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Background: Robotic suturing training is in increasing demand and can be done using suture-pads or robotic simulation training. Robotic simulation is less cumbersome, whereas a robotic suture-pad approach could be more effective but is more costly. A training curriculum with crossover between both approaches may be a practical solution. However, studies assessing the impact of starting with robotic simulation or suture-pads in robotic suturing training are lacking. Methods: This was a randomized controlled crossover trial conducted with 20 robotic novices from 3 countries who underwent robotic suturing training using an Intuitive Surgical® X and Xi system with the SimNow (robotic simulation) and suture-pads (dry-lab). Participants were randomized to start with robotic simulation (intervention group, n = 10) or suture-pads (control group, n = 10). After the first and second training, all participants completed a robotic hepaticojejunostomy (HJ) in biotissue. Primary endpoint was the objective structured assessment of technical skill (OSATS) score during HJ, scored by two blinded raters. Secondary endpoints were force measurements and a qualitative analysis. After training, participants were surveyed regarding their preferences. Results: Overall, 20 robotic novices completed both training sessions and performed 40 robotic HJs. After both trainings, OSATS was scored higher in the robotic simulation-first group (3.3 ± 0.9 vs 2.5 ± 0.8; p = 0.049), whereas the median maximum force (N) (5.0 [3.2–8.0] vs 3.8 [2.3–12.8]; p = 0.739) did not differ significantly between the groups. In the survey, 17/20 (85%) participants recommended to include robotic simulation training, 14/20 (70%) participants preferred to start with robotic simulation, and 20/20 (100%) to include suture-pad training. Conclusion: Surgical performance during robotic HJ in robotic novices was significantly better after robotic simulation-first training followed by suture-pad training. A robotic suturing curriculum including both robotic simulation and dry-lab suturing should ideally start with robotic simulation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To understand and describe attitudes toward general health checkups, breast health knowledge, cultural beliefs, and health-promoting behaviors among Myanmar American immigrant women in the United States. SAMPLE & SETTING: 267 women participated in the study. 10 women were excluded because of missing data, so the total sample size was 257 participants. METHODS & VARIABLES: A descriptive, crosssectional survey design was used to describe and investigate breast health perceptions and behaviors. RESULTS: Nearly 75% of the study sample reported having negative attitudes toward general health checkups and were found to have less accurate breast health knowledge and more fatalistic views about breast cancer. Only 29% of older women adhered to mammogram recommendations. Younger women reported more barriers to mammograms, and older women reported fewer barriers to mammograms. IMPLICATIONS FOR NURSING: This study demonstrated the need for additional research focusing on unique perspectives when investigating breast health practices among Myanmar American immigrant women. The findings highlight the essential need to build a strong partnership with stakeholders to combat breast health disparities and address the complex nature of acculturation. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p <.001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings. [ABSTRACT FROM AUTHOR]

Background: The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players. Methods: Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45–60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season. Results: No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p < 0.001, 2.16 < d < 2.58), the T-test (p = 0.024, d = 1.03), the squat (p < 0.001, d = 4.04), and the countermovement jump test (p < 0.001, d = 2.21), the Loughborough soccer passing test (LSPT) (p = 0.019, d = 1.08), and the 1-RM back squat test (p < 0.001, d = 2.53). Post-hoc tests indicated that NMT provided larger improvements for SJ, CMJ, 1-RM back squat, the 5-m sprint, 10-m sprint, 30-m sprint, T-test and LSPT compared to ET (1.07 > d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014). Conclusions: The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players. Key points: • Our results indicate that the integration of 45 to 60 min of preseason neuromuscular training, three times per week, for 6 weeks, can improve physical fitness and prevent injuries in young female soccer players. • The present study demonstrated that the neuromuscular training program can reduce the incidence injury rate by more than 50% and the burden by more than 65% compared to the endurance-dominated training. • Neuromuscular training is an effective approach during the preseason period to improve diverse measures of physical fitness and to reduce injury occurrence. • Preseason neuromuscular training appears to improve the fitness level of female soccer players and as such could allow them to compete at the high level. [ABSTRACT FROM AUTHOR]

Objective: Accurate imaging biomarkers that indicate disease progression at an early stage are highly important to enable timely mitigation of symptoms in progressive lung disease. In this context, reproducible experimental models and readouts are key. Here, we aim to show reproducibility of a lung injury rat model by inducing disease and assessing disease progression by multi-modal non-invasive imaging techniques at two different research sites. Furthermore, we evaluated the potential of fibroblast activating protein (FAP) as an imaging biomarker in the early stage of lung fibrosis. Methods: An initial lung injury rat model was set up at one research site (Lund University, Lund, Sweden) and repeated at a second site (Radboudumc, Nijmegen, The Netherlands). To induce lung injury, Sprague-Dawley rats received intratracheal instillation of bleomycin as one single dose (1,000 iU in 200 µL) or saline as control. Thereafter, longitudinal images were acquired to track inflammation in the lungs, at 1 and 2 weeks after the bleomycin challenge by magnetic resonance imaging (MRI) and [18F]FDG-PET. After the final [18F] FDG-PET scan, rats received an intravenous tracer [89Zr]Zr-DFO-28H1 (anti-FAP antibody) and were imaged at day 15 to track fibrogenesis. Upon termination, bronchoalveolar lavage (BAL) was performed to assess cell and protein concentration. Subsequently, the biodistribution of [89Zr]Zr-DFO-28H1 was measured ex vivo and the spatial distribution in lung tissue was studied by autoradiography. Lung sections were stained and fibrosis assessed using the modified Ashcroft score. Results: Bleomycin-challenged rats showed body weight loss and increased numbers of immune cells and protein concentrations after BAL compared with control animals. The initiation and progression of the disease were reproduced at both research sites. Lung lesions in bleomycin-exposed rats were visualized by MRI and confirmed by histology. [18F]FDG uptake was higher in the lungs of bleomycin-challenged rats compared with the controls, similar to that observed in the Lund study. [89Zr]Zr-DFO-28H1 tracer uptake in the lung was increased in bleomycin-challenged rats compared with control rats (p = 0.03). Conclusion: Here, we demonstrate a reproducible lung injury model and monitored disease progression using conventional imaging biomarkers MRI and [18F]FDG-PET. Furthermore, we showed the first proof-of-concept of FAP imaging. This reproducible and robust animal model and imaging experimental set-up allows for future research on new therapeutics or biomarkers in lung disease. [ABSTRACT FROM AUTHOR]

Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered. [ABSTRACT FROM AUTHOR]

Background: Misconceptions about male nurses not only exacerbate the gender imbalance in the nursing profession but also negatively impact male nurses embarking on their careers. Currently, no tool exists to measure the gender biases toward males in nursing among nursing students in China. Consequently, the primary objective of this study is to assess the validity and reliability of the Chinese translation of the Gender Misconceptions of Men in Nursing (GEMINI) scale among nursing students. Methods: This cross-sectional study involved 1,102 nursing students from China who participated online. We utilized the Brislin translation technique with a forward-backward approach. To determine the factor structure within the Men in Nursing Gender Misconceptions Scale's Chinese version, both exploratory (EFA) and confirmatory factor analysis (CFA) were applied. The scale's internal consistency was measured through the Cronbach's alpha coefficient, corrected item-total correlation, and a retest reliability assessment. Results: The scale showed a content validity index of 0.938 and a retest reliability of 0.844. EFA indicated a two-factor structure for the translated instrument. CFA revealed a chi-square/degree of freedom of 3.837, an incremental fit index (IFI) of 0.952, a goodness-of-fit index (GFI) of 0.910, a comparative fit index (CFI) of 0.952, and an RMSEA of 0.073, all of which were within acceptable limits. The scale's Cronbach's α was 0.953, and the corrected item-total correlations ranged between 0.539 and 0.838. Gender-based misconceptions about men in nursing among students appeared to be influenced by their gender and whether they considered a nursing program as their first choice when applying for a major. Misconceptions about male nurses are greater among men and those who do not consider nursing programs as their first choice when applying for a major. Conclusions: The Chinese adaptation of the GEMINI scale showcased high reliability and validity. It stands as a potential instrument to gauge gender misconceptions concerning male nurses among Chinese nursing students. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is common among postmenopausal women, and can affect their health and quality of life. However, it can be managed by physical activity. The present study aims to investigate the combined effect of core stability and dynamic resistive exercises on bone mineral density (BMD) in postmenopausal women. Material and methods: Sixty postmenopausal women diagnosed with osteoporosis, age 50 to 60, BMI < 30 kg/m², were randomly divided into two equal groups: the study group received core stability and dynamic resistance exercise (two sessions per week) in addition to 70 mg Alendronate (one tablet) per week for four months, while the control group only received 70 mg Alendronate (one tablet) per week (n = 30 each group). Both groups were assessed for BMD (dual-energy x-ray absorptiometry; DEXA), and quality of life (Oswestry Disability Index; ODI), both pre- and post-treatment. Results: Both groups demonstrated a significantly greater bone mineral density in the lumbar spine and left femoral neck and improved quality of life post-treatment compared to pre-treatment (p < 0.001). However, comparing groups, the study group demonstrated significantly higher lumbar spine (Z value = -5.588) and left femoral neck bone mineral density (Z value = -4.794), and significantly lower ODI score (F value = 243.686), compared to the control group (p < 0.001). Conclusions: Core stability and dynamic resistance exercise appear to be safe and effective methods in the treatment of osteoporosis in post-menopausal women. [ABSTRACT FROM AUTHOR]

