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Context: There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Design: Prospective case-control. Methods: Seventy-seven adolescent female athletes aged 12–18 years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Results: Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1–13.8, P =.01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1–15.8, P =.03) compared with female athletes without history of SRC. Conclusions: Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk. [ABSTRACT FROM AUTHOR]

Individuals with intellectual disabilities often face unique challenges in physical capabilities, making traditional training methods less effective for their specific needs. This study aimed to investigate the effect of combining balance, plyometric, and strength (CBPS) training with sprint training on physical performance in male athletes with intellectual disabilities. Twenty-seven participants were randomly assigned to either a CBPS group or a control group that only maintained their regular sprint training. Participants underwent pre- and posttraining tests, including measures of balance, jumping, agility, and sprinting ability. The results showed that the CBPS group demonstrated significant improvements (p <.05) in one-leg stance, crossover-hop jump, squat jump, countermovement jump, and 10- and 30-m sprint at posttraining compared with pretraining. CBPS training combined with sprinting significantly improves physical performance in male athletes with intellectual disabilities, suggesting implications for tailored training programs to enhance their physical fitness and overall health. [ABSTRACT FROM AUTHOR]

Context: Mindfulness interventions (yoga, meditation) in traumatic brain injury populations show promising improvements in injury outcomes. However, most studies include all injury severities and use in-person, general programming lacking accessibility and specificity to the nuance of concussion. Therefore, this study investigated the feasibility and preliminary effectiveness of an online, concussion-focused meditation intervention among young adults with a concussion history. Design: Unblinded, single-arm, pilot intervention. Methods: Fifteen young adults aged 18 to 30 with a concussion history within the past 5 years completed 10 to 20 minutes per day of online, guided meditations for 6 weeks. Feasibility was assessed using the Feasibility of Intervention Measure. Concussion symptoms were measured using the Rivermead Post-Concussion Symptom Questionnaire, perceived stress the Perceived Stress Scale-10, and mindfulness the Five Facet Mindfulness Questionnaire. Descriptive statistics described the study sample and determined intervention adherence and feasibility. Paired sample t tests were used to examine preintervention/postintervention changes in concussion symptoms, perceived stress, and mindfulness, with descriptive statistics further detailing significant t tests. Results: Fifteen participants were enrolled, and 12 completed the intervention. The majority completed 5+ days per week of the meditations, and Feasibility of Intervention Measure (17.4 [1.8]) scores indicated high feasibility. Concussion symptom severity significantly decreased after completing the meditation intervention (11.3 [10.3]) compared with before the intervention (24.5 [17.2]; t[11] = 3.0, P =.01). The number of concussion symptoms reported as worse than before their concussion significantly decreased after completing the meditation intervention (2.7 [3.9]) compared with before the intervention (8.0 [5.7]; t[11] = 3.7, P =.004). Postintervention, 83.33% (n = 10) reported lower concussion symptom severity, and 75.00% (n = 9) reported less concussion symptoms as a mild, moderate, or severe problem (ie, worse than before injury). Conclusions: Findings suggest positive adherence and feasibility of the meditation intervention, with the majority reporting concussion symptom improvement postintervention. Future research is necessary to expand these pilot findings into a large trial investigating concussion-specific meditation programming. [ABSTRACT FROM AUTHOR]

Despite increasing interest in supporting older workers' motivation, retention, and well‐being at work, knowledge about how social networks at work may affect the efficacy of training interventions among older employees is scarce. These social ties are an important source of resources for older workers' careers. This study examined the characteristics of older workers' personal social networks as boundary conditions for the effects of late‐career management intervention on work engagement. Data were used from an earlier randomized controlled trial (RCT) in which senior employees (mean age of 58 years) participated in a peer group‐based training intervention and were asked to complete follow‐up surveys at baseline, post‐intervention, and after 6 months (Vuori et al., 2019, Journal of Vocational Behavior, 115: 103327). The results showed that older workers' social ties at higher organizational levels (upper reachability) and the number of social ties at work moderated the effect of the intervention on work engagement. Specifically, the intervention aimed at enhancing employees' personal resources improved work engagement for senior employees with few or no social ties at work with whom they could discuss important matters, and for those with social ties at higher organizational levels. However, the relationship quality between older workers and their leaders showed no moderation effect. This study encourages human resources professionals to consider the social network characteristics and peer learning of older workers when providing training to enhance their work engagement. [ABSTRACT FROM AUTHOR]

We integrate the job characteristics and dual work passion models to explore the indirect (via work meaningfulness) effects of job characteristics (i.e., job autonomy, task identity, skill variety, task significance, feedback from the job and feedback from others) on two types of work passion, harmonious passion (HP) and obsessive passion (OP). We first advance occupation‐specific predictions for job characteristics‐to‐work passion relationships and then explore differences in those relationships between HP and OP across four occupational sectors: knowledge work (n = 201), blue‐collar work (n = 148), nonprofit work (n = 141), and managerial work (n = 133). Our findings demonstrate that job characteristics are important drivers of work passion. However, our key discovery is that the motivational impact of the job characteristics is not universally applicable but rather depends on the specific occupational context and whether passion is harmonious or obsessive. We therefore conclude that when it comes to translating job characteristics into work passion, the one‐size‐fits‐all approach is not appropriate. [ABSTRACT FROM AUTHOR]

Purpose: Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. Method: Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. Results: BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (−0.036; 95% confidence interval, −0.070 to −0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. Conclusions: BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI. [ABSTRACT FROM AUTHOR]

To investigate how frailty modifies the association of sitting time with all-cause and cardiovascular mortality in Chilean adults. This prospective study included 2,604 participants aged ≥35 from the Chilean National Health Survey 2009–2010. Sitting time was self-reported, while frailty was assessed using a 36-item Frailty Index. Sitting time was categorized as low, medium, and high. Cox proportional hazard models were used to estimate the risk of mortality stratified for the sitting time categories. Over a median follow-up of 8.9 years, 311 participants died, 28% of them due to cardiovascular events. Frail people with prolonged sitting time were at higher risk of all-cause and cardiovascular mortality (hazard ratio 3.13; 95% confidence interval [2.06, 4.71] and hazard ratio 2.41; 95% confidence interval [1.50, 3.64], respectively). The observed risk was higher in women than men. Public health and individual strategies should be implemented to decrease sitting time across the population, with special attention on frail people. [ABSTRACT FROM AUTHOR]

We tested if a dance trial yielded improvements in physical function and cardiorespiratory fitness (CRF) in middle-aged/older Latino adults. Physical activity was assessed using the Community Healthy Activities Model Program for Seniors, physical function with the Short Physical Performance Battery (SPPB) protocol, and estimated CRF with the Jurca nonexercise test model. Multivariate analysis of covariance models found significant change in SPPB protocol total scores, F(1, 329) = 4.23, p =.041, and CRF, F(1, 329) = 5.16, p =.024, between the two study arms in favor of the dance group. Mediation models found moderate- to vigorous-intensity physical activity to mediate to mediate between group and SPPB scores (β = 0.054, 95% confidence interval [0.0142, 0.1247]). Moderate- to vigorous-intensity physical activity and total physical activity were found to partially mediate between group and CRF (β = 0.02, 95% confidence interval [−0.0261, 0.0751]), with the direct pathway no longer being significant (p >.05). This provides support for Latin dance programs to have an effect on SPPB protocol and CRF. [ABSTRACT FROM AUTHOR]

Context: Blood flow restriction (BFR) is a rehabilitation tool which may introduce a constraint, similar to muscle fatigue, that challenge patients' sensorimotor system during balance exercises. The purpose of our study was to examine whether adding BFR to dynamic balance exercises produced a decrease in balance performance and an increase in ratings of perceived exertion and instability in individuals with chronic ankle instability (CAI) compared with dynamic balance exercises without BFR. Designs: Crossover design. Methods: Our sample included N = 25 young adults with a history of CAI. Participants completed 2 laboratory visits. At each visit, participants completed 4 sets (30×-15×-15×-15×) of dynamic balance exercises, performed similar to the modified star excursion balance test (SEBT), once with BFR and once with control (no BFR) conditions. We measured composite SEBT scores at baseline and during the final repetitions of each set of balance exercise (sets 1–4). We also measured ratings of perceived exertion and instability following each balance exercise set. Results: We observed no difference in composite SEBT scores between conditions at baseline; however, composite SEBT scores were significantly lower during all balance exercises sets 1 to 4 with the BFR condition compared with control. During the BFR condition, composite SEBT scores were significantly lower during all balance exercise sets compared with baseline. During the control condition, composite SEBT scores did not significantly change between baseline and each balance exercise set. Ratings of perceived exertion and instability scores were significantly greater in the BFR group compared with the control group during all balance exercise sets. Conclusions: Individuals with CAI demonstrated lower composite SEBT scores and greater perceived instability and exertion during dynamic balance exercise with BFR compared to without BFR. BFR introduced a novel muscle fatigue constraint during dynamic balance exercises in individuals with CAI. Additional research is needed to determine if adding BFR to balance training could improve clinical outcomes in CAI patients. [ABSTRACT FROM AUTHOR]

Context: Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. Design: Cross-sectional study. Methods: The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. Results: Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC >.78 for the pectoralis musculature) and excellent (ICC >.94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, −22.8 to 252.5 kPa for the dominant arm [P =.039]). Mean pectoralis major and minor stiffness differences were not significant (P >.214). Conclusions: Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected. [ABSTRACT FROM AUTHOR]

Background: Weakness of the shoulder girdle muscles has been reported in patients with chronic lateral elbow tendinopathy. The aim of this study was to assess the short- and long-term effects of a conventional treatment plus scapular exercises program in patients with chronic lateral elbow tendinopathy. Methods: A single-group prestudy and poststudy were conducted. The primary outcome was the Patient-Rated Tennis Elbow Evaluation questionnaire score. Secondary outcomes were grip strength; Disabilities of the Arm, Shoulder, and Hand questionnaire score; Visual Analogue Scale score at rest and at grip, and presence of scapular dyskinesis. Results: A total of 65 patients (72.3% females), with a mean age of 41.8 years, were analyzed. At the end of 6 weeks, the results showed clinically and statistically significant differences (P< .05). At 1-year follow-up, the differences were: Patient-Rated Tennis Elbow Evaluation -31 points (P<.001); grip strength +33.6% (P<.001); Disabilities of the Arm, Shoulder, and Hand -34.2 points (P < .001); Visual Analogue Scale at rest -2.5 cm (P < .001); and Visual Analogue Scale at grip -2.3 cm (P < .001). Conclusion: At the end of 6 weeks and at 1-year follow-up, conventional treatment plus scapular exercises program showed statistically and clinically significant differences in all functional outcomes assessed in patients with lateral elbow tendinopathy. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate the extent to which motivational regulations influence physical activity behavior through role identity among people 55 years or older. Participants (N = 409; Mage = 66.29 years [SD = 7.06]) completed online questionnaires to measure motivational regulations, role identity, and the frequency of physical activity in a typical week and in the past month. Mediation analysis using ordinary least squares path analysis revealed that autonomous forms of motivational regulation (positively) and controlled forms of motivational regulation (negatively) influenced role identity, which then positively influenced physical activity behavior. Bootstrap confidence intervals (95%) for the indirect effects (a × b) based on 5,000 bootstrap samples were entirely above or below zero. These findings point to future experimental evaluations of interventions aiming at both increasing and decreasing autonomous and controlled motivational regulations, respectively, to promote physical activity behavior through role identity. [ABSTRACT FROM AUTHOR]

The present study assessed the impact of a fixed prosthetic rehabilitation on masticatory function in patients diagnosed with stage IV periodontitis. Eligible participants were adults in need of complex rehabilitation due to masticatory dysfunction. Masticatory function was evaluated using the two‐ colored chewing gum mixing ability test (VOH) at the diagnostic phase (T0), 1 week after delivery of the prosthetic prototype (T1), and 1 week after delivery of the final prosthetic solution (T2). Ten subjects were treated with a fixed prosthesis following periodontal and implant surgery using an individualized, fully digital workflow. Full-mouth plaque and bleeding scores, pocket depth, and clinical attachment level improved significantly. VOH was 0.472 ± 0.168 at T0, 0.358 ± 0.166 at T1, and 0.250 ± 0.123 at T2. A significant improvement in VOH was observed from T0 to T1 (difference: –0.114; 95% CI: –0.199 to –0.029; P = .014) and from T1 to T2 (difference: –0.108; 95% CI: –0.200 to –0.015; P = .027). From T0 to T2, VOH increased by 44.3%. Self-perceived assessment of masticatory function also improved from T0 to T2 (P = .002). The fixed prosthetic rehabilitation in patients with stage IV periodontitis allowed for a significant improvement in objective and subjective measurements of masticatory function. [ABSTRACT FROM AUTHOR]

This study aimed to examine the relationship between Walk Score index with walking to commuting, moderate-to-vigorous physical activity, and screen time in older adults. Georeferenced addresses were entered into the Walk Score platform. Walking to commute and moderate-to-vigorous physical activity were assessed using the International Physical Activity Questionnaire and categorized according to the World Health Organization recommendations. Screen time was analyzed through self-reported time watching television/being on the computer. We used binary logistic regression to estimate the association between variables. Older adults who lived in places with higher Walk Score had a higher prevalence of walking to commuting (odds ratio = 1.73; 95% confidence interval [1.18, 2.55]) and engaging in moderate-to-vigorous physical activity (odds ratio = 1.76; 95% confidence interval [1.05, 2.98]). A relationship also was observed between higher Walk Score and more time in screen time (odds ratio = 1.67; 95% confidence interval [1.19, 2.34]). The results showed that residing in a more walkable neighborhood increased the chances of the older adults spending 3 hr or more in front of a screen. [ABSTRACT FROM AUTHOR]

Purpose: Few data are available on sleep characteristics of elite track-and-field athletes. Our study aimed to assess (1) differences in sleep between sexes and among different track-and-field disciplines, (2) the effect of individualized sleep-hygiene strategies on athletes' sleep parameters, and (3) daytime nap characteristics in track-and-field athletes. Methods: Sleep characteristics of 16 elite Olympic-level track-and-field athletes (male: n = 8; female: n = 8) were assessed during the preseason period, at baseline (T0), and during the in-season period, after the adoption of individualized sleep-hygiene strategies (T1). Sleep parameters were objectively monitored by actigraphy for a minimum of 10 days, for each athlete, at both T0 and T1. A total of 702 nights were analyzed (T0 = 425; T1 = 277). Results: Female athletes displayed better sleep efficiency (88.69 [87.69–89.68] vs 91.72 [90.99–92.45]; P =.003, effect size [ES]: 0.44), lower sleep latency (18.99 [15.97–22.00] vs 6.99 [5.65–8.32]; P <.001, ES: 0.65), higher total sleep time (07:03 [06:56–07:11] vs 07:18 [07:10–07:26]; P =.030, ES: 0.26), earlier bedtime (00:24 [00:16–00:32] vs 00:13 [00:04–00:22]; P =.027, ES: 0.18), and lower nap frequency (P <.001) than male athletes. Long-distance runners had earlier bedtime (00:10 [00:03–00:38] vs 00:36 [00:26–00:46]; P <.001, ES: 0.41) and wake-up time (07:41 [07:36–07:46] vs 08:18 [08:07–08:30]; P <.001, ES: 0.61), higher nap frequency, but lower sleep efficiency (88.79 [87.80–89.77] vs 91.67 [90.95–92.38]; P =.013, ES: 0.44), and longer sleep latency (18.89 [15.94–21.84] vs 6.69 [5.33–8.06]; P <.001, ES: 0.67) than athletes of short-term disciplines. Furthermore, sleep-hygiene strategies had a positive impact on athletes' total sleep time (429.2 [423.5–434.8] vs 451.4 [444.2–458.6]; P <.001, ES: 0.37) and sleep latency (14.33 [12.34–16.32] vs 10.67 [8.66–12.68]; P =.017, ES: 0.19). Conclusions: Sleep quality and quantity were suboptimal at baseline in Olympic-level track-and-field athletes. Large differences were observed in sleep characteristics between sexes and among different track-and-field disciplines. Given the positive effect of individualized sleep-hygiene strategies on athlete's sleep, coaches should implement sleep education sessions in the daily routine of top-level athletes. [ABSTRACT FROM AUTHOR]

Context: An easy-to-administer, function-based questionnaire to assess patients with various foot problems was required for a Greek-speaking population. This study aimed to translate and cross-culturally adapt the Quick Foot and Ankle Ability Measure (Quick-FAAM) into Greek and evaluate its reliability and validity. Design: Cross-sectional study. Methods: Established international guidelines for the cross-cultural adaptation of questionnaires were followed. The face and content validity of the Greek version of the Quick-FAAM (Quick-FAAM-GR), as well as the internal consistency and test-retest reliability upon repeated administration after 5 days, were examined. In addition, the construct validity of the scale was examined via exploratory factor analysis as well as by testing for associations with the Manchester Foot Pain and Disability Index, the 12-item Short-Form Survey (version 2), and a functional balance assessment test--the Y-Balance Test. Results: Sixty participants (18 women) with self-reported chronic ankle instability symptoms, with a median (interquartile range) age of 27 (7.7) years, participated in the study. Half of the participants were included in the test-retest reliability study. The Quick-FAAM-GR demonstrated face and content validity. Excellent internal consistency (Cronbach a =.961) and intrarater test-retest reliability (intraclass correlation coefficient ICC[2,1] = .93) were demonstrated, with a comparable error margin to the original version (standard error of the measurement = 2.1, 95% minimum detectable change = 5.9). Associations of the Quick-FAAM-GR scores to other questionnaires ranged from weak to strong (Spearman rho), all being statistically significant (Manchester Foot Pain and Disability Index from -.26, P = .04, to -.67, P< .001, and 12-item Short-Form Survey, version 2, between .41 and .72, P<.001), and to the Y-Balance Test between lower-limb differences (-.35 to -.58, P< .001). The exploratory factor analysis confirmed the single- factor structure of this scale. No floor/ceiling effects were observed. Conclusions: The Greek Quick-FAAM has proven to be a valid and reliable tool for evaluating chronic ankle instability and can be used for clinical and research purposes in Greek- speaking individuals. [ABSTRACT FROM AUTHOR]

Integrating the theory of workplace deviance with person–environment fit theory, we propose a two‐pathway model to explain why and how employees who feel overqualified engage in time theft behavior. Specifically, we anticipate that feeling overqualified will negatively influence focal employees' experienced authority fairness and erode their work meaningfulness, which in turn will lead to increased time theft behavior. Further, we argue that voice endorsement serves as a key boundary condition mitigating the negative effects of perceived overqualification. We conducted two multi‐waved and multi‐sourced field studies to test our proposed hypotheses. Study 1 (247 employees and 47 supervisors) revealed that perceived overqualification is associated with time theft behavior through the mediators of experienced authority fairness and meaningfulness. Study 2 (405 employees and 73 supervisors) replicated the findings of Study 1 and tested our full model. We discuss the theoretical and practical implications of our findings. [ABSTRACT FROM AUTHOR]

After decades, dialogues on human resource management (HRM), intellectual capital (IC), and ambidexterity still continue, mirroring that the role of ambidextrous capability in translating the impact of HRM into superior performance remains unclarified. At this juncture, the current study proposes a novel theoretical framework to extend research on the relationship between IC‐enhancing HR practices and innovation. It is done sophisticatedly by examining how firm exploitative and exploratory capabilities mediate the relationship between different combinations of HR configurations and firm innovation. To this end, we designed rigorous time‐lagged research with three waves of data collection from the Iranian healthcare sector. Our analyses revealed that firm explorative and exploitative capabilities significantly mediate the relationship between human, social, and organizational capital‐enhancing HR configurations and firm innovation. More conspicuously, by unraveling interaction patterns among distinct HR configurations, our study revealed the intricacies of the functioning of IC‐enhancing HR practices in fueling firm ambidexterity. Hence, our study offers design options to navigate through exploitation and exploration in light of the firm's core innovation strategy. We discuss the theoretical and practical implications of our findings and suggest future research avenues. [ABSTRACT FROM AUTHOR]

Contributing to the literature on positive effects of overqualification, this research examines when and why perceived overqualification predicts affiliative and proactive performance at work. Integrating optimal distinctiveness theory with self‐construal theory, we propose that depending on the nature of an employee's self‐construal (i.e., independent, or interdependent), perceived overqualification will be associated with two opposing motivational processes—namely, differentiation and assimilation. We expect perceived overqualification to have a positive relationship with a motive for assimilation when an employee has a strong interdependent self‐construal. Conversely, we expect perceived overqualification to have a positive relationship with a motive for differentiation when an employee has a strong independent self‐construal. We further argue that assimilation‐seeking and differentiation‐seeking motives will be positively related to affiliative and proactive performance, respectively. We conducted two multi‐waved and multisourced studies to test our hypotheses. In a pilot study (N = 249), we first tested our moderation hypothesis. In our main study (N = 496), we tested our overall moderated mediation model. Results from both studies reveal that perceived overqualification can trigger a need for differentiation or assimilation in employees depending on the nature of their self‐construal. The differentiation‐seeking motive was positively related to proactive performance, while the assimilation‐seeking motive was positively related to affiliative performance. Our findings advance overqualification and motivation literatures and provide insights into talent acquisition and management. [ABSTRACT FROM AUTHOR]

Children and adolescents with cerebral palsy (CP) show a reduced physical activity (PA) level compared with their typically developed peers. This study aimed to identify potential predictors of objectively evaluated habitual PA using data from a national clinical registry—the Cerebral Palsy Follow-Up Program (CPFP)—and proxy-reported questionnaires. Data from the CPFP database showed that female sex was associated with a lower PA level. Additional questionnaire data revealed age, popliteal angle limitation, Pediatric Outcomes Data Collection Instrument–Sports and Physical Functioning Scale score, screen time, Functional Mobility Scale score at 50 m, and fatigue as predictors. The proposed models can be used for the prediction and early detection of the PA level and consequently for the potential improvement among ambulant/semiambulant individuals with CP. Further research should investigate the predictive impact of personal, social, and environmental factors on the PA level and the gap in PA levels between girls and boys. [ABSTRACT FROM AUTHOR]

Our study aimed to demonstrate the association between physical activity (PA) and frailty incidence among Japanese community-dwelling older adults with a narrow age range of 70–74 years. This study included 485 participants from the Japan Gerontological Evaluation Study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International PA Questionnaire at baseline. Logistic regression was performed to calculate the odds ratio with 95% confidence intervals after adjusting for potential confounders. The associations of frailty scores with both PA volume and daily walking time presented a U-shaped curve, albeit only the latter was statistically significant. After adjusting for potential confounders, walking for 0.5–1 hr/day displayed a greater association with decreased frailty risk than higher levels of daily walking time. Further study is needed to cumulate the evidence that moderate PA levels may delay frailty incidence and improve the aging process. [ABSTRACT FROM AUTHOR]

Context: The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed to evaluate the key elements that runners use to self-assess their own running ability following common running-related injuries. The aim of this study was to translate and culturally adapt the UWRI and to evaluate the psychometric properties of its Turkish version (UWRI-Tr) in runners. Design: Prospective cohort study. Methods: The study included 129 runners. The UWRI-Tr, the Lower Extremity Functional Scale, the Oswestry Disability Index, the Hip Outcome Score, the International Knee Documentation Committee Subjective Knee Evaluation Form, and the Foot and Ankle Ability Measure were applied for the validation purposes. Internal consistency, reliability, construct validity, and discriminant validity of the UWRI-Tr were tested. Results: The test–retest reliability of the UWRI-Tr was excellent with an intraclass correlation coefficient of.85 and a Cronbach α value of.84. There was a small to strong correlation among the UWRI-Tr and Lower Extremity Functional Scale (r =.278), Oswestry Disability Index (r = −.744), Hip Outcome Score (r =.684), The International Knee Documentation Committee Subjective Knee Evaluation Form (r =.758), and Foot and Ankle Ability Measure (r =.498 and.767), indicating that its construct validity was appropriate for use with Turkish runners. Conclusions: The UWRI-Tr was shown to be a valid and reliable tool to use in clinical and research settings as a sport-specific measurement tool. [ABSTRACT FROM AUTHOR]

Context: The international sports community is becoming more proactive in clinical mental health practice and research. An athlete-specific psychological distress screening tool can identify potential mental health illness. Design: The Athlete Psychological Strain Questionnaire (APSQ) is a simple screening tool for detecting early signs of athlete-specific strain and related mental health concerns. Methods: We evaluated the internal consistency and reliability of the translated and culturally adjusted Arabic version of the APSQ (APSQ-Ar) with Arabic-speaking elite athletes. The final translation underwent standard forward and backward translation, an inspection by a team of experts, and then preliminary testing. The APSQ-Ar was cross-culturally validated and then assessed for internal consistency and reliability among (n = 98) Arabic-speaking athletes. Results: There were no problems with the patients' understanding or interpretation of the items on the APSQ-Ar translation. The intraclass correlation value was.93 (95% confidence interval,.89–.95), and the mean difference was 2.4 with a minimal detectable change of 5.12, demonstrating strong test–retest reliability. Moreover, Cronbach alpha showed excellent internal consistency (.76). Conclusions: The APSQ-Ar was demonstrated to be good, reliable, and internally consistent. With APSQ-Ar, sports medicine professionals in Arabic-speaking countries will be able to identify psychological distress and symptoms in athletes and, as a result, provide them with mental health support. [ABSTRACT FROM AUTHOR]

Context: Contralateral training in the early stages after surgery can improve the balance of the reconstructed knee, which is impaired following anterior cruciate ligament reconstruction (ACLR). However, little is known about the neuromuscular cross exercise after ACLR. Objective: To investigate the effects of an 8-week cross exercise on balance and function of the reconstructed knee following ACLR. Design: A single-blind randomized clinical trial. Participants: Thirty athletic males who underwent ACLR were randomly divided into intervention (n = 15) and control groups (n = 15). Intervention: The intervention and control groups received a routine physiotherapy program. In addition, the intervention group performed neuromuscular exercises on the nonoperated limb. Outcome Measures: Before and 9 weeks after ACLR, dynamic and static balance, function, and pain in the reconstructed knee were measured by Star Excursion Balance Test (SEBT), stork balance stand test, balance error scoring system (BESS), Lysholm questionnaire, and visual analog scale. Data were analyzed by SPSS using 2-independent sample t test, paired t test, and analysis of covariance. Results: Between-group comparison showed that, contralateral knee neuromuscular exercises significantly increased in the reaching distance in SEBT in the anterior (P <.001), posterior (P <.001), posteromedial (P =.010), and posterolateral directions (P =.007), decreased the number of errors in 4 stance positions of BESS including single stance on the firm (P ≤.001) and foam surface (P ≤.001), and tandem stance on the firm (P =.028) and foam surface (P ≤.001). It also increased the time of standing of the stork stand test (P =.044) and decreased the pain intensity (P =.014). Conclusion: Neuromuscular exercise of the nonsurgical knee could improve the dynamic and static balance, and pain in the early stages following ACLR in the surgical leg. These findings may be potentially valuable for current rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Context: Pulsed current and kilohertz frequency alternating current are 2 types of neuromuscular electrical stimulation (NMES) currents often used by clinicians during rehabilitation. However, the low methodological quality and the different NMES parameters and protocols used in several studies might explain their inconclusive results in terms of their effects in the evoked torque and the discomfort level. In addition, the neuromuscular efficiency (ie, the NMES current type that evokes the highest torque with the lowest current intensity) has not been established yet. Therefore, our objective was to compare the evoked torque, current intensity, neuromuscular efficiency (evoked torque/current intensity ratio), and discomfort between pulsed current and kilohertz frequency alternating current in healthy people. Design: A double-blind, randomized crossover trial. Methods: Thirty healthy men (23.2 [4.5] y) participated in the study. Each participant was randomized to 4 current settings: 2 kilohertz frequency alternating currents with 2.5 kHz of carrier frequency and similar pulse duration (0.4 ms) and burst frequency (100 Hz) but with different burst duty cycles (20% and 50%) and burst durations (2 and 5 ms); and 2 pulsed currents with similar pulse frequency (100 Hz) and different pulse duration (2 and 0.4 ms). The evoked torque, current intensity at the maximal tolerated intensity, neuromuscular efficiency, and discomfort level were evaluated. Results: Both pulsed currents generated higher evoked torque than the kilohertz frequency alternating currents, despite the similar between-currents discomfort levels. The 2 ms pulsed current showed lower current intensity and higher neuromuscular efficiency compared with both alternated currents and with the 0.4 ms pulsed current. Conclusions: The higher evoked torque, higher neuromuscular efficiency, and similar discomfort of the 2 ms pulsed current compared with 2.5-kHz frequency alternating current suggests this current as the best choice for clinicians to use in NMES-based protocols. [ABSTRACT FROM AUTHOR]

Acute ketone monoester (KE) supplementation can alter exercise responses, but the performance effect is unclear. The limited and equivocal data to date are likely related to factors including the KE dose, test conditions, and caliber of athletes studied. We tested the hypothesis that mean power output during a 20-min cycling time trial (TT) would be different after KE ingestion compared to a placebo (PL). A sample size of 22 was estimated to provide 80% power to detect an effect size dz of 0.63 at an alpha level of.05 with a two-tailed paired t test. This determination considered 2.0% as the minimal important difference in performance. Twenty-three trained cyclists (N = 23; peak oxygen uptake: 65 ± 12 ml·kg−1 min−1; M ± SD), who were regularly cycling >5 hr/week, completed a familiarization trial followed by two experimental trials. Participants self-selected and replicated their diet and exercise for ∼24 hr before each trial. Participants ingested either 0.35 g/kg body mass of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate KE or a flavor-matched PL 30 min before exercise in a randomized, triple-blind, crossover manner. Exercise involved a 15-min warm-up followed by the 20-min TT on a cycle ergometer. The only feedback provided was time elapsed. Preexercise venous [β-hydroxybutyrate] was higher after KE versus PL (2.0 ± 0.6 vs. 0.2 ± 0.1 mM, p <.0001). Mean TT power output was 2.4% (0.6% to 4.1%; mean [95% confidence interval]) lower after KE versus PL (255 ± 54 vs. 261 ± 54 W, p <.01; dz = 0.60). The mechanistic basis for the impaired TT performance after KE ingestion under the present study conditions remains to be determined. [ABSTRACT FROM AUTHOR]

Background: High turnover rates and burnout are prevalent issues among registered nurses in public hospitals in Hong Kong. Pay level satisfaction is one of the crucial factors influencing organisational and professional turnover intention. Understanding whether pay level satisfaction can mitigate the negative impact of burnout on turnover intention can provide insights into the role of financial rewards in employee retention. Objective: This study aims to evaluate the relationship between job demands and turnover intention among registered nurses in Hong Kong public hospitals. Additionally, it seeks to examine the mediating role of burnout and explore the potential moderating effect of pay level satisfaction on the relationship between burnout and turnover intention. Methods: The study was a cross‐sectional online survey of public hospital staff in Hong Kong. A total of 502 registered nurses who had worked at their employing facility for at least 6 months participated in this cross‐sectional survey. Study variables included work overload, job stress, work–family conflict, family–work conflict, conflict with other nurses, burnout, pay level satisfaction and turnover intention. The collected data were analysed using bivariate Pearson correlation analysis and mediated moderation analysis with the PROCESS macro in SPSS 28.0. Results: Burnout mediated the relationship between job demands, including work overload, job stress, work–family conflict, family–work conflict and conflicts with nurses, and organisational and professional turnover intention. Pay level satisfaction did not exert a moderating influence on the relationship between job demands and turnover intention through burnout mediating this relationship. Conclusions: The importance of addressing job stress and burnout to mitigate turnover intention and promote nurse retention is underscored. Contrary to expectations, pay level satisfaction did not buffer the negative impact of job demands on turnover intentions via burnout. This suggests that compensation alone may not be sufficient to offset the detrimental effects of high job demands and burnout on nurses' intention to leave their jobs or the profession. Further research is warranted to explore potential moderators that may influence the relationship between job demands and turnover intention. [ABSTRACT FROM AUTHOR]

COVID‐19 brought many difficulties for medical workers' mental health. They tend to exhibit a high turnover rate, which has deteriorated the situation of high demands on the healthcare workforce. Thus, enhancing medical interns' resilience is of great significance. Previous studies have delved into how job crafting relates to resilience, but there has been limited exploration of how the three dimensions of job crafting interplay with resilience. Thus, our research examined the moderating role of social media use intensity in associations between task crafting, cognitive crafting, relational crafting, and resilience. A total of 605 medical interns were obtained. The results revealed that task crafting, cognitive crafting, and relational crafting exhibited significant and positive associations with resilience. More importantly, social media use intensity moderated associations between task crafting, cognitive crafting, and resilience, with these associations being weaker for individuals with high levels of social media use intensity. However, the moderating role of social media use intensity was not significant between relational crafting and resilience. Finally, the findings provided some guidance for instructors to enhance medical interns' resilience and thus prepare them for employment. [ABSTRACT FROM AUTHOR]

Background: Students' attitudes towards digital technologies affect their use of innovations in digital education. In the study, it was aimed to determine undergraduate health sciences students' views about the Metaverse and digital technology. Methods: This study was a cross-sectional descriptive study. In the study sample, 289 health sciences students who voluntarily agreed to participate in the research and filled out the online data collection form were included. The Independent Samples T-Test, Multivariate ANOVA analysis of variance (MANOVA) and Pearson correlation analysis were used. P-values less than 0.05 were considered statistically significant. Results: The mean score the participants obtained from the Metaverse Scale was 53.54 ± 9.00, indicating that their levels of knowledge and awareness about the Metaverse were high. The mean score they obtained from the Attitude Scale for Digital Technology was 135.98 ± 21.28, which indicated that displayed positive attitudes towards digital technology. There was no significant difference between the mean scores the participants obtained from the Attitude Scale for Digital Technology and the Metaverse Scale according to their departments and years in school. There was a positive and weak relationship between the Metaverse Scale scores and Attitude Scale for Digital Technology scores. Conclusions: The participants' knowledge and awareness levels about the Metaverse were high and they displayed positive attitudes towards digital technology. It is recommended that digital technologies should be used in planning undergraduate education and Metaverse platforms or applications in virtual classroom settings. [ABSTRACT FROM AUTHOR]

Purpose: The aims were to translate the Evaluation of Daily Activity Questionnaire (EDAQ) into Turkish, then test validity and reliability in people with rheumatoid arthritis (RA) in Turkey. Material and Methods: Phase 1: The EDAQ was forward and backward translated, culturally adapted following cognitive debriefing interviews with participants with RA (n = 10) and finalized by an expert committee. Phase 2: Participants (n = 215) completed a questionnaire including the EDAQ, Health Assessment Questionnaire (HAQ), and Short-Form 36 v1 (SF-36v1). Two weeks later, the EDAQ was again completed for test–retest reliability (n = 82:38%). Internal construct validity was assessed using Rasch analysis. Internal consistency, concurrent validity, and test–retest reliability were assessed. Results: Following cultural adaptation, one item was removed, and examples increased or changed. Cronbach's α values were 0.71 − 0.93 for all EDAQ domains, that is, acceptable to good. The EDAQ met Rasch model requirements for fit (excellent construct validity: p > 0.05). Concurrent validity was moderate to strong for most EDAQ domains with HAQ (rs 0.49–0.81) and SF-36-v1 Physical Function (rs 0.42–0.70). There was excellent test–retest reliability for all domains (ICC (2,1): 0.95–1.00). Conclusion: The Turkish EDAQ is a valid, reliable measure of daily activity ability for use in practice and research with Turkish speakers with RA. IMPLICATIONS FOR REHABILITATION: The Evaluation of Daily Activity Questionnaire provides a comprehensive evaluation of daily activity ability for people with rheumatic and musculoskeletal diseases. The Turkish Evaluation of Daily Activity Questionnaire is a valid, reliable patient-reported outcome measure in patients with rheumatoid arthritis, who considered it easy to complete. The Turkish Evaluation of Daily Activity Questionnaire is suitable for use in clinical practice and research to evaluate daily activity ability in people with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Purpose: To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. Materials and methods: Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. Results: Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups. Conclusions: MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitation: The year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs. Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands. Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD. Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the relationship between physical activity (PA) levels and short-term changes in skeletal muscle characteristics in patients with subacute hemiparetic stroke. Materials and Methods: This prospective observational study included 76 patients with stroke who received inpatient care in a convalescent rehabilitation ward. The PA level was measured as the duration of daily total PA (≥ 1.5 metabolic equivalents) using a triaxial accelerometer for 7 days after admission. The outcomes were changes in the quadriceps muscle quality and quantity on the affected and unaffected sides, as assessed by ultrasonography at admission and 1 month after admission. Results: Multiple regression analysis indicated that the duration of total PA was significantly associated with a percentage change in quadriceps muscle quality (p = 0.011) and quantity (p = 0.012) on the affected side. However, no significant relationship was observed between the muscle quality and quantity on the unaffected side. Conclusions: The results revealed that PA was associated with changes in the quadriceps muscle quality and quantity on the affected side in patients with subacute hemiparetic stroke. These findings highlight the importance of promoting PA in stroke rehabilitation to improve muscle properties and functional outcomes. IMPLICATIONS FOR REHABILITATION: Improving skeletal muscle quality and quantity is an important goal in post-stroke rehabilitation. We investigated physical activity and post-stroke changes in muscle properties. Physical activity is related to changes in muscle quantity and quality on the affected side. Promoting physical activity is essential for improving muscle quantity and quality on the affected side. [ABSTRACT FROM AUTHOR]

Our objective was to understand how empathy and self-awareness content, alongside traditional deescalation training, might impact ambulatory clinic staff responses to patient and family escalation events. Verbal and physical workplace violence is escalating across healthcare organizations, including ambulatory clinics. Deescalation content is often developed with acute care, psychiatric, or emergency care in mind. There is a need for relevant and empathic deescalation training for ambulatory clinic staff to address their specific needs. We developed empathic and self-reflective deescalation training which was interactive and relevant to ambulatory clinic staff. Staff were trained using both in-person and virtual modalities. Participant self-reflection pre- and postintervention questionnaires indicated increases in understanding and application of deescalation methodologies. Multiple ambulatory clinics where staff participated saw a decrease in patient complaints and grievances. Participating ambulatory clinics also saw an improvement in the likelihood to recommend practice. However, participating ambulatory clinics did not see a reduction in reported patient-involved workplace violence events. Ensuring both empathy and self-awareness content in deescalation training, along with relevant ambulatory clinic scenarios, support ambulatory staff to respond effectively and appropriately to escalation events, helps reduce patient complaints, and improves patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: This study assessed the cost-effectiveness of proton beam therapy (PBT) compared to conventional radiotherapy (CRT) for treating patients with brain tumors in Sweden. Methods: Data from a longitudinal non-randomized study performed between 2015 and 2020 was used, and included adult patients with brain tumors, followed during treatment and through a one-year follow-up. Clinical and demographic data were sourced from the longitudinal study and linked to Swedish national registers to get information on healthcare resource use. A cost-utility framework was used to evaluate the cost-effectiveness of PBT vs. CRT. Patients in PBT group (n = 310) were matched with patients in CRT group (n = 40) on relevant observables using propensity score matching with replacement. Costs were estimated from a healthcare perspective and included costs related to inpatient and specialized outpatient care, and prescribed medications. The health outcome was quality-adjusted life-years (QALYs), derived from the EORTC-QLQ-C30. Generalized linear models (GLM) and two-part models were used to estimate differences in costs and QALYs. Results: PBT yielded higher total costs, 14,639 US$, than CRT, 13,308 US$, with a difference of 1,372 US$ (95% CI, -4,914–7,659) over a 58 weeks' time horizon. Further, PBT resulted in non-significantly lower QALYs, 0.746 compared to CRT, 0.774, with a difference of -0.049 (95% CI, -0.195–0.097). The probability of PBT being cost-effective was < 30% at any willingness to pay. Conclusions: These results suggest that PBT cannot be considered a cost-effective treatment for brain tumours, compared to CRT. Trial registration: Not applicable. Novelty and Impact: This study informs on the cost-effectiveness of proton beam therapy (PBT) versus conventional radiotherapy (CRT) for patients with brain tumors in Sweden. Amidst global concerns regarding the cost-effectiveness of PBT, our investigation fills a notable gap by providing evidence from the Swedish healthcare landscape. Using real-world data, our study demonstrates the application of established health economic methodology to compare PBT and CRT for brain tumors, furthering research in this area. [ABSTRACT FROM AUTHOR]

Background: Missed nursing care poses a significant challenge for healthcare staff in terms of patient safety and care quality. Objective: To evaluate presenteeism and missed care attitudes of nurses and to determine the correlation between presenteeism and missed care. Methods: This descriptive, correlational, and observational study was conducted between February and August 2023. The Stanford Presenteeism Scale-Short Form and the MISSCARE Survey were used to collect the data among nurses at two public hospitals in a city in Turkey. The study was completed with 229 nurses representing 27.4% of the total number of nurses who met the inclusion criteria. The data was analyzed using a comprehensive analytical approach, including Cronbach's alpha analysis, frequency and percentage distribution, the Shapiro–Wilk test of normality, correlation coefficient analysis, Pearson correlation coefficient, and the Bonferroni test. Results: The participants' mean age was 30.22 ± 7.14 years, and 74.2% of them were female. 53.3% of the participants reported difficulty providing patient care due to material shortages, and 62.9% experienced challenges delivering care due to the intensity of paperwork in the clinic. Nurses who felt that paperwork intensity affected patient care and were not confident in their care provision had higher levels of presenteeism (p = 0.041) and a significantly higher frequency of missed care instances (p < 0.001). Conclusions: Material shortages and high paperwork intensity are contributing factors to the difficulties experienced by nurses in their practice. These difficulties may lead to an increase in presenteeism and instances of missed nursing care. It is important to address these challenges to ensure adequate care provision and reduce the likelihood of presenteeism among nurses. The correlation between presenteeism and instances of missed nursing care highlights the impact of presenteeism behaviors on the quality of patient care. [ABSTRACT FROM AUTHOR]

The increased funding provided for Community Health Worker (CHW) hiring and training as part of the COVID‐19 pandemic response was to increase their impact in alleviating the effects of negative social determinants of health in the lives of the most vulnerable individuals and communities. This enhanced use of CHW in vulnerable populations can also be used to improve access to such populations for applied research to study ways to improve health outcomes for low‐income minority populations. We carried out a feasibility study using the State CHW association as partners to reach CHWs working with low‐income minority population. Three hundred and three (303) clients of CHWs were interviewed on various demographic, health access, and employment information and both univariate and multivariate analyses was used to determine factors associated with being unvaccinated against COVID‐19 and chi‐squared used to determine if employment was associated with having health insurance. About half of the clients self‐identified as Black/African American and half as Hispanic. Two‐thirds were women and 52.1% were unemployed and 55.1% had no health insurance. There was no association between employment status and having health insurance. Majority (71.6%) had received one dose of a type of COVID‐19 vaccine and being younger and being African American were associated with not getting a dose of COVID‐19 vaccine, as well as being unemployed and not having health insurance. Most of the clients came to see the CHW about a Health/Healthcare issue of the five social determinants of health (SDOH). There were 38 different job titles provided by the clients and the job titles were mainly blue collar jobs and jobs in health and personal care. Our results indicate that CHWs reach the most vulnerable population who have limited health access and high unemployment and that CHWs can effectively be used for linkage to low‐income minority population for applied research. Our analyses found that in this low‐income population, being younger, being African American, being unemployed, and not having health insurance are each associated with not getting vaccinated against COVID‐19, and employment is not associated with having health insurance. We have shown that partnership with CHWs to access their clients as research subjects leads to elucidating new information on the population that can be used in addressing public health programming. [ABSTRACT FROM AUTHOR]

Background: Altered meal timing patterns can disrupt the circadian system and affect metabolism. Our aim was to describe sex-specific chrono-nutritional patterns, assess their association with body mass index (BMI) and investigate the role of sleep in this relationship. Methods: We used the 2018 questionnaire data from the population-based Genomes for Life (GCAT) (n = 7074) cohort of adults aged 40–65 in Catalonia, Spain, for cross-sectional analysis and its follow-up questionnaire data in 2023 (n = 3128) for longitudinal analysis. We conducted multivariate linear regressions to explore the association between mutually adjusted meal-timing variables (time of first meal, number of eating occasions, nighttime fasting duration) and BMI, accounting for sleep duration and quality, and additional relevant confounders including adherence to a Mediterranean diet. Finally, cluster analysis was performed to identify chrono-nutritional patterns, separately for men and women, and sociodemographic and lifestyle characteristics were compared across clusters and analyzed for associations with BMI. Results: In the cross-sectional analysis, a later time of first meal (β 1 h increase = 0.32, 95% CI 0.18, 0.47) and more eating occasions (only in women, β 1 more eating occasion = 0.25, 95% CI 0.00, 0.51) were associated with a higher BMI, while longer nighttime fasting duration with a lower BMI (β 1 h increase=-0.27, 95% CI -0.41, -0.13). These associations were particularly evident in premenopausal women. Longitudinal analyses corroborated the associations with time of first meal and nighttime fasting duration, particularly in men. Finally, we obtained 3 sex-specific clusters, that mostly differed in number of eating occasions and time of first meal. Clusters defined by a late first meal displayed lower education and higher unemployment in men, as well as higher BMI for both sexes. A clear "breakfast skipping" pattern was identified only in the smallest cluster in men. Conclusions: In a population-based cohort of adults in Catalonia, we found that a later time of first meal was associated with higher BMI, while longer nighttime fasting duration associated with a lower BMI, both in cross-sectional and longitudinal analyses. [ABSTRACT FROM AUTHOR]

Background: Psychiatric nurses face additional challenges due to negative perceptions, workplace violence, and a lack of respect, impacting their well-being and job satisfaction, which are crucial for improving psychiatric care and patient outcomes. Objectives: This study aims to examine the relationship between effort-reward imbalance, well-being, burnout, and decent work among psychiatric nurses. Methods: This study used a cross-sectional design. Data were collected using a convenience sampling method in February 2024 from 397 psychiatric nurses at two psychiatric hospitals in Hangzhou and Huzhou, Zhejiang Province. The Effort-Reward Imbalance Scale, Decent Work Perception Scale, Maslach Burnout Inventory-General Survey, and General Well-Being Schedule Scale were used for data collection. Data analysis was conducted using SPSS 26.0 and the PROCESS macro. Results: The study found that effort-reward imbalance among psychiatric nurses was negatively correlated with decent work (r = -0.564, p < 0.001) and well-being (r = -0.541, p < 0.001), and positively correlated with burnout (r = 0.603, p < 0.001). Burnout mediated the relationship between effort-reward imbalance and well-being (95% CI [-0.386, -0.257]), while decent work also served as a mediator (95% CI [-0.100, -0.012]). Additionally, burnout and decent work were found to mediate the relationship between effort-reward imbalance and well-being (95% CI [-0.050, -0.006]). Conclusion: This study highlights the impact of effort-reward imbalance on well-being, confirming that burnout and decent work serve as mediators. Enhancing support, fair compensation, reasonable work schedules, and professional development can promote psychiatric nurses' perception of decent work and improve their well-being. [ABSTRACT FROM AUTHOR]

Background: Anticipatory grief is common among family caregivers of cancer patients and may be related to caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping strategies. The purpose of this study was to examine the mediating role of cognitive appraisal and coping strategies in the relationship between caregiver burden, family resilience, psychological capital, and anticipatory grief among caregivers of cancer patients. Methods: This study surveyed from January to September 2023 among 265 caregivers of lung and breast cancer patients in two public hospitals. They completed measures of caregiver burden, family resilience, psychological capital, cognitive appraisal, coping, and anticipatory grief. AMOS software was used to model the data with Bayesian structural equation modeling. Results: Bayesian structural equation modeling results showed that caregiver burden had a direct effect on anticipatory grief. The chain mediating effects for cognitive appraisal tendency and coping tendency between caregiver burden, family resilience, psychological capital, and anticipatory grief, respectively. Coping tendency acted as a mediator between psychological capital and anticipatory grief. Conclusions: The relationships between caregiver burden, family resilience, and psychological capital with anticipatory grief are embedded in the mediating effects of cognitive appraisal and coping. Early identification and intervention for caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping methods may prevent anticipatory grief in caregivers of cancer patients. [ABSTRACT FROM AUTHOR]

Background: Hypertension affects approximately 1 in 2 adults in the US. Home blood pressure (BP) monitoring programs are effective in the diagnosis and management of hypertension. Free clinics serve as an integral safety net for millions of uninsured and economically disadvantaged patients in the US. The feasibility and effects of a free home BP monitoring and follow-up program in a free clinic setting is not well characterized. Methods: This was a prospective study of the implementation of a pilot BP monitoring and follow-up program between March 2021 and August 2023 at 2 free clinics in the San Francisco Bay Area. A total of 78 hypertensive patients were enrolled in the program and given a free BP monitor. We surveyed via telephone the change in systolic and diastolic BPs and BP monitor use and comfort at 3 weeks. Volunteers in clinic roles involved in the BP monitoring program were surveyed to assess their time spent and perceptions of the program. Results: Of the 78 patients, 37 provided responses to the 3-week survey. A total of 36 of 37 (97%) patients reported using their BP monitor. A total of 35 patients reported using it at least once a week (95%), with the majority reporting at least four uses a week (68%). A total of 36 patients (97%) planned on continuing to use their BP monitor. At 3 weeks, the mean systolic and diastolic BP changed by −6.40 mmHg (95% CI, −10.8 to −2.01 mmHg; P =.00577) and −2.72 mmHg (95% CI, −5.62 to 0.188 mmHg; P =.0657), respectively. The time commitment for this program ranged from 130 ± 51 min for program leaders to 16 ± 14 min per week for patient-facing roles. All volunteer roles (patient-facing, phone follow-up, program leaders) expressed that they had a clear understanding of their responsibilities in the program (median 4 on Likert scale, IQR 3-5). Conclusion: Home BP monitoring and follow-up is feasible to implement in free clinics, resulting in high rates of patient engagement among respondents. Our findings suggest that home BP monitoring and follow-up programs may be beneficial in vulnerable patient populations. [ABSTRACT FROM AUTHOR]

Background: The aging population in Poland poses significant challenges to social and health systems. By 2050, the percentage of people over 65 in Poland is projected to reach 32.7%. Promoting physical activity among seniors is crucial for preventing chronic diseases, improving quality of life, and reducing healthcare burdens. Local governments play a pivotal role in implementing healthpromoting measures. Objective: The study aims to analyze seniors’ satisfaction with local government activities in promoting physical activity and to identify the best activities and future needs of seniors in the Silesia, Mazovia, and Pomerania regions of Poland. Material and Methods: The survey, conducted between May 2023 and May 2024, utilized the Computer Assisted Web Interviewing (CAWI) method to gather data from 1,500 seniors aged 65 and above across the Silesia, Mazovia, and Pomerania regions. The study population was carefully selected to ensure representativeness in terms of gender, age, education, and place of residence. Data analysis included chi-square tests and logistic regression to assess satisfaction levels and identify influencing factors. Results: The survey revealed regional differences in satisfaction levels. Seniors in the Mazovia region exhibited the highest satisfaction (74% positive ratings), followed by the Silesian (64%) and Pomeranian (56%) regions. Factors influencing satisfaction included gender, age, education, and place of residence. Women, older seniors, those with higher education, and urban residents reported higher satisfaction levels. The most appreciated local government activities were related to sports infrastructure and sports programs. Future needs emphasized the demand for more sports programs and better infrastructure, with regional variations in preferences. Conclusion: Seniors’ satisfaction with local government activities in promoting physical activity varies significantly across regions. Tailoring activities to regional preferences and continuous evaluation of programs are essential for enhancing effectiveness and satisfaction. Increased funding and support for physical activity programs are necessary, especially in less developed regions. [ABSTRACT FROM AUTHOR]

Background: The University of Jyvaskyla Active Aging Scale (UJACAS) assesses active aging through willingness, ability, opportunity, and frequency of involvement in activities. Recognizing the lack of a German version, the Finnish original was translated (UJACAS-G). This study aimed: (1) to evaluate the test-retest reliability of UJACAS-G; and (2) to explore correlations with health-related parameters (concurrent validity). Methods: The study (test-retest design) targeted healthy older adults aged 65+. Reliability of UJACAS-G (total and subscores) was assessed using Bland-Altman analyses and Intraclass Correlation Coefficients (ICCs). Furthermore, correlations (Spearman's rho) between UJACAS-G scores and physical function (walking speed, handgrip strength, balance, 6-minute walk distance), physical activity (International Physical Activity Questionnaire), life-space mobility (Life-Space Assessment), and health-related quality of life (Short Form-36 Health Survey) were calculated. Results: Bland-Altman analyses (N = 60; mean age 72.3, SD 5.9 years; 50% women) revealed mean differences close to zero and narrow limits of agreement for all scores (total score: mean difference −1.9; limits −31.7 to 27.9). The ability subscore showed clustering at its upper limit. ICC was 0.829 (95% CI 0.730 to 0.894) for the total score and ranged between 0.530 and 0.876 for subscores (all p-values < 0.001). The total score correlated with walking speed (rho = 0.345; p = 0.008), physical activity (rho = 0.279; p = 0.033) and mental health (rho = 0.329; p = 0.010). Conclusions: UJACAS-G is reliable for assessing active aging among German-speaking healthy older adults. A potential 'ceiling effect' regarding the ability subscore should be considered when applying UJACAS-G to well-functioning populations. Analyses of concurrent validity indicated only weak correlations with health-related parameters. [ABSTRACT FROM AUTHOR]

Background: Sleep problems are common in early childhood and may be affected by parental adverse childhood experiences (ACEs). However, few studies have examined the longitudinal effect of parental ACEs on offspring sleep problems and the underlying mechanism. This study examined parents' psychological distress and harsh discipline (psychological aggression and corporal punishment) as mediators in the longitudinal pathway from parental ACEs to offspring sleep problems. Methods: The participants included 617 3-year-old children (mean age of 43.13 months, SD = 3.82) and their parents (mean age of 33.24 years, SD = 4.01) from Wuhu, China. The participants completed an online questionnaire on ACEs, psychological distress, and demographic characteristics in September 2022 (Time 1). Parents completed another online questionnaire in September 2023 (Time 2) on harsh discipline and offspring sleep problems. A path model was used to examine the associations. Results: Parental ACEs did not directly predict offspring sleep problems. Psychological distress (β = 0.041, 95% CI [0.005, 0.111]) and harsh discipline in the form of psychological aggression (β = 0.019, 95% CI [0.006, 0.056]) separately mediated the relationship between parental ACEs and offspring sleep problems. Psychological distress and psychological aggression also played a serial mediating role in the association of parental ACEs with offspring sleep problems (β = 0.014, 95% CI [0.007, 0.038]). Conclusions: Our findings showed the importance of psychological distress and psychological aggression in the intergenerational effect of trauma on offspring sleep problems. Specific interventions aimed at improving mental health and parenting practices should be provided for parents who were exposed to ACEs. [ABSTRACT FROM AUTHOR]

Background: Hashimoto's thyroiditis (HT) is an inflammatory disease characterized by increased reactive oxygen species. Diets rich in anti-inflammatory and antioxidant properties may be linked to a reduced risk of developing HT. The aim of this study was to investigate the association between the dietary inflammatory index (DII) and dietary total antioxidant capacity (DTAC) with HT in Iranian adults. Methods: The study was a hospital-based case-control study conducted on 230 participants (115 cases and 115 controls). Dietary intake was assessed using a food frequency questionnaire (FFQ). The FFQ data were used to calculate DII and DTAC scores. Anthropometric measurements, thyroid function, and antibody tests were evaluated using standard methods. Multivariable logistic regression analysis was performed in both raw and adjusted models to determine the association between DII and DTAC scores with HT. Results: The average age of the participants was 39.76 ± 9.52 years. The mean body mass index in the case and control groups was 28.03 ± 6.32 and 26.43 ± 5.13 (kg/m2), respectively (P = 0.036). In the HT group, the DII level was higher (P < 0.001) and the DTAC level was lower than those in the healthy group (P = 0.047). In the multivariable logistic regression model, after adjusting for confounding factors, subjects in the last tertile of DII had a nonsignificantly higher HT risk than those in the first tertile (OR = 1.75; 95% CI = 0.83–3.65; P = 0.130). Regarding DTAC, the subjects in the last tertile of DTAC had a significantly decreased risk of HT (OR = 0.47; 95% CI = 0.23–0.98; P = 0.043) compared to those in the first tertile. The DII had a positive correlation with anti-thyroid peroxidase antibody (anti-TPO), thyroglobulin antibodies (TG-Ab) and thyroid-stimulating hormone, while DTAC had a negative correlation with anti-TPO and TG-Ab (P < 0.050). Conclusion: The increase in DII is not associated with an increase in the risk of HT, while DTAC can significantly reduce its risk. Having an anti-inflammatory and antioxidative diet can be effective in improving thyroid function. These conclusions should be confirmed in additional prospective studies. [ABSTRACT FROM AUTHOR]

Background: The role of the geriatric nutritional risk index (GNRI) as a prognostic factor in intensive care unit (ICU) patients with acute kidney injury (AKI) remains uncertain. Objectives: The aim of this study was to investigate the impact of the GNRI on mortality outcomes in critically ill patients with AKI. Methods: For this retrospective study, we included 12,058 patients who were diagnosed with AKI based on ICD-9 codes from the eICU Collaborative Research Database. Based on the values of GNRI, nutrition-related risks were categorized into four groups: major risk (GNRI < 82), moderate risk (82 ≤ GNRI < 92), low risk (92 ≤ GNRI < 98), and no risk (GNRI ≥ 98). Multivariate analysis was used to evaluate the relationship between GNRI and outcomes. Results: Patients with higher nutrition-related risk tended to be older, female, had lower blood pressure, lower body mass index, and more comorbidities. Multivariate analysis showed GNRI scores were associated with in-hospital mortality. (Major risk vs. No risk: OR, 95% CI: 1.90, 1.54–2.33, P < 0.001, P for trend < 0.001). Moreover, increased nutrition-related risk was negatively associated with the length of hospital stay (Coefficient: -0.033; P < 0.001) and the length of ICU stay (Coefficient: -0.108; P < 0.001). The association between GNRI scores and the risks of in-hospital mortality was consistent in all subgroups. Conclusions: GNRI serves as a significant nutrition assessment tool that is pivotal to predicting the prognosis of critically ill patients with AKI. [ABSTRACT FROM AUTHOR]

Background: The prevalence of heart failure is increasing owing to the aging of the population, resulting in growing medical costs and an increasing number of patients with multimorbidity. The optimal management of heart failure by general physicians in addition to internal medicine physicians, such as cardiologists, is essential, although the specifics are unclear. In this study, we aimed to determine the differences in heart failure management outcomes among older patients between those managed by general physicians and those managed by internal medicine physicians, especially in terms of hospitalization and mortality rates. Methods: This was a retrospective cohort study of patients with heart failure who visited a community hospital in Japan. Patients with heart failure were selected based on International Classification of Diseases codes from electronic medical record data over 9 years, from September 2015 to August 2023. The independent variables were whether a general physician treated the patient; the primary outcome was death; the secondary outcome was hospitalization; and the covariates were patient background, including comorbidities. Multiple logistic regression analysis was used to evaluate the association between being managed by a general physician and death and hospitalization, after adjusting for confounding factors. Results: A total of 1032 patients with heart failure were identified, with a mean age of 82.4 years, and 48.9% were men. Patients treated by general physicians were older, were more likely to have dementia and were more likely to need care than those treated by internal medicine physicians. Being treated by a general physician was significantly negatively associated with death (odds ratio [OR], 0.62) and hospitalization (OR, 0.73). Conclusions: In Japan, where medical specialties are increasingly differentiated, the comprehensive management of older patients with heart failure and multiple comorbidities by general physicians may reduce hospitalization and mortality rates. Appropriate education of general physicians and an increase in their numbers may prove essential for the successful management of patients with heart failure in aging communities. [ABSTRACT FROM AUTHOR]

Background: Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive. Design: This was an observational, cross-sectional study using convenience sampling method. Methods: After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established. Results: The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P < 0.001; βattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (βsocial support = 0.04, P < 0.001; βattitude = 0.06, P < 0.001). In addition, narrative nursing knowledge (β = 0.08, P < 0.001) and the nurses' growth environment (β=-0.06, P < 0.001) also affected the practice of narrative nursing. Conclusion: Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is one of the most common chronic diseases globally. Despite the presence of national strategies to prevent potential sequelae DM has been associated with increased morbidities and mortality in Ethiopia, and the prevalence appears to be on the rise. Although studies have been conducted among DM patients in the country, there is a lack of information that could allow an in-depth understanding of the situation. Objective: To assess dietary practices and associated factors among adult DM patients at academic tertiary-level hospitals in central Ethiopia. Methods: The institution-based concurrent mixed-methods study was conducted from January 01 to 30 2024 involving 420 adult DM patients. Participants were selected using a simple random sampling technique for quantitative study. A purposive sampling technique was used to select 16 participants for qualitative analysis. For the quantitative study, a self-administered structured questionnaire was used to collect data, and an in-depth interview for the qualitative part. Multivariate binary logistic regressions were used to assess the explanatory variables associated with dietary practice. A thematic analysis was performed for qualitative data. Result: Of 420 eligible participants, 406 (96.7%) participated in the study. The overall proportion of good dietary practices among participants was 172 (44.2%). The being female, urban residence a family history of DM, and good dietary were significantly associated with the dietary practice. From qualitative analysis, two themes have emerged; Living as before and not adhering to diabetic dietary recommendations and barriers to adherence to effective eating practice. Conclusions and recommendations: Less than half of adult DM patients had good dietary practices. Sex, geographic location, family history of DM, and level of knowledge of diabetic diet were associated with dietary practice. Intervention programs on awareness creation and training to improve the dietary practice by stakeholders were recommended. [ABSTRACT FROM AUTHOR]

Background: For patients with sepsis receiving non-invasive ventilation (NIV), early rehabilitation is crucial. The Sitting Baduanjin (SBE) is an efficient early rehabilitation exercise suitable for bed patients. There is no consensus about the effect of SBE on the early rehabilitation of septic patients with NIV. This study focused on how the SBE affected the early rehabilitation of sepsis patients with NIV. Methods: 96 sepsis patients with NIV were randomly assigned to either an Baduanjin group that received the SBE based on the routine rehabilitation exercise (n = 48) or a control group (n = 48) that received routine rehabilitation exercise. The primary outcome was the Medical Research Council(MRC)score, and the Barthel Index score, the duration of NIV, length of ICU stay, length of total stay, hospitalization expense as secondary outcomes. Results: A total of 245 sepsis patients were screened, with 96 randomly assigned. The study was completed by 90 patients out of the 96 participants.Results revealed that the MRC score increased in both groups, but the improvement of muscle strength in Baduanjin group was more obvious, with statistical significance (p < 0.001).There was statistically significantly difference between the two groups in Barthel Index at the day of transfer out of ICU(P = 0.028).The patients in the Baduanjin group had an average reduction of 24.09 h in the duration of NIV and 3.35 days in total length of hospital stay compared with the control group (p < 0.05).Of note, the Baduanjin group had significantly reduction the total hospitalization expense. No serious adverse events occurred during the intervention period. Conclusions: In patients with sepsis, the SBE appears to improve muscle strength and activities of daily living (ADL), and lowed the duration of NIV, the length of the total stay, and the hospitalization expense. Trial registration: The study registered on the Chinese Clinical Trial Registry (www.chictr.org.cn), Clinical Trials identifier ChiCTR1800015011 (28/02/2018). [ABSTRACT FROM AUTHOR]