, yet the postsurgical neuromuscular recovery of patients has been inadequately studied. Objective: To investigate the effect of short‐term and simple jaw motor training on accuracy and precision of jaw motor control in patients following orthodontic treatment and orthognathic surgery. Methods: Twenty patients who had completed preoperative orthodontics, 20 patients who had undergone bimaxillary orthognathic surgery and 20 age‐and‐gender‐matched healthy controls participated in the study. Participants were asked to perform 10 continuous jaw opening and finger lifting movements before and after a 30‐min motor training session. The variability in the amplitude of these simple movements was expressed as percentage in relation to the target position (accuracy – Daccu) and as coefficient of variation (precision – CVprec) to describe the motor performance. Furthermore, the changes in amplitude before and after training were measured in percentage. Results: Daccu and CVprec of simple jaw and finger movements significantly decreased after motor training (p ≤.018) in all groups. The relative changes in finger movements were higher than jaw movements (p <.001) but with no differences among the groups (p ≥.247). Conclusion: Both accuracy and precision of simple jaw and finger movements improved after short‐term motor training in all three groups, demonstrating the inherent potential for optimization of novel motor tasks. Finger movements improved more than jaw movements but with no differences between groups, suggesting that changes in occlusion and craniofacial morphology are not associated with impaired neuroplasticity or physiological adaptability of jaw motor function. [ABSTRACT FROM AUTHOR]

This article explores the proposed psychiatric diagnostic category of nonsuicidal self‐injury disorder (NSSID) through the lens of feminist psychiatric disability theory. Mobilising insights from labelling theory's accounts of stigma and recovery, in conjunction with critical and feminist disability theory's attention to emotional and physical pain, we suggest that a feminist psychiatric disability approach to NSSID can illuminate the limits of a fully demedicalised engagement with self‐injury. While remaining critical of psychiatrisation processes, we explore the implications of 'strategic (dis)identifications' with illness labels as mechanisms through which to manage and access care, treatment and recovery. Such a nuanced account engenders more deeply material considerations of pain, stigma, treatment and 'cure' at the site of NSSID, opening new avenues of engagement with self‐injury for sociologists and critical disability scholars alike. [ABSTRACT FROM AUTHOR]

Receiving buprenorphine should not be contingent upon receiving counseling as well, the federal government has said in a "Dear Colleague" letter issued May 9. The letter, from the Food and Drug Administration and the Substance Abuse and Mental Health Services Administration (SAMHSA, states that "an often‐cited barrier to prescribing buprenorphine for the treatment of OUD [opioid use disorder] is the perception that patients must engage in counseling and other services in order to start or continue receiving the medication," and goes on: "This letter serves to clarify the importance of counseling and other services as part of a comprehensive treatment plan, but to also reiterate that the provision of medication should not be made continent upon participation in such services." [ABSTRACT FROM AUTHOR]

Objective: The objective of this program evaluation was to measure the impact of a medically tailored meals (MTM) intervention on participants' self‐reported recovery and satisfaction while recovering from a recent hospitalization. Design: A qualitative design was employed using a brief survey among all participants at the end of the intervention and phone interviews with a subset of participants. Sample: Participants in this study were recently discharged from the hospital and were members of (redacted for review) who had received 2–4 weeks of MTM. Measurements: The survey assessed overall satisfaction with the meals and perceived impact on their recovery after hospitalization (81% response rate). Interview questions asked how they felt the meals may have helped while recovering (e.g., helped them financially or with their ability to remain independent). Results: Among survey participants, 65% were extremely or very satisfied with their meals. Reasons that MTM were helpful while they were recovering included having sufficient food to eat, having healthy food to eat, the convenience of the meals, and ease of preparing the meals. Conclusions: Participants receiving MTM were generally very satisfied with the program. Including nutrition education and more flexibility in quantity and frequency of food may improve satisfaction and consumption of food. [ABSTRACT FROM AUTHOR]

