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Sufficient variable screening (SVS) with the false discovery rate (FDR) controlled rapidly reduces dimensionality with high probability in high dimensional modeling. By using quantiles, this paper proposes a new SVS procedure by controlling the FDR based on two‐stage Pearson's goodness testing with Chi‐square statistics for high dimensional data, abbreviated as QC‐SVS‐FDR. Without any specified distribution of the actual model, the QC‐SVS‐FDR method screens important predictors by a series of testing procedures combined with the adaptive composite of Pearson's chi‐square statistics. The quantile correlation‐based sufficient utility is sensitive to capture the subtle correlations under different quantile levels and is easy to implement with computational efficiency. Asymptotic results and sufficient screening properties of the proposed methods are obtained under mild conditions. Numerical studies including simulation studies and real data analysis demonstrate the advantages of the proposed method in practical settings. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, Ireland implemented a series of stringent public health measures, including lockdowns and suspension of non‐urgent clinical services. Aims: To investigate the impact of the COVID‐19 pandemic on the demand for and delivery of speech and language therapy (SLT) services in Ireland in 2020. Methods & Procedures: Two iterations of a cross‐sectional, mixed‐methods online survey were distributed to speech and language therapists (SLTs) and SLT students in Ireland in the spring and autumn of 2020 using a combination of purposive and snowball sampling. The spring survey yielded 407 responses (including 14 from SLT students), while 197 respondents took part in the autumn (13 students). Survey analysis focused on questions related to the impact of the COVID‐19 pandemic on delivery and demand for SLT services (student responses were excluded from analysis owing to low response rate). The largest group in respect of experience were senior SLTs (58% in both surveys). The work settings most strongly represented were HSE primary care (34.4%) and disability services (26.5%) in the spring, and HSE primary care (39.1%), acute hospitals (22.8%) and disability services (20.8%) in the autumn. We used descriptive statistics, including distribution analysis, to analyse the quantitative data. Free text data were interrogated through a variant of a conventional qualitative content analysis. Outcomes & Results: In the spring, cessation of face‐to‐face services featured prominently (reported by 65.6% versus 14.2% in the autumn), across SLTs' work settings, except acute hospitals. Lower demand was reported by 42.5% in the spring, while in the autumn, 48.7% indicated that demand was higher. SLTs experienced large‐scale redeployment (spring: 45.9%, autumn: 38.4%), with HSE primary care SLTs redeployed most (spring: 71.7%; autumn: 62.3%). The need to suddenly pivot to telehealth was a significant challenge in terms of training, technology and logistics. New ways of working emerged and gradually, telehealth became more embedded. SLTs also had to adapt to working with evolving public health measures, such as space restrictions and personal protective equipment (PPE) requirements. Across the two survey iterations, SLTs reported tensions between demands and capacity: while referrals and demand initially decreased in the spring, this led to increased backlog and longer waiting lists, ongoing and increasing pressure on clinicians and services, and negatively impacted clients and families. Conclusions & Implications: The COVID‐19 pandemic had a significant negative impact on SLT services in Ireland. Going forward, the SLT profession and its services will require sustained support to mitigate long‐term negative consequences, such as increased waiting lists. WHAT THIS PAPER ADDS: What is already known on this subject: The negative impact of the COVID‐19 pandemic on SLT services has been examined in several countries. Ireland imposed more stringent pandemic‐management measures than many other countries, and it was therefore warranted to investigate how SLT services in the country were affected. What this study adds to the existing knowledge: Face‐to‐face SLT services effectively ceased in most non‐urgent contexts in spring 2020. This coincided with large‐scale redeployment of SLTs to non‐SLT contexts. By autumn 2020, demand had increased again, but not all services had recommenced, and redeployment was still a factor. Although SLTs adapted to the ongoing changes imposed by the pandemic, they voiced concern about increasing backlogs and longer waiting lists, ongoing and increasing pressure on both SLTs and services, and negative impacts on clients and families. What are the actual and clinical implications of this work?: The COVID‐19 pandemic had a significant negative impact on SLT services in Ireland. Going forward, the SLT profession and its services will require sustained support to mitigate long‐term negative consequences, such as increased waiting lists. [ABSTRACT FROM AUTHOR]

In this paper we focus on the distributed cyber attack detection and physical fault diagnosis problem for a class of interconnected large-scale systems (ILSSs). In the proposed scheme, apart from node measurement, edge measurement is also used to construct distributed Kalman filter to estimate the state of each subsystem. The gain matrices of Kalman filter are determined by minimizing the covariance of estimation error in the attack-free and fault-free case, which reduces the false alarm rate of cyber attack detection and physical fault diagnosis. Based on this filter, a bank of adjacent residual generators is constructed to characterize the influence of cyber attack on the edge measurement, and the Chi-square test is used to detect whether the received edge measurements are attacked. At the same time, a local residual generator is constructed for each subsystem to characterize the influence of physical faults on it, and the residual signal is evaluated by variance and directional residual, so as to make distributed fault detection and isolation of each subsystem. It is worth noting that at each step, each subsystem first performs attack detection on the received edge measurements, and then estimates its own state using the attack-free edge measurements and node measurement, which further improves the accuracy of fault detection and isolation. In addition, a sufficient condition that ensuring the mean square exponential boundedness of the estimation error is given. Finally, the proposed scheme is verified by an illustrative example. • A distributed Kalman filter using both node and edge measurements is proposed. • The gain matrices are determined by minimizing the estimation error covariance. • The adjacent residuals are tested by Chi-square test. • The local residual is evaluated by variance and directional residual. • The proposed scheme is completely distributed. [ABSTRACT FROM AUTHOR]

Background & Objective: As bleeding is a serious complication during and after hysterectomy, this paper aims to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy. Materials & Methods: In the present clinical trial, 46 patients who were candidates for abdominal hysterectomy in Hajar Hospital in Shahrekord, were randomly divided into two groups. In group A, superficial cauter and Surgicel were used and in group B, superficial cauter and ChitoHem were used to control bleeding. Hematocrit and hemoglobin levels were determined before, and six and 12 hours after surgery. Drain discharge volume, time to stop bleeding and bleeding volume were also determined. The pain was determined by the VAS scale at the time of recovery, 48 hours postoperatively, and one and three months postoperatively. Data were analyzed by SPSS statistical software. Results: Based on repeated-measures test, the mean of hemoglobin in the studied times showed a significant difference, so that in six and 12 hours after surgery they were significantly less than the ones before surgery, but their mean was not significantly different between the two groups. The mean pain score one month after surgery in group B was significantly lower than group A (P <0.001). The mean volume of drainage and clotting time in group B were significantly lower than group A (P <0.01). The mean volume of intraoperative bleeding, the frequency of vaginal bleeding and cuff-related complications were not significantly different in the two groups. Conclusion: The results of the present study show that ChitoHem is probably effective in reducing bleeding during hysterectomy surgery. [ABSTRACT FROM AUTHOR]

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The university cafeteria is a crucial element in shaping students' dining experiences and their physical well-being. This study was conducted at a public university in Bangladesh. This research has a dual purpose: firstly, to assess student satisfaction with the university cafeteria using key indicators and secondly, to identify critical factors influencing this satisfaction through advanced data analysis employing recursive feature elimination (RFE). The ultimate goal is to enhance cafeteria services, align them with student preferences, and boost overall satisfaction. Data collection involved 150 paper-based questionnaires with mixed data types, including questions based on prior research assessments. The model-building process included the chi-squared test and the recursive feature elimination process. The study identifies 12 factors significantly affecting cafeteria food satisfaction, with four factors having a notable impact: meal type and freshness, staff attitude, and wait length. This research highlights the interconnectedness of seemingly distinct cafeteria factors and their potential to influence health outcomes. Practical recommendations are made for improving cafeteria efficiency and adapting to changing student needs. Health education interventions aimed at enhancing the cafeteria experience for university students should include a quantitative analysis of factors impacting students' overall cafeteria satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: This paper explores older adults' perceptions on sexuality and affectivity in Chile, according to class and sex. Methods: The study is based on computer-assisted telephonic interviews with people aged 60 and over, men and women (n = 481). Data were analyzed using chi-squared tests and binary logistic regressions. Results and discussion: Maintaining an active sex life is important for older adults of both sexes, contradicting the commonsense view according to which the relevance allocated to sex decreases significantly with age. However, the data show significant differences in perceptions by sex, suggesting that gendered conceptions regarding sexuality are influential along the entire life cycle. There are also relevant differences according to class, revealing the inequalities present in the expression of sexuality in Chile. [ABSTRACT FROM AUTHOR]