This research discusses the correlation between the results of socialization of child-friendly pesantren program by the ministry of religion and the ministry of women's empowerment and protection on the program implementation in pesantrens in Padangpanjg City, West Sumatra. The purpose of the research was to obtain information about the correlation between the results of socialization on the implementation of the childfriendly pesantren program. The hypothesis in this study is that there is a correlation between the results of socialization and the on the implementation of child-friendly pesantren programs in Pesantrens in Padangpanjang City. The research method is descriptive method. The technique used in this research is proportionate stratified random sampling technique. The results showed that the proposed hypothesis was accepted that there was a significant correlation between the results of socialization on the implementation of the child-friendly pesantren program with he correlation coefficient calculation known that r hitung is 0,660 wheres r table with significant degree 5% for N = 62 and df = N-2 = 62 - 2 = 60 is 0,254. Thereby r hitung = rtabel or 0,660 > 0,254, thereby Ha is accepted. [ABSTRACT FROM AUTHOR]

Problem: Existing bullying research among Arab Americans is limited, focusing mainly on school‐age adolescents and victimization. There is a lack of studies that examine retrospective bullying perpetration, bullying victimization, and physical fights during high school and their effect on current Arab American college students' stress and health outcomes. This study examines if bullying perpetration, bullying victimization, and physical fights during high school predict current stress and the physical and mental health of Arab American college students. In addition, we examined if perceived psychological stress mediates the relationships between bullying and fighting involvement and health. Methods: One hundred and sixty‐two undergraduate Arab American college students were recruited from a Midwestern university and completed self‐report measures of bullying, stress, and health (both physical and mental). Findings: Controlling for demographic variables, only high school victimization was significantly associated with current stress and physical and mental health. Stress fully mediated the relationship between victimization and health (both physical and mental). Conclusions: Victimization during high school years may result in serious physical and mental health consequences during college years. However, perpetration and fighting may not have similar effects. Addressing stress among bullying victims may reduce the negative impact of this experience on immigrant Arab American college students. Implications for practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Background Study: The research discusses the need for a paradigm shift in engineering education current practices to accommodate the digital native students. The paper emphasizes the importance of integrating disruptive technologies, namely Virtual Reality (VR) through Head Mounted Displays VR (HMD VR) and Desktop Based VR (DB VR) and comparing it with the traditional teaching methods. The research focuses on second‐year undergraduate students enrolled in a concrete structures course. Objectives: The objective of the study is to analyse the impact of DB VR and HMD VR on students' motivation, performance and workload in comparison with traditional 2D drawings. The study also aims to investigate how simulation sickness and system usability could impact students' motivation and performance when interpreting concrete structures. Methods: The study divided second‐year civil engineering students into three groups, 2D, DB VR and HMD VR. The performance and motivation levels of students were assessed based on the number of mistakes identified and an intrinsic motivation survey. Furthermore, data on system usability and simulation sickness were collected. Spearman rank correlation was conducted to analyse the relationships between the variables tested. Results: The results have shown that students' motivation and performance were much higher when using VR in general and HMD VR specifically, students' efficiency and accuracy were also observed. On the other hand, usability was found to be moderately correlated with motivation, with students rating HMD VR as the most usable approach. A moderate inverse correlation was observed between simulation sickness and motivation, indicating that higher simulation sickness led to lower motivation levels. Conclusion: The study concludes that integrating VR in general, DB VR, or HMD VR into a concrete structures course for undergraduate students can significantly improve students' performance and motivation. Furthermore, enhancing usability of any of the methods used can also improve the performance and motivation. On the other hand, simulation sickness inversely affects motivation and performance, therefore, VR developers and educators should not neglect it. Lay Description: What is already known about the topic: Traditional teaching methods in engineering education require improvement.Integrating digital technologies into engineering education enhances performance.Digital technologies can potentially enhance motivation. What this paper adds: Compares traditional teaching methods for concrete structures interpretation with virtual reality.Establishes correlations between motivation, performance and usabilityIntroduces how desktop‐based VR and head‐mounted display VR can produce varying results. Implications for practice and/or policy: Decision‐makers can use the information to integrate updated pedagogy into engineering curricula.Allows for further exploration of different digital technologies that can be used for concrete structure interpretation.Allows instructors to introduce virtual reality in their courses. [ABSTRACT FROM AUTHOR]

Aim: To compare the physical activity pattern before and during the COVID-19 pandemic and verify the association with contextual, behavioral, and health variables related to the pandemic in adults and older adults from southern Brazil. Subject and methods: This is a panel-type, population-based study in Rio Grande-RS and Criciúma-SC, with 4290 individuals. The physical activity pattern (dependent variable) was measured using the International Physical Activity Questionnaire-IPAQ. In addition, contextual, behavioral, and health aspects related to the pandemic (independent variables) were assessed by questionnaires. Fisher's exact test was used for bivariate analyses and Poisson regression with robust variance to calculate crude and adjusted prevalence, with their respective 95% confidence intervals. Results: There was a 72% reduction in commuting physical activity and a 145% increase in physical inactivity when compared before and during the pandemic. Social distancing, excessive search for information about COVID-19, fear of the pandemic, and COVID-19 infection were all factors that contributed to the decline in physical activity during the pandemic. The home office was a protective factor for physical inactivity. Conclusion: The COVID-19 pandemic has negatively affected the pattern of physical activity in the general population, except for those who switched to working from home. [ABSTRACT FROM AUTHOR]

Coptis chinensis Franch (RC), has historically been used for the treatment of "Xiao Ke" and "Xia Li" symptoms in China. "Xia Li" is characterized by abdominal pain and diarrhea, which are similar to the clinical symptoms of ulcerative colitis (UC). For the first time, this study aims to compare the anti-colitis effects of berberine (BBR) and total RC alkaloids (TRCA) and investigate the underlying metabolites and gut microbiota biomarkers. Metabolomics results showed that several colitis-related biomarkers, including lysophosphatidyl ethanolamine, lysophosphatidylcholine, scopolamine-methyl-bromide, N1-methyl-2-pyridone-5-carboxamide, 4-hydroxyretinoic acid, and malic acid, were significantly improved in model mice after BBR and TRCA treatments. High-dose BBR and TRCA treatments reversed the mouse colon shortening caused by dextran sodium sulfate (DSS), alleviated bowel wall swelling, and reduced inflammatory cell infiltration. BBR and TRCA restored the damaged mucosa integrity in colitis mice by upregulating claudin 1 and occludin, preventing colon epithelium apoptosis by inhibiting the cleavage of caspase 3. Additionally, BBR and TRCA significantly decreased the richness of the pathogenic bacteria Bacteroides acidifaciens but increased the abundance of the probiotic Lactobacillus spp. Notably, TRCA exhibited superior anti-colitis effects to those of BBR. Thus, this agent warrants further study and application in the treatment of inflammatory bowel disease in the clinic. [ABSTRACT FROM AUTHOR]

