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Context: To stabilize the humeral head within the glenoid fossa during arm elevation, the rotator cuff muscles may contribute through internal and external rotation. The main purpose of the current study was to compare the acromiohumeral distance between athletes with primary subacromial impingement syndrome who received progressive resistance exercises consisting of either shoulder internal or external rotation. Design: A randomized and controlled clinical study. Methods: Thirty athletes with primary subacromial impingement syndrome were enrolled and randomly divided into 2 experimental groups. The progressive resistance exercise protocol in experimental group I comprised shoulder internal rotation, while in experimental group II consisted of shoulder external rotation. The experimental groups worked out 3 days a week for 6 weeks. The experimental groups were compared with the control group consisting of 15 healthy athletes. The acromiohumeral distance was measured before and after the intervention using an ultrasound machine under the passive and active across no arm elevation and 45°of arm elevation. Results: The acromiohumeral distance significantly increased in both experimental groups under the passive and active arm positions following the intervention (P <.001), with no significant differences detected between the experimental groups (P >.665). The paired comparisons of the acromiohumeral distance discrepancy indicated a significant difference between the control group and each experimental group under the active and passive arm positions (P <.001), while no significant difference was observed between the experimental groups (P >.999). Conclusions: The present study revealed, for the first time, that both progressive resistance exercise protocols involving either the shoulder internal or the external rotation increased the acromiohumeral distance in individuals with primary subacromial impingement syndrome and improved associated pain and disabilities. [ABSTRACT FROM AUTHOR]

Context: The persistence and the recurrence of posterior medial knee pain (PKP) after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon graft are often overlooked during rehabilitation. Design: Cross-sectional observational study. Methods: The study aimed (1) to evaluate the prevalence of these types of PKP before 4 months post-ACLR, (2) to measure their consequences on the knee flexors strength, and (3) to evaluate the role of the type of ACLR. From a cohort of patients operated on with hamstring tendon procedures, the persistent and the recurrent PKP were sought at 4 months post-ACLR. The evolution of isokinetic muscle strength recovery in PKP subjects was compared with those of nonpainful subjects. The functional deficit was measured at 6/7 months post-ACLR by a hop test. Results: Three hundred seventeen subjects (25.8 [6.0] y) were included. At 4 months post-ACLR, 2 populations were identified based on the recurrent onset of PKP (PKP+, n = 40) or the absence of knee pain (PKP−, n = 277). The prevalence of PKP was 8.3%. At the fourth month post-ACLR, the PKP+ group had a higher flexor strength deficit compared with the PKP− group (limb symmetry index at 60°/s: 67.2% [12.4%] vs 84.3% [12.6%]; P <.05). At 6/7 months, the loss of strength persisted (limb symmetry index at 60°/s: 82.3% [13.4%] vs 87.7% [12.8%]; P <.05). The hop test deficit was comparable, and no difference was shown according to the type of graft. Conclusions: Persistent and recurrent PKP during the rehabilitation period were not uncommon and were associated with a worsening of flexors strength loss on the ACLR side. [ABSTRACT FROM AUTHOR]

There has been an increase in the use of commercially available multi-ingredient preworkout supplements (MIPS); however, there are inconsistencies regarding the efficacy of MIPS in resistance-trained women. Purpose: To determine the effect of varying doses of MIPS compared with caffeine only (C) and a placebo (PL) on resistance-training performance in trained women. Methods: Ten women (21.5 [2.3] y) completed 1-repetition-maximum tests at baseline for leg press and bench press. A within-group, double-blind, and randomized design was used to assign supplement drinks (ie, PL, C, MIPS half scoop [MIPS-H], and MIPS full scoop [MIPS-F]). Repetitions to failure were assessed at 75% and 80% to 85% of 1-repetition maximum for bench and leg press, respectively. Total performance volume was calculated as load × sets × repetitions for each session. Data were analyzed using a 1-way repeated-measures analysis of variance and reported as means and SDs. Results: There were no differences in repetitions to failure for bench press (PL: 14.4 [3.2] repetitions, C: 14.4 [2.9] repetitions, MIPS-H: 14.2 [2.6] repetitions, MIPS-F: 15.1 [3.1] repetitions; P =.54) or leg press (PL: 13.9 [7.8] repetitions, C: 10.8 [5.9] repetitions, MIPS-H: 13.1 [7.1] repetitions, MIPS-F: 12.4 [10.7] repetitions; P =.44). Furthermore, there were no differences in total performance volume across supplements for bench press (PL: 911.2 [212.8] kg, C: 910.7 [205.5] kg, MIPS-H: 913.6 [249.3] kg, MIPS-F: 951.6 [289.6] kg; P =.39) or leg press (PL: 4318.4 [1633.6] kg, C: 3730.0 [1032.5] kg, MIPS-H: 4223.0 [1630.0] kg, MIPS-F: 4085.5 [2098.3] kg; P =.34). Conclusions: Overall, our findings suggest that caffeine and MIPS do not provide ergogenic benefits for resistance-trained women in delaying muscular failure. [ABSTRACT FROM AUTHOR]

In response to a financial crisis, many organizations adjust their pay systems to reduce labor costs. In this research, we focus on the use of delayed pay (the postponement of employees' contractual compensation) and examine its effect on employee voluntary turnover outcomes. In a field study (Study 1) with data collected from the executive managers of 129 Chinese hotels experiencing a financial crisis caused by coronavirus disease 2019 (COVID‐19), we find a positive relationship between delayed pay and the voluntary turnover rate at the organizational level. In addition, this relationship becomes weaker when delayed pay consists of a larger proportion of pay‐for‐performance (PFP). We then conduct an experiment (Study 2) to extend our theoretical framework to the individual level, establish causality, and examine the underlying mechanism. The results show that the perceived negative instrumentality of stay (i.e., expected economic losses associated with staying in an organization) explains why individuals intend to leave organizations adopting delayed base pay but not delayed PFP. We further replicate these findings in a critical incident technique study (Study 3). We also discuss the theoretical and practical implications of these findings. [ABSTRACT FROM AUTHOR]

This study contributes to the diversity literature by probing whether diversity papers are cited as frequently as nondiversity papers in management and industrial/organizational (I/O) psychology journals. Based on the stigma‐by‐association theory, I argue that as a result of their association with minority groups, diversity papers may be devalued and thus "othered" by scholars. Using a citation analysis of 46,930 papers published in 29 peer‐reviewed management and I/O psychology journals, I present empirical evidence in Study 1 that diversity papers were cited significantly less frequently than nondiversity papers. The authors' gender and institutional prestige, journal tier and domain, and year of publication were not moderators. In Study 2, I used a scenario experiment to demonstrate the stigma‐by‐association effect. The authors' gender demonstrated a significant moderating effect in this experiment. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe individual training characteristics, racing strategies, and periodization in preparation for the Tour de France in 2 world-class road cyclists finishing in the top 5 of the general classification. Methods: Week‐by‐week power meter training and racing data of 2 (A and B) road cyclists (age: 29 and 23 y; maximum oxygen consumption: 83 and 81 mL·min−1·kg−1; and relative 20‐min record power output: 6.9 and 6.5 W·kg−1) in the preparation phase (December–July/August) leading up to the Tour de France were retrospectively analyzed. Weekly volume and intensity distribution in power zones were considered. Results: Cyclists A and B completed 46 and 19 races, 22.5 (6.3) and 18.2 (5.1) h·wk−1, with a pyramidal intensity distribution of 81.0%–13.3%–5.7%, and 88.8%–7.9%–3.3% in zone 1–zone 2–zone 3. Cyclist B spent 14 days at altitude. Increased high-intensity volume and polarization index occurred during race weeks. During periods without racing, training intensity progressively increased. Strength training was performed during November and December but not during the following months. During tapering, total exercise volume and time at high intensity decreased. Conclusion: These data provide novel insights into the periodization of world-class road cyclists in advance of a top 5 placing in the Tour de France general classification. [ABSTRACT FROM AUTHOR]