Introduction: Socially responsible investments (SRI) increased their popularity among investors over the last two decades. However, there is still a lack of knowledge on socially responsible investors' characteristics and motivations behind the decision to invest in SRI. The present paper aims at filling this gap by profiling current and potential sustainable investors. Method: Cross-sectional data from a representative sample of Italian consumers (N = 1,002) was used to perform a Latent Profile Analysis (LPA), a clustering technique, and identify various sub-groups within the respondents. Subsequently, chi-square test and one-way ANOVA were performed to determine which profile(s) was mostly associated with current and potential socially responsible investing. Results and discussion: Five profiles of consumers were identified through the LPA, each one differently associated with the likelihood of investing in socially responsible products. The profile that best describes sustainable investors is characterized by high levels of knowledge toward SRI, risk appetite, positive attitudes on SRI, personal norms, perceived behavioral control, environmental concerns, and connectedness to nature. These findings suggest that non-financial aspects, namely psychological characteristics such as attitudes and personal values, play a key role in the decision to invest responsibly as well. [ABSTRACT FROM AUTHOR]

Summary: The foundations of correspondence analysis rests with Pearson's chi‐squared statistic. More recently, it has been shown that the Freeman–Tukey statistic plays an important role in correspondence analysis and confirmed the advantages of the Hellinger distance that have long been advocated in the literature. Pearson's and the Freeman–Tukey statistics are two of five commonly used special cases of the Cressie–Read family of divergence statistics. Therefore, this paper explores the features of correspondence analysis where its foundations lie with this family and shows that log‐ratio analysis (an approach that has gained increasing attention in the correspondence analysis and compositional data analysis literature) and the method based on the Hellinger distance are special cases of this new framework. [ABSTRACT FROM AUTHOR]

Objective: Exenatide (twice daily) has been used as a glucagon-like peptide-1 receptor agonist in patients with diabetes with inadequate glycemic control for over a decade. In this paper, we aimed to investigate the long-term glycemic control and change in body weight in patients treated with exenatide. Methods: A total of 287 patients who were treated with exenatide twice daily between 2012 and 2022 were included in this retrospective study. The changes in glycated hemoglobin (HbA1c) levels and body weight were assessed over time after exenatide administration. The administered insulin dosage and metabolic parameters were documented. The baseline data were compared over a period of 3 months to 3 years. Results: The study included 101 (36%) males and 186 (64%) females, with an average age of 56.4 ± 10.7 years. The baseline HbA1c level was 8.0 ± 1.8%, and the body mass index was 38.8 ± 5.9 kg/m². The HbA1c level had decreased by 1.29% from the baseline at 3 months (P < .001), which continued up to 3 years (−0.63%, P = .010). During the 3-year period, body weight continued to decrease significantly (−12.1, P < .001). Glucose levels were significantly reduced, but the lipid levels and glomerular filtration rate after exenatide treatment were similar. Notably, exenatide administration resulted in a decrease in insulin dosage for patients treated with insulin. Conclusion: Exenatide therapy produced continued improvements in glycemic control and progressive weight loss for 3 years in patients with diabetes in a real-life setting. [ABSTRACT FROM AUTHOR]

This paper discusses perceptions regarding the roles of PhD- and MLS (or MLIS)-holding librarians within academic libraries in the United States gathered via a survey conducted in 2019. Based on a review of previous literature and the results of the survey—which present mixed opinions about PhD holders as librarians—the authors provide recommendations for ways libraries can effectively address some of the tensions regarding the role of PhD holders within academic librarianship. This article is useful for librarians of all educational backgrounds, PhD holders who are considering the transition to a library career, and library administrators involved in the hiring process. [ABSTRACT FROM AUTHOR]

Quality assessment enables organisations to identify the strengths and weaknesses of their services, which is essential for continuous improvement and adaptation to customer needs. IBM SPSS Statistics is one of the most widely used statistical analysis tools that enables efficient processing and evaluation of survey data. With its wide range of features and intuitive interface, SPSS is the ideal tool for data analysis in a variety of fields, including transportation. The aim of this paper is to present methods for data analysis in transport services, focusing on the use of IBM SPSS Statistics. Using chi-square test, the relationships between different quality criteria will be investigated, which will provide valuable information for improving the services provided and increasing customer satisfaction. The results of this analysis will highlight the importance of a systematic approach to quality management and the benefits it brings to organisations operating in a dynamic and competitive environment. [ABSTRACT FROM AUTHOR]

There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9–11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed. [ABSTRACT FROM AUTHOR]

Time series forecasting is an important application of many statistical methods. When it is appropriate to assume that the data may be projected towards the future based on the past history of the dataset, a preliminary examination is usually required to ensure that the data sequence is autocorrelated. This is a quite obvious assumption that has to be made and can be the object of a formal test of hypotheses. The most widely used test is the portmanteau test, i.e., a sum of the squared standardized autocorrelations up to an appropriate maximum lag (the truncation point). The choice of the truncation point is not obvious and may be data-driven exploiting supplementary information, e.g. the largest autocorrelation and the lag where such maximum is found. In this paper, we propose a portmanteau test with a truncation point equal to the lag of the largest (absolute value) estimated autocorrelation. Theoretical and simulation-based comparisons based on size and power are performed with competing portmanteau tests, and encouraging results are obtained. [ABSTRACT FROM AUTHOR]

Across most developmental periods, males tend to drink at a higher frequency and at a higher intensity than females. In identifying the mechanism responsible for these differences, biological factors have been a prevalent focus; however, gender expression is also highlighted. The purpose of this paper is to decipher how differences in binge drinking are attributed to sex differences and gendered traits. Using data from Wave III of the National Longitudinal Study of Adolescent to Adult Health (ADD Health) (n = 8,882), we conducted a multiple group moderation analysis to examine how differences in biological sex and gender roles in emerging adulthood predicted binge drinking. We found that binge drinking in emerging adulthood was most strongly predicted by high levels of masculinity and low levels of femininity in emerging adulthood. As masculinity decreased, alcohol use decreased. Femininity significantly moderated masculinity's association with binge drinking, primarily when masculinity was high, and this did not vary across sex after controlling for gender roles. Our findings expand sex and gender research surrounding alcohol use. For both males and females, the higher the masculinity the more frequent alcohol use, an effect of which was buffered by higher levels of femininity. Clinicians should take into consideration gender role ascription of their clients when determining the risk profile during assessment. [ABSTRACT FROM AUTHOR]