BACKGROUND: The precision of quasi-static airway driving pressure (DP) assessed in pressure support ventilation (PSV) as a surrogate of tidal lung stress is debatable because persistent muscular activity frequently alters the readability of end-inspiratory holds. In this study, we used strict criteria to discard excessive muscular activity during holds and assessed the accuracy of DP in predicting global lung stress in PSV. Additionally, we explored whether the physiological effects of high PEEP differed according to the response of respiratory system compliance (CRS). METHODS: Adults with ARDS undergoing PSV were enrolled. An esophageal catheter was inserted to calculate lung stress through transpulmonary driving pressure (DPL). DP and DPL were assessed in PSV at PEEP 5, 10, and 15 cm H2O by end-inspiratory holds. CRS was calculated as tidal volume (VT)/DP. We analyzed the effects of high PEEP on pressure-time product per minute (PTPmin), airway pressure at 100 ms (P0.1), and VT over PTP per breath (VT/PTPbr) in subjects with increased versus decreased CRS at high PEEP. RESULTS: Eighteen subjects and 162 end-inspiratory holds were analyzed; 51/162 (31.5%) of the holds had DPL 6 12 cm H2O. Significant association between DP and DPL was found at all PEEP levels (P < .001). DP had excellent precision to predict DPL, with 15 cm H2 O being identified as the best threshold for detecting DPL 6 12 cm H2O (area under the receiver operating characteristics 0.99 [95% CI 0.98--1.00]). CRS changes from low to high PEEP corresponded well with lung compliance changes (R2 0.91, P < .001) When CRS increased, a significant improvement of PTPmin and VT/PTPbr was found, without changes in P0.1. No benefits were observed when CRS decreased. CONCLUSIONS: In subjects with ARDS undergoing PSV, high DP assessed by readable end-inspiratory holds accurately detected potentially dangerous thresholds of DPL. Using DP to assess changes in CRS induced by PEEP during assisted ventilation may inform whether higher PEEP could be beneficial. [ABSTRACT FROM AUTHOR]

To develop and identify the effectiveness of a hospital-to-home transitional intervention based on an interaction model of client health behavior in adult patients with stroke. A non-equivalent control group pretest-posttest. Thirty-eight patients participated (18=intervention, 20=control); the intervention group received 12 weeks of the intervention. The intervention influenced anxiety, disease severity, health behavior adherence, patient satisfaction, and quality of life in adult patients with stroke. Transitional programs have potential to improve the health behaviors of subjects, and community health nurses can assist in the implementation of these programs. Health behaviors and quality of life scores were significantly higher in the intervention group than in the control group; these findings support the need for continuity of nursing care during the transitional period for patients with stroke. Given the challenges faced by adult stroke patients after stroke, community nurses should pay attention to patients' transitional experiences. [ABSTRACT FROM AUTHOR]

Aim: The aims of the present study are to describe the status of selfmanagement behaviors and illness perception, and explore the relationship between illness perception and self-management behaviors among Chinese diabetic foot patients. Methods: A cross-sectional study was conducted at the endocrinology department of a comprehensive tertiary hospital in Guangzhou, China. Data were collected on illness perception, self-management behaviors, and demographic and clinical characteristics over 9 months among 156 subjects. Data were analyzed using Pearson correlation analysis, univariate analysis and multiple linear regression analysis. Results: Only 3.2% of participants maintained excellent self-management behaviors. Additionally, the participants perceived diabetic foot as chronic and could be well controlled through treatment. Multiple linear regression analysis revealed that illness perception was associated with self-management behaviors. Conclusions: Patient illness perception is an important factor influencing self-management behaviors. It may be helpful to improve self-management behaviors by tailoring the content of the intervention to fit the patients' illness perceptions. [ABSTRACT FROM AUTHOR]

Aim: To assess the social cognitive elements of the stigma of mental illness (knowledge, attitudes and behaviours) among healthcare professionals (HCPs) in Jordan. Design: A cross‐sectional descriptive design. Methods: A total of 206 HCPs were conveniently recruited from general hospitals in Jordan. The mental attitude, knowledge and intended behaviours scales were used to measure stigma elements. Results: Participants reported a moderate level of knowledge, a moderate negative attitude and a moderate or not greater interest to deal with people with mental health illnesses. The bivariate correlation revealed a negative significant correlation between HCPs' knowledge and attitude, indicating that HCPs with more knowledge significantly have more positive attitude (lower average score) towards those suffering from the illness. A more significant correlation was found between HCPs' knowledge and behaviour. The HCPs who had more knowledge were holding more interest and willingness towards dealing with persons with mental illness. Patient or Public Contribution: Negative attitudes among HCPs demand awareness programmes pertaining to the stigma of mental illness to afford higher standards of practice for patients with mental problems. [ABSTRACT FROM AUTHOR]

INTRODUCTION The use of e-cigarettes has steadily increased, and vocational students are one primary target of e-cigarette marketing. This cross-sectional survey research aimed to explore e-cigarette use and examine the factors associated with it. METHODS Multistage cluster random sampling was employed to select 1536 students in vocational education institutions. A self-administered questionnaire was used to collect the data from September to December 2019. Multinomial logistic regression analysis was used to obtain the adjusted odds ratio (AOR) to determine the associated factors of e-cigarette use. RESULTS Altogether, 28.7% of the subjects were currently e-cigarette users, 7.4% used e-cigarettes only, and 21.3% were dual users. Various factors were found to be significantly associated with e-cigarette use by 43.7%. Those consisted of sex (male) (AOR=2.183; 95% CI: 1.510-3.157), grade point average (GPA) of <2.5 (AOR=2.363; 95% CI: 1.502-3.717), having neutral attitudes toward e-cigarette use (AOR=2.676; 95% CI: 1.499-4.779) and positive attitudes toward e-cigarette use (AOR=4.171; 95% CI: 2.250-7.734), moderate level of perceived behavioral control on e-cigarette use (AOR=3.520; 95% CI: 2.287-5.418) and low level of perceived behavioral control on e-cigarettes use (AOR=4.959; 95% CI: 3.274-7.511), moderate price of e-cigarettes (AOR=1.436; 95% CI: 1.009-2.044), and e-cigarette use of their parents (AOR=1.827; 95% CI: 1.137-2.938), close friends (AOR=4.327; 95% CI: 2.954-6.338) and idols (AOR=4.604; 95% CI: 1.844-11.497). CONCLUSIONS Students should be encouraged to develop negative attitudes toward e-cigarette use and increase their self-confidence to control the use of e-cigarettes. This can be achieved by regularly distributing information on the product's risks. Moreover, students can find inspiration and guidance from peers, close friends, or their idols, who will act as positive role models and inspire them not to initiate e-cigarette use. [ABSTRACT FROM AUTHOR]

Sense of belongingness in the academic environment has been associated with positive student outcomes and increased student success. To cultivate belongingness, graduate nursing students were invited to participate in a virtual fitness challenge. Sense of belongingness was measured through pre-(n = 103) and post-intervention (n = 64) surveys with three subscales: other students, faculty, and the university. Students reported improved sense of belongingness following the intervention for all subscales, with statistically significant improvements related to other students (p = .007) and the university (p = .023). A virtual fitness challenge may improve sense of belongingness among graduate nursing students. [ABSTRACT FROM AUTHOR]

The argument for a female advantage in word list learning is often based on partial observations that focus on a single component of the task. Using a large sample (N = 4403) of individuals 13–97 years of age from the general population, we investigated whether this advantage is consistently reflected in learning, recall, and recognition and how other cognitive abilities differentially support word list learning. A robust female advantage was found in all subcomponents of the task. Semantic clustering mediated the effects of short-term and working memory on long-delayed recall and recognition, and serial clustering on short-delayed recall. These indirect effects were moderated by sex, with men benefiting more from reliance on each clustering strategy than women. Auditory attention span mediated the effect of pattern separation on true positives in word recognition, and this effect was stronger in men than in women. Men had better short-term and working memory scores, but lower auditory attention span and were more vulnerable to interference both in delayed recall and recognition. Thus, our data suggest that auditory attention span and interference control (inhibition), rather than short-term or working memory scores, semantic and/or serial clustering on their own, underlie better performance on word list learning in women. [ABSTRACT FROM AUTHOR]