Context: Bridge exercises are extensively used in trunk-strengthening programs. The aim of this study was to investigate the effect of bridging duration on lateral abdominal muscle thickness and gluteus maximus activation. Design: Cross-sectional. Methods: Twenty-five young males participated in this study. Transversus abdominal (TrA), external and internal oblique ultrasound thickness, gluteus maximus electromyographic activation, and sacral tilt angle were simultaneously measured for every second during 30-second bridging exercise. The contraction thickness ratio and root mean squared signal (normalized to maximum isometric contraction signal) during 6 exercise durations (from 0 to 5, 10, 15, 20, 25, and 30 s) were also calculated and compared using analysis of variance designs. Results: TrA and internal oblique contraction thickness ratio and gluteus maximus root mean squared increased during the first 8 to 10 seconds and remained elevated until the end of the 30-second exercise (P <.05). External oblique contraction thickness ratio declined during exercise (P <.05). Five-second bridging showed less TrA thickness and anteroposterior and mediolateral sacral tilt angle and a lower anteroposterior tilt variability compared with bridges, which lasted more than 10 seconds (P <.05). Conclusions: Bridge exercises longer than 10 seconds may be better for promoting TrA recruitment than bridges of shorter duration. Clinicians and exercise specialists could adjust the duration of bridge exercise based on the aims of the exercise program. [ABSTRACT FROM AUTHOR]

Purpose: To determine the optimal implant diameter under limited bone width by comparing the effects of implants with different diameters on implant stability, peri-implant bone stability, and osseointegration. In addition, to evaluate the reliability of resonance frequency analysis (RFA) in detecting osseointegration and marginal bone level (MBL). Materials and Methods: Mandibular premolars and first molars of seven beagle dogs were extracted. After 8 weeks, their mandibular models and radiographic information were collected to fabricate implant templates. Implant sites were randomly divided into three groups according to diameter: Ø3.3, Ø4.1, and Ø4.8 mm. Implant stability quotient (ISQ) measurement and radiographic evaluation were performed after surgery (baseline) and at 4, 8, and 12 weeks. Three dogs were euthanized at 4 weeks to observe osteogenesis and implant-tissue interface biology. Four dogs were euthanized at 12 weeks to observe osseointegration. Hard tissue sections were prepared to analyze osteogenesis (fluorescence double labeling) and osseointegration (methylene blue-acid fuchsin staining). Results: At baseline and at 4, 8, and 12 weeks, the ISQ values of Ø4.1- and Ø4.8-mm implants did not differ (P > .05), but both had higher values than the Ø3.3-mm implants (P < .05). The mean marginal bone resorption (MBR) associated with Ø3.3-, Ø4.1-, and Ø4.8-mm implants was 0.65 ± 0.58 mm, 0.37 ± 0.28 mm, and 0.73 ± 0.37 mm, respectively. The buccal MBR of Ø4.8-mm implants was significantly higher than that of Ø4.1-mm implants (P < .05). The bone-to-implant contact (BIC) percentage at 12 weeks did not differ for any group (P > .05). The correlation coefficients between the ISQ and MBL of the Ø3.3-, Ø4.1-, and Ø4.8-mm implants were -0.84 (P < .01), -0.90 (P < .001), and -0.93 (P < .001), respectively, while that between the ISQ and BIC was 0.15 (P > .05). Conclusions: During the early healing stage, the performance of Ø4.1- and Ø4.8-mm implants in terms of implant stability was better than that of Ø3.3-mm implants. Implant diameter may not influence BIC percentage. RFA can be used to evaluate implant stability and MBL but is not suitable to assess the degree of osseointegration. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the outcomes that are most important to prosthesis users and funders. A Prosthetic Interventions Core Outcome Set (PI-COS) will help researchers and practitioners measure outcomes that are the most important to prosthesis users and funders. Materials and methods: Prosthesis users and funders rated the importance of 121 International Classification of Functioning, Disability, and Health (ICF) second-level categories using a two-round Delphi survey. A Consensus Meeting using the nominal group technique resolved rating differences between groups. The ICF second-level categories were ranked according to importance and a K-Means Cluster Analysis helped establish the PI-COS. Results: 65 users and 8 funders completed the Delphi surveys, followed by a Consensus Meeting. 26 ICF second-level categories were considered important to prosthesis users and funders and a PI-COS of 14 ICF second-level categories drawn predominantly from five ICF chapters was established: Sensory Functions and Pain (b2), Neuromusculoskeletal and Movement-related Functions (b7), General Tasks and Demands (d2), Mobility (d4), and Products and Technology (e1). Conclusions: The PI-COS describes the outcomes that are most important to prosthesis users and funders. The PI-COS can help focus on the most important outcome measures in clinical practice and research, including future prosthetic health economic evaluations. [ABSTRACT FROM AUTHOR]

Purpose: After stroke, upper limb somatosensation can be impaired which affects motor control. Vision is often used to compensate for this. A clinical assessment which assesses the combined sensorimotor function in the absence of vision would be beneficial in studies targeting sensorimotor improvement. Methods and materials: We adapted the Action Research Arm Test (ARAT) to be performed without vision and called this modified version the sensorimotor ARAT (sARAT). Sixty healthy participants and 22 participants with chronic stroke performed the ARAT, sARAT, Fugl-Meyer upper extremity assessment (FM-UE) and Erasmus modified Nottingham sensory assessment (EmNSA). Discriminative validity of sARAT was evaluated by comparing performance between healthy participants and participants with chronic stroke. Convergent validity was evaluated by correlating sARAT with FM-UE and EmNSA. Results: Participants with stroke performed worse on the sARAT compared to healthy participants (p < 0.001), with median scores of 52 (IQR 32-57) and 57 (IQR 57-57), respectively. The sARAT showed high correlations with FM-UE and EmNSA (r = 0.80-0.90). Conclusions: The sARAT shows good discriminative and convergent validity in people with chronic stroke. It allows a quick assessment of the combined upper limb sensorimotor function, by performing the well-known ARAT with the eyes closed. IMPLICATIONS FOR REHABILITATION: The sensorimotor adaptation of the Action Research Arm Test (sARAT) is a clinical assessment of upper limb activity which is performed with the eyes closed. Combining the gold standard ARAT with the sensorimotor adaptation sARAT can inform about the influence of somatosensory impairments on upper limb activity in stroke survivors when vision is blocked. The sARAT shows good discriminative and convergent validity in persons with chronic stroke. [ABSTRACT FROM AUTHOR]

Objective: To investigate in vivo 6-degree-of-freedom (DOF) vertebral motion in patients with isthmic spondylolisthesis (IS) during various functional weight-bearing activities. Methods: Fifteen asymptomatic volunteers (mean age 54.8 years) and fourteen patients with IS at L4-5 (mean age 53.4 years) were recruited. The positions of the vertebrae (L4-L5) in the supine, standing, flexion–extension, left–right twisting and left–right bending positions were determined using previously described CT-based models and dual fluoroscopic imaging techniques. Local coordinate systems were established at the center of the anterior vertebra of L4 isthmic spondylolisthesis (AIS), the posterior lamina of L4 isthmic spondylolisthesis (PIS) and the center of the L5 vertebra to obtain the 6DOF range of motion (ROM) at L4-L5 and the range of motion (ROM) between the AIS and the PIS. Results: The translation along the anteroposterior axis at L4-L5 during flexion–extension, left–right bending and left–right twisting was significantly greater than that of the healthy participants. However, the translation along the mediolateral axis at L4-L5 presented paradoxical motion under different positions: the ROM increased in the supine-standing and flexion–extension positions but decreased in the left–right bending and left–right twisting positions. The separation along the anteroposterior axis during flexion was significantly greater than that during standing, on average, reaching more than 1 mm. The separation along the mediolateral axis during standing, flexion and extension was significantly greater than that in the supine position. Conclusions: This study revealed the occurrence of displacement between the AIS and PIS, primarily in the form of separation during flexion. Symptomatic patients with isthmic spondylolisthesis exhibit intervertebral instability, which might be underestimated by flexion–extension radiographs. [ABSTRACT FROM AUTHOR]