Background: Reading comprehension is an interactive process. Yet, instructional needs are usually identified with isolated componential tests. This study examined whether a dynamic approach, in which componential abilities are measured within the same text and global text comprehension is facilitated via feedback, can help in understanding variation in children's reading comprehension. Objectives: With a pretest‐posttest control group design, componential abilities before and after feedback were related to growth in global text comprehension within the same text. Methods: At pretest, third to fifth graders read 30 short texts, each followed by one global text comprehension question. This was repeated at posttest, but additional questions were asked with feedback prior to each global text comprehension question. The vocabulary group received two vocabulary questions with feedback (n = 97). The vocabulary plus integration group received two vocabulary questions and one sentence‐integration question with feedback (n = 98). The control group (n = 98) only answered the global text comprehension questions. Results and Conclusion: Participants in the experimental conditions who needed feedback (i.e., lower‐skilled) experienced a decrease in global text comprehension, whereas this was not found for the control group and participants in the experimental groups who did not need feedback (i.e., higher‐skilled). There was also less decrease among those lower‐skilled participants who had profited from the feedback. Implications: It is concluded from explorative analyses that not feedback but the overall design caused the decrease. Conceptually, the dynamic approach is worth further research. Lay Description: What is already known about this topic: Reading comprehension is a complex interaction of several componential abilities at word level, sentence level, and text level (e.g., vocabulary and sentence‐integration).Instruction should adapt to the profile of strengths and weaknesses in componential abilities.Assessing componential abilities with isolated tests does not align with the interactive processes in reading comprehension.Measuring learning ability can help to identify children with low responsiveness to instruction. What this paper adds: Reading comprehension is profiled by asking questions on vocabulary, sentence‐integration, and global text comprehension for the same text in third to fifth graders (8–11 years olds).Feedback is provided after a mistake in a vocabulary and sentence‐integration question, and the feedback effect on global text comprehension is measured with a pretest‐posttest design.Children who receive feedback decrease in global text comprehension but children with higher skills in componential abilities decrease less.Explorative analyses and previous research indicate that the assessment design had a negative impact on performance, for example, via cognitive load, attention, self‐esteem, and motivation. Implications for practice and/or policy: Global text comprehension cannot always be facilitated by providing feedback on vocabulary and sentence‐integration within the same text.The design of the assessment and its influence on performance should be carefully considered by instructional designers, educators, and researchers, especially in case of young learners.It remains unclear from this study if facilitating global text comprehension via feedback with a dynamic approach is useful to understand variation in children's reading comprehension.The dynamic approach with a proper design may potentially still provide a useful insight in individual differences. [ABSTRACT FROM AUTHOR]

Background: In a context where synchronous online teaching has become a new trend of instruction for online education due to the COVID‐19 pandemic, it is valuable and insightful to examine what factors contribute to teachers' satisfaction with synchronous online teaching. Objective: Informed by the technology acceptance model (TAM), this study investigated English‐as‐a‐foreign‐language (EFL) university teachers' synchronous online teaching satisfaction in China from social (i.e., subjective norms), institutional (i.e., facilitating conditions), and individual (i.e., self‐efficacy, attitudes toward use, perceived usefulness, and perceived ease of use) levels during the COVID‐19 pandemic. Methods: A total of 250 in‐service EFL university teachers participated in this study. An online questionnaire was adaptively developed to measure teachers' perceptions of and satisfaction with synchronous online teaching. The structural equation modelling (i.e., path analyses) was performed to find out a model that can best represent EFL university teachers' synchronous online teaching satisfaction. Results and Conclusion: The results showed that facilitating conditions, self‐efficacy, attitudes toward use, and perceived usefulness are direct contributors to EFL university teachers' satisfaction with synchronous online teaching. Whereas, perceived ease of use, self‐efficacy, and subjective norms are indirect contributors through the mediation of attitudes toward use. Moreover, different from previous TAM research, facilitating conditions have been found to be the most significant direct factor positively contributing to satisfaction. The findings of this study are expected to shed light on how to enhance teachers' synchronous online teaching satisfaction. Lay Description: What is already known about this topic: The technology acceptance model (TAM) has been frequently adopted to examine teachers' acceptance of technology in various contexts over the last two decades.The TAM model identifies three key factors that contribute to people's intention of technology use: perceived usefulness, perceived ease of, and attitudes toward technology use.Although the TAM model has been extensively examined in various technology‐supported teaching contexts, there has been a lack of focus on livestream technology‐supported synchronous online teaching. What the paper adds: EFL university teachers' synchronous online teaching satisfaction during the COVID‐19 in China.Teachers' satisfaction with synchronous online teaching is a joint interplay of individual (i.e., self‐efficacy, attitudes toward use, perceived usefulness, and perceived ease of use), institutional (i.e., facilitating conditions), and social (i.e., subjective norms) factors.Facilitating conditions, self‐efficacy, attitudes toward use, and perceived usefulness are direct contributors, while perceived ease of use, self‐efficacy, and subjective norms are indirect contributors to teachers' synchronous online teaching satisfaction through the mediation of attitudes toward use.Different from previous TAM research, facilitating conditions have been found to be the most significant direct factor positively contributing to satisfaction. Implications for practice and/or policy: This study offers a diagnostic measure for schools and universities to understand the status quo of their teachers' perceptions of and satisfaction with synchronous online teaching.Universities are advised to provide teachers with readily accessible support and training to enhance their self‐efficacy for synchronous online teaching so that their satisfaction with synchronous online teaching can be strengthened. [ABSTRACT FROM AUTHOR]

Background: Students often show unfavourable attribution: they attribute poor school performance to stable factors such as lack of ability and good school performance to variable factors such as effort. However, attribution can be influenced by individualized digital re‐attributional feedback leading to positive motivational effects and higher learning outcomes. This is very promising, but it still is unclear, whether this digital re‐attributional feedback can also be successfully integrated in everyday classroom activities. Objectives: The present field experiment investigated how integrating digital re‐attributional feedback into classroom instruction affects student attribution, motivation and learning outcomes. Methods: In the experiment, 8th–10th grade high school students (N = 322) worked with a digital mathematics learning program which was integrated in a three‐week teaching unit. Half the students in each classroom received only standard feedback after each practice task (SF group); the other half received additionally an individual re‐attributional feedback (RF group) after every third task. Attribution, mathematics self‐concept, and self‐efficacy were measured by an online questionnaire twice a week; learning outcomes in mathematics were measured weekly. Results and Conclusion: Hierarchical analyses showed that re‐attributional feedback led to a more favourable attribution in case of success on stable factors. Especially low‐performing students benefited from this feedback. No effects on attribution in case of failure, self‐efficacy or learning outcomes could be found. Further research could investigate if certain adaptations to the digital re‐attributional feedback is more effective in a real classroom setting and has a broader impact on different students. Lay Description: What is already known about this topic: Working with computers in the classroom and at home is becoming more common.Re‐attributional feedback can increase student's motivation when given directly after solving a task and at a high density.Digital re‐attributive feedback can be given in a high density.Re‐attributional training sessions have been shown to be effective in individual training sessions or outside the students' classroom. What this paper adds: The study took place within a real teaching environment during mathematics class for 4 weeks.Digital re‐attributional feedback sessions were directly integrated into the students' online learning which was part of the teaching plan. The implications of study findings for practitioners: Computer‐based re‐attributional training show some limited effects in regular classroom instruction and could be well integrated in student online learning—when adapted accordingly.Low‐performing students show less favourable attribution than better‐performing students in case of success and benefit the most from re‐attributional training. [ABSTRACT FROM AUTHOR]

This paper introduces a methodology for generating secure cryptographic key bits from analog values obtained from the Lorenz chaotic circuit. The analog values are transferred from the chaotic circuit to the computer via an Analog Discovery-2 device and then post-processed by using a fixed-point number representation format and Von-Neumann corrector for the sampled values on the MATLAB program. By employing this method, the analog values are digitized and randomized as the main idea is to obtain secure and efficient statistically random bits. Furthermore, the generated random bits are utilized for secure audio encryption by demonstrating a practical application of the proposed methodology. In addition to the classical randomness test criteria, NIST 800.22 statistical test suite, the throughput bit stream is also subjected to Chi-square and FIPS 140-1 tests to further evaluate its effectiveness. The results of these comprehensive tests confirm the successful performance of the proposed system in generating statistically random bits and its secure audio encryption system. The utilization of the Lorenz chaotic circuit as an entropy source in generating true random bits for secure audio transmission applications showcases the potential of the proposed system. [ABSTRACT FROM AUTHOR]