BACKGROUND: Consumption of an organic diet reduces exposure to a range of agricultural pesticides. Only three studies have examined the effect of an organic diet intervention on exposure to the herbicide glyphosate, the most heavily used agricultural chemical in the world. Despite its widespread use, the primary sources of glyphosate exposure in humans are poorly understood. OBJECTIVE: Our objective was to examine the effect of an organic diet intervention on urinary glyphosate concentrations among pregnant individuals. METHODS: We conducted a 2-wk randomized crossover trial in which 39 pregnant participants living near (≤0.5 km) and far (>0.5 km) from agricultural fields received a 1-wk supply of conventional groceries and 1 wk of organic groceries, randomized to order. We collected daily first morning void urine samples and analyzed composite samples from each week for glyphosate. We examined differences in urinary glyphosate concentrations between the conventional week and the organic week among all participants and stratified by residential proximity to an agricultural field. RESULTS: Median specific gravity-adjusted glyphosate concentrations were 0.19 μg/L and 0.16 μg/L during the conventional and organic weeks, respectively. We observed modest decreases in urinary glyphosate concentrations from the conventional to organic week among far-field participants, but no difference among near-field participants. In secondary analyses excluding participants who did not meet a priori criteria of compliance with the intervention, we observed significant decreases in urinary glyphosate concentrations, particularly among far-field participants (푝< 0.01-0.02, depending on exclusion criteria). DISCUSSION: This trial is the first to examine the effect of an organic diet intervention on glyphosate among people living near and far from agricultural fields. Our results suggest that diet is an important contributor to glyphosate exposure in people living >0.5 km from agricultural fields; for people living near crops, agriculture may be a dominant exposure source during the pesticide spray season. [ABSTRACT FROM AUTHOR]

Laptop use appears to contribute to poor working postures and neck pain among university students. Postural braces have the potential to improve upper back/neck posture and therefore might have a role as an ergonomic aid for this population. Therefore, the purpose of this study was to assess the short-term effects of scapular bracing on pain, fatigue, cervicothoracic posture, and the activity of the neck and upper-back muscles in healthy college students. A randomized controlled crossover trial was conducted to evaluate the self-reported pain and fatigue, the amplitude and median frequency of surface electromyography in neck extensors, upper trapezius, and lower trapezius, as well as the neck and shoulder sagittal alignment (measured by inertial sensors and digital photographs) during a 30-min typing task in a sample of young, healthy university students with or without a scapular brace. The brace condition resulted in significantly smaller levels of bilateral trapezius muscle activity (p < 0.01). Rounded shoulder posture was slightly better in the brace condition, but these differences were not significant (p > 0.05). There were no significant immediate differences in pain or fatigue scores, neck alignment, or the electromyographic activity of the other muscles tested between brace and non-brace conditions (all p > 0.05). However, bracing appears to immediately reduce the electromyographic activity of the lower trapezius muscles (p < 0.05). These findings shed some light on the possible advantages of scapular bracing for enhancing laptop ergonomics in this group of individuals. Future studies are warranted to evaluate the effects of different types of braces, the importance of matching the brace to the user, and the short- and long-term effects of brace use on computer posture and muscle activity. [ABSTRACT FROM AUTHOR]

Consumption of unhealthy commercial foods and beverages (UCFB) is common among infants and young children living in low- and middle-income countries. Such foods can displace other nutritious foods, however, there is limited evidence on how this consumption tracks across time. This study assessed and tracked UCFB consumption of children living in rural/peri-urban Cambodia during the complementary feeding period, identified UCFB consumption patterns of these children, and explored the association between UCFB consumption and growth. A 6-month longitudinal cohort study was implemented among 567 caregivers of children aged 10-14 months at recruitment. UCFB consumption was estimated each month via a telephone-administered 7-day food frequency questionnaire, and UCFB consumption patterns were identified based on changes in this frequency of consumption over time. The majority of children either maintained (45.7%, n = 246) or developed (43.5%, n = 234) an unhealthy consumption pattern and only 10.8% (n = 58) of children maintained/transitioned into a healthy consumption pattern. High consumers of UCFB at 10-14 months had a 4.7 (CI: 4.7 [3.1-7.2]) times odds of being high consumers of UCFB at 15-19 months (p < 0.001). There was a trend of lower length- for-age z-scores (LAZ) among children maintaining or developing an unhealthy consumption pattern (~-0. SD LAZ) compared to children maintaining/transitioning into a healthy consumption pattern, however, this association was not statistically significant. Findings indicate that high UCFB consumption begins during infancy and tracks into early childhood. National policies and programmes centred on early interventions addressing the use of UCFB for infant and young child feeding are needed. [ABSTRACT FROM AUTHOR]

Simple Summary: The number of pigmented moles is the most important risk factor for melanoma. This "real world" study conducted in 25 Australian childcare centers is the first to show it is possible to prevent a significant proportion of pigmented moles in young Caucasian children by dressing them in UPF 30-50+ clothing that covers at least half their body on a daily basis. Regularly wearing this clothing for 3.5 years was sufficient to prevent almost one-quarter of the pigmented moles that young children developed on their skin. This should, by implication, reduce their risk of developing melanoma in the future. Primary health care providers should stress the importance of garment coverage when recommending sun protection for children and should lobby for all sun-protective clothing standards to assess and report garment coverage, in addition to the transmission of ultraviolet radiation through the fabric (reported as UPF), on clothing labels and packaging for children's clothing, including school uniforms. Numerous pigmented moles are associated with sun exposure and melanomarisk. This cluster randomized controlled trial aimed to determine if sun-protective clothing could prevent a significant proportion of the moles developing in young children (ACTRN12617000621314; Australian New Zealand Clinical Trials Registry. Twenty-five childcare centers in Townsville (19.25° S), Australia, were matched on shade provision and socioeconomic status. One center from each pair was randomized to the intervention arm and the other to the control arm. Children at 13 intervention centers wore study garments and legionnaire hats at childcare and received sun-protective swimwear and hats for home use, while children at the 12 control centers did not. The 1–35-month-old children (334 intervention; 210 control) were examined for moles at baseline (1999–2002) and were re-examined annually for up to 4 years. Both groups were similar at baseline. Children at intervention centers acquired fewer new moles overall (median 12.5 versus 16, p = 0.02; 0.46 versus 0.68 moles/month, p = 0.001) and fewer new moles on clothing-protected skin (6 vs. 8; p = 0.021 adjusted for confounding and cluster sampling) than controls. Intervention children had 24.3% fewer new moles overall (26.5 versus 35) and 31.6% (13 versus 19) fewer moles on clothing-protected skin than controls after 3.5 years. Sunlight's influence on nevogenesis is mitigated when children regularly wear UPF 30-50+ clothing covering half their body, implying that increased clothing cover reduces melanoma risk. Sun-protective clothing standards should mandate reporting of the percentage of garment coverage for childrenswear. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between illness perception and care-seeking intention in Japanese patients with chronic heart failure (CHF). A cross-sectional study was conducted on 160 CHF outpatients with reference to the framework of the Common-Sense Model. Illness perception was measured using the Brief Illness Perception Questionnaire (B-IPQ). Care-seeking intention was assessed based on the intent to consult medical care at the onset of varying symptoms. Association between illness perception and the care-seeking intention was analyzed by logistic regression analysis after univariate analysis. In the univariate analysis, illness perception was only associated with care-seeking intention at the onset of dyspnea at rest. Treatment control, which means the expected effectiveness of treatment in B-IPQ, was associated with care-seeking intention at the onset of dyspnea at rest (OR : 1.261, 95% CI [1.025–1.550]). It may be necessary to assess the patients' perceptions of their treatment and explain its effects. [ABSTRACT FROM AUTHOR]

Research on stress-related disorders and brain imaging suggests that (acute) stress might impact the capacity to mentally simulate specific episodic future events (EFT) through the effects of cortisol on brain regions supporting this cognitive function, such as the prefrontal cortices. This study aims to examine the mechanisms underlying this link, using transcranial Direct Current Stimulation (tDCS) over the left dorsolateral prefrontal cortex. 60 healthy participants were subjected to the Montreal Imaging Stress Task (MIST), followed by either active or sham tDCS. After stimulation, the EFT task was administered. Salivary cortisol was measured throughout the protocol. Higher cortisol AUCi values were linked to less specific episodic future thoughts. Moreover, active tDCS enhanced EFT specificity irrespective of cortisol, especially in high trait ruminators. We did not observe an effect from active tDCS on cortisol AUCi, and equally there was no interaction effect between cortisol AUCi and stimulation condition predictive for EFT specificity. Although we did not find evidence for the effects of tDCS on the HPA-system, our data reveal a crucial link between two critical predictors of mental health for the first time, and provide a solution to help rehabilitate EFT deficits. Trial registration: Netherlands National Trial Register identifier: ntr004.. [ABSTRACT FROM AUTHOR]

