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This longitudinal study examined the relationships between multiple dimensions of singlehood and mental health, along with their moderators, in a diverse cohort of sexual and gender minority youth assigned female at birth (N = 205, Mage = 19.5; 39% < 18 years old; 27% gender minority; 74% racial/ethnic minority) who were single (no romantic partnership) at least once across 7 visits (retention >90% at all visits). Singlehood dimensions included single status, length of singlehood, and transitions into and out of singlehood at each visit, as well as proportion of singlehood periods across all visits. At the between-person level, individuals with a higher proportion of singlehood periods across the study reported higher stress, anxiety, and depression. At the within-person level, while youth experienced increased depression when single, their depression and stress decreased as the length of singlehood increased. Additionally, fear of being single (FOBS) and perceived social support, each showing unique associations with mental health outcomes in this study, were included as moderators. Notably, only those with low to average (not high) FOBS experienced a reduction in mental health problems as singlehood length increased. Taken together, the findings shed light on the factors associated with mental health and well-being in single individuals from a vulnerable and marginalized population. [ABSTRACT FROM AUTHOR]

Background: There have been recurring UK initiatives to increase nurse research capability but little robust evaluation of long-term effectiveness. More nurses undertake doctorates, yet few lead major funded projects. Previous research suggests potential explanations but the perspectives of nurse lead-investigators themselves have not been examined. Aim: To explore the perceptions of nurse lead-investigators about what has helped or hindered them to lead funded research projects. Methods: Lead investigators of research projects from major UK funders (1 Apr 2017–Sept 2022) were identified from publicly available data. University profiles were screened to identify registered nurses. Entire population was approached (no sample size calculation required). Consenting participants completed an online survey (five open questions). Results: A total of 65 nurse-lead investigators were identified, 36 (55%) completed the survey (20 December 2022 to 17 February 2023). Participants identified Building (multi-disciplinary) collaborations and mentorship as having been most important to their success. High-quality mentoring was also identified as most important in helping novice nurse researchers become leaders. Participants highlighted the critical importance of being supported by individuals with a track record of funding success and benefits of being situated in research-supportive environments. Lack of career pathway/ infrastructure and being unable to pursue research due to competing clinical/teaching priorities were identified as most unhelpful to this group AND the most common reasons for peers not going on to lead research. Conclusions: Ensuring access to mentors with an established track record is an important component of schemes to increase research capability in nurses. Funded, protected time for research and career structures that reward the significant skill development required to succeed in a competitive, multi-disciplinary funding arena is important. Impact: Interdisciplinary collaboration and mentorship by experienced researchers are critical to success and should be incorporated into future interventions to increase research capability in nurses. No patient or public contribution (as exploring a professional issue). [ABSTRACT FROM AUTHOR]

Aim: To explore whether sleep deprivation contributes to medication errors in registered nurses (RNs). Background: Sleep deprivation is a potential issue for RNs, particularly those who work shifts. Sleep deprivation has been found to have a negative impact on numerous cognitive processes. Nurses administer several medications to patients a day, potentially while sleep deprived—anecdotal reports suggest that this could result in an increased risk of error occurring. Design: A scoping review was conducted using the Prisma‐ScR extension framework to explore what is known about the effect of RNs' sleep deprivation on medication administration errors. Methods: A search of databases generated 171 results. When inclusion and exclusion criteria were applied, 18 empirical studies were analysed. Studies included retrospective analysis of errors, surveys of perceptions of causes and observational studies. Results: Data indicated that RNs consider fatigue, which may be caused by sleep deprivation, to be a contributing factor to medication errors. The search only identified three observer studies, which provided conflicting results as to whether lack of sleep contributes to the error rate. Of the numerous tools used to measure sleep, the Pittsburgh Sleep Quality Index was the most frequently used. Conclusion: Although RNs anecdotally consider a lack of sleep potentially contributes to medication errors, there is insufficient research to provide robust evidence to confirm this assumption. No Patient or Public Contributions: Patient or public contributions were not required for this scoping review. Relevance to Clinical Practice: Sleep deprivation is a potential issue for nurses, especially those who work shifts. Poor sleep impacts cognitive processes that potentially could increase errors. Nurses should be aware of the impact sleep may have on patient safety. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between the attitudes of pregnant women toward general vaccines based on the Health Belief Model and their attitudes toward the COVID-19 vaccine. The study, which was designed as a descriptive, cross-sectional, and correlational study, was conducted with 348 pregnant women in three public hospitals in Northern Cyprus between June 24 and November 28, 2022. Data were collected using the "Participant Information Form," "Public Attitude Toward Vaccination Scale-Health Belief Model" (PAVS-HBM), and "Attitudes Toward the COVID-19 Vaccine" (ATV-COVID-19). The COVID-19 vaccination rate among pregnant women was quite high. Pregnant women have a high perception of sensitivity, importance, benefit, and health responsibility for routine vaccines and vaccination programs based on the HBM, and a low perception of barriers to vaccination. These results showed that pregnant women have a determined and positive attitude toward the acceptance of vaccines in general. On the other hand, the attitude of pregnant women toward the COVID-19 vaccine was moderately negative. Despite the reservations about the COVID-19 vaccine, a determined and positive attitude toward vaccines in general has increased acceptance of the COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. Materials and Methods: A descriptive–exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State–Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). Results: a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = −0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. Discussion and Conclusion: Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses. [ABSTRACT FROM AUTHOR]

A strong link between children's emotion regulation and oppositional defiant disorder (ODD) symptoms has been documented; however, the within-person mechanisms remain unclear. Based on the self-control theory and self-regulation theory, our study investigated the longitudinal, bidirectional relationship between emotion regulation and ODD symptoms in school-age children with ODD using parent- and teacher-reported data, respectively. A total of 256 Chinese elementary school students participated in a three-wave longitudinal study spanning two years. We used the random intercept cross-lagged panel model (RI-CLPM) to investigate the concurrent and longitudinal associations between emotion regulation and ODD symptoms. Results from the RI-CLPMs revealed that ODD symptoms were negatively correlated with emotion regulation and positively correlated with emotion lability/negativity at both the between-person and within-person levels across settings. Additionally, in the school setting, emotion regulation negatively predicted subsequent ODD symptoms but not vice versa, whereas emotion lability/negativity was bidirectionally associated with ODD symptoms over time. The longitudinal associations of ODD symptoms with emotion regulation and lability/negativity were not observed in the home setting. These findings suggest a circular mechanism between children's emotion regulation and ODD symptoms and support the view that emotion regulation, particularly emotion lability/negativity, plays an important role in the development of ODD symptoms. [ABSTRACT FROM AUTHOR]

Objective Survivors of breast cancer with persistent cancer-related fatigue (CRF) report less exercise participation compared with survivors of breast cancer without CRF. Although CRF predicts other domains of self-efficacy among survivors, the effect of CRF on exercise self-efficacy (ESE)—an important predictor of exercise participation—has not been quantified. This study examined the relationship between CRF, ESE, and exercise participation and explored the lived experience of engaging in exercise among survivors of breast cancer with persistent CRF. Methods Fifty-eight survivors of breast cancer (3.7 [SD = 2.4] years after primary treatment) self-reported CRF, ESE, and exercise participation (hours of moderate-intensity exercise per week). Regression and mediation analyses were conducted. Survivors who reported clinically significant CRF and weekly exercise were purposively sampled for 1-on-1 interviews (N = 11). Thematic analysis was performed across participants and within higher versus lower ESE subsets. Results Greater CRF predicted lower ESE (β  = −0.32) and less exercise participation (β  = −0.08). ESE mediated the relationship between CRF and exercise participation (β  = −0.05, 95% CI = −0.09 to −0.02). Qualitative data showed that survivors of breast cancer with higher ESE perceived exercise as a strategy to manage fatigue, described self-motivation and commitment to exercise, and had multiple sources of support. In contrast, survivors with lower ESE described less initiative to manage fatigue through exercise, greater difficulty staying committed to exercise, and less support. Conclusions Survivors of breast cancer with persistent CRF may experience decreased ESE, which negatively influences exercise participation. Clinicians should screen for or discuss confidence as it relates to exercise and consider tailoring standardized exercise recommendations for this population to optimize ESE. This may facilitate more sustainable exercise participation and improve outcomes. Impact This study highlights the behavioral underpinnings of CRF as a barrier to exercise. Individualized exercise tailored to optimize ESE may facilitate sustainable exercise participation among survivors of breast cancer with CRF. Strategies for clinicians to address ESE are described and future research is suggested. Lay Summary Women with fatigue after breast cancer treatment may have lower confidence about their ability to engage in exercise. Individually tailoring exercise to build confidence as it relates to exercise may result in more consistent exercise and better health-related outcomes. [ABSTRACT FROM AUTHOR]

We disentangle whether students who believe they know about campus reporting avenues and procedures for addressing sexual misconduct are able to correctly respond to factually – based knowledge statements related to procedures and reporting. Data from a climate survey administered at one university were analyzed to explore how well students' perceptions of their knowledge about university sexual misconduct reporting and procedures match with their responses to factually – based knowledge statements (i.e., mandatory reporting, investigations, confidential resources, and accommodations for survivors). Many students who say they know about university reporting and procedures correctly respond to the factually – based statements. However, anywhere between one in five to one in three students responded incorrectly, and thus, have a disconnect between their perceived knowledge and factual knowledge. Implications for the inclusion of questions in climate surveys and future research are discussed. It is important to ensure students have a comprehensive understanding of campus reporting and procedures for addressing sexual misconduct as universities continue to respond to experiences of the campus community. [ABSTRACT FROM AUTHOR]

In this study, we identified (1) subgroups of youth during middle childhood who displayed distinct profiles of social emotional learning (SEL) skills including cooperation, prosocial behaviors, work habits, emotion regulation, and self-control; and (2) how these profiles predict longitudinal academic and social functioning during early adolescence. Using the NICHD SECCYD dataset (N = 932, 49% girls), four profiles emerged: relatively low SEL (14%), moderate-high SEL (51%), prosocial/self-control (22%), and cooperation/work habits (13%). Longitudinally, the prosocial/self-control group and cooperation/work habits group demonstrated area-specific weakness. The prosocial/self-control youth were at risk of poor academic competence; the high cooperation/work habit youth were at risk of poor social functioning whereas the relatively low SEL skills youth demonstrated highest risk in poor academic and social functioning in early adolescence. [ABSTRACT FROM AUTHOR]

Online cognitive behavioural therapy for insomnia (iCBT-I) provides scalable access to psychological interventions; however, the effectiveness of these courses during COVID-19 has not been examined. This study investigated the uptake and potential effectiveness of iCBT-I during the first 10 months of the pandemic in Australia (March- December 2020) and compared outcomes in the year prior. Two thousand six hundred and ninety-four adults commenced a four-lesson iCBT-I course (1,883 during the pandemic; 811 in the year before). Measures of insomnia and psychological distress were administered pre-, mid- and post-treatment. In the COVID-19 period, we observed a 140% increase in monthly course registrations compared to the year prior (with a peak increase of 257% from April-June 2020). Insomnia symptom severity was marginally lower for the during-COVID group compared to the pre-COVID group, although levels of psychological distress were similar. Before and during COVID-19, iCBT-I was associated with large effect size reductions in insomnia symptom severity (gs =.86–1.09) and small effect size improvements in psychological distress and wellbeing (gs = 0.34–0.41). iCBT-I uptake substantially increased during the pandemic; treatment outcomes were similar. The findings demonstrate the scalability and potential effectiveness of iCBT-I. Key Points What is already known about this topic: Insomnia is a significant public health issue. Internet delivered cognitive behaviour therapy (iCBT) is effective in reducing insomnia symptom severity. The COVID-19 pandemic has had a large impact on mental health with higher estimated rates of insomnia during the pandemic. What this topic adds: Uptake of an online insomnia course increased by >180% during COVID-19. The course was associated with large effect size reductions in insomnia symptoms. Results highlight the utility and scalability of digital mental health services. [ABSTRACT FROM AUTHOR]

The government of a country is responsible and accountable for the provision of quality healthcare services to its citizens. Teenage pregnancy and its complications occur worldwide. Hypertensive disorders in pregnancy (HDP) are considered the third leading cause of maternal mortality in South Africa. The current study investigated the implementation of the 2016 Department of Health Guidelines for Maternity Care in South Africa for HDP in teenagers. A retrospective quantitative research design was used. A sample of 173 maternity records of pregnant teenagers diagnosed with hypertension were systematically sampled from the period of January 2019 to December 2019 in six district hospitals and one community health centre in one district in KwaZulu-Natal (KZN), South Africa. The respondents were aged between 13 and 19 years. A pretested structured checklist was used to record the data. The Social Sciences Statistics Software IBM SPSS version 26.0 was used to analyse the data, and simple descriptive statistics to present the findings. The findings revealed that maternity care for pregnant teenagers with hypertension was not implemented according to the prescribed GMCSA. None of the pregnant teenagers received aspirin as prophylaxis against the development of hypertension; 82% were not assessed for oedema during the initial visit; and 90.17% were not assessed during antenatal care (ANC) periods. Mental state assessment was done on only 1.7% of the pregnant teenagers. The study found discrepancies in the implementation of the GMCSA for HDP, compromising maternity care among teenagers. Strategies for improving the quality of maternity care for pregnant teenagers are deemed necessary. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery. [ABSTRACT FROM AUTHOR]

Background. It has been estimated that approximately 14% of maternal death has resulted due to pregnancy-induced hypertension. Evidence also suggests that pregnancy-induced hypertension may result in adverse maternal and child outcomes. The aim of this study was to assess the determinants of pregnancy-induced hypertension among mothers attending antenatal and delivery services at public health hospitals in Wolaita zone, southern Ethiopia. Methods. An institutionally based unmatched case-control study was conducted at three public hospitals. A total of 283 study participants were recruited for this study. Cases were selected consecutively as they were being diagnosed for pregnancy-induced hypertension, and two controls were selected for each case. Data were collected via the face-to-face interview technique using a pretested questionnaire. Unconditional logistic regression analysis was used to identify the independent predictor variables and produced odds ratio (OR) as a measure of association. Results. The mean ± (SD) ages of cases and controls were 26.1 ± 5.4 and 26.1 ± 4.5 years, respectively. Being rural residents (AOR: 2.25, 95% CI: 1.09–4.65), illiterate (AOR: 3.12, 95% CI: 1.20–8.08), having the history of pregnancy-induced hypertension (AOR: 6.62, 95% CI: 2.48–17.71), history of kidney disease (AOR: 3.14, 95% CI: 1.05–9.38), and family history of hypertension (AOR: 5.59, 95% CI: 2.73–11.45) were determinants that increased the odds of suffering from hypertensive disorders of pregnancy. More importantly, eating vegetables and fruit reduces the odds of suffering from pregnancy-induced hypertension by 77% (AOR: 0.23, 95% CI: 0.06–0.79). Conclusion. Being rural residents, illiterate, having a history of pregnancy-induced hypertension, and history of kidney disease, as well as the family history of hypertension were identified determinates of hypertensive disorders of pregnancy in the study area. Furthermore, fruit and vegetable intakes were identified as protective factors for pregnancy-induced hypertension. Therefore, early diagnosis and intervention of this disorder are warranted to reduce adverse outcomes. [ABSTRACT FROM AUTHOR]

Background. Insomnia is one of the major health problems related with a decrease in quality of life (QOL) and also in poor functioning in night-shift nurses, that also may negatively affect patients' care. The aim of this study is to evaluate the prevalence of insomnia in night shift nurses. This observational online web-based survey using Google®® modules specifically aimed to investigate the prevalence and risk factors for insomnia among Italian nurses. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 March 2021 to 1 April 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison among insomnia categories was assessed by one-way ANOVA or Kruskal–Wallis test according to variable distribution. Categorical variables were analyzed using chi-square test. Results. A total of 2355 responses were included in the final analysis, with 917 from the Northern zone, 815 from the Western zone, and 623 from the Southern zone of Italy. The prevalence of insomnia in the overall population was 65.4% (1524 out 2355 nurses suffered from insomnia). Conclusions. Nursing is a high-pressure profession, with heavy duties and high professional risks. We found an important prevalence of insomnia in night shift nurses, and we hope it may help to solicit further studies aimed to identify the risk factors for this working disorder among nurses. [ABSTRACT FROM AUTHOR]

Background Although vaginal symptoms are common, diagnosis of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and Trichomonas vaginalis (TV) is not standardized. Diagnostic approaches and appropriateness of treatment were evaluated for women with symptoms of vaginitis who were seeking care at community practice sites. Methods Three hundred three symptomatic women, across 8 University of Pittsburgh Medical Center–affiliated clinics, were evaluated per standard office-based practice. Four of 5 vaginal swabs (1 cryopreserved) were collected for a US Food and Drug Administration–authorized nucleic acid amplification test (NAAT) for vaginitis/vaginosis diagnosis; Nugent scoring (BV); yeast culture (VVC); and a second NAAT (for TV). Two hundred ninety women had evaluable samples. Medical record extraction facilitated verification of treatments prescribed within 7 days of the index visit and return visit frequency within 90 days. Results Women had a mean age of 29.4 ± 6.5 years, 90% were not pregnant, 79% were of white race, and 38% reported vaginitis treatment within the past month. Point-of-care tests, including vaginal pH (15%), potassium hydroxide/whiff (21%), and wet mount microscopy (17%), were rarely performed. Of the 170 women having a laboratory-diagnosed cause of vaginitis, 81 (47%) received 1 or more inappropriate prescriptions. Of the 120 women without BV, TV, or VVC, 41 (34%) were prescribed antibiotics and/or antifungals. Among women without infectious vaginitis, return visits for vaginitis symptoms were more common among women treated empirically compared to those not receiving treatment (9/41 vs 5/79, P =.02). Conclusions Within a community practice setting, 42% of women having vaginitis symptoms received inappropriate treatment. Women without infections who received empiric treatment were more likely have recurrent visits within 90 days. Clinical Trials Registration NCT03151928. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore factors of health behaviour maintenance from the perspective of coronary heart disease (CHD) patients. Background: The majority of CHD patients do not achieve appropriate theory‐based intervention to maintain health behaviours. Previous health behaviour change theories give little importance to behaviour maintenance. Design: A qualitative descriptive study. Methods: Thirty CHD patients were recruited purposively and interviewed from four hospitals in Beijing, China, during January 2017–August 2019. Data were analysed using template analysis methods. The COREQ checklist was used. Results: Perceived enjoyment and perceived effectiveness from the newly adopted behaviours emerged as vital factors for maintaining health behaviour; contemplation‐action‐maintenance (CAM) model to explain the behaviour change and maintenance of CHD patients was constructed. Conclusions: The CAM model provides insight into the factors of health behaviour action and maintenance among CHD patients. Professionals can develop interventions from the perspective of patients' experiences to promote maintenance of behaviour. Relevance to clinical practice: Professionals need to consider that the goal of behavioural intervention should initially and continuously target patients' perseverance. Interventions of health behaviour that bring enjoyment may aid long‐term maintenance. Also, healthcare providers can enhance patients' perception of effectiveness to motivate their behaviour maintenance in lifestyle change programmes. [ABSTRACT FROM AUTHOR]

Purpose : This study aims to investigate the differences in fatigue, sleepiness, and near-miss according to sleep disturbance among shift nurses in intensive care units (ICUs). Methods : A cross-sectional study in a tertiary hospital was performed. A total of 122 shift nurses working in the six ICUs were recruited. They completed self-reported questionnaires about sleep disturbance, fatigue, sleepiness, and near-miss in the past two weeks. Results : The prevalence of reported sleep disturbance was 30.3% (37 out of 122 subjects). Compared to the non-sleep disturbance group, the sleep disturbance group reported significantly more sleepiness (11.46 vs. 8.86) and higher fatigue (82.62 vs. 69.39). The sleep disturbance group showed higher rates of near-miss (78.4 vs. 57.6%) and a higher frequency of them (4.49 vs. 2.11/2weeks) compared to the non-sleep disturbance group. Medication error was the most common type of near-miss. Conclusions : This study suggests that sleep disturbances could increase fatigue, sleepiness, and near-miss among ICU shift nurses. Personal and organizational programs should be developed to support the sleep of ICU nurses. [ABSTRACT FROM AUTHOR]

Aim: To investigate age group differences in objective working‐hour characteristics and their associations with short (1–3 days) sickness absence. Background: Irregular working hours, that is shift work with non‐standard schedule, may influence sickness absence rates in hospital workers. Methods: We collected daily working hours and the first incidence of short sickness absence from the employers' electronic records from 2008 to 2017. A case‐crossover study compared the characteristics of the working hours 28 days preceding the sickness absence (exposure window) and 28 days earlier (control window) across 10‐year age groups (conditional logistic regression for odds ratios (OR) with 95% confidence intervals (95% CI)). Results: Younger employees had longer working hours and more night and consecutive shifts. Extended weekly working hours were associated with short sickness absence in all age groups. Age‐related differences were few: extended working hours among oldest age group (OR: 1.01, 95% CI: 1.00–1.01) and daily working hours in the youngest and middle‐age groups (Ors: 1.14–1.17) were associated with increased sickness absence. Conclusions: Length of working hours, and night and consecutive shifts differed between age, but the associations with short sickness absence were similar across all age groups. Implications for Nursing Management: Among older employees, the length of working hours should be paid special attention. [ABSTRACT FROM AUTHOR]

Aim: We employed the job demands–resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety. Background: Employee mental health and patient safety represent important organisational goals in most hospitals. However, their relationships to insomnia, professional resources and job crafting, as related to the job demands–resources model among nurses, remain unclear. Methods: A convenience sample of 2095 registered hospital nurses was recruited from 25 provinces of mainland China from June 2019 to July 2019. Data were collected using self‐reported questionnaires that included the following instruments: the Chinese version of the Athens Insomnia Scale, the Practice Environment Scale of the Nursing Work Index, the Job Crafting Scale, the Emotional Exhaustion Scale, the Utrecht Work Engagement Scale, the General Health Questionnaire and the Safety Attitudes Questionnaire. Results: The final model confirmed our hypotheses: burnout mediated the relationship between actual job demands and mental health; work engagement mediated the relationship between perceived job resources and attitudes with regard to patient safety; and job crafting enhanced work engagement and practice environment. Conclusion: The job demands–resources model was extended based on the nurses' job characteristics and mental health, as well as patient safety. Implications for Nursing Management: These findings may contribute to nursing management strategies that encourage employees to prevent burnout, promote work engagement and job crafting, and in turn promote nurses' mental health and patient safety. [ABSTRACT FROM AUTHOR]

Aims: To examine the longitudinal effects of individual characteristics on the change pattern of insomnia and the association of occupational stress with insomnia over time in newly graduated nurses. Background: The association between individual factors and insomnia in nurses is inconclusive. Longitudinal research on insomnia in newly graduated nurses is limited. Methods: This prospective longitudinal study included 200 participants generating 800 observations of insomnia severity during their first year of nursing. We employed growth mixture modelling for data analyses. Both time‐varying covariate (occupational stress) and time‐invariant covariates (nurses' characteristics) were entered into the model simultaneously. Results: Nurses had a homogeneous insomnia trajectory during the whole year of survey. The educational level significantly predicted the growth rate of insomnia severity among nurses. Occupational stress at each time point was significantly associated with worse insomnia across time points (all p < .001). Conclusions: Nurses with a baccalaureate degree were more resilient to the development of severe insomnia. Additional studies have an opportunity to investigate the reason for the effects of the educational level on the pattern of insomnia. Implications for Nursing Management: Considering nurses' occupational stress and educational level would lead more effective management of stress and insomnia in newly graduated nurses. [ABSTRACT FROM AUTHOR]

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) youth are at increased risk for negative outcomes. Yet little is known about their engagement with communities and resources that may ameliorate risk, particularly online. Oriented by a uses and gratifications approach, this secondary analysis (n = 4,009) of LGBTQ+ youth (aged 14–29) compares online versus offline experiences. Respondents were significantly more likely to participate in LGBTQ+ communities online. Youth were also more active, and felt safer and more supported, when participating in online LGBTQ + communities. Additionally, respondents sought online information, support, and resources at higher rates than offline. Increased attention toward online programming and resource development is warranted. [ABSTRACT FROM AUTHOR]

Aim and objective: To explore the accuracy with which nursing students can identify the fundamentals of care. Background: A challenge facing nursing is ensuring the fundamentals of care are provided with compassion and in a timely manner. How students perceive the importance of the fundamentals of care may be influenced by the content and delivery of their nursing curriculum. As the fundamentals of care play a vital role in ensuring patient safety and quality care, it is important to examine how nursing students identify these care needs. Design: Cross‐sectional descriptive design. Methods: A total of 398 nursing students (pre‐ and postregistration) from universities in Sweden, England, Japan, Canada and Australia participated. The Fundamentals of Care Framework guided this study. A questionnaire containing three care scenarios was developed and validated. Study participants identified the fundamentals of care for each of the scenarios. All responses were rated and analysed using ANOVA. Results: The data illustrate certain fundamentals of care were identified more frequently, including communication and education; comfort and elimination, whilst respecting choice, privacy and dignity were less frequently identified. The ability to identify all the correct care needs was low overall across the pre‐ and postregistration nursing programmes in the five universities. Significant differences in the number of correctly identified care needs between some of the groups were identified. Conclusions: Nursing students are not correctly identifying all a patient's fundamental care needs when presented with different care scenarios. Students more frequently identifying physical care needs and less frequently psychosocial and relational needs. The findings suggest educators may need to emphasise and integrate all three dimensions. Relevance to clinical practice: To promote students' ability to identify the integrated nature of the fundamentals of care, practising clinicians and nurse educators need to role model and incorporate all the fundamental care needs for their patients. [ABSTRACT FROM AUTHOR]

This study explored whether implicit beliefs and 2 × 2 achievement goals were related to enjoyment in youth sport over 1 year and whether perceived changes in the coach–athlete relationship moderated these relationships. Indirect and conditional indirect effect analyses were conducted in a sample of 247 regular sport participants (Mage= 13.03 years). After adjusting for enjoyment at Time 1, incremental beliefs were indirectly related to Time 2 enjoyment via mastery-approach goals. However, this effect was evident only when the coach–athlete relationship was perceived to have deteriorated. Results highlight the protective value of adaptive implicit beliefs and achievement goals in youth sport. [ABSTRACT FROM PUBLISHER]

Background: Increasing transgender health care coverage has resulted in easier access to gender confirmation surgery. Patients considering surgery consistently access medical information online to improve knowledge regarding surgical options, complications, recovery, and life after transitioning. As a result, national health institutes recommend that patient educational materials be written at a sixth-grade–reading level. The purpose of this study is to assess the complexity of online gender confirmation surgery information. Methods: An Internet search was performed using the key phrase “transgender surgery”. Health care and non–health care websites were evaluated for pertinent articles regarding gender confirmation surgery. Readability analyses were conducted using Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook Index, and Automated Readability Index. A two-tailed z test was used to compare means; significance was set atp≤ 0.05. Results: A total of 108 articles from 87 websites were analyzed. The average readability for all online gender confirmation-surgery information was at an 11th-grade reading level. Materials written by health care entities were written at a 12th-grade–reading level compared to non–health care articles, which were written at a 10th-grade level (p< 0.001). Male-to-female surgery materials were written at a 12th-grade level, significantly higher than the 11th-grade reading level of female-to-male surgery materials (p= 0.04). Conclusion: Online information regarding gender confirmation surgery is written at a level that is too complex for patients to understand. Informational materials should be written at lower grade levels to improve patient education, informed consent, and outcomes. [ABSTRACT FROM PUBLISHER]

This study aimed to determine whether sleep management with self-help treatment is more effective in improving insomnia, compared to a waiting-list control. A total of 51 participants with insomnia, aged ≥60 years, were assigned to two groups: the treatment group or waiting-list control group. Intervention included sleep education, group work, moderately intense exercise, and self-help treatment using a sleep diary for 2 weeks. Participants completed the Insomnia Severity Index (ISI-J) and sleep diaries wearing an activity recorder pre- and post-treatment. The treatment group showed a significant improvement in the ISI-J with a fairly large effect size (Cohen's d: within = 0.78, between = 0.70), whereas the waiting-list control group did not. Sleep diary and activity recorder data showed small to moderate effect sizes in the treatment group. Thus, sleep management with self-help treatment was superior to a waiting-list control for insomnia severity in the targeted elderly population. [ABSTRACT FROM AUTHOR]

Little research has focused on the ethical issues around using social media for HIV prevention in low- and middle-income countries, such as Peru. This study surveyed participants from the HOPE social media HIV intervention in Peru to assess their experiences and perceptions of ethical issues in the study and the impact of age on their experiences and perceptions. This study found that, compared to younger participants, older participants were more likely to express higher levels of understanding of the consent form and trust that other participants were real. Older participants also reported being less likely to benefit from learning about their HIV status. Findings suggest that age plays a role in participants’ experiences in a social-media-based HIV intervention. [ABSTRACT FROM AUTHOR]

The G/A mutation in SLC2A4 promoter, rs5418, was investigated to assess the relationship between the SLC2A4 gene and aerobic endurance in the muscle uptake of glucose. Genotypic/allelic frequencies of rs5418 in SLC2A4 in 102 top-level long-distance runners (53 men and 49 women) were compared with those of 206 healthy controls (118 men and 88 women) from the same ethnic background (Han Chinese). The functional significance of rs5418 was analysed using the dual-luciferase reporter assay system. The A allele of SLC2A4 rs5418 was overrepresented in athletes (61.8%) compared with that in the controls (45.6%; P<0.05, power = 0.989), and the AA genotype in athletes (74.5%) was higher than that in the controls (66.0%; P<0.05, power = 0.999). The luciferase reporter vector containing the SLC2A4 promoter with rs5418-A alleles produced significantly greater relative luciferase activity (19.49±4.41) than that with rs5418-G alleles (13.04±4.45; P<0.05, power = 0.867). Our findings suggest that the AA genotype and A allele of SLC2A4 rs5418 were associated with top-level endurance performance in the northern Han Chinese population. The molecular mechanism was based on the functional mutation that changed the activity of the promoter, thereby affecting gene expression. [ABSTRACT FROM AUTHOR]

Worldwide automated Internet health interventions have the potential to greatly reduce health disparities. High attrition from automated Internet interventions is ubiquitous, and presents a challenge in the evaluation of their effectiveness. Our objective was to evaluate variables hypothesized to be related to attrition, by modeling predictors of attrition in a secondary data analysis of two cohorts of an international, dual language (English and Spanish) Internet smoking cessation intervention. The two cohorts were identical except for the approach to follow-up (FU): one cohort employed only fully automated FU (n= 16 430), while the other cohort also used ‘live’ contact conditional upon initial non-response (n= 1000). Attrition rates were 48.1 and 10.8% for the automated FU and live FU cohorts, respectively. Significant attrition predictors in the automated FU cohort included higher levels of nicotine dependency, lower education, lower quitting confidence and receiving more contact emails. Participants' younger age was the sole predictor of attrition in the live FU cohort. While research on large-scale deployment of Internet interventions is at an early stage, this study demonstrates that differences in attrition from trials on this scale are (i) systematic and predictable and (ii) can largely be eliminated by live FU efforts. In fully automated trials, targeting the predictors we identify may reduce attrition, a necessary precursor to effective behavioral Internet interventions that can be accessed globally. [ABSTRACT FROM AUTHOR]

Evidence suggests that gender differences appear in a variety of biological and psychological responses to stress and perhaps in coping with acute and chronic illness as well. Dysfunctional parenting is also thought to be involved in the process of coping with stress and illness; hence, the present study aimed to verify whether dysfunctional remembered parenting would influence psychological distress in a gender-specific manner in patients suffering from cancer. Patients attending an outpatient oncology clinic completed the Remembered Relationships with Parents (RRP), Hospital Anxiety and Depression and Spielberger's State-Trait Anxiety Inventory scales and the National Cancer Center Network Distress Thermometer. Although no baseline gender differences were detected, a multivariate analysis confirmed that anxiety and depression symptoms of men and women suffering from cancer are differentially affected by the RRP Control and Alienation scores. Women with remembered parental alienation and overprotection showed significantly more anxiety symptoms than men, whereas men were more vulnerable to remembered alienation than overprotection with regard to the Distress Thermometer scores. These results suggest that remembered dysfunctional parenting is crucially, and in a gender-specific manner, involved in the coping strategy adopted by male and female cancer patients. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: Clinician‐rated performance status (C‐PS) is used routinely to predict whether patients are fit enough to undergo treatment for lung cancer. However, a good proportion of those with seemingly good C‐PS do not go on to receive, let alone complete treatment. The value of C‐PS in accurately predicting this is unclear, as is the merit of evaluating patient‐rated PS (P‐PS). Objectives: Our aim was to prospectively assess Eastern Cooperative Oncology Group (ECOG) and Karnofsky C‐PS and P‐PS in patients attending a rapid access lung cancer service (RALCS), the agreement between these scores, and whether any score could predict receipt and completion of multidisciplinary team (MDT)‐planned treatment. Results: ECOG and Karnofsky scores were highly correlated (Spearman's rho −0.79 for C‐PS and −0.828 for P‐PS, both p < 0.001). There was poor agreement between C‐PS and P‐PS scores (kappa statistics 0.275 for ECOG and 0.172 for Karnofsky); however, clinicians did not tend to consistently under‐ or overestimate patients' scores. ECOG P‐PS showed an association with completion of MDT‐planned treatment (p = 0.007), but C‐PS did not. Conclusion: Clinician‐rated PS was not associated with completion of MDT‐planned treatment, but there may be a role for patient‐rated PS. C‐PS and P‐PS were poorly correlated in a RALCS. [ABSTRACT FROM AUTHOR]