The triumph of vaccination programs requires the modification of human behavior, which in turn, needs an understanding of knowledge, attitudes, and practices (KAPs) regarding vaccine and vaccination. This paper aimed to investigate the COVID-19 vaccine and vaccination KAPs of the teachers. Following a quantitative correlation research design, 2272 K to 12 teachers from Mindanao, Philippines were surveyed using an adapted instrument. The data collected were treated using descriptive statistics, Chi-square, t-test for independent samples, ANOVA, Point Biserial Correlation, and Pearson r. The result shows that most teachers perceive themselves as knowledgeable, possess desirable attitudes, and demonstrate favorable practices toward COVID-19 vaccine and vaccination. It was further found that COVID-19 vaccine and vaccination knowledge significantly differed across gender while both attitudes and practices significantly differed across age, gender, monthly income, and teaching experience. Hence, future policies and measures to improve knowledge, attitudes, and practices should be developed targeting samples with these characteristics. Lastly, the result reveals that COVID-19 vaccine and vaccination knowledge influence attitudes and practices. Thus, to increase desirable attitudes and favorable practices, government officials and concerned groups must promote COVID-19 vaccine and vaccination knowledge. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this article is to analyse the determinants of risky behaviour of school children and their impact on early sexual initiation, considering differences between sexes. Methods: The paper analyses the results of the HBSC international study conducted in Slovakia in 2018. A total of 1,293 schoolchildren (81.8% response rate) participated in the study. 15-year-old adolescents were assessed. Differences between boys and girls were also analysed. Results: In the 2018 data collection, the occurrence of underage sexual intercourse was more common among boys (17%) than girls (11.3%). Overall, 94.3% of children reported not having smoked and not having had an early sexual experience. Conversely, 26.1% of the children who admitted having smoked, had had sex. As for alcohol consumption, 19.2% of the pupils who had drunk alcohol reported early sexual initiation but, in a statistically significant indicator, up to 34.1% of adolescents who had had sexual intercourse were in a state of drunkenness at the time. Conclusion: To some extent, experimentation and risky behaviours in adolescence are socially acceptable. However, the timing of adolescents' first sexual intercourse can have an impact on their health and mental well-being. There is a need to recognise and monitor possible determinants that may lead to their risky sexual activities. There is also a clear and pressing need for legislative standards. Paediatric care and nursing play a vital role in the primary prevention of risk activities. [ABSTRACT FROM AUTHOR]

In community-based studies, mid-upper arm circumference (MUAC) appears to be a superior predictor of childhood under nutrition than many other anthropometric indicators. This study aimed to evaluate the nutritional status of children aged 2-5 years using mid-upper arm circumference (MUAC) cut-off values recommended by the World Health Organization in 2007. The present study was a cross-sectional study carried out in randomly selected 44 ICDS canters in Maynaguri Block, Jalpaiguri District, West Bengal, India. Children aged 24 – 60 months (Boys - 499 and Girls - 522) from three (Rajbanshi, Nama Shudra, Nashya Seikh) ethnic communities. Significant age variation was found among boys (F = 14.777; p< 0.001) and girls (9.465; p< 0.001). The overall percentage of moderate and severe undernourished girls (moderate – 25.67%; severe – 5.75%) is higher than the boys (moderate – 24.85 %; severe – 5.41%). Chi-square analysis shows a statistically significant relationship of under nutrition with age, birth weight, ethnicity, birth order, number of siblings, bath place, fuel of cooking, income level and Asiaspecific maternal BMI level. Comparison with international studies reveals that the prevalence of under nutrition in the present study is higher than the children of Malaysia, Cameroon, Nepal, Nigeria and Pakistan. In the context of India, the present study reported a higher prevalence of under nutrition than the children of Midnapur South 24 Pargana of West Bengal, children of Odisha and Bihar. [ABSTRACT FROM AUTHOR]

Scant studies have investigated adverse childhood experience (ACE) outcomes and mastery during adolescence in different cultural contexts. This cross‐sectional study examines the impact of ACEs on subjective well‐being, health complaints, and healthcare utilization during late adolescence, including the mediating role of the sense of mastery in the Saudi context. Adolescents (N = 396) aged 17–21 years were recruited via convenience sampling from colleges and local communities from two regions in Saudi Arabia. Data were collected using a paper‐pencil anonymous survey and analyzed using path analysis. Of the sample, 85.5% experienced at least one ACE. ACEs had a direct effect on subjective well‐being (p = 0.034), health complaints (p < 0.001), healthcare utilization (p < 0.001), and sense of mastery (p < 0.001). Sense of mastery had an effect on subjective well‐being (p < 0.001) and health complaints (p < 0.001), but not on healthcare utilization (p = 0.436). Sense of mastery partially mediated the relationship between ACEs and subjective well‐being (p = 0.034) and health complaints (p < 0.001), but not healthcare utilization (p = 0.438). ACEs have detrimental effects on adolescent health. Attention should be paid to primary prevention and early detection to avoid further harm, and interventions that address the role of the sense of mastery should be developed for adolescents. [ABSTRACT FROM AUTHOR]

In the last few decades, numerous studies and review papers have examined a wide range of potential risk factors in an attempt to understand adolescent smoking. In the majority of those studies, family is often regarded as an important element in the life of an adolescent. The authors investigated whether family factors such as child–parent relationship and parental educational level are predictors of adolescent smoking status in three school types using archival data. Both Spearman correlation and Chi-square test of independence were used to examine the relationships. In viewing all the school types as one, the result showed that at (rho =.148, n = 751, p < 0.05), a significant positive relationship existed between child-father relationship and adolescent smoking but not with child–mother relationship. However, in controlling for school types, the Chi-square test of independence revealed (Imam Hatip high school (X2(8) = 7.121, p > 0.05), Anadolu high school (X2(8) = 12.423, p > 0.05) and Vocational high school (X2(8) = 17.744, p < 0.05) a relationship between child–mother relationship and adolescent in Vocational high school. As to whether the influence of child–father relationship on adolescent smoking differed in terms of school types, result suggested a relationship existed in all the three school types (Imam Hatip high school (X2(8) = 30.965, p < 0.05), Anadolu high school (X2(8) = 21.241, p < 0.05), and Vocational high school (X2(8) = 30.804, p < 0.05). [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cause of mortality due to cancer for women both in Lithuania and worldwide. The chances of survival after diagnosis differ significantly depending on the stage of disease at the time of diagnosis and other factors. One way to estimate survival is to construct a Kaplan–Meier estimate for each factor value separately. However, in cases when it is impossible to observe a large number of patients (for example, in the case of countries with lower numbers of inhabitants), dividing the data into subsets, say, by stage at diagnosis, may lead to results where some subsets contain too few data, thus causing the results of a Kaplan–Meier (or any other) method to become statistically incredible. The problem may become even more acute if researchers want to use more risk factors, such as stage at diagnosis, sex, place of living, treatment method, etc. Alternatively, Cox models can be used to analyse survival data with covariates, and they do not require the data to be divided into subsets according to chosen risks factors (hazards). We estimate the chances of survival for up to 5 years after a breast cancer diagnosis for Lithuanian females during the period of 1995–2016. Firstly, we construct Kaplan-Meier estimates for each stage separately; then, we apply a (stratified) Cox model using stage, circumstance of diagnosis, and year of diagnosis as (potential) hazards. Some directions of further research are provided in the last section of the paper. [ABSTRACT FROM AUTHOR]

Introduction This paper aimed to evaluate the effect of opium on bladder cancer grade and stage. We analyzed the impact of opium on the stage and grade of bladder cancer. Methods In this retrospective study, we analyzed 446 patients with pathologically confirmed bladder cancer treated from February 2012 to January 2019. Demographic data including sex, age, body mass index, opium consumption, and smoking, were collected. Exclusion criteria were patients receiving chemotherapy, inaccessible pathologic reports, and previous abdominopelvic radiotherapy. Chi-squared test was used in case of categorical variables. The significance level was set at 0.05. The analyses were performed using the statistical software Stata ver. 13. Results Our results indicate show that higher muscle-invasive stages occurred in opium users group compared to the non-opium users (P-value<0.001 vs. P-value: 0.104). The BMIs≥25 indicated a greater high grades percentage in the opium users compared with non-users (P-values=0.137 and 0.316 for the ages <65 and ≥65 years and 0.602 and 0.013 for the BMIs <25 and ≥25). Accordingly, in people with BMIs≥25, odds of high grades were 2.8-fold, compared with non-users. Patients with BMIs of 25 or more had 2.8 times the chance of getting high grades compared to those who did not. Regarding muscle stages, while all subgroups showed significance, the largest effect size of 4.2 was obtained for the <65 age group. Conclusions Our data revealed the higher muscle-invasive stages in the opium users comparing compared to non-opium users. Also, in patients with BMIs≥25, odds of high grades were 2.8 folds, compared with non-opium users. [ABSTRACT FROM AUTHOR]

Background: Preoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education. Methods: This cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed. Results: We received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary. Conclusions: The implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education. [ABSTRACT FROM AUTHOR]

Objective: Multiple myeloma (MM) is a bone marrow cancer that profoundly affects plasma cells involved in the immune response. Myeloma cells alter the average production of cells in the bone marrow. Anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy allows genetic modifications of an individual's T-cells to increase the expression of CARs used to identify and attach BCMA proteins to the malignant cells. Our main objective is to perform a systematic review and meta-analysis to explore the efficacy and safety of anti-BCMA CAR T-cell therapy for MM. Material and Methods: We searched five databases, PubMed, CNKI, EMBASE, Cochrane, Web of Science, and CNKI, for studies published on anti-BCMA,CAR-T-cell treatment for MM. Inclusion criteria involved prospective single-arm studies either single or multi-center, in various MM phases and studies that reported anti-BCMA,CAR-T-cell treatment for MM. We excluded non-English publications and conference papers. All statistical analyses were performed in R software and Review Manager 5.4.1. Results: Thirteen articles were included in the analysis. We found that the overall response survival complete response increase was statistically significant. Similarly, the reduction in cytokine release syndrome grades 3 and 4 and neurotoxicity after follow-up was statistically significant. However, the reduction in minimal residual disease negativity (MRDN) was not statistically significant. Conclusion: Using anti-BCMA CAR T-cell therapy in MM was highly efficacious and safe in lowering the adverse outcomes and improving the survival outcomes, complete response, and overall response. [ABSTRACT FROM AUTHOR]

To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464) The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement. As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists. As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary. [ABSTRACT FROM AUTHOR]

Background: In Italy, there is a network of centres headed by the Italian Association of Pediatric Hematology and Oncology (AIEOP) for the diagnosis and treatment of paediatric cancers on almost the entire national territory. Nevertheless, migration of patients in a hospital located in a region different from that of residence is a widespread habit, sometimes motivated by several reasons. The aim of this paper is to assess the impact of migration of children with cancer to AIEOP centres in order to verify their optimal distribution throughout the national territory. Methods: To this purpose, we used information on 41,205 registered cancer cases in the database of Mod.1.01 Registry from AIEOP centres, with age of less than 20 years old at diagnosis, diagnosed from 1988 to 2017. Patients' characteristics were analysed and compared using the X2 or Fisher's exact test or Mann–Whitney test, when appropriate. Survival distributions were estimated using the method of Kaplan and Meier, and the log-rank test was used to examine differences among subgroups. Results: Extra-regional migration involved overall 19.5% of cases, ranging from 23.3% (1988–1997) to 16.4% (2008–2017) (p < 0.001). In leukaemias and lymphomas we observed a mean migration of 8.8% overall, lower in the North (1.2%) and Centre (7.8%) compared to the South & Isles (32.3%). In the case of solid tumours, overall migration was 25.7%, with 4.2% in the North, 17.2% in the Centre and 59.6% in the South & Isles. For regions with overall levels of migration higher than the national average, most migration cases opted for AIEOP centres of close or even neighbouring regions. Overall survival at 10 years from diagnosis results 69.9% in migrants vs 78.3% in no migrants (p < 0.001). Conclusions: There is still a certain amount of domestic migration, the causes of which can be easily identified: migration motivated by a search for high specialization, migration due to lack of local facilities, or regions in which no AIEOP centres are present, which makes migration obligatory. Better coordination between AIEOP centres could help to reduce so-called avoidable migration, but technical and political choices will have to be considered, with the active participation of sector technicians. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic immensely impacted care provision, including quality of care in general practice. This paper aimed: (1) to assess how Belgian general practices acted upon the six dimensions of quality of care during COVID-19; (2) to study differences between the three Belgian regions; and (3) to benchmark the performance of the Belgian practices against the performance in other European countries. Methods: The data collected from 479 Belgian practices during 2020–2021 using an online survey as part of the international cross-sectional PRICOV-19 study were analyzed. Hereby, descriptive statistics, chi-squared tests, and binary logistic regression analyses were performed. Thirty-four survey questions related to the six dimensions of quality of care were selected as outcome variables. The adjusted regression models included four practice characteristics as covariates: practice type, being a teaching practice for GP trainees, multidisciplinarity of the team, and payment system. Results: Belgian practices made important organizational changes to deliver high-quality care during COVID-19. Most practices (n = 259; 56.1%) actively reached out to vulnerable patients. Limitations to the practice building or infrastructure threatened high-quality care in 266 practices (55.5%). Infection prevention measures could not always be implemented during COVID-19, such as using a cleaning protocol (n = 265; 57.2%) and providing a separate doctor bag for infection-related home visits (n = 130; 27.9%). Three hundred and sixty practices (82.0%) reported at least one safety incident related to a delayed care process in patients with an urgent condition. The adjusted regression analysis showed limited significant differences between the Belgian regions regarding the quality of care delivered. Belgian practices demonstrated varied performance compared to other European countries. For example, they excelled in always checking the feasibility of isolation at home but reported more patient safety incidents related to timely care than at least three-quarters of the other European countries. Conclusions: Future studies using different design methods are crucial to investigate which country and practice characteristics are associated with delivering high-quality care. [ABSTRACT FROM AUTHOR]

Medicaid is a major insurer of autistic people. However, during the transition to adulthood, autistic individuals are more likely than people with intellectual disability to lose their Medicaid benefits. Individuals with intellectual disability may have greater success maintaining Medicaid coverage during this time because most states provide coverage to individuals with intellectual disability throughout adulthood, which is not the case for autism. Using national Medicaid data from 2008 to 2016, we estimated the probability of intellectual disability diagnosis accrual among autistic Medicaid beneficiaries. Medicaid beneficiaries ages 8 to 25 with 1+ inpatient or 2+ outpatient autism spectrum disorder claims, but no intellectual disability claim, in a 12-month eligibility period were included. We used a person-month discrete-time proportional hazards model. Disruptions in Medicaid coverage were operationalized as 2+ consecutive months of no coverage before coverage resumed (yes/no). One in five autistic individuals ages 8–25 accrued an intellectual disability diagnosis. The probability of accruing an intellectual disability diagnosis was higher among autistic individuals who had disruptions in Medicaid coverage compared to those without disruptions, and peaked at age 21 (during the transition to adulthood). Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual and improve health outcomes for autistic adults. What is known? In most states, Medicaid waivers provide individuals with an intellectual disability diagnosis generous healthcare coverage throughout adulthood. By comparison, fewer Medicaid programs are available for autistic individuals, and they are more likely to experience disruptions, or gaps, in Medicaid coverage and subsequently not re-enroll. What this paper adds? One in five autistic individuals with Medicaid coverage between ages 8 and 25 accrued a new intellectual disability diagnosis. The probability of a new intellectual disability diagnosis was higher among those who had previous disruptions in Medicaid coverage. Implications for research and policy. Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual. Input from autistic individuals and their families regarding their health insurance access and healthcare experiences is critically important to understanding next steps for research. [ABSTRACT FROM AUTHOR]

Background: Male youth soccer players competing at a high level will typically engage in large volumes of soccer training from a young age. However, it is not known whether the high levels of habitual training that these high-performing players are exposed to limit their ability to respond to strength, plyometric or combined training interventions. Objective: The primary aim of our systematic review and meta-analysis was to compare the specific effects of strength, plyometric and combined training with active controls (standard soccer training) on the strength, power and speed characteristics of high-level, highly trained young male soccer players. Methods: We performed a literature search across PubMed, Scopus, CINAHL, Web of Science and SPORTDiscus to identify controlled studies that implemented strength, plyometric or combined training in high-level male youth soccer players. Participants were defined as high level or highly trained based on established guidelines related to either competition level or age-related weekly hours spent in soccer training. Studies needed to report at least one outcome of lower body strength, squat jump, countermovement jump, horizontal power, acceleration (0–10 m), speed (15–40 m) or change of direction speed. A meta-analysis was then performed using a random-effects model to determine the magnitude (Hedge's g) of training responses and whether effects differed across modes of training. Results: From an initial return of 5464 papers, n = 34 studies met the inclusion criteria and provided a total sample of n = 1396 high-level male youth soccer players. Strength, plyometric and combined training resulted in improvements in strength, squat and countermovement jump, horizontal power, acceleration, change of direction speed (all p < 0.05; g = 0.73–1.08, moderate) and speed (p < 0.05; g = 0.40–0.59, small). Lower body strength was the only outcome where training mode had a significant effect (p < 0.05), with plyometric training producing small effects (g = 0.27, p < 0.05) compared with moderate effects for strength (g = 1.07, p < 0.05) and combined (g = 0.75, p < 0.05) training. Prediction intervals for overall effects (all training modes combined) showed that the greatest confidence that future training will lead to positive effects was in the squat and countermovement jump, horizontal power and acceleration (prediction intervals = 0.03–1.81). Conclusions: High-level, highly trained male youth soccer players can experience positive gains in indices of strength, power and speed from strength, plyometric and combined training, and the magnitude of gains are mostly similar across modes of training. Based on prediction intervals, there is a good level of certainty that future strength, plyometric and combined training in this population would lead to positive improvements in vertical and horizontal power and sprint acceleration. [ABSTRACT FROM AUTHOR]

This paper presents a study on color preferences among a sample of Ghanaian adults. Two surveys were conducted, with a total of 143 participants (50 in Survey 1, and 93 in Survey 2). The participants completed both printed and digital questionnaires to gather data on their color preferences. The results showed that blue was the most preferred color by both males and females in general, but not for specific items. In survey 2, a chi-square test on categorical variables revealed a significant relationship between gender and preference for light, dark, or bright colors (p=0.025), as well as gender and number of preferred colors per personal item (p=0.02). However, no significant relationships were found between gender and change of colors from childhood (p=0.73), gender and number of preferred colors (p=0.204), gender and most preferred colors (p=0.216), age, and the number of preferred colors (p=0.19). Interestingly, 66.3% of the participants in Survey 2 indicated that their preferred colors were based on innate attraction, regardless of whether their color preferences had changed or remained the same since childhood. Overall, blue and red were the most preferred colors, with a score of 34.4%. These findings provide valuable insights for design practitioners and communicators and offer a basis for future research on color preferences among Ghanaians. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aims to propose a self‐management clusters classification method to determine the self‐management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). Background: MCI associated with DM is a common chronic disease in old adults. Self‐management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self‐management ability are heterogeneous. Design: A cross‐sectional study based on cluster analysis is designed in this paper. Method: The study included 235 participants. The diabetes self‐management scale is used to evaluate the self‐management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k‐means clustering, k‐means clustering analysis, analysis of variance and chi‐square test. Results: Three clusters of self‐management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. Conclusion(s): This study classified three groups of self‐management styles, and each group has its own self‐management characteristics. The characteristics of the three clusters may help to provide personalized self‐management strategies and delay the disease progression of MCI associated with DM patients. Relevance to clinical practice: Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self‐management to delay the progress of the disease. Patient or public contribution: In our study, we invited patients and members of the public to participate in the research survey and conducted data collection. [ABSTRACT FROM AUTHOR]

This systematic review investigates the bidirectional relationship between alcohol consumption and disrupted circadian rhythms. The goal of this study was to identify (i) the types of circadian rhythm disruptors (i.e. social jet lag, extreme chronotypes, and night shift work) associated with altered alcohol use and (ii) whether sex differences in the consequences of circadian disruption exist. We conducted a search of PubMed, Embase, and PsycINFO exclusively on human research. We identified 177 articles that met the inclusion criteria. Our analyses revealed that social jet lag and the extreme chronotype referred to as eveningness were consistently associated with increased alcohol consumption. Relationships between night shift work and alcohol consumption were variable; half of articles reported no effect of night shift work on alcohol consumption. Both sexes were included as participants in the majority of the chronotype and social jet lag papers, with no sex difference apparent in alcohol consumption. The night shift research, however, contained fewer studies that included both sexes. Not all forms of circadian disruption are associated with comparable patterns of alcohol use. The most at-risk individuals for increased alcohol consumption are those with social jet lag or those of an eveningness chronotype. Direct testing of the associations in this review should be conducted to evaluate the relationships among circadian disruption, alcohol intake, and sex differences to provide insight into temporal risk factors associated with development of alcohol use disorder. [ABSTRACT FROM AUTHOR]

Background: Dysarthria, aphasia and executive processes have been examined for their role in producing impaired communicative competence post traumatic brain injury (TBI). Less understood is the role of emotional dysregulation, that is, apathy and disinhibition, and social cognition, that is, reading and interpreting social cues. Methods & Procedures: In this study, we examined 49 adults with moderate to severe TBI and 18 neurologically healthy adults. We hypothesised that apathy and disinhibition would predict communication outcomes as would social cognition. We also predicted that apathy and disinhibition would influence social cognition. Communication outcomes were measured by the La Trobe Communication Questionnaire (LCQ) and the Social Skills Questionnaire‐TBI (SSQ‐TBI). Apathy and disinhibition were measured by the Frontal Systems Behavior Scale (FrSBe). We measured four aspects of social cognition: emotion perception and theory of mind using The Awareness of Social Inference Test (TASIT) and the Complex Audio‐Visual Evaluation of Affect Test (CAVEAT), empathy using the Questionnaire of Cognitive and Affective Empathy (QCAE) and the Balanced Emotional Empathy Scale (BEES), and alexithymia using the Toronto Alexithymia Scale (TAS‐20) and the Bermond–Vorst Alexithymia Questionnaire. Outcomes & Results: Consistent with predictions, the LCQ and SSQ‐TBI were associated with disinhibition and the LCQ was also associated with apathy. The LCQ was associated with the full range of social cognition constructs although the SSQ‐TBI was not. Finally, apathy and disinhibition predicted a number of social cognition measures. Conclusions and Implications: These results are discussed in relation to understanding the nature of communication disorders following TBI and how they are measured, as well as the interrelation between emotion dysregulation and social cognition. What this study adds: What is already known on this subject: The role of emotional dysregulation and social cognition in producing impaired communicative competence post traumatic brain injury (TBI) is not well understood. Although most adults with severe TBI have minimal or possibly no language impairment, they often struggle with functional communication in everyday situations. Many have been reported to be overtalkative, insensitive, childish and self‐centred, displaying an inappropriate level of self‐disclosure and making tangential and irrelevant comments. Conversely, some speakers with TBI have been noted to have impoverished communication, producing little language either spontaneously or in response to the speaker's questions and prompts. What this paper adds to existing knowledge: We found that both apathy and disinhibition were strongly associated with the Latrobe Communication Questionnaire both empirically and conceptually, despite the LCQ being developed from a different, pragmatic orientation. Disinhibition was also associated with the Social Skills Questionnaire for TBI. We also found that poor social cognition scores predicted communication difficulties. Finally, we found that behavioural dysregulation itself, i.e., both apathy and disinhibition, predicted poor social cognition. What are the potential or actual clinical implications of this work?: Our findings highlight the central role that apathy and disinhibition play in both communication and social cognition. These insights point to the importance of remediation to target behavioural and autonomic dysregulation as a means to improve everyday social function. [ABSTRACT FROM AUTHOR]

Purpose: The present study investigated experiences of traumatic perinatal events, the provision of related education, and educational needs of nurses working in the labor and delivery room (LDR). Methods: Nurses working in the LDRs of six institutions and two nurse portal sites were invited to participate in the survey, delivered on paper or online. The data were collected from October 1 to November 25, 2022. Data from 129 nurses were analyzed using frequency, the chi-square test, the Fisher exact test, the t-test, and analysis of variance. Results: Virtually all participants (98.6%) reported having experienced at least one traumatic perinatal event (dystocia, postpartum hemorrhage, neonatal congenital anomalies, severe maternal or neonatal injury, stillbirth, and maternal or neonatal death) while working in the LDR. The most shocking traumatic perinatal event experienced was the maternal or neonatal death (40.3%), but 24.8% of participants did not recall ever receiving education on the topic. About 63% of participants experienced traumatic perinatal events within a year of working in the LDR. The average score for education needs regarding traumatic perinatal events was 3.67±0.37 out of 4, and participants preferred simulation education as the most effective educational method. Conclusion: Since most of the participants had experienced various traumatic perinatal events in the early stages of working in the LDR and expressed a high level of need for education on traumatic perinatal events, it is necessary to provide more effective stimulation education programs in the early period of work in the LDR. [ABSTRACT FROM AUTHOR]

The success of sustainability and corporate social responsibility (CSR) depends upon the active support of all stakeholders. Thus, it is highly relevant and becomes the goal of this paper to perform a pilot case study of the negative determinants of readiness of the new Central European generation of financially sufficiently strong consumers to support CSR, in particular, to answer two research questions: (i) which is the prevailing determinant and (ii) whether it is gender-sensitive. Therefore, 53 male and 53 female Generation Z students from a private university in Prague, ready to pay a CSR bonus, were surveyed in the summer of 2021 regarding the negative determinants of their decisions. The collected answers were statistically processed via cross-tabulation and chi-squared test measures, and the dependence between negative determinants and genders was considered to answer both research questions. The data analysis implies four prevailing negative determinants, two of them related to the infodemic, represented differently by male and female members of Generation Z. This leads to propositions linked to prior studies and advancing them in a new direction. Namely, this indicative pilot case study suggests that Generation Z's readiness to support CSR by paying a CSR bonus is eroded by the infodemic and that male members of Generation Z are more sensitive in this respect than female members. Implications for Central European audience: This article targets the underestimated issue of factors deterring committed young consumers from their support to sustainability via their readiness to pay a CSR bonus. It empirically points out the relevance of proper information and the negative and gender-sensitive impacts of the infodemic. Theoretical implications include a pioneering contribution to the conceptual appreciation, methodological processing and assessment of particular aspects of infodemic and negative CSR determinants for an emerging cohort of Central European consumers. Practical implications include the dramatic importance of enhancement of awareness and practical suggestions regarding how to inform these male and female consumers and engage them in sustainability and CSR. [ABSTRACT FROM AUTHOR]

Hearing loss that arises from various causes at different stages of life has a direct impact on individuals' physical and mental well-being. This paper aimed to evaluate the employment, workplace adaptation, productivity, and professional success of individuals who have hearing loss and whose hearing loss is corrected with a cochlear implant. In this cross-sectional study, data were collected between November 2022 and March 2023 with the participation of individuals with cochlear implants living in several settlements in all regions of Türkiye. A total of 142 participants with severe hearing loss who were corrected with a cochlear implant were included in this study. The survey method was used to collect data for the study. The questionnaire consisted of 32 questions and was distributed to the participants online. In the first part of the questionnaire (questions 1–10), the general characteristics of implant patients were investigated. In the second part (questions 11–32), the positive or negative effects of implantation on the work lives of the participants were evaluated. Almost half of the research group (49.3%, n = 70) consisted of women, and the mean age of the participants was determined to be 35.8 ± 14.8 years. There was no significant difference between gender, educational status, implanted side, working time, working style (physical, desk), and factors affecting work life (p > 0.05). Professional satisfaction and success at work increased significantly more in those with acquired hearing loss (p = 0.010). Post-implantation workplace compliance, success, and productivity were found to be higher in those with acquired hearing loss (p = 0.013). Hearing loss had a significantly less negative impact on work performance in those implanted in childhood than in those implanted in adulthood (p = 0.043). It was observed that hearing loss had a greater negative impact on the work life of married people (p = 0.006). Cochlear implantation greatly enhances workplace satisfaction, increases self-confidence, and has a positive impact on the future of profoundly deaf individuals. [ABSTRACT FROM AUTHOR]

Downhill skiing evokes many emotions. In more experienced skiers, they manifest themselves primarily in a positive form, in beginners often in a negative form, in the form of apprehension or fear, mainly due to an unfamiliar way of moving - sliding and moving on skis. In the school environment, we encounter these phenomena quite often on ski training courses. The aim of the paper was to find out through a survey among teachers of lower secondary education (n=105), the fear and apprehension of pupils during ski courses, as well as the use of playful activities during their teaching. We analysed the results from the aspect of intersex differences using the chi-square test on the significance level of p<0.05, resp. p<0.01. We carried out the survey itself from January to March 2023. The results of our study showed that after the completion of ski course, the fear and anxiety of primary school pupils showed a clear trend of decrease. The use of games as one of the forms of warming up, practicing and perfecting selected elements of methodological series of skiing, but also at the end of daily job, is significantly (p<0.01) used to a greater extent by women. During the entire duration of the course, teachers make the most use of movement games of traditional nature - chases, relays, etc. therefore, we recommend that when teaching downhill skiing, movement games with the use of non-traditional aids (skis, poles, etc.) are included to a greater extent, but also games that require the cooperation of pupils, the so-called cooperative games. The results of our study also pointed to the fact that, according to teachers, students' fear of skiing is dominantly caused by an unfamiliar way of moving, when students lose their balance, which they cannot control (p<0.01). [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to evaluate the quality of life of adult patients with onco-hematological disease treated with hematopoietic stem cell transplantation up to two years post-transplantation. Method: A quantitative, observational, longitudinal, and analytical study was conducted with 121 participants diagnosed with onco-hematological cancer who underwent hematopoietic stem cell transplantation between October 2017 and September 2019, with a 2-year post-transplantation follow-up, of whom only 39 completed the study. The Functional Assessment of Cancer Therapy—Bone Marrow Transplantation (FACT-BMT) questionnaire and its subscales, Functional Assessment of Cancer Therapy—General (FACT-BMT) and Functional Assessment of Cancer Therapy Trial Outcome Index (FACT-TOI), developed by the Functional Assessment of Chronic Illness Therapy (FACIT) and validated for Spain, were used to assess quality of life. Result: The average age for hematopoietic stem cell transplantation was 54 years, with a majority of male participants. The evaluation of quality of life showed a decrease at the time of hospital discharge, followed by a progressive improvement up to one year after the transplantation. There was a significant difference in the quality of life questionnaire scores between both sexes during all stages of the research, with higher scores in male participants. The length of hospital stay significantly affected patients' physical and functional well-being, and marital status was related to differences in the perception of quality of life. Conclusions: Despite the initial decrease in quality of life for patients undergoing hematopoietic stem cell transplantation, levels of quality of life similar to baseline are regained one year after the transplantation. Sociodemographic variables are related to how these patients perceive their quality of life. However, further studies with a larger sample size are needed for more precise results. [ABSTRACT FROM AUTHOR]

To systematically explore the effects of minimally invasive plate osteosynthesis (MIPO) versus intramedullary nail (IMN) on wound infection and wound healing in patients with distal tibia fractures. A computerised search of PubMed, Web of Science, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database (CBM) and China National Knowledge Infrastructure databases was performed, from their inception to October 2023, to identify relevant studies on the application of MIPO and IMN in patients with distal tibial fractures. The quality of the included literature was evaluated by two researchers based on inclusion and exclusion criteria, and basic information of the literature was collected, with wound infection, postoperative complications and wound healing time as the main indicators for analysis. Stata 17.0 software was applied for analysis. Overall, 23 papers and 2099 patients were included, including 1026 patients in the MIPO group and 1073 patients in the IMN group. The results revealed, when compared with IMN treatment, patients with distal tibia fractures who underwent MIPO treatment had a lower incidence of postoperative complications (OR = 0.33, 95% CI: 0.25–0.42, p < 0.001) and a shorter wound healing time (SMD = −1.00, 95% CI: −1.51 to −0.49, p < 0.001), but the incidence of postoperative wound infection was higher (OR = 2.01, 95% CI: 1.35–3.01, p = 0.001). Both MIPO and IMN are excellent treatments for distal tibia fractures. MIPO is effective in reducing the incidence of complications as well as shortening the time of wound healing time but increases the risk of wound infection. In clinical practice, surgeons can make individual choices based on the patient's wishes and proficiency in both techniques. [ABSTRACT FROM AUTHOR]

The main objective of this paper is to examine how teacher reflection could result in possible change in practice. The essential value of teacher reflection is to think about improvements to be made for practice. This paper adapted Ward and McCotter's reflection rubric into a Teacher Reflection survey scale to explore and examine the varying years of teaching experience, teaching level and designation on teachers' teaching practices. A total of 436 primary and secondary school mathematics teachers took part in an online survey. Confirmatory factor analyses were conducted to validate the survey instruments. Findings suggest that there were no major differences in teacher reflection based on their years of teaching experience, designation, and teaching levels. Correlational, regression, and path analyses of the three dimensions of teacher reflection (i.e. Focus, Inquiry, and Change) and teacher Change Practise revealed interesting associations among these variables. Findings indicate that the Focus dimension is the basis of teacher reflection and from there it extends to the Inquiry and Change dimensions and ultimately to Change Practise. This study suggests that the focus on a transformative mindset based on intentional reflection is a powerful stimulus for change and growth in teaching practice. [ABSTRACT FROM AUTHOR]

This paper aims at analysing the level of awareness of the symptoms and the methods of protection from COVID‐19 based on the Rural Impact Survey of the World Bank, collected from 5200 households belonging to six states in India that is, Andhra Pradesh, Bihar, Jharkhand, Madhya Pradesh, Rajasthan, and Uttar Pradesh. Data has been analysed using chi‐square test and regression analysis. Results of the analysis indicate that about 70.8% rural households are aware of the symptom of coronavirus, and 81.9% are aware of the preventive measures for controlling the spread of COVID‐19. Analysis indicates a significant association between awareness level on symptoms and prevention of COVID‐19 and socio‐demographics and location. The study further analyses the key determinants of awareness of COVID‐19 symptoms and preventive measures using the logistics regression model, indicating that age, gender, education, income, poverty status, access to information, cash relief and medical services are the determining factors of health awareness on COVID‐19 pandemic among rural households in India. Considering the importance of self‐protecting measures in fighting the pandemic, this paper highlights the importance of strengthening public awareness for containing the spread of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effects of solution‐focussed education and counselling on problematic internet usage, sleep quality and school achievement. Methods: This randomized controlled trial was conducted between January ‐ December 2016 with 44 adolescents who participated in a solution‐focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent–Child Internet Addiction Scale and the students' end‐of‐term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi‐square test, Independent t test, Man–Whitney U test, Friedman test and Spearman correlation analysis. Results: The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow‐up (r = 0.537, P = 0.010; r = 0.576 P = 0.005). Conclusion: The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant. Summary statement: What is already known about this topic? Problematic internet usage is a common public health problem among adolescents, and it affects their physical, social and academic lives.There are some studies in the literature on the prevalence and treatment of problematic internet usage, but there are few on preventing its occurrence.Strengths‐based approaches in adolescent interventions encourage active learning. What this paper adds? A solution‐focussed approach was used for the first time in adolescents to prevent and manage problematic internet usage and accompanying problems.A programme of solution‐focussed health education and counselling was found to be an effective intervention for preventing problematic internet usage and some accompanying problems in adolescents. The implications of this paper: For the prevention and management of problematic internet usage school nurses should screen young adolescents for Internet addiction symptoms and accompanying problems.Nurses must have the benefit of multiple approaches to systematize health care in fulfilling their school health responsibilities.Health education programmes administered by school nurses to address Internet addiction in students can be based on solution‐focussed approaches. [ABSTRACT FROM AUTHOR]

Background: Digital game‐based learning is gaining increased attention from both researchers and educators for improving mathematics instruction. However, the evidence for game‐based learning is mixed and research with rigorous research design and analyses are limited. Objective: Here, in a pre‐registered randomized controlled study, we investigated whether a fraction game designed collaboratively by educational experts and professional game developers may serve as a useful tool to enhance students' fraction knowledge. Methods: We assigned French fifth graders to either an experimental group who used the game (n = 110) or a control group (n = 78) who received traditional instruction on fractions. Fraction knowledge was assessed pre‐ and post‐intervention. Results: Results show that students in the active control group had superior overall fraction performance than students in the experimental group at the end of intervention. However, the game had a positive effect on decimal learning. We also found a positive relation between game performance and overall fraction knowledge scores at post‐test. Contribution: The study highlights the importance of game metrics as indicators of personalized assessment tools. Given the increased usage of games in learning mathematics and the equivocal results on the effectiveness of these games, our study also highlights the importance of pre‐registration and randomized controlled studies. Lay Description: What is already known about this topic: Digital game‐based learning (DGBL) is gaining popularity in mathematics teaching.DGBL shows potential for teaching difficult abstract concepts such as fractions.However, research evaluating DGBL for fractions is limited. What this paper adds: The study examines a fraction game designed by education experts and game designers.Students fraction knowledge is assessed using paper‐based test.Challenges associated with DGBL in the classroom are discussed in the paper. Implications for practice: The results will guide educators in designing effective fraction instruction in classroom.The study highlights the critical role of instructional support in DGBL for fractions.Game based metrics can be used to individualize instruction in the classroom. [ABSTRACT FROM AUTHOR]

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Purpose: The purpose of this paper is to identify the factor structure of the Ways of Coping Questionnaire (WCQ) among abused Iranian women. Design/methodology/approach: This paper is a methodological study. The participants included 554 abused married women who were selected by convenience sampling from the women presenting to health centers and hospitals and their companions as well as women visiting mosques and parks in Shahroud, Iran. The exploratory factor analysis was used to investigate the factor structure of the WCQ. The reliability of the questionnaire was estimated using Cronbach's alpha coefficient. Findings: Following the exploratory factor analysis, 36 items and 5 factors were extracted, which could explain 73.24% of the variance in the concept of coping with intimate partner violence. The extracted factors included distancing, planning, wishful thinking, seeking social support and problem-solving. Cronbach's alpha coefficient of the questionnaire as a whole was 0.91. Originality/value: This paper has practice and research implications for promoting coping among abused women. The factor structure of the WCQ obtained in this paper can validly measure coping with intimate partner violence among abused Iranian women. Learning about the coping strategies used by abused women can help design context-based interventions to assist these women in better coping with their husband's violence and improving their well-being. This version of WCQ also enables assessing the effectiveness of the designed interventions. [ABSTRACT FROM AUTHOR]