Introduction: Studies analyzing postures and mobility of the thoracic spine in the context of cervicogenic headache are missing. Insight in these parameters is needed since the cervical and thoracic spine are biomechanically related. Objective: To compare self-perceived optimal and habitual postures, active-assisted maximal range of motion, and repositioning error of the upper-thoracic and lower-thoracic spine between a cervicogenic headache-group and matched healthy control-group before and after a 30 min-laptop-task. Methods: A non-randomized longitudinal design was used to compare thoracic postures and mobility between 18 participants with cervicogenic headache (29–51 years) and 18 matched healthy controls (26–52 years). Outcomes were: self-perceived optimal and habitual postures, active-assisted maximal range of motion, and repositioning error of the upper-thoracic and lower-thoracic spine evaluated in sitting with a 3D-Vicon motion analysis system. Results: Habitual upper-thoracic postures in the cervicogenic headache-group were significantly (p =.04) less located toward the maximal range of motion for flexion compared to the control-group, self-perceived optimal upper-thoracic posture was significantly (p =.004) more extended in the cervicogenic headache-group compared to the control-group, and self-perceived optimal lower-thoracic posture could not be reestablished in the cervicogenic headache-group after the laptop-task (p =.009). Conclusion: Thoracic postures differ between a cervicogenic headache-group and control-group. These differences were detected by expressing the habitual thoracic posture relative to its maximal range of motion, and by analyzing the possibility of repositioning the thoracic spine after a headache provoking activity. Longitudinal studies are needed to determine the contribution of these musculoskeletal dysfunctions to the pathophysiology of cervicogenic headache. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the effect of aromatherapy with an essential oil blend containing lavender, bergamot, ylangylang, and sweet orange, compared with placebo, on perceptions of anxiety in ICU RNs. Methods: Nurses recruited from six adult ICUs and a neonatal ICU participated in this blinded, randomized, placebo-controlled study, which took place over a 30-day intervention period. Results: Although there were no statistically significant changes in anxiety pre- to postintervention or between the intervention and placebo groups, there were also no adverse events or untoward effects. Conclusion: The results of this study may support aromatherapy as an evidence-based strategy to reduce anxiety in ICU nurses. Additional research is needed. [ABSTRACT FROM AUTHOR]

Purpose: Dietary nitrate (NO3−) supplementation enhances muscle blood flow and metabolic efficiency in hypoxia, however, its efficacy on neuromuscular function and specifically, the effect on motor unit (MU) activity is less clear. We investigated whether NO3− supplementation affected MU activity following a 3 min sustained ischemic contraction and whether this is influenced by blood flow restriction (BFR) during the recovery period. Method: In a randomized, double-blinded, cross-over design, 14 males (mean ± SD, 25 ± 6 years) completed two trials following 5 days of supplementation with NO3−-rich (NIT) or NO3−-depleted (PLA) beetroot juice to modify plasma nitrite (NO2−) concentration (482 ± 92 vs. 198 ± 48 nmol·L−1, p < 0.001). Intramuscular electromyography was used to assess MU potential (MUP) size (duration and area) and mean firing rates (MUFR) during a 3 min submaximal (25% MVC) isometric contraction with BFR. These variables were also assessed during a 90 s recovery period with the first half completed with, and the second half completed without, BFR. Results: The change in MUP area and MUFR, did not differ between conditions (all p > 0.05), but NIT elicited a reduction in MUP recovery time during brief isometric contractions (p < 0.001), and during recoveries with (p = 0.002) and without (p = 0.012) BFR. Conclusion: These novel observations improve understanding of the effects of NO3− on the recovery of neuromuscular function post-exercise and might have implications for recovery of muscle contractile function. Trial registration: The study was registered on clinicaltrials.gov with ID of NCT05993715 on August 08, 2023. [ABSTRACT FROM AUTHOR]

Introduction: In the current health care landscape, a paradigm shift toward team-based care is underway. Integrating interprofessional education experiences into graduate communication sciences and disorders (CSD) programs is essential to cultivate collaborative skills and prepare future professionals for the interprofessional demands of the field. Within this context, peer teaching has emerged as a noteworthy strategy to promote learning. This study aims to contribute to this evolving field by reporting the impact of an interprofessional (speech-language pathology and audiology) peer teaching educational intervention on physician assistant (PA) students' knowledge of speech-language-hearing developmental milestones and developmental screening. Method: A quantitative, descriptive methodology with a pretest, posttest interventional design was utilized to assess the impact of a CSD peer-led educational intervention on the knowledge of 35 PA students. The perceived satisfaction of the PA students with the peer-led educational experience was also evaluated. Results: Data analysis revealed a significant increase on knowledge posttest scores compared to pretest scores. PA students also reported an overall positive peer learning experience. Conclusion: The collaboration between speech-language pathology, audiology, and PA students through peer teaching holds significant importance in the context of pediatric primary care, and for CSD graduate trainings programs interested in improving educational experiences that tailor to interprofessional learning and practice. [ABSTRACT FROM AUTHOR]

Background: The health‐related quality of life instrument with 8 items (HINT‐8) was developed to measure health‐related quality of life (HRQoL) in Korea. However, the HINT‐8 has not yet been validated among the family caregivers of people with dementia (PwD). Design: A cross‐sectional pilot study. Objective: The study aimed to examine the convergent and discriminant validity of the HINT‐8 among family caregivers of individuals with dementia. Sample: Forty‐seven family caregivers of PwD. Measurements: HINT‐8 was compared with the 5‐level EQ‐5D (EQ‐5D‐5L) to assess its convergent and discriminant validity. Additionally, the association between the two instruments assessing HRQoL was examined using the short‐form Bédard‐Zarit Burden Interview (SZBI). Results: The HINT‐8 was a promising and valid HRQoL instrument for family caregivers of PwD. There was a significantly high correlation between the overall HINT‐8 and EQ‐5D‐5L indices (r = 0.85, p <.001). The HINT‐8 had acceptable psychometric properties compared to the commonly used EQ‐5D‐5L, as indicated by the subdomains associated with family caregiversʼ burden measured by the SZBI. Conclusion: Future studies should compare the HINT‐8 with existing dementia carer‐specific QoL instruments among a larger study sample to enhance its statistical power and confirm its reliability and structural validity. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the effect of the MC and endogenous sex hormone concentrations on performance-determining variables in three distinctMC phases in endurance-trained females. Methods: Twenty-one eumenorrheic trained/highly trained endurance athletes completed a standardized test battery during the early follicular phase (EFP), ovulatory phase (OP), and midluteal phase (MLP) for either one (n = 7) or two test cycles (n = 14). MC phases were determined using calendar-based counting, urinary ovulation testing, and verified with serum hormone analysis. MCs were retrospectively classified as eumenorrheic or disturbed. Disturbed MCs were excluded from analysis. The test battery consisted of 4-6 x 5-min submaximal stages with stepwise speed increases, a 30-s all-out double-poling ski ergometer test, and a maximal incremental treadmill running test. Results: At a group level, there was no effect of MC phase or the serum concentrations of estrogen and progesterone on peak oxygen uptake (...), oxygen uptake at 4 mmol⋅L-1 blood lactate concentration, time to exhaustion, running economy, or mean 30-s power output (MPO30s). Serum testosterone concentration was positively associated with MPO30s (P = 0.016). Changes in ... from EFP to MLP were inconsistent between individuals and across cycles. Conclusions: None of the measured performance-determining variables were influenced by MC phase or serumestrogen or progesterone concentrations. Although some individual patterns could be observed, there was no indication that any single MC phase is consistently associated with improved or impaired ... on a group level. [ABSTRACT FROM AUTHOR]

Objectives: To develop and validate a novel questionnaire aimed at providing a structured, evidence-based methodology for hearing aid recommendation and selection using self-reported importance ratings for different modern hearing aid features. Design: The initial questionnaire items were created through a concept mapping approach that involved input from hearing aid users. Hearing care professional focus groups (n = 10) were conducted to assess questionnaire content and design, and to guide modifications. Validation of this initial 34-item version of the questionnaire was conducted using an anonymous online survey tool (Qualtrics). Exploratory factor analysis was used to assess the factor structure of the dataset, using principal axis factoring. Questionnaire reliability and inter-item correlation were assessed. Items with low factor loading and high cross-loading were removed. Study sample: Two hundred and eighteen adult participants with a self-reported hearing loss (median age = 48 years, range = 18–95 years) completed the questionnaire. Results: Analysis and item removal resulted in a 28-item questionnaire. Three factors were identified, dividing the hearing aid features into the subscales: "Advanced connectivity & streaming", "Physical attributes & usability", and "Sound quality & intelligibility". Conclusion: This study has resulted in a patient-oriented questionnaire that allows clinicians to gather patient input in a structured manner. [ABSTRACT FROM AUTHOR]

Develop and test a Food-Related Control Scale (FRCS) measuring resident-perceived control in long-term care food service. A bank of 15 initial items based on a multidimensional locus of control construct was developed initially. Expert review, cognitive interviews, a pilot study, and factor analysis were used to validate the instrument and assess reliability. Individual phone-based cognitive interviews and 16 skilled nursing facilities in the US. Cognitive interviews included a convenience sample of independently living adults aged ≥ 65 (n = 13), whereas the pilot study included skilled nursing facility-residing adults (n = 166). Perception of food-related control in a long-term care setting. Cognitive interviews were analyzed to develop items. Quantitative data from skilled nursing facility residents were analyzed using SAS software for structural equation modeling and factor analysis. A 2-dimensional construct (9 items) of the FRCS demonstrated reliability with factor analysis. Concurrent validity within the locus of control construct was demonstrated with the Multidimensional Health Locus of Control Scale (standardized estimate of 0.430; P < 0.1). The FRCS may be used to determine how residents in long-term care perceive control over their food experiences. Further testing is necessary to determine the appropriateness of the FRCS for different population uses. [ABSTRACT FROM AUTHOR]

Purpose: The Program for the Education and Enrichment of Relational Skills (PEERS®) is a group-based social skills training program for adolescents on the autism spectrum. Although the program has been shown to be effective in improving social skills in autistic adolescents, evidence of its effectiveness from the Mandarin-speaking Chinese population is sparse. The present study used a non-randomized, pre- and post-intervention research design to investigate the feasibility and cultural validity of the program, as well as examine the moderators of intervention outcomes. Methods: Thirty-three autistic adolescents with intelligence quotient above 70 (Mage = 13.57, SDage = 1.43; Male: Female 25:8) and their parents received 14 concurrent 90-minute sessions. Adolescents' autistic traits, challenging behaviors, emotional functioning, socio-cognitive process, social environment factors (school support), and caregivers' well-being were evaluated. Results: The findings suggest that with minor adjustments, the Mandarin version of PEERS® was generally acceptable and feasible for autistic adolescents and their parents. PEERS® may improve the social skills knowledge, reciprocal communication abilities, and emotional well-being of autistic adolescents. Also, participants with a higher level of school support, and parents with lower perceived subjective well-being at baseline may gain more benefits from PEERS®. The cultural adaptation and acceptability of the Mandarin Version of PEERS® were discussed. Conclusion: This feasibility study (Chinese Clinical Trial Registry: ChiCTR2200061417, 2022-06-23, retrospectively registered) provides a basis for further randomized control trials of the Mandarin version of PEERS®. [ABSTRACT FROM AUTHOR]

Online vendors often deploy limited-time and limited-quantity cues on their e-commerce sites to influence consumers purchase decisions. Although these scarcity cues can reflect genuine restrictions in the availability of goods, they are increasingly considered as ill-intentioned nudges or 'dark patterns' due to their omnipresence and success in persuading consumers. In an online experiment (N = 202), we examined the effects of limited-time and limited-quantity cues on perceived task load, perceived benevolence, and user experience. Results suggest that participants associated scarcity cues with a lack of benevolence from online vendors. E-commerce site design without scarcity cues provided participants with a superior hedonic and pragmatic user experience. In the case of limited-time scarcity cues, participants reported frustration-related negative emotions. We discuss the implications of these findings from the perspectives of dark pattern researchers, designers, and online vendors. [ABSTRACT FROM AUTHOR]

This study was designed to test the effects of two message features (source and level of autonomy support) that are commonly found in short-form social media (e.g. TikTok) videos about Pap tests. The source is defined as who is communicating the message, and autonomy support refers to providing an individual with the independence, respect, and choice to make their own decision. In an online experiment, 636 females aged 21–29 viewed TikTok videos about Pap tests varying in source (doctor vs. peer) and level of autonomy support (either using controlling language to demand getting a Pap test or being supportive of one's choice of whether they receive a Pap test) and then responded to outcomes measures including perceived source credibility, perceived message effectiveness, attitude toward the message, attitude toward Pap tests, intention to engage with the videos, and intention to get a Pap test. Doctors were perceived as more credible than peers, and doctor videos were perceived to be more effective than peer videos. Autonomy support interacted with source, such that autonomy-supportive videos delivered by a doctor improved attitude toward the messaging and attitude toward Pap tests. Regardless of the source, autonomy-supportive videos increased intention to engage with the content on social media. As Pap test rates have recently declined among young women in the United States and viewing of Pap test-related videos has skyrocketed on the TikTok platform, short-form social media sites like TikTok may be an effective health communication tool for health professionals. [ABSTRACT FROM AUTHOR]

Background: Vitamin B12 deficiency is widely prevalent in all age groups which is of major concern. However, there is no valid Food Frequency Questionnaire (FFQ) for dietary vitamin B12 estimation. Hence, we aimed to develop and validate an FFQ for the estimation of dietary intake of Vitamin B12. Materials and Methods: Commonly consumed B12-rich food items were selected from literature and filtered using a market survey. For concordant and discriminant validation, B12 and homocysteine levels were estimated. To establish convergent validity, the Cobalamin Intake in North Indians by Food Frequency Questionnaire (COIN-FFQ) and 72-hour dietary recall (72HrDR) were both administered to the same subjects. The COIN-FFQ was readministered after initial administration for test-retest reliability. Internal consistency of the FFQ was then tested using Cronbach's alpha. Results: We enrolled 115 adults with a mean age and weight of 31.9 ± 8.7 years and 66.0 ± 11.8 kg, respectively. In total, 19.1% were vegetarian. The dietary B12 using COIN-FFQ (n = 60; mean = 4.3 ± 1.8 µg/d) was significantly correlated (r = 0.255; P = 0.049) with serum levels (mean = 120.1 ± 62.6 pmol/L) establishing concordant validity. A significant difference was noted between the dietary, serum B12, and homocysteine levels of vegetarians versus nonvegetarians establishing discriminant validity (mean diff 1.4 (0.5-2.4), P = 0.004; Z-statistic -2.182, P value 0.029, and Z-statistic -2.438; P value 0.015), respectively. FFQ was strongly correlated with 72HrDR and test--retest FFQ (n = 27; r = 0.814, P < 0.001 and r = 0.869, P < 0.001, respectively) establishing convergent validity and test--retest reliability. The internal consistency with Cronbach's alpha was in the acceptable range, 0.631 (n = 115). Conclusion: The newly developed COIN-FFQ is valid and reliable in estimating dietary B12 intake. [ABSTRACT FROM AUTHOR]

Antibiotic resistance (AR) rates in Vietnam are among the highest in Asia, and recent infections due to multi-drug resistance in the country have caused thousands of deaths each year. This study investigated a Vietnamese community's preferences for antibiotic treatment and its knowledge and attitudes regarding antibiotics. A discrete choice experiment-based survey was developed and administered to the population of interest. The respondents were given sociodemographic-, knowledge- and attitude-related items and 17 pairs of choice tasks. Two hypothetical options were included in each choice task. Latent class analysis was conducted to determine the differences among the respondents' preferences. Among 1,014 respondents, 805 (79.4%) gave valid questionnaires. A three-latent-class model with four covariates (age, healthcare-related education or career, occupation, and attitude classifications) was used in the analysis. All five attributes significantly influenced the respondents' decisions. The majority, including young employed respondents with non-healthcare-related work or education, found treatment failure more important. Older respondents who had healthcare-related education/careers and/or appropriate antibiotic use- and antibiotics resistance-related attitudes, regarded contribution to antibiotic resistance as an important attribute in selecting antibiotic treatments. Unemployed individuals with correct knowledge identified the cost of antibiotic treatment as the most essential decision-making factor. Findings suggest minimal antibiotic impact on resistance; only 7.83% view it as amajor concern. The respondents exhibited substantial preference heterogeneity, and the general Vietnamese public had poor knowledge of and attitudes toward antibiotic use and antibiotic resistance. This study emphasizes the need for individual responsibility for antibiotic resistance and appropriate antibiotic use. [ABSTRACT FROM AUTHOR]

In this study, we developed and validated the Clinical Student Version of the Japanese Interprofessional Competency Self-Assessment Scale (C-JASSIC) for healthcare students in their clinical practice phase. Data obtained from 331 students (medical, 98; nursing, 99; pharmacy, 134) during orientation for interprofessional education (pre-IPE) and from 319 students (medical, 94; nursing, 93; pharmacy, 132) within a week following IPE (post-IPE) were analyzed. Exploratory pre-IPE and Confirmatory post-IPE factor analyses revealed a consistent 6-factor structure aligning with the Japanese Interprofessional Competency domains. The scale exhibited strong internal consistency, with Cronbach's α values exceeding 0.8 for all factors both pre- and post-IPE. Scores for overall competency and individual domains increased post-IPE in 234 matched cases. A notable significant pre vs post difference concerned "Understanding of Others," indicating enhanced interprofessional comprehension after clinical practice. There was a weak but significant positive correlation between IPE satisfaction and difference in pre- and post-IPE scores. However, no significant differences were observed among medical, nursing, and pharmacy students. Despite its strengths, such as its competency-based design and cultural relevance to Japan, a limitation of the study may be potential self-reporting bias. Nonetheless, C-JASSIC represents a valuable tool for seamless competency evaluations from student to professional stages, with implications for broader Asian contexts. [ABSTRACT FROM AUTHOR]

Even in academic fields dominated by women students (e.g., educational research), academic careers are characterized by vertical gender segregation in favor of men. This clashes with the public understanding of educational research as a women's domain that is more strongly associated with warmth (a stereotypically feminine trait) than competence (a stereotypically masculine trait), as revealed in our first study. We thus conducted an experimental vignette study of 189 adults from the general public to explore how women versus men researchers working in educational research versus physics (as a contrasting domain clearly dominated by men) were perceived on several dimensions of competence and warmth. Whereas the female researcher in physics was rated as more competent than the female researcher in educational research, the woman in physics was penalized for her gender stereotype-incongruent domain choice by being perceived as less warm. However, the male researcher in educational research was perceived as both warmer and more competent than his man counterpart in physics, and as smarter than the female researcher in educational research. These findings suggest rewards instead of penalties for men pursuing academic careers in initially women-dominated domains, likely contributing to the increasing gender gap in academic careers in these domains. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is a common and significant issue for patients with multiple sclerosis (MS), adversely affecting their overall quality of life. Proper sexual counseling can be beneficial for these women. This study aimed to evaluate the impact of a counseling intervention based on the PLISSIT model on family functioning and sexual quality of life in women with MS. This interventional study was conducted in 2020 at the largest center for special diseases in southeast Iran. Sixty women with MS were selected through convenience sampling and randomly assigned to either an intervention group or a control group. The intervention group participated in four 90-minute individual counseling sessions based on the PLISSIT model over four weeks, while the control group received routine training. Data were collected using a demographic information form and questionnaires on family functioning and sexual quality of life, both before and after the intervention. Results showed no significant differences between the two groups in terms of family functioning and sexual quality of life scores before the intervention (p > 0.05). However, after the intervention, the intervention group exhibited significant improvements in both family functioning and sexual quality of life scores (P < 0.0001). Specifically, there was a notable increase in the mean scores for family functioning and sexual quality of life in the intervention group post-intervention (P = 0.001 and P = 0.0001, respectively). In contrast, the control group showed no significant change in family functioning (P = 0.79) and a significant decrease in sexual quality of life (P = 0.014) during the second assessment. The results suggest that sexual counseling based on the PLISSIT model can effectively enhance family functioning and sexual quality of life in women with multiple sclerosis. [ABSTRACT FROM AUTHOR]

To investigate the effect of dual-task training on balance and knee proprioception in both weight-bearing and non-weight-bearing conditions in older adults with significant imbalance and high risk of falling. This pre-posttest experimental design included 83 older adults (43 males, 40 females), selected based on age criteria (65–75 years) and specific inclusion and exclusion criteria. Participants underwent dual-task training consisting of 30-minute sessions, three times per week, for four weeks (totaling 12-sessions). Measures included Berg Balance Scale and knee proprioception deficit before and after dual-task training. The study showed statistically significant effect of dual-task training on balance (p < 0.001) and knee proprioception in both weight-bearing (p < 0.001) and non-weight-bearing (p < 0.001) in older adults. Pre-and post-measurements of independent variables between male and female older adults showed no significant difference. Dual-task training improves balance and knee proprioception in both weight-bearing and non-weight-bearing conditions in older individuals, thereby enhancing stability and reducing the risk of falls. [ABSTRACT FROM AUTHOR]

Functional communication training (FCT) provides an efficient means for reducing a variety of challenging behaviors while increasing social communication. After establishing a functional communication response (FCR), interventionists may need to design a program to thin the schedule of reinforcement to provide more durable effects and maintenance in the natural environment. Hanley et al. provided one means for thinning schedules that involved the systematic introduction of extinction (or denial trials) following a process of delaying reinforcement. This study evaluates a southeastern U.S. classroom application of this thinning process with three elementary age students who engaged in a variety of aggression, self-injury, disruption, and crying. The results indicate positive effects of the FCT program with systematic introduction of denial trials once the participants demonstrated proficiency with the FCR. In addition, data for two participants show prolonged effects post-intervention. Results are discussed in terms of extending Hanley et al. and how these procedures can be used within typical school-based settings. [ABSTRACT FROM AUTHOR]

The present study examines how supportive touch impacts evaluations of esteem support content containing high emotion-focused (HEF) or high problem-focused (HPF) messages during observed esteem support interactions. A 2 (verbal content; i.e., HEF or HPF) by 2 (nonverbal content; i.e., presence or absence of supportive tactile communication) experiment was conducted to test for main and interactional effects. Results revealed that HEF conditions were perceived to be more effective by observers at enhancing the recipient's state self-esteem, state self-efficacy, and alleviating distress compared to HPF conditions. The supportive tactile communication conditions were perceived as better at enhancing state self-esteem and alleviating distress compared to the no supportive tactile communication conditions by observers. However, these main effects were qualified by significant two-way interactions between message content and nonverbal behavior on ratings of state self-esteem and distress alleviation, such that the addition of supportive tactile communication enhanced the effectiveness of HPF message content but not HEF content. [ABSTRACT FROM AUTHOR]

This study examined the development of social power perceptions among Chinese children aged 3–5 years (N = 105). After watching videos about various social power cues, such as resource possession, resource control, goal achievement, permission, giving orders, setting norms and popularity, the children were asked to identify the powerful agents (whom do you believe is the more powerful person?) in the videos and provide explanations (why do you think he (she) is a powerful person?). Three‐year‐olds can recognize powerful agents who can grant 'permission' to other agents. By the age of 4, children begin to associate 'popularity', 'resource possession' and 'goal achievement' with social power. Five‐year olds demonstrated the ability to recognize agents who control resources as being more powerful. Analysis of the reasons the children provided for their judgements revealed that for almost every cue (except giving orders), more than 14% of the responses highlighted 'possession of material resources' as an indicator of power. For children aged 3–5 years, 'resource possession' cues may be their preferred basis for inferring and explaining power differences. These results would facilitate researchers to further unravel the mechanisms underlying the development of children's social power perceptions. [ABSTRACT FROM AUTHOR]

Introduction: Although oncology has seen large scientific and clinical advances over the last decade, it also has one of the lowest success rates for novel agents across therapeutic areas. Adaptive clinical trial design has been a popular option for increasing clinical trial efficiency and the chances of trial success. Seamless clinical trial design are studies in which two or more clinical trial phases are combined into a single study with a pre-specified transition between stages. This integration of phases may enhance efficiency. Methods: To understand the precedent for the use of seamless designs, this working group was formed to conduct a comprehensive literature search on seamless clinical trials conducted with confirmatory intent in oncology. Trial design features were extracted into a database and analyzed with descriptive statistics. Results: A literature search identified 68 clinical trials meeting inclusion and exclusion criteria. The most common design feature was a gate on treatment efficacy, where the trial would only proceed to the second stage if sufficient efficacy was observed in the first. The next most common feature was a selection of a dose or treatment regimen. Inferentially and operationally seamless designs were approximately equally represented. Discussion: Key statistical considerations for seamless phase II/III designs include optimizing design choices by evaluating and comparing operating characteristics across design alternatives as well as showing control of overall Type I error rates. Executing the transition between phases should be evaluated for issues related to accrual, drug production, and procedures to maintain trial integrity. Conclusions: While there are unique statistical, regulatory, and operational considerations for seamless designs they are also uniquely suited to many development settings. These include, for example, addressing dose selection under FDA's Project Optimus and addressing the growing use of biomarkers and personalized medicine approaches in cancer treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Educational environments can have environmental conditions that are incompatible with the needs of students, compromising their well-being and affecting their performance. OBJECTIVE: To identify the environmental variables that influence the performance of university students and measure this influence through an experiment in indoor environments. METHODS: The study applied an experimental methodology for three consecutive days in seven educational environments located in different regions of Brazil, measuring the environ-mental conditions, the students' perception of the environment, and their cognitive performance. The impact of environmental variables and environmental perception on student performance was analyzed using Generalized Linear Models and a Structural Equation Model. RESULTS: Students who took the test at air temperatures between 22.4°C and 24.7°C had a 74.20% chance of performing better than those outside this range. Air temperatures between 26.2°C and 29°C were associated with an 86% chance of taking less time to complete the test. High illuminance levels increased the chance of taking longer to answer the test by 41.7%. CONCLUSIONS: Three environmental variables (relative humidity, lighting and air temperature) and two perceptual dimensions (light and thermal perception) directly influence student performance. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals frequently encounter various forms of aggression, ranging from verbal abuse to physical assaults, which can compromise both their occupational well-being and patient-care quality. Despite its prevalence and serious consequences, workplace aggression is often underreported due to a lack of standardized assessment tools. This study aims to develop a valid Italian version of the Hospital Aggressive Behaviour Scale-Users. Methods: The scale's structure was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses on two samples of healthcare professionals during and after the pandemic. Reliability, measurement invariance, and nomological validity were examined. Results: EFA revealed a two-factor structure comprising eight items (χ2 = 59.651, df = 13, p = 0.00; CFI = 0.98; TLI = 0.95; RMSEA = 0.07; SRMR = 0.02), distinguishing non-physical and physical aggression, and meeting all recommended criteria. CFA confirmed this structure, demonstrating good reliability and outperforming alternative models. The same factor structure was confirmed in standard (χ2 = 35.01, df = 19, p = 0.00; CFI = 0.99; TLI = 0.99; RMSEA = 0.03; SRMR = 0.02) and emergency (χ2 = 30.65, df = 19, p = 0.04; CFI = 0.98; TLI = 0.97; RMSEA = 0.06; SRMR = 0.04) contexts. Full residual invariance was found across job tenure groups. Aggression was positively associated with emotional exhaustion, psychological distance, psychosomatic symptoms, post-traumatic stress symptoms, and turnover intentions while negatively related to job satisfaction. Nurses and healthcare assistants reported higher levels of aggression than doctors. Conclusions: This study provides a reliable, context-specific instrument for documenting and analysing outsider aggression. The insights can inform targeted interventions, contributing to a healthier hospital environment. [ABSTRACT FROM AUTHOR]

The adjustment of stroke survivors is self-directed and multi-dimensional. This study developed an adaptive behavior scale for stroke survivors reflecting these characteristics and performed a psychometric evaluation. The item pool was derived based on conceptual attributes and indicators of adaptive behaviors for stroke survivors. Ten experts assessed the content validity. The scale was refined through pilot testing and interviews with 10 stroke survivors. From December 2021 to May 2022, a self-report questionnaire consisting of a five-point Likert scale was administered to 215 stroke survivors visiting a university hospital in S City, South Korea. Item analysis and confirmatory factor analysis were conducted to assess the construct validity; reliability was confirmed using Cronbach's α. The final scale comprised three factors and 16 items: taking an optimistic view, restructuring daily activities to suit oneself, and carrying out one's daily life. The confirmatory factor analysis indicated a good fit for the three-factor model; Cronbach's α coefficient of the scale was 0.90, indicating a very good internal consistency. This easy-to-use, concise self-report scale applies to stroke survivors from subacute to chronic stages, providing healthcare professionals with the basic data needed to assess their adaptation. It may also facilitate individualized intervention program development to improve stroke survivor adaptation. [ABSTRACT FROM AUTHOR]

Background & Objective: The role of the mothers is very important in providing care and monitor their children's health in general. Their awareness concerning quality of foods which is needed for each child's developmental stage can effect on nutritional status This Study assess the effect of an nutritional education Program on mother knowledge regarding their children nutritional status. Materials & Methods: Sixty moms were chosen from Al-Ayn Social Care Foundation International in Al-Samawah City and take on using a quasi-experimental design. The researcher used a non-probability "purposive sample" and measured the height and weight for child before calculating the body mass index. Results: The current study found a relationship between moms' educational level and knowledge regard to sociodemographic characteristics with a p-value of .001. However, there were no significant correlations observed between mothers' knowledge in the control group and their age, level of education, occupation, residency, monthly income, and sources of information. Conclusion: Following the interventional program on nutrition-related health, the level of knowledge among the mothers in the study group was enhanced. The study suggested that the nutrition education program should be offered to all moms in order to enhance their understanding and enthusiasm regarding the significance of child nutrition. Additionally, it was advised that their education should be regularly updated. [ABSTRACT FROM AUTHOR]

Purpose: For clients to understand social insurance decisions and processes, information from authorities needs to be comprehensible, and clients need sufficient individual abilities. These dimensions are captured by the concept social insurance literacy, which has been operationalized into a measure, the Social Insurance Literacy Questionnaire (SILQ). The aim of this study was to describe the development of the SILQ and evaluate its psychometric properties using Rasch measurement theory. Methods: The development of the SILQ included a Delphi study and cognitive interviews. A preliminary version, divided on four scales corresponding to the domains of the concept (obtaining information, understanding information, acting on information, and system comprehensibility) was psychometrically evaluated according to Rasch measurement theory, in a survey to a stratified random sample of people on sick leave (n = 1151) sent out in the fall of 2020. Results: Overall, the items in the final version of the SILQ demonstrated good fit to the Rasch model, and the response scale worked as intended. Unidimensionality was supported for all scales, but minor problems with local dependency was detected for three items. The person separation was 0.80 for the Obtain scale, 0.82 for the Understand scale, 0.68 for the Act scale, and 0.81 for the System scale. Corresponding ordinal alpha values were 0.91, 0.91, 0.86, and 0.91, respectively. Conclusion: This study is a first step toward exploring literacy in the social insurance field. The SILQ covers individual abilities and systems' comprehensibility, and the results show that it has acceptable psychometric properties. [ABSTRACT FROM AUTHOR]

Purpose: To develop an index to assess capacity to work in relation to common mental disorders (CMDs) in the general working population and field test its psychometric properties. Methods: Content analysis of three qualitative studies on people (n = 49) with their own experiences of working with CMD guided the items selected for the index. Face and content validity and test-retest reliability were performed. The index was field tested in two versions with 26 and 17 items, respectively, among health care professionals regarding internal reliability, component structure and concurrent validity. Results: The final version of the Capacity to Work Index (C2WI; 17 items) was normally distributed in the field test with high internal reliability (Cronbach's alpha, 0.84). Missing responses were randomly distributed and nonspecific. Principal component analysis showed one clear component with negatively framed items. Concurrent validity showed high correlation with the WHO-5 Well-Being Scale (Pearson's r, 0.68), but lower correlation for the general health question (r, − 0.44), one item of the Work Ability Index (r, − 0.33), and the Stress of Conscience constructs (r, 0.44). Conclusion: The C2WI showed promising psychometric qualities. Low and negative correlation with the item from Work Ability Index suggests that the C2WI measures additional dimensions, but further testing in larger and more diverse samples is required. [ABSTRACT FROM AUTHOR]

Emergency medical services (EMS) clinicians are tasked with early fluid resuscitation for patients with sepsis. Traditional methods for prehospital fluid delivery are limited in speed and ease-of-use. We conducted a comparative effectiveness study of a novel rapid infusion device for prehospital fluid delivery in suspected sepsis patients. This pre-post observational study evaluated a hand-operated, rapid infusion device in a single large EMS system from July 2021-July 2022. Prior to device deployment, EMS clinicians completed didactic and simulation-based device training. Data were extracted from the EMS electronic health record. Eligible patients included adults with suspected sepsis treated by EMS with intravenous fluids. The primary outcome was the proportion of patients receiving goal fluid volume (at least 500 mL) prior to hospital arrival. Secondary outcomes included in-hospital mortality, disposition, and length of stay. Multivariable logistic regression was used to compare outcomes between 6-month pre- and post-implementation periods (July-December 2021 and February-July 2022, respectively), adjusting for patient demographics, abnormal prehospital vital signs, and EMS transport interval. Of 1,180 eligible patients (552 in the pre-implementation period; 628 in the post-implementation period), the mean age was 72 years old, 45% were female, and 25% were minority race-ethnicity. Median (interquartile range) fluid volume (in mL) increased between the pre- and post-implementation periods (600 [400,1,000] and 850 [500–1,000], respectively). Goal fluid volume was achieved in 70% of pre-implementation patients and 82% of post-implementation patients. In adjusted analysis, post-implementation patients were significantly more likely to receive goal fluid volume than pre-implementation patients (adjusted odds ratio (aOR) 2.00, 95% confidence interval (CI) 1.51–2.66). Pre-post in-hospital mortality was not significantly different (aOR 0.91, 95% CI 0.59–1.39). In a single EMS system, sepsis education and introduction of a rapid infusion device was associated with achieving goal fluid volume for suspected sepsis. Further research is needed to assess the clinical effectiveness of infusion device implementation to improve sepsis patient outcomes. [ABSTRACT FROM AUTHOR]

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Background: Auditory reaction time (ART) and visual reaction time (VRT) are critical for patients with stroke, especially during balance training. According to the research, most patients with stroke are fatigued at sub-maximal levels during their stroke rehabilitation. Sub-maximal physical fatigue may affect ART and VRT and impede stroke rehabilitation. Hence, it is important to study the effect of submaximal physical fatigue on ART and VRT. A pilot study on healthy adults paves the way for further research on stroke rehabilitation. The purpose of this research is to find out if submaximal physical fatigue affects ART and VRT in healthy adults. In addition, this study also determines if ART and VRT recover to baseline after 15 min of rest post-fatigue session. Furthermore, the goal is to determine whether sub-maximal physical fatigue has a greater effect on ART or VRT. Methods: A repeated measures within-subject design was used in the study. Eighteen healthy participants (median age 24 years) completed two sessions of a sub-maximal fatigue protocol on a cycle ergometer until they reached a rating of perceived exertion (RPE) of 15 on a scale of 6–20. Two different fatigue sessions were conducted (one to study the effects of fatigue on ART and the other for VRT). ART or VRT was measured on computer software before (PRE), immediately after (POST-0), and 15 min after (POST-15) the sub-maximal physical fatigue protocol. Results: The value of median ART increased significantly from PRE to POST-0 (P = 0.002) and it decreased significantly at POST-15 (P = 0.010). Similarly, the value of mean VRT increased from PRE to POST-0 (P = 0.001) before decreasing significantly at POST-15 (P = 0.001). There was no significant difference between the effects of submaximal fatigue on ART and VRT (P = 0.156). Conclusion: Due to submaximal physical fatigue, ART and VRT were slower, but they returned to baseline after 15 min of rest. Submaximal physical fatigue had an equal impact on ART and VRT. As balance training requires quicker ART and VRT for optimal outcomes, it may be better if the physiotherapists consider a 15-min rest period between the exercise and balance training in patients with stroke. [ABSTRACT FROM AUTHOR]

Background: Management of type 2 diabetes (T2D) as a chronic disease requires treatment adherence such as controlling the blood glucose level and adopting a healthy lifestyle. The present study aimed to develop and psychometrically evaluate a questionnaire based on the Pender's Health Promotion Model (HPM) to measure treatment adherence and the associated factors among T2D patients. Methods: The present study was conducted in qualitative and the quantitative phases between March 2022 and March 2023. The participants were T2D patients visiting Shahid Mohammadi hospital Diabetes Clinic in Bandar Abbas in the south of Iran. The first draft of items was extracted from the qualitative phase. The present study used interviews with T2D patients, item construction, validity and reliability evaluation of the instrument, and the relevant statistical analyses. It emphasized the significance of content, face, and construct validity, along with reliability testing using Cronbach's alpha and test-retest method. Data were analyzed using SPSS software, V16 and AMOS, V23. Results: A 97-item questionnaire was developed through the qualitative phase and, after content validity, it was reduced to 86 items. Five items were removed in face validation, and after the test-retest method, 79 items were retained. The confirmatory factors analysis confirmed a 65-item model with appropriate fitness of data. Cronbach's alpha coefficient showed an acceptable reliability of the diabetes treatment adherence questionnaire (α = 0.92). Conclusion: The questionnaire developed based on the HPM model provides a standard and comprehensive measurement of the degree of adherence to treatment and the associated factors among Iranian T2D patients. This is especially valuable in the Iranian healthcare context, where effective management of chronic diseases such as diabetes is of a top priority. Questionnaires can help identify barriers and facilitators of treatment adherence to inform systematic and goal-oriented interventions. The proposed questionnaire had good psychometric properties, and can be used as a valid and practical instrument to measure the factors related to treatment adherence behaviors. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disturbance that affects many women worldwide and is characterized by chronic anovulation, hyperandrogenism, and ovarian dysfunction. Placenta-derived mesenchymal stem cells (PDMSCs) are derived from the placenta and have advantages over other sources of MSCs in terms of availability, safety, and immunomodulation. Materials and methods: In this experimental study, twenty female Wistar rats were assigned to four groups (n = 5) including control, sham, PCOS, and PCOS+PDMSCs groups. Then, PCOS was induced in the rats through administering letrozole for 21 days. PDMSCs (1 × 106 cells) were injected through the tail vein. Fourteen days after the cell infusion, evaluation was performed on the number of healthy follicles, corpus luteum, and cystic follicles as well as the levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), fasting blood glucose, fasting insulin, and insulin resistance. Moreover, the serum levels of cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. Liver function was also determined by the evaluation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Results: The number of corpus luteum and primordial, primary, secondary, and antral follicles was significantly elevated in the PCOS+PDMSCs group compared to the PCOS group. However, the number of cystic follicles significantly decreased in the PCOS+PDMSCs group. The LH and testosterone levels also decreased significantly, while FSH levels increased significantly in the PCOS+PDMSCs group. The levels of fasting blood glucose, fasting insulin, and insulin resistance notably decreased in the PCOS+PDMSCs group. Moreover, the lipid profile improved in the PCOS+PDMSCs group along with a significant decrease of cholesterol, LDL, and TG and an increase in HDL. The PCOS+PDMSCs group exhibited marked decreases in the AST and ALT levels as well. Conclusion: The results of this study suggest that PDMSCs are a potential treatment option for PCOS because they can effectively restore folliculogenesis and correct hormonal imbalances, lipid profiles and liver dysfunction in a rat model of PCOS. However, further research is needed to establish the safety and effectiveness of PDMSCs for treating PCOS. [ABSTRACT FROM AUTHOR]

Background: Healthy lifestyle behaviors encompass activities aimed at promoting, maintaining, or reclaiming health. Evaluating these behaviors accurately requires comprehensive, valid, and reliable tools. Aims: This study aimed to develop the Healthy Lifestyle Behavior Scale and evaluate its psychometric properties in the Turkish population. Methods: For this methodological research, a cross-sectional online-based survey was conducted between 21 March 2023 and 31 March 2023 among 330 participants who were recruited via convenience sampling. The initial item pool included 90 items across seven domains (exercise, health responsibility, preventive health actions, sleep, stress and social support, nutrition, smoking, and alcohol). The content validity of the scale was verified by taking expert opinions. Construct validity and reliability were assessed using principal component analysis (PCA) and Cronbach's alpha. Results: A total of 330 people were recruited for the study (65.2% female, mean age 34.2 ± 9.4 years). The final scale comprised 34 items: 5 on exercise, 4 on health responsibility, 4 on preventive health actions, 2 on sleep, 5 on social support, 3 on stress management, 5 on nutrition, 4 on smoking and 2 on alcohol. The construct validity analysis revealed a 9-factor structure explaining 62.35% of the variance (Kaiser–Meyer–Olkin value = 0.807). Internal consistency was confirmed with Cronbach's alpha (α = 0.863 for the scale, > 0.7 for subscales) and high item-total correlation. Conclusions: Our newly developed Healthy Lifestyle Behavior Scale demonstrated good validity and reliability. It outperformed existing scales, boasting higher alpha values for subfactors and explained variance. This scale is a robust tool for assessing healthy lifestyle behaviors in adults. [ABSTRACT FROM AUTHOR]

Background: There are limited tools to measure the burden of disease and effectiveness of medical/surgical interventions in patients with cryptoglandular fistulas. The aim of this study was to explore concepts that are relevant and important to patients with complex cryptoglandular fistulas (CCF) and to develop a patient-centred, disease-specific, patient-reported outcome measure (PROM) to assess symptom burden and impacts of CCF. Methods: A targeted literature review was conducted, followed by one-to-one telephone interviews with five colorectal surgeons (USA, n = 3; UK, n = 1; Spain, n = 1) and 20 US adult patients with CCF to inform the development of a conceptual model and a CCF-specific PROM. The targeted literature review informed the development of the preliminary conceptual model and identified a PROM in the literature that was used as a reference to generate the draft CCF-specific PROM. The colorectal surgeon interviews provided insights on the experience of patients with CCF to refine the conceptual model, formulate probing questions for use in patient interviews, and to develop the draft CCF-specific PROM. Patients' descriptions of their experiences with symptoms and the impacts on their lives and evaluation of the draft CCF-specific PROM in concept elicitation and cognitive interviews were used to develop the final conceptual model and final CCF-specific PROM. Results: Ten symptoms (odour, pain during bowel movement, abscess, post-operative pain, discharge/drainage/leakage, anal/perianal pain, inflammation/swelling, skin irritation, bleeding and itchiness) and 11 impacts (discomfort, inability to exercise, embarrassment, difficulty sitting, worry about disease, adapted life to maintain hygiene, negatively impacted social life/isolation, inability to perform daily activities, reduced interest in sex, negatively impacted intimate relationships and negatively impacted mood) were reported as most salient by patients. The patient experience, clinician perspective, and literature review provided input to item generation. Evaluation of relevance and patient understanding through cognitive interviews with patients provided evidence for the content validity of the new patient-reported outcome measure: the 20-item Complex Cryptoglandular Fistula Questionnaire™ (CCFQ-20™). Conclusion: The CCFQ-20™ is a new clinician-guided, patient-validated, disease-specific patient-reported outcome measure that measures disease impact and quality of life in patients with CCF. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a precursor to the development of many diseases (atherosclerosis, diabetes, etc.). It is marked by disruptions in glucose and lipid metabolism, along with hypertension. Numerous types of risk factors contribute to the development of the MetS, inflammation and insulin resistance are present throughout the metabolic abnormalities. Chrysanthemum indicum L. is a traditional Chinese plant used for both tea and medicine, known for its high content of total flavonoids, which are important secondary metabolites. Our research led to the extraction of a Buddleoside-Rich Chrysanthemum indicum L. extract (BUDE) which has demonstrated anti-inflammatory properties. Nonetheless, the specific role and mechanism of BUDE in preventing MetS remain unclear. Methods: The study initially evaluated the role of BUDE in preventing MetS. Subsequently, it investigated the anti-inflammatory properties of BUDE in the liver and pancreas in response to unhealthy diets. It then examined the level of insulin resistance and pancreatic β-cell function induced by inflammation. Additionally, an lipopolysaccharide (LPS)-induced macrophage inflammation model was used to further investigate the ameliorative effects of BUDE in inflammation. Results: BUDE has hypotensive, hypoglycemic and hypolipidemic effects. It can also resolve the imbalance between macrophage subpopulations, impede the triggering of the NF-κB signaling pathway, reduce the secretion of inflammatory mediators, ameliorate insulin resistance, and safeguard organs such as the liver and pancreas from inflammatory damage. These effects collectively contribute to preventing the development of MetS. Discussion: BUDE has the ability to modulate macrophage-mediated inflammation, leading to improved insulin resistance. Additionally, it delivers antihypertensive, hypoglycemic, and hypolipidemic effects, offering a potential for preventing MetS. [ABSTRACT FROM AUTHOR]

Background: Given increases in China's aging population, the growing demand for public health services and the shortage of human resources among nurses have become more prominent. Under such a background, "Internet + Nursing Services" have received more attention. Thus, exploring the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective: This study aimed to develop a scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and to test the validity and reliability of the scale. Methods: A preliminary scale was developed based on a literature review, theoretical research, semistructured qualitative interviews, and two rounds of Delphi expert inquiry. A convenient sampling method was used for the questionnaire survey. A 5-point Likert scale was used to evaluate the importance of the items. The survey data of 659 clinical nurses obtained from February to March 2023 were used for item analysis, exploratory factor analysis (EFA), and reliability and validity tests of the scale. The survey data of 538 clinical nurses obtained in April 2023 were used for confirmatory factor analysis (CFA) of the final scale. Results: The final scale consists of 25 items and 4 dimensions (performance expectations, perceived risk, need for professional knowledge training, and nonprofessional knowledge training). The scale showed good structural validity and content validity: the Cronbach's α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the kaiser-meyer-olkin(KMO) value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The scale content validity index(S-CVI) was 0.914. The confirmatory factor analysis model had favorable fit indices: χ2/df = 4.234, RMSEA = 0.078, NFI = 0.940, IFI = 0.953, TLI = 0.947, and CFI = 0.953. Conclusion: The scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" has good reliability and validity, and provides a reference for evaluating nurses' willingness to participate in "Internet + Nursing Services". [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of Balint Group in improving stress, negative mood and empathy of psychiatric nurses. Method: In March 2022-March 2023, 150 psychiatric nurses from four hospitals in Lanzhou were selected for the study, randomly grouped into experimental group and control groups (75 per group), the experimental group participated the Balint Group activities biweekly, the control group only attended mental health knowledge lectures. Job stress, negative emotion and empathy of the two groups before and after the intervention were evaluated and compared by using job stressor Scale, coping style Assessment Scale, self-assessment scale for depression, self-assessment Scale for anxiety and Jefferson Empathy Scale. Results: After intervention, the job stressor scale and coping style evaluation of nurses in the two groups were significantly decreased, and the experimental group was lower than the control group (P < 0.05). The depression and anxiety of nurses in the two groups were significantly improved, and the experimental group was better than the control group (P < 0.05). The differences in the total score and dimensions of Jefferson Empathy scale in the experimental group after intervention were higher than those in the control group (P < 0.05). Conclusion: Balint group activities can effectively relieve the stress, depression and anxiety of psychiatric nurses, and improve the ability of empathy at work. [ABSTRACT FROM AUTHOR]

Background: Patient-centered care aims to prevent disease and promote well-being by actively involving patients in treatment and decision-making that is based on respecting the patients and their families. However, no scales have been developed to assess patient-centered care from the nurse's perspective. This study aimed to develop a scale to measure nurses' level of patient-centered communication and confirm its validity and reliability. Methods: A methodological cross-sectional study was adopted to develop and validate the Patient-Centered Communication Scale (PCCS). The items were developed through a literature review and online interviews with nurses. Content validity was assessed by experts and the content validity index was calculated. A pretest of the questionnaire was conducted with 10 clinical nurses. To evaluate the factor structure and internal consistency reliability, the PCCS was administered online to 325 nurses in South Korea. Data were analyzed using descriptive statistics, explanatory factor analysis (EFA), and confirmatory factor analysis (CFA). Results: The final instrument consisted of 12 items and three factors: (1) information sharing, (2) patient-as-person, and (3) therapeutic alliance. EFA revealed a distinct three-factor structure, explaining 59.0% of the total variance. CFA confirmed the adequacy of the model fit and validated the inclusion of the final items. The Cronbach's alpha values ranged from 0.60 to 0.77, indicating acceptable internal consistency. Convergent validity was evidenced by the correlation between the PCCS and a measure of interpersonal communication competence. Conclusions: The 12-item PCCS showed good reliability, construct validity, and convergent validity. The scale has utility for measuring the level of patient-centered communication skills in nurses. [ABSTRACT FROM AUTHOR]