Athletes often undertake intensified training loads prior to competition with the goal of functionally overreaching for temporary performance enhancement; however, little is known about the impact of this on cognitive function. The aim of this study was to investigate the effect of intensified training induced fatigue on cognitive function, psychological state and performance in trained cyclists. Twenty-three trained male cyclists were randomly assigned to an intensified training group or a control group for two-weeks, followed by a two-week taper period. At baseline, one-week, two-weeks and post-taper, participants undertook a series of cognitive, performance, mood and recovery-stress assessments. The training intervention significantly increased training volume, load and strain by 108%, 116% and 151% respectively. Peak and mean power output on a maximal test and time trial significantly decreased by 4.8% and 9.4% following the two-week training intervention compared to baseline, in addition to a 169% change in total mood disturbance and significant disruption to recovery-stress balance. No change in any cognitive measure was observed across the study period. Following a two-week taper, performance, mood and well-being measures returned to baseline. Two weeks of intensified training resulted in overreaching as identified by performance and psychological measures. Cognitive function was not sensitive to intensified training promoting caution with its use as a measure for the early identification of overreaching. Highlights Two-weeks of intensified training significantly increased training volume, load and strain eliciting a state of overreaching in trained male cyclists. Intensified training caused deteriorations in physical performance but did not influence cognitive measures. Mood and recovery-stress balance were negatively affected by intensified training but recovered back to baseline following a two-week taper at a reduced training volume. A two-week taper period following two-weeks of intensified training did not result in improved physiological measures, physical performance parameters or mood above initial baseline values highlighting the need for careful consideration over the purpose, desired outcomes and necessity of intensified training on an individualised basis. [ABSTRACT FROM AUTHOR]

Research Gap: It is now established that definitions of recovery in eating disorders (EDs) should be informed by the lived/living experience of individuals and consider a broad range of physical, behavioral, and psychological factors. Autism is a common co‐occurring condition in EDs reflecting unique needs and experiences; however, very little research to date has explored definitions of recovery from EDs in Autistic populations. The current article will briefly review what we know about autism and EDs, before addressing how we can apply and extend what we know about broader ED recovery research to the unique needs of Autistic individuals with ED. Suggested Approach: We propose that future studies are urgently required exploring definitions and conceptualizations of recovery in Autistic individuals with EDs, rooted in autism‐led, participatory research approaches and incorporating physical, behavioral, and psychological factors. Discussion: Benefits and possible obstacles of implementing the proposed approach are discussed, before the authors outline specific suggestions for participatory designs and targets for future studies. Multidimensional and mixed method approaches to ED recovery will work toward integrating clinically measurable outcomes with lived/living experience perspectives. Public Significance: EDs are common in Autistic individuals, however, very little is known about definitions of ED recovery in this population. Cross‐disciplinary, research‐driven definitions involving lived/living experience at all stages of the research process will generate meaningful and translational research. [ABSTRACT FROM AUTHOR]

Objective: Anorexia nervosa (AN) is associated with significant individual mental and physical suffering and public health burden and fewer than half of patients recover fully with current treatments. Comorbid exercise dependence (ExD) is common in AN and associated with significantly worse symptom severity and treatment outcomes. Research points to cognitive inflexibility as a prominent executive function inefficiency and transdiagnostic etiologic and maintaining mechanism linking AN and ExD. This study will evaluate the initial efficacy of adjunctive Cognitive Remediation Therapy (CRT), which has been shown to produce cognitive improvements in adults with AN, in targeting cognitive inflexibility in individuals with comorbid AN and ExD. As an exploratory aim, this study also addresses the current lack of quick and cost‐effective assessments of cognitive flexibility by establishing the utility of two proposed biomarkers, heart rate variability and salivary oxytocin. Method: We will conduct a single‐group, within‐subjects trial of an established CRT protocol delivered remotely as an adjunct to inpatient or intensive outpatient treatment as usual (TAU) to adult patients (n = 42) with comorbid AN and ExD. Assessments, including self‐report, neuropsychological, and biomarker measurements, will occur at three time points. Results: We expect CRT to increase cognitive flexibility transdiagnostically and consequently, along with TAU, positively impact AN and ExD compulsivity and symptom severity, including weight gain. Discussion: Findings will inform the development of more effective integrative interventions for AN and ExD targeting shared mechanisms and facilitate the routine assessment of cognitive flexibility as a transdiagnostic risk and maintaining factor across psychopathologies in clinical and research settings. Public Significance: Patients with anorexia nervosa often engage in excessive exercise, leading to harmful outcomes, including increased suicidal behavior. This study examines the preliminary efficacy of an intervention that fosters flexible and holistic thinking in patients with problematic eating and exercise to, along with routine treatment, decrease harmful exercise symptoms. This study also examines new biological markers of the inflexible thinking style thought to be characteristic of anorexia nervosa and exercise dependence. [ABSTRACT FROM AUTHOR]

The article offers information on the importance of addressing post intensive care syndrome (PICS) and improving the quality of life for ICU survivors. The topics discussed include the physical and psychological challenges faced by ICU survivors, the need for increased awareness of their recovery needs, and the importance of promoting ICU rehabilitation despite potential obstacles.

Background: Critical illness is a traumatic experience, often resulting in post‐intensive care syndrome, affecting people's physical, psychological, emotional, and social well‐being. The early recovery period is associated with increased risk, negatively impacting longer‐term outcomes. Aims: The aims of this study were to understand the recovery and rehabilitation needs of people who survive a COVID‐19 critical illness. Study design: An exploratory descriptive qualitative interview study with 20 survivors of COVID‐19 critical illness from two community‐based healthcare settings in London, England. Data collection took place September 2020–April 2021, at least 1 month after hospital discharge by telephone or virtual platform. Data were subjected to inductive thematic analysis and mapped deductively to the three core concepts of self‐determination theory: autonomy, competence and relatedness. Results: Three key themes emerged: traumatic experience, human connection and navigating a complex system. Participants described how societal restrictions, fear and communication problems caused by the pandemic added to their trauma and the challenge of recovery. The importance of positive human connections, timely information and support to navigate the system was emphasized. Conclusions: Whilst findings to some extent mirror those of other qualitative pre‐pandemic studies, our findings highlight how the uncertainty and instability caused by the pandemic add to the challenge of recovery affecting all core concepts of self‐determination (autonomy, competence, relatedness). Relevance to clinical practice: Understanding survivors' perspectives of rehabilitation needs following COVID‐19 critical illness is vital to delivery of safe, high‐quality care. To optimize chances of effective recovery, survivors desire a specialist, co‐ordinated and personalized recovery pathway, which reflects humanized care. This should be considered when planning future service provisions. [ABSTRACT FROM AUTHOR]

Background: Discourse analysis has recently received much attention in the aphasia literature. Even if post‐stroke language recovery occurs throughout the longitudinal continuum of recovery, very few studies have documented discourse changes from the hyperacute to the chronic phases of recovery. Aims: To document a multilevel analysis of discourse changes from the hyperacute phase to the chronic phase of post‐stroke recovery using a series of single cases study designs. Methods & Procedures: Four people with mild to moderate post‐stroke aphasia underwent four assessments (hyperacute: 0–24 h; acute: 24–72 h; subacute: 7–14 days; and chronic: 6–12 months post‐onset). Three discourse tasks were performed at each time point: a picture description, a personal narrative and a story retelling. Multilevel changes in terms of macro‐ and microstructural aspects were analysed. The results of each discourse task were combined for each time point. Individual effect sizes were computed to evaluate the relative strength of changes in an early and a late recovery time frame. Outcomes & Results: Macrostructural results revealed improvements throughout the recovery continuum in terms of coherence and thematic efficiency. Also, the microstructural results demonstrated linguistic output improvement for three out of four participants. Namely, lexical diversity and the number of correct information units/min showed a greater gain in the early compared with the late recovery phase. Conclusions & Implications: This study highlights the importance of investigating all discourse processing levels as the longitudinal changes in discourse operate differently at each phase of recovery. Overall results support future longitudinal discourse investigation in people with post‐stroke aphasia. What This Paper Adds: What is already known on the subject: Multi‐level discourse analysis allows for in‐depth analysis of underlying discourse processes. To date, very little is known on the longitudinal discourse changes from aphasia onset through to the chronic stage of recovery. This study documents multi‐level discourse features in four people with mild to moderate aphasia in the hyperacute, acute, subacute and chronic stage of post‐stroke aphasia recovery. What this paper adds to existing knowledge: The study found that most discourse variables demonstrated improvement throughout time. Macrostructural variables of coherence and thematic units improved throughout the continuum whereas microstructural variables demonstrated greater gains in the early compared to the late period of recovery. What are the potential or actual clinical implications of this work?: This study suggests that multilevel discourse analysis will allow a better understanding of post‐stroke aphasia recovery, although more research is needed to determine the clinical utility of these findings. Future research may wish to investigate longitudinal discourse recovery in a larger sample of people with aphasia with heterogenous aphasia profiles and severities. [ABSTRACT FROM AUTHOR]

Aim: To explore the effect of information‐motivation‐behavioural skills (IMB) model on psychological and emotional state of caesarean section (CS) women. Design: Control‐group patients got routine nursing during the preoperative, intraoperative and postoperative periods. Observation‐group patients received routine nursing combined with the IMB model that included specific informational, motivational and behavioural interventions. Methods: Pregnant women (n = 102) who underwent CS in Hangzhou Women's Hospital were randomly divided into Control and Observation‐groups (n = 51 each). Self‐rating anxiety scale (SAS), self‐rating depression scale (SDS) and general self‐efficacy scale (GSES) scores, complication rate, fatigue severity scale (FSS) and Edinburgh postpartum depression scale (EPDS) scores were compared. Result: Interventions lowered SAS and SDS scores, significantly lower in the Observation‐group (p < 0.05), and increased GSES scores, significantly higher in the Observation‐group (p < 0.05). Observation‐group had less complications (4.08% vs. 17.39% in the Control‐group; p < 0.05), and decreased FSS and EPDS scores (p < 0.05). [ABSTRACT FROM AUTHOR]

Aim: To explore the factors affecting the quality of accelerated rehabilitation for patients with cervical spinal cord injury, therefore, to propose targeted improvement strategies and provide reference for promoting the quality of nursing care for accelerated rehabilitation. Design: This descriptive qualitative inquiry followed the COREQ guidelines. Methods: From December 2020 to April 2021, 16 subjects including orthopaedic nurses, nursing management experts, orthopaedic surgeons, anaesthesiologists and physical therapists experienced in accelerated rehabilitation were selected by objective sampling method to conduct semi‐structured interviews. Thematic analysis was used to analyse the interview content. Results: Through analysis and summary of the interview data, the following two themes and nine sub‐themes were finally extracted. Factors related to the quality of accelerated rehabilitation structure include: construction of multidisciplinary teams, thorough system guarantee and adequate staffing. Factors related to the quality of accelerated rehabilitation process include: inadequate training and assessment, lack of medical staff's awareness, incapability of the accelerated rehabilitation team members, poor multidisciplinary communication and collaboration, lack of patient's awareness, and ineffective health education. Conclusion: Quality of implementation of accelerated rehabilitation can be improved by maximizing the role of multidisciplinary team, establishing a flawless accelerated rehabilitation system, increasing allocation of nursing resources, enhancing knowledge of medical staff, improving their awareness of accelerated rehabilitation, establishing personalized clinical pathways of accelerated rehabilitation, increasing communication and collaboration among multidisciplinary disciplines, and improving health education of patients. [ABSTRACT FROM AUTHOR]

Background: Family members in many countries often share caregiving responsibilities for an older relative recovering from an injury. However, few studies have examined strategies employed when multiple family members provide care for an older relative recovering from hip‐fracture surgery. Objective: This study aimed to understand family group caregiving strategies when two or more family members provide caregiving for an older relative recovering from hip‐fracture surgery. Methods: This study used a grounded theory design. Semistructured interviews were conducted over 1 year with 13 Taiwanese family caregivers from five families. Caregivers shared caregiving responsibilities for an older relative (62–92 years of age) recovering from hip‐fracture surgery. Transcribed interviews were analysed using open, axial and selective coding. Results: The core category describing caregiving among family members was 'Preventive Group Management: strategies for family group caregiving'. Three strategies were employed: explicit division of labour (two stem/patriarchal families and one older two‐generation/democratic family); disconnected caregiving (one nuclear/noncommunicative family) and patriarchal caregiving (one extended/traditional Chinese family). Strategies reflected family type, structure, cultural values, communication patterns and available outside support. Components of family group caregiving involved family type's division of labour, approaches to caregiving and implementation challenges and allowed family caregivers to maximise safety and stability and prevent harmful events during their relative's recovery from surgery. Conclusions: There was no one‐size‐fits‐all approach for the strategies of family group caregiving. Components of Preventive Group Management varied with family type, cultural values, communication patterns and available outside support. Healthcare professionals should be sensitive to the dynamics of family caregivers. Implications for Practice: Enhance group management for family caregivers by developing interventions to optimize collaboration, thereby better addressing the needs of older adults recovering from hip fracture surgery. [ABSTRACT FROM AUTHOR]

A personal narrative is presented which explores the author's experience of receiving treatment for his multiple myeloma while working as geriatric medical professional.

Introduction and Objectives: Urinary incontinence (UI) remains a significant concern after radical prostatectomy. As a part of a nursing follow‐up, we evaluate quality‐of‐life (QoL) which includes UI recovery. Patients proposed to Retzius‐sparing robot assisted radical prostatectomy (RS‐RARP) have a bundle of appointments starting pre‐operatively and continuing after surgery 1 week, 1, 3, 6, 9 and 12 months. In these, we started a urinary rehabilitation programme (URP) performing Kegel Exercises, adaptative and behavioural strategies. The objective is to evaluate timeline until urinary continence recovery after RS‐RARP, since this is one of the most asked question by our patients. Materials and Methods: Between July 2017 and April 2020 we conducted a prospective observational single‐centre study with a total of 208 patients submitted to RS‐RARP. We applied the Expanded Prostate Cancer Index Composite‐26 (EPIC‐26) questionnaire pre and postoperatively at 3, 6, 9 and 12 months, and studied UI by evaluating pad count measured in the 3rd question. The inclusion criteria are: patients that did not have adjuvant or salvage treatments during the follow up; have all pre‐ and post‐operative evaluations; who were continent pre‐operatively; and started the URP. A total of 72 patients were included. We have considered the criteria of no pad use for continence recovery. Every patient provided written informed consent for study inclusion, approved by the Institutional Ethics Committee (Approval 07.07.2017). Results: Preliminary analysis of enrolled patients reveals that 57 (79,16%) recovered continence during the 12 months period. By 3‐month mark, we observed that 42 (73,68%) patients were continent; 7 (12,28%) recovered continence at 6‐month mark; 4 (7,02%) recovered continence at 9‐month mark and 4 (7,02%) recovered continence 1 year after surgery. We further analysed the total number of pads used daily by the 15 patients (20,83%) that had UI at 12‐month mark: 13 patients (86,67%) reported using 1 pad a day and 2 patients (13,33% or 2,77% of all studied population) reported using 3 or more pads a day. Conclusion: The preliminary results demonstrate a gradual improvement in UI over the first year, with a significant number of patients recovering at 3‐month mark. These positive results are most probably consequences of both the surgical approach and the URP. Is required a sub‐group analysis to further delineate factors impacting continence recovery, aiding in postoperative rehabilitation care plans that will impact positive outcome on QoL associated with a fast UI recovery. For the latter, digital tools to conduct patient reported outcomes are necessary to ascertain the extent of impact in QoL. Furthermore, we need to rethink remote strategies to improve patient compliance as a significant number of them were excluded for not attending on‐site nursing appointments. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular sequelae may occur in patients recovered from coronavirus disease 2019 (COVID‐19). Recent studies have detected a considerable incidence of subclinical myocardial dysfunction—assessed with speckle‐tracking echocardiography—and of long‐COVID symptoms in these patients. This study aimed to define the long‐term prognostic role of subclinical myocardial dysfunction and long‐COVID condition in patients recovered from COVID‐19 pneumonia. Methods: We prospectively followed up 110 patients hospitalized at our institution due to COVID‐19 pneumonia in April 2020 and then recovered from SARS‐CoV‐2 infection. A 7‐month clinical and echocardiographic evaluation was performed, followed by a 21‐month clinical follow‐up. The primary outcome was major adverse cardiovascular events (MACE), a composite of myocardial infarction, stroke, heart failure hospitalization, and all‐cause mortality. Results: A subclinical myocardial dysfunction—defined as an impairment of left ventricular global longitudinal strain (≥−18%)—was identified at a 7‐month follow‐up in 37 patients (34%), was associated with an increased risk of long‐term MACE with a good discriminative power (area under the curve:.73) and resulted in a strong independent predictor of extended MACE in multivariate regression analyses. Long‐COVID condition was not associated with a worse long‐term prognosis, instead. Conclusions: In patients recovered from COVID‐19 pneumonia, a subclinical myocardial dysfunction is present in one‐third of the whole population at 7‐month follow‐up and is associated with a higher risk of MACE at long‐term follow‐up. Speckle‐tracking echocardiography is a promising tool to optimize the risk‐stratification in patients recovered from COVID‐19 pneumonia, while the definition of a long‐COVID condition has no prognostic relevance. [ABSTRACT FROM AUTHOR]

Objectives: Assessing for recovery in delirium is essential in guiding ongoing investigation and treatment. Yet, there is little scrutiny and no research or clinical consensus on how recovery should be measured. We reviewed studies which used tests of neuropsychological domains and functional ability to track recovery of delirium longitudinally in acute hospital settings. Methods/Design: We systematically searched databases (MEDLINE, PsycInfo, CINAHL, Embase, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials), from inception to October 14th, 2022. Inclusion criteria were: adult acute hospital patients (≥18 years) diagnosed with delirium by a validated tool; 1+ repeat assessment using an assessment tool measuring domains of delirium/functional recovery ≤7 days from baseline. Two reviewers independently screened articles, performed data extraction, and assessed risk of bias. A narrative data synthesis was completed. Results: From 6533 screened citations, we included 39 papers (reporting 32 studies), with 2370 participants with delirium. Studies reported 21 tools with an average of four repeat assessments including baseline (range 2–10 assessments within ≤7 days), measuring 15 specific domains. General cognition, functional ability, arousal, attention and psychotic features were most commonly assessed for longitudinal change. Risk of bias was moderate to high for most studies. Conclusions: There was no standard approach for tracking change in specific domains of delirium. The methodological heterogeneity of studies was too high to draw firm conclusions on the effectiveness of assessment tools to measure delirium recovery. This highlights the need for standardised methods for assessing recovery from delirium. Key points: Assessing for recovery is an essential part of delirium care, to guide clinicians' ongoing investigation and treatment and to provide accurate information to patients and carers.It is unclear what assessment tools are used to measure delirium recovery on a longitudinal basis, specifically which neuropsychological and functional domains should be assessed.A total of 21 assessment tools measuring 15 different symptom domains of delirium were used in the included studies, however, there was no standard approach for tracking change in these domains over time.The symptom domains most frequently assessed for longitudinal change in the included studies were general cognition, functional ability, arousal, attention and psychotic features. [ABSTRACT FROM AUTHOR]

Question(s): How do individuals living with musculoskeletal disorders perceive the concept of prognosis? Design: Exploratory phenomenological study. Participants: Individuals aged 18 years or older currently experiencing a musculoskeletal disorder. Data analysis: Single semi‐structured one‐on‐one interviews were conducted. Data was analysed using inductive coding and thematic analysis. Results: Five themes were identified. First, participants defined prognosis as the likely outcome associated with their diagnosis. Their prognosis was often associated with outcomes related to pain, tissue health, and function. Second, participants perceived pain as having a negative impact on their prognosis by limiting their function and having a psychological impact. Third, participants held biomedical views in that tissue health was perceived as a cause for their pain and that tissue healing was essential for pain cessation. It was also difficult for participants to distinguish between pain related to tissue damage, and pain that was not. Fourth, participants use their ability to complete leisure and functional activities to determine the success of their recovery. Finally, participants perceived receiving individual prognoses for pain, tissue health, and function that may be simultaneously occurring as both important and beneficial. Conclusion: Overall, participants viewed receiving prognostic information as important and beneficial. When constructing their views on prognosis participants perceived that pain, tissue health, and functional ability could all impact upon prognosis, whilst having a prognosis of their own. Physiotherapists should consider conceptualising and discussing prognosis in terms of pain, tissue health, and function when managing musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Objective: Understanding the unmet needs of healthcare consumers with attention‐deficit/hyperactivity disorder (ADHD) (individuals with ADHD and their caregivers) provides critical insight into gaps in services, education and research that require focus and funding to improve outcomes. This review examines the unmet needs of ADHD consumers from a consumer perspective. Methods: A standardised search protocol identified peer‐reviewed studies published between December 2011 and December 2021 focusing on consumer‐identified needs relating to ADHD clinical care or research priorities. Results: 1,624 articles were screened with 23 studies that reviewed examining the needs of ADHD consumers from Europe, the U.K., Hong Kong, Iran, Australia, the U.S.A. and Canada. Consumer‐identified needs related to: treatment that goes beyond medication (12 studies); improved ADHD‐related education/training (17 studies); improved access to clinical services, carer support and financial assistance (14 studies); school accommodations/support (6 studies); and ongoing treatment efficacy research (1 study). Conclusion: ADHD consumers have substantial unmet needs in clinical, psychosocial and research contexts. Recommendations to address these needs include: improving access to and quality of multimodal care provision; incorporating recovery principles into care provision; fostering ADHD health literacy; and increasing consumer participation in research, service development and ADHD‐related training/education. [ABSTRACT FROM AUTHOR]

Introduction: Guidelines indicate primary‐prevention implantable cardioverter‐defibrillators (ICDs) for most patients with left ventricular ejection fraction (LVEF) ≤ 35%. Some patients' LVEFs improve during the life of their first ICD. In patients with recovered LVEF who never received appropriate ICD therapy, the utility of generator replacement upon battery depletion remains unclear. Here, we evaluate ICD therapy based on LVEF at the time of generator change, to educate shared decision‐making regarding whether to replace the depleted ICD. Methods: We followed patients with a primary‐prevention ICD who underwent generator change. Patients who received appropriate ICD therapy for ventricular tachycardia or ventricular fibrillation (VT/VF) before generator change were excluded. The primary endpoint was appropriate ICD therapy, adjusted for the competing risk of death. Results: Among 951 generator changes, 423 met inclusion criteria. During 3.4 ± 2.2 years follow‐up, 78 (18%) received appropriate therapy for VT/VF. Compared to patients with recovered LVEF > 35% (n = 161 [38%]), those with LVEF ≤ 35% (n = 262 [62%]) were more likely to require ICD therapy (p =.002; Fine‐Gray adjusted 5‐year event rates: 12.7% vs. 25.0%). Receiver operating characteristic analysis revealed the optimal LVEF cutoff for VT/VF prediction to be 45%, the use of which further improved risk stratification (p <.001), with Fine‐Gray adjusted 5‐year rates 6.2% versus 25.1%. Conclusion: Following ICD generator change, patients with primary‐prevention ICDs and recovered LVEF have significantly lower risk of subsequent ventricular arrhythmias compared to those with persistent LVEF depression. Risk stratification at LVEF 45% offers significant additional negative predictive value over a 35% cutoff, without a significant loss in sensitivity. These data may be useful during shared decision‐making at the time of ICD generator battery depletion. [ABSTRACT FROM AUTHOR]

Objective: Investigate the economic consequences of injuries to female Australian footballers from a health sector and societal perspective. Methods: This prospective observational study invited 242 females to complete an online questionnaire 3–6 months following an Australian football injury which involved presentation to an ED in Victoria, Australia. The questionnaire inquired regarding healthcare use, time off work, return to playing football and extent of recovery following injury. Relevant information was also extracted from respondents' medical records regarding injury‐type, body part injured, investigations and treatments. Healthcare costs were determined for each respondent's ED presentation, hospital admission/s (when relevant), and subsequent healthcare use. Societal costs were determined as lost income to the respondent and/or carer. Results: A total of 108 people responded to the questionnaire. Sprains/strains and fractures accounted for 84.2% of respondents' injuries. Sixteen respondents (14.8%) required admission to hospital at the time of injury and 81 (75.0%) required subsequent healthcare appointments following discharge from the ED or hospital. Time off work or school following the injury was common (64.8% of respondents) and 27.8% of respondents had a carer take time off work. More than 80% of respondents missed training and matches following the injury. The median healthcare cost per respondent was AUD$753 and the median cost due to work absence was AUD$1393. One‐quarter of respondents reported a full recovery. Conclusions: Injuries to female Australian footballers can produce substantial healthcare and societal costs, which has important implications for healthcare provision and prioritising and implementing injury prevention programmes and post‐injury rehabilitation. [ABSTRACT FROM AUTHOR]