Background Phenytoin is a commonly used antiepileptic drug (AED) for postoperative seizure prophylaxis; it is associated with adverse cardiovascular effects. Fosphenytoin is considered a safer alternative but can produce prolongation of QT interval. This hypothesis generating pilot study evaluated the changes in hemodynamics and the heart rate corrected QT interval (QTc) with phenytoin and fosphenytoin during propofol and sevoflurane anesthesia. Methods Eighty American Society of Anesthesiologists I and II patients aged 20 to 60 years undergoing elective supratentorial craniotomy requiring a loading dose of the intraoperative AED for seizure prophylaxis were randomized into four groups: group PP, receiving propofol (0.2mg/kg/min) for maintenance and phenytoin (15mg/kg) for seizure prophylaxis; group SP, receiving sevoflurane (1minimal alveolar concentration) for maintenance and phenytoin(15mg/kg) for seizure prophylaxis; group PF, receiving propofol for maintenance and fosphenytoin (22.5mg/kg) for seizure prophylaxis; and group SF, receiving sevoflurane for maintenance and fosphenytoin for seizure prophylaxis. The heart rate, systolic, diastolic,mean arterial pressure, and QTc weremeasured at baseline before anesthesia, during maintenance of anesthesia, and during various phases of AED infusion and up to 1 hour after completion of AED administration. Appropriate statistical analysis was done and a two-tailed p-value of less than 0.05 was considered significant. Results The incidence of changes in the heart rate and hypotension was not significant among the groups. Administration of fosphenytoin significantly prolonged QTc, which was more remarkable when coadministered with sevoflurane than with phenytoin. Conclusion Fosphenytoin did not confer hemodynamic benefits over phenytoin. Fosphenytoin produces prolongation of QTc, and when coadministered with sevoflurane, the prolongation is more significant, suggesting a possible additive effect. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of functional movement screen (FMS)-based functional exercise in patients after anterior cruciate ligament reconstruction (ACLR). Design: Randomized, controlled, single-blind trial. Setting: Institutional, single center. Patients: A total of 38 patients who underwent ACLR were recruited and randomly assigned to group 1 (n = 19) or group 2 (n = 19). Interventions: Both groups received 6-month routine rehabilitation immediately after surgery. From the postoperative fourth to sixth month, group 1 received FMS-based functional exercise plus routine rehabilitation and group 2 received routine rehabilitation only. The FMS-based functional exercise was individualized and customized functional corrective exercise, which was designed based on the 3-month postoperative FMS results. The frequency of rehabilitation was 1 hour per session, twice a week, for a total duration of 6 months. Main Outcome Measures: At 3 and 6 months postoperatively, patients were evaluated by FMS scoring, Lysholm Knee Score, and International Knee Documentation Committee 2000 Score. Results: After the intervention, both groups had significantly increased FMS, Lysholm Knee Score, and International Knee Documentation Committee 2000 score. Group 1 had significantly greater changes in FMS (median: 4 vs 3, P <.001), Lysholm Knee Score (median: 24 vs 16, P =.001), and International Knee Documentation Committee 2000 Score (median: 22 vs 8, P <.001) than group 2. Conclusion: The application of FMS-based functional exercise to patients after ACLR resulted in significant improvement in knee function and movements. The authors suggested integrating FMS evaluation and FMS-based training into routine post-ACLR rehabilitation programs. [ABSTRACT FROM AUTHOR]

Objectives: A cross-sectional survey was made on self-rated health, which is a simple and easy-to-administer measure of general health. It is a valid and reliable measure among those without cognitive impairment. Initially, it replaced clinical assessments in survey research and clinical settings. Materials and Methods: This study was a cross-sectional survey and the study was conducted in a community-based online survey of 6-month duration. Psychologically ill patients, pregnant women, and pediatrics were excluded from this study. The sample size was set to be >800, and the collected data were 806. The data was procured from every willing individual in the age group of 18-60 years old. To identify the similarity and variances in their responses, they were correlated with the health rating of the responders. The physicians at RDT Hospital, Bathalapalli, Anantapur, Andhra Pradesh Prepared and validated the data collection form. Results: This study was evaluated to check the impact of health literacy on one’s health. All the factors were included and taken into consideration while framing the questionnaire. The parameters and the respondent’s answers were compared and correlated they were assessed by two-tailed test and significantly correlated using Pearson’s correlation. The self-rating of the health of the responders was found to be 47%. The major factors affecting health are age, gender, body mass index (BMI), occupation, weight profile, work profile, surrounding hygiene, quality of life, physical activity, eating habits, regular sleep cycle, sleep quality, stress factor, psychological and mental health, comorbidities, side effects, nutritional supplements, self-medication or doctor’s prescription, and literacy score. Respondent’s physical activities were collected and found to be 89.7% negative and statistically significant. The BMI of the responders was classified into four categories: Underweight (16.7%), normal (51.86%), overweight (20.09%), and obese (7.94%). It was found to be negatively significant and two-tailed correlated. Conclusion: The study has now provided evidence on what factors influence an individual’s health self-rating and how these factors correlate to influence each other on the same platform. [ABSTRACT FROM AUTHOR]

Background: Concussion public policies have been developed to address the burden of concussions. The aim of the present study was to examine implementation compliance, barriers, and facilitators of Canada's first concussion public policy, Ontario's Policy/Program Memorandum 158: School Board Policies on Concussion (PPM158). Methods: An electronic survey was sent to 515 randomly selected elementary and high school principals across specific geographic, language, and publicly funded school types in Ontario. Data were analyzed using both qualitative and quantitative methods. Results: One hundred and thirty‐five principals responded to the survey (26%). Concussion education was provided to teachers in 81% of schools, to students in 83%, and coaches in 79%. Additionally, 89% reported having a return‐to‐learn protocol in place and 90% reported having a return‐to‐play protocol. Implementation barriers included difficulties in providing concussion education to parents (42%), obtaining notes from physicians, and maintaining the volume of documentation. Eighty‐seven percent of respondents believed that PPM158 improves student well‐being. Conclusions: Identified implementation barriers and facilitators can inform concussion policy practices to improve student well‐being. We recommend: (1) an appointed concussion policy lead at each school, (2) electronic documentation, (3) determining the optimal education format to improve parent/guardian education, (4) fostering relationships between schools and health care professionals, and (5) student concussion education in every grade in Ontario schools. [ABSTRACT FROM AUTHOR]

Purpose of study: The need for forgiveness education for nursing self-care and forgiveness facilitation has risen. Therefore, the present pilot study tested the efficacy of an 8-week forgiveness bibliotherapy with a small number of undergraduate nursing students. Design of study: Matched pairs of nursing students were randomly assigned to either the experimental group or no-contact control group. The experimental group, using 8 keys to forgiveness by R. Enright (2015) as the treatment manual, read one chapter a week for 8 weeks and provided weekly reflections. Forgiveness and forgiveness-related outcome measures were administered at pretest, posttest, and one-month follow-up. Findings: At the posttest, the experimental group had significantly greater improvement in forgiveness compared to the control group with a large effect size, which was maintained at one month follow-up. There was no other significant difference between the two groups. Within-group comparisons of the experimental group showed improvement in forgiveness, anxiety, depression, and fatigue from pre to post testing periods and forgiveness, anger, anxiety, depression, and fatigue from pre to follow-up testing periods. Conclusion: Use of bibliotherapy may be a cost-effective way to promote the virtue of forgiveness for students in nursing programs. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships between transformational leadership, psychological empowerment and innovative behaviour among nurses in China. Background: The innovative behaviour of nurses is important to adapt to the changing medical environment. However, there is currently a limited understanding of the relationship between nurses' innovative behaviour and transformational leadership and psychological empowerment during the pandemic. Methods: Convenience sampling was used to conduct an investigation involving 1317 nurses from 10 hospitals in China from January 2022 to April 2022. Data analysis was performed using correlation analysis, univariate analysis and multiple regression analysis. The STROBE checklist was followed when writing this manuscript. Results: High transformational leadership and high psychological empowerment were associated with high innovative behaviour. The results of the multiple linear regression analysis showed that physical condition, whether or not you have attended academic conferences or whether or not you have participated in fund research projects, transformational leadership and psychological empowerment were the main factors on nurses' innovative behaviour, together explaining 64.5% of the total variance. Conclusion: Promotion of transformational leadership and psychological empowerment is vital for nurses to promote innovation, thereby meeting the urgent demand for innovative nurses and the rapid development of nursing disciplines. Implications for Nursing Management: This study highlights the importance of transformational leadership in developing nurses' innovative behaviours. Understanding the role of psychological empowerment can help nurse managers formulate relevant intervention strategies and cultivate nurses' innovative behaviour. [ABSTRACT FROM AUTHOR]

Aims: To describe adult intensive care nurses' experiences and attitudes towards intrahospital transport (IHT) of critically ill patients and to assess the relationship between nurses' characteristics, attitudes and experiences. Design Cross‐sectional survey. Methods: Factor analysis identified factors within the attitudinal and experience domains. Univariate analysis was performed to demonstrate the relationship between attitudinal and experience factors and demographic and professional characteristics of the participants. Multiple regression equations were applied to determine associations between nurses' experiences and attitudes. The study took place from July to August 2019. Results: A total of 480 nurses from 12 adult intensive care units in China participated, with a response rate of 65%. Most respondents had a baccalaureate nursing degree (75%). The majority (80%) had participated in IHT of critically ill more than five times in the previous 12 months and 90% agreed that checklists led to an improvement in patient safety during transport. However, 75% of respondents expressed that transport increased the workload of the nurses who accompany patients off unit and those who remained in the intensive care unit (66%). Variables that were associated with a favourable perception of transport competency and checklists/tool use were nurses' prior transport experiences and knowledge/training. Conclusion: Nurses perceived IHT was a sourse of stress and increased workload. Checklists and training were beneficial for patient safety during IHT. Impact The findings point out a clear need for ICU nurse training, standardised policy/procedure and customisation of existing intrahospital transfer checklists according to hospital procedures and local circumstances. New research is needed to evaluate the impact of novel IHT interventions on patient safety and nurses' stress. [ABSTRACT FROM AUTHOR]

First-year students experience various stressors in their attempt to adapt to their new academic environment, which undoubtedly require them to employ effective coping styles. This study was conducted to examine psychological capital (PsyCap) and happiness as predictors of coping among university students. Using a cross-sectional survey, data were collected using standardised questionnaires from 207 students in a public university in South Africa. Data analysed using both simple and standard multiple regression showed that optimism, hope and resilience were associated with productive coping. The study also found that pleasure and meaningful engagement were significantly related to productive coping. The findings of this study underscore the need for interventions that focus on developing constructive psychological resources that will result in the use of more constructive coping strategies when faced with stressors. [ABSTRACT FROM AUTHOR]

Schools of social work are tasked with preparing students to support the field's ethical challenge of eliminating racism. Given that color-blind racial attitudes constitute a form of continued racism, identifying the factors associated with color-blind racial ideology (CBRI) in social work students represents a first step toward meeting this challenge. Drawing from critical race theory, this cross-sectional study surveyed a convenience sample of 305 master of social work (MSW) students across five schools of social work to explore which individual characteristics are significantly associated with CBRI at the bivariate and multivariate levels. A multiple linear regression assessed CBRI's multivariate associations with demographic characteristics (i.e., age, gender, ethnicity, race, sexual orientation) and professional characteristics (i.e., prior work experience with marginalized communities, bachelor of social work [BSW] attainment, MSW concentration). Results showed that increased age, gender identification as men, and BSW attainment had statistically significant, positive associations with CBRI, compared to their respective reference groups. Compared to straight sexual orientation, identification as gay or lesbian, bisexual, and other sexual orientation was significantly associated with lower CBRI. Macro-focused MSW concentration was the strongest statistically significant independent variable and was associated with decreased CBRI. Fostering critical self-awareness of MSW students' racial blind spots may support meeting social work's ethical challenge. [ABSTRACT FROM AUTHOR]

The study aimed to explore the potential effect of short-term visual perceptual training based on virtual reality (VR) and augmented reality (AR) platforms in postoperative strabismic patients. We enrolled 236 postoperative strabismic patients, among whom 111 patients received VR-based training, and 125 patients received AR-based training. The stereoacuity of 1.5 m and dynamic stereopsis were improved by VR training; meanwhile, AR training exhibited more improvement in stereoacuity of 0.8 and 1.5 m, dynamic and coarse stereopsis. It was suggested that the visual perceptual training based on VR and AR technology can be potentially applied in postoperative strabismus treatment to promote the recovery of binocular vision. [ABSTRACT FROM AUTHOR]

Self-efficacy (SE) can affect athletic training students' progression during their professional education and transition to autonomous clinical practice. It is unclear how course delivery may affect athletic training students' SE in various injury evaluation courses. Determine the relationship of course delivery modality and athletic training students' injury evaluation SE. Cross-sectional investigation. Web-based survey. Ninety-five noncertified National Athletic Trainers' Association student members (38/95 undergraduate athletic training students; 57/95 graduate athletic training students). A 2-part survey including participant characteristic questions and piloted adapted General Self Efficacy (GSE) scales were distributed using the National Athletic Trainers' Association's Research Survey Service. The adapted GSE scales asked participants to rate their agreeance from 1 (not at all true) to 4 (exactly true) for 10 statements focused on injury evaluations in 6 areas. Descriptive statistics were calculated, and nonparametric tests were used to determine the differences in GSE scores based on course delivery modality (online model, hybrid model, and traditional face-to-face model). Measures of central tendencies were also calculated. Only completed surveys (66.4%; 95/143) were included in the analysis (access rate = 14.3%). A significant difference existed between course delivery modality and upper extremity GSE scores (P =.001). No significant differences were found between GSE scores for courses with delivery modalities affected or not affected by the COVID-19 pandemic as well as between athletic training students who had or did not have previous online or hybrid course experiences. As health care education continues to shift toward technology-rich environments, educators can consider offering courses through various delivery modalities to promote didactic and clinical education. However, consideration of the content area and difficulty may be warranted while purposefully planning courses to best address learning objectives and students' SE. [ABSTRACT FROM AUTHOR]

The current study aimed to identify specific feedback mechanics and psychological processes that may contribute to positive outcomes in biofeedback applications for anxiety regulation. Specifically, using a dismantling study design, the unique impact of visualizations that directly mirror users' breathing was examined in relation to anxiety regulation as well as locus of control and self-efficacy. Following an anxiety induction, participants (N = 67) were randomly assigned to play one of two variations of a biofeedback video game. In both versions, players' in-game movement was contingent on their breathing; however, the experimental condition additionally included visualizations that directly mirrored players' breathing. Changes in self-reported state anxiety and physiological arousal were measured as well as the level of internal control and self-efficacy participants experienced while playing the game. Results showed that all participants were able to effectively reduce their anxiety and arousal, but no condition differences were found. Implementing mirroring visualizations did not contribute to individuals' ability to self-regulate nor their self-efficacy or locus of control above and beyond receiving feedback based on their in-game movement. Overall, individuals who experienced higher self-efficacy and a stronger internal locus of control were better able to regulate their anxiety, but no clear links were found with changes in self-reported physiological arousal. In light of these results, we recommend the continued exploration of the role of specific design choices and intervention components as well as underlying mechanisms of change in biofeedback interventions, especially pertaining to how individuals perceive themselves and their ability to change. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare markers of hydration during submaximal exercise and subsequent time trial performance when consuming water (PW) or coconut water (CW). There was also a secondary aim to assess the palatability of CW during exercise and voluntary intake during intense exercise. 10 males (age 27.9 ± 4.9 years, body mass 78.1 ± 10.1kg, average max minute power 300.2 ± 28.2W) completed 60-min of submaximal cycling followed by a 10-km time trial on two occasions. During these trials participants consumed either PW or CW in a randomized manner, drinking a 250 ml of the assigned drink between 10-15 min, 25-30 min and 40-45 min, and then drinking ad libitum from 55-min until the end of the time trial. Body mass and urine osmolality were recorded preexercise and then after 30-min, 60-min, and post time trial. Blood glucose, lactate, heart rate, rate of perceived exertion (RPE; 6-20) and ratings of thirst, sweetness, nausea, fullness and stomach upset (1 =very low/none, 5= very high) were recorded during each drink period. CW did not significantly improve time trial performance compared with PW (971.4 ± 50.5 and 966.6 ± 44.8 s respectively; p = .698) and there was also no significant differences between trials for any of the physiological variables measured. However there were subjective differences between the beverages for taste, resulting in a significantly reduced volume of voluntary intake in the CW trial (115 ± 95.41 ml and 208.7 ± 86.22 ml; p < .001). [ABSTRACT FROM AUTHOR]

Context: Few recent studies indicate that short-term repeated-sprint (RS) training in hypoxia (RSH) improves RS performance compared with identical training under normoxic conditions (RSN) in endurance-trained subjects. Purpose: To determine the effects of RSH against RSN on RS performance under normoxic and moderate hypoxic conditions, using a randomized, doubleblind, crossover experimental design. Methods: Fifteen endurance-trained male subjects (age 25 ± 4 y) performed 4 wk of RS training (3 sessions/wk) in normobaric hypoxia (RSH, FiO2 = 13.8%) and normoxia (RSN, FiO2 = 20.9%) in a crossover manner. Before and after completion of training, RS tests were performed on a cycle ergometer with no prior exercise (RSNE), after an incremental exercise test (RSIE), and after a time-trial test (RSTT) in normoxia and hypoxia. Results: Peak power outputs at the incremental exercise test and time-trial performance were unaltered by RSH in normoxia and hypoxia. RS performance was generally enhanced by RSH, as well as RSN, but there were no additional effects of RSH over RSN on peak and mean sprint power output and the number of repeated sprints performed in the RSNE, RSIE, and RSTT trials under normoxic and hypoxic conditions. Conclusions: The present double-blind crossover study indicates that RSH does not improve RS performance compared with RSN in normoxic and hypoxic conditions in endurance-trained subjects. Therefore, caution should be exercised when proposing RSH as an advantageous method to improve exercise performance. [ABSTRACT FROM AUTHOR]

Aim: To analyse junior nurses' transition shock status and its associated factors. Background: When nurses experience transition shock, turnover intentions followed by turnover behaviour are likely, which is unfavourable for the stable development of nursing teams. Methods: Using convenience sampling, 1,148 Chinese junior nurses were recruited. Those recruited completed a demographic questionnaire and the head nurses' humanistic care behaviour for nurses, feedback‐seeking behaviour and transition shock of nurses scales. Data and associated factors of transition shock were analysed using SPSS and univariate and multivariate analyses, respectively. Results: Head nurses' humanistic care behaviour and nurses' feedback‐seeking behaviour were significantly and negatively correlated with junior nurses' transition shock (mean score: 2.87 ± 0.85). Income satisfaction, head nurses' humanistic care behaviour, night shift frequency and educational background entered the regression equation. Conclusions: Transition shock exists not only in new nurses but also in junior nurses with ≤5‐year service. Those dissatisfied with their income have frequent night shifts, and higher education backgrounds have higher levels of transition shock. Implications for Nursing Management: Head nurses need to reduce transition shock of nurses with ≤5‐year service by integrating humanistic care into nursing management and creating a friendly environment to stimulate feedback‐seeking behaviour. [ABSTRACT FROM AUTHOR]

Purpose: Parkinson's disease (PD) is a progressive neurological disease that results in motor and cognitive impairments, including impaired speech production. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that shows promise in improving limb motor skills and executive function in individuals with PD. The aim of this study was to examine the impact of tDCS on speech production in individuals diagnosed with PD. Method: Six males, aged 65-78 years, with a diagnosis of PD, participated in a double-blinded controlled crossover study to assess the immediate effects of tDCS to the premotor cortex on speech production. Auditory-perceptual (Consensus Auditory-Perceptual Evaluation--Voice) and acoustic voice outcomes (e.g., fundamental frequency, intensity, noise-to-harmonic ratio [NHR], and speech rate) were gathered pre- and post-anodal simulation and sham conditions. Measures were compared across times and conditions. Results: Speech rate was below normative levels for all participants prior to tDCS. Speech rate increased significantly in conversation following stimulation but not sham conditions and exceeded normative values for two participants. NHR increased following stimulation. No significant difference in other perturbation measures, perceptual ratings, fundamental frequency, or intensity were noted. Conclusions: All participants completed the protocol without discomfort. The observed increase in speech rate needs to be interpreted in the context of excitation resulting from neurostimulation using tDCS. [ABSTRACT FROM AUTHOR]

Age-related cerebrovascular defects contribute to vascular cognitive impairment and dementia (VCID) as well as other forms of dementia. There has been great interest in developing biomarkers and other tools for studying cerebrovascular disease using more easily accessible tissues outside the brain such as the retina. Decreased circulating insulin-like growth factor 1 (IGF-1) levels in aging are thought to contribute to the development of cerebrovascular impairment, a hypothesis that has been supported by the use of IGF-1 deficient animal models. Here we evaluate vascular and other retinal phenotypes in animals with circulating IGF-1 deficiency and ask whether the retina mimics common age-related vascular changes in the brain such as the development of microhemorrhages. Using a hypertension-induced model, we confirm that IGF-1 deficient mice exhibited worsened microhemorrhages than controls. The retinas of IGF-1 deficient animals do not exhibit microhemorrhages but do exhibit signs of vascular damage and retinal stress such as patterns of vascular constriction and Müller cell activation. These signs of retinal stress are not accompanied by retinal degeneration or impaired neuronal function. These data suggest that the role of IGF-1 in the retina is complex, and while IGF-1 deficiency leads to vascular defects in both the brain and the retina, not all brain pathologies are evident in the retina. [ABSTRACT FROM AUTHOR]

Introduction. Perfectionism consists of high standards and hypercritical self-evaluation. Some doctor of physical therapy (DPT) students experience increased stress levels due to rigorous academic expectations. There is limited understanding of how successful these students are at managing increased stress, especially among perfectionists. The purpose was to examine perfectionism among entry-level DPT students and its relationship to perceived stress. Review of Literature. Researchers have studied perfectionism and stress in health professions programs, but not DPT programs. Being a Maladaptive Perfectionist (MP) was positively and strongly associated with stress among health professions students. Subjects. Convenience sample of first-year, second-year, and third-year DPT students (n = 163). Methods. This was a nonexperimental, single-site, cross-sectional study. Investigators used 3-way analysis of variance to compare student characteristics and binomial logistic regressions to determine whether characteristic and/or perceived stress was predictive of perfectionism subtype. They completed bivariate correlations to determine associations between perfectionism and stress. Results. Sample results demonstrated 41.10% Adaptive Perfectionists and 25.15% MPs. There was a moderate, direct association between perceived stress and the perfectionism discrepancy measure (r s =.51, P <.01). The perceived stress and perfectionism subtype logistic regression model was statistically significant, [chi]2(1) = 18.73, P <.01. Participants with increased perceived stress had 1.17 times higher odds of being categorized as an MP than those with lower stress levels. Discussion and Conclusion. Maladaptive Perfectionist students may be at greater risk for stress-related issues. Perfectionism and stress measures may assist educators in identifying at-risk students, monitor student response to stress management interventions, and consider curricular changes to lower stress. Students who effectively manage stress may ultimately have overall greater well-being. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although prior studies have established the association of asthma with smoking and obesity, literature on difference-in-differences analyses involving sexual identity is sparse. Therefore, this study aimed to examine the between and within sexual identity-group differences in asthma prevalence among individuals who smoke and are obese. METHODS: We aggregated the 2017-2019 National Survey on Drug Use and Health data on adults (N = 128,319) to perform weighted multivariable logistic regression analysis and marginal estimates and marginsplot to determine asthma prevalence by sexual identity and the status of smoking and obesity. RESULTS: About 66% of the study population reported having asthma. Among the individuals with asthma, 42% were obese, 10% were daily cigarette smokers, and 6% identified as bisexual persons. Lesbian/gay daily smokers (86%) or former smokers (75%) had a higher probability of having asthma than bisexual (daily smokers = 78% vs former smokers = 72%) and heterosexual (daily smokers = 68% vs former smokers = 65%) persons. Within each sexual identity subgroup, daily smokers (68-86%) had the highest probability of asthma. Obese bisexual (73%) or lesbian/gay (72%) persons had higher probabilities of having asthma than heterosexual persons (69%). Obese (73%) or overweight (72%) bisexual (compared to normal weight = 70% or underweight = 51%) and obese (69%) or overweight (65%) heterosexual (compared to normal weight = 62% or underweight = 57%) persons had the highest probabilities of having asthma within their groups, whereas overweight persons (overweight = 81% vs underweight = 79%, normal weight = 78%, and obese = 72%) had the highest probabilities within lesbian/gay persons. CONCLUSIONS: Smoking and obesity show heightened odds for asthma, with significant odds for sexual minorities in asthma diagnosis relative to heterosexuals. These findings provide formative information for future longitudinal and experimental studies to explore these mechanisms of asthma risks among sexual and gender minorities. [ABSTRACT FROM AUTHOR]

Background: Ball skill performance changes over time during childhood and depends on the child's physical and psychological characteristics, environmental opportunities, and task constraints. The aim of this study was to examine whether different standardized ball skill-items measure similar constructs and whether results differentiate among age groups. Methods: A total of 250 children (6–10 years) were administered the Movement Assessment Battery for children second edition (MABC-2), the subtest upper-limb coordination of the Bruininks–Oseretsky Test of Motor Proficiency second edition (BOT-2), the tennis ball throw of the Fitness Test Battery (FTB), and the ball skills and overhead throw of the Performance and Fitness test (PERF-FIT). Results: Correlations among scores of BOT-2, FTB, and PERF-FIT ranged from fair to moderate, but correlations were low with the MABC-2. Principal component analysis retrieved three components: the first component contained catch, dribble, bounce, and throw items (MABC-2, BOT-2-SF, and PERF-FIT, respectively); the second contained throwing for distance (PERF-FIT and FTB); the third contained aiming (MABC-2). Most ball skill scores differed significantly between 6–7 and 7–8 years, but less between 8–9 years; the PERF-FIT discriminated best between age groups. Conclusion: Most ball skill items in motor tests belong to a comparable construct containing throw, dribble, bounce, and catch skills. However, aiming tasks belong to a separate category. Additionally, throwing for distance is a task that requires predominantly explosive power. [ABSTRACT FROM AUTHOR]

Purpose: Interprofessional education (IPE) activities assist health care professionals outside of dentistry learn about the importance of oral care and its connection to overall health, while also encouraging the integration of dental hygienists into primary health care teams. The purpose of this study was to evaluate the effect of a simulation activity on dental hygiene and nursing students' attitudes about interprofessional collaboration (IPC). Methods: Second-year dental hygiene (n=35) and nursing students (n=45) from a community college in the Midwestern United States were recruited to participate via e-mail. Participants completed an online module about oral care and ventilatorassociated pneumonia followed by the Interprofessional Education Collaborative (IPEC) Competency Self-Assessment Survey version 3 prior to participating in an IPE simulation activity. The IPEC survey measures two domains: interprofessional interaction and interprofessional values. Following the simulation activity, participants completed the survey again. A Wilcoxon signed-rank test compared pre/post-survey responses. Results: A total of 61 students completed the pre-IPE survey (73%; dental hygiene: n= 29, nursing: n=32); and a total of 38 students (47%) completed the post-IPE survey. Ten post-IPE surveys were excluded in the final analysis (dental hygiene: n=15, nursing: n=13). A significant difference was found between pre-IPE and post-IPE scores for the interprofessional interaction domain (p<.001). No difference was found for the interprofessional values domain (p<.18) Conclusions: Participants had a high regard for IPC and their attitudes improved following the simulation activity. Openended responses indicated an increase in knowledge of the importance of IPC and a heightened awareness of professional roles and responsibilities. Interprofessional activities are needed across the health professions curricula to provide future collaboration and quality patient care. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the laser effect associated with stretching exercise on pain and functionality in patients with knee osteoarthritis. Design: A randomised controlled trial Setting: Special Rehabilitation Services. Subjects: We enrolled 215 knee osteoarthritis patients (430 knees were treated). Intervention: Group Laser + Stretch (n = 43), Placebo + Stretch (n = 43), Stretch (n = 43), Laser (n = 43) and Control (n = 43) were treated with active laser and stretching exercises; placebo laser and stretching exercises; stretching exercises; active laser, and control, respectively. Interventions were conducted 3 times a week for 8 or 11 weeks. Main outcome measures: The primary outcome was the change in knee pain and disability. Secondary outcomes included severity of osteoarthritis, mobility, knee range of motion, flexibility, activity, severity of osteoarthritis and medication intake for pain relief. Results: The patients' average age was 63.52 (6.8) years. Pain scores at baseline and post treatment (p < 0.001) were 7.43 (2.10) and 2.79 (1.92) for group Laser + Stretch, 7.39 (1.98) and 4.47 (2.82) for group Placebo + Stretch, 6.83 (1.42) and 4.24 (2.43) for group Stretch, 6.61 (1.68) and 2.94 (2.65) for group Laser, 6.74 (1.75) and 6.47 (2.29) for group Control, respectively. Disability score at baseline and post treatment (p = 0.000237) were 12.36 (5.02) and 8.08 (4.64) for group Laser + Stretch, 12.71 (5.12) and 9.90 (4.95) for group Placebo + Stretch, 11.83 (2.77) and 7.20 (5.28) for group Stretch, 11.58 (5.59) and 8.21 (6.18) for group Laser, 11.23 (4.68) and 11.45 (4.83) for group Control, respectively. Conclusion: Laser therapy combined with stretching exercises improves pain during rest, activities of daily living, stiffness, muscle shortening and range of motion in patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Aim: Nurses are considered a major source of professional support for patients. However, little is known about what cancer patients need from nurses regarding professional support and the provision of services in China. The purpose of this study is to investigate professional nursing supportive care needs, perceived supply, and the possible gaps between the two for patients with cancer in mainland China. Methods: A total of 390 inpatients with different types of cancer were recruited. The professional nursing supportive care scale was used to assess the needs for and perceived supply of various types of support. Results: The information aspect was one of the most critical needs for supportive care, and the technical aspect was the one with the highest perceived level of supply. Significant mismatches between actual needs and perceived supply were identified. Conclusions: Significant gaps existed between actual needs and perceived supply. Nurses should pay more attention to the higher actual needs and lower perceived levels of supply regarding supportive care for cancer patients. [ABSTRACT FROM AUTHOR]

Two studies investigating the impact of dried fruits eaten as a snack on weight control were designed to examine the effects of prunes and raisins on appetite (phase 1), and whether prunes undermine weight loss, due to the increase in energy density on drying, when included in a structured weight loss programme (phase 2). Phase 1 compared the effect on appetite of equi‐weight or equi‐caloric snacks of prunes (100 or 140 g) and raisins (100 or 111 g) with a control condition (100 g/335 kcal jelly babies), in a pre‐load, cross‐over design (n = 40 analysed). A significant effect of condition on food intake was observed, with significantly lower weight of food consumed in the 140 g prune group versus control, and on Area Under the Curve (AUC) fullness, due to a greater effect in the 140 g prune group versus control. In phase 2, change in bodyweight and waist circumference were measured in a 12‐week randomised, parallel‐groups intervention study (n = 100 analysed, 50 per group). Prunes (females: 140 g, males: 171 g/day) replaced usual snacks whilst following a weight loss programme. The active control group followed the same programme and participants were instructed on healthy snacking. A significant reduction in mean bodyweight in the prune group versus baseline was consistent with the phase 1 evidence that prunes can aid appetite control, although it could also be explained by overall diet in the context of a structured weight loss programme. Prunes did not produce a detrimental effect on mean weight loss over 12 weeks versus control (prune group: −1.99 kg; active control: −1.53 kg), nor on decrease in waist circumference (prune group: −2.40 cm; active control: −1.74 cm). No additional benefit on weight loss was seen (between‐group difference was non‐significant). The daily intake of prunes was well‐tolerated. Phase 1 demonstrated that prune snacks produced beneficial changes in appetite. Phase 2 demonstrated that prunes did not undermine weight management, and this warrants further study. [ABSTRACT FROM AUTHOR]