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Background: The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. Aim: To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. Methods: A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Results: Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Conclusion: Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students. [ABSTRACT FROM AUTHOR]

Copyright of Journal of College of Education / Wasit is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Diaries are used in sexual behaviour research to reduce recall bias. Diary collection via mobile phone text messaging (SMS) has not been trialled previously in sexual behaviour research. This randomized controlled trial compared SMS, paper and online diaries on response rate, timeliness, completeness of data and acceptability. The correlation between behaviour reported in all three types of diaries and data collected in a retrospective questionnaire was also determined. Methods Participants were recruited by telephone and randomised into one of three groups. They completed weekly sexual behaviour diaries for 3 months by SMS, online or paper (by post). An online survey was conducted at the end of 3 months to compare retrospective reports to the diaries and assess opinions on the diary collection method. Results 72 participants were enrolled in the study, 24 in each group. Online diaries were more likely to be submitted late than SMS diaries (p<0.001). 3.9% of SMS diaries, 3.1% of paper diaries and 0.5% of online diaries were incomplete (p=0.001). Online data collection was the preferred mode for 51%. 65 participants completed the end point retrospective questionnaire. The correlation between the diary and questionnaire on sexual risk classification was substantial (κ=0.74) regardless of diary mode. Conclusions SMS is a convenient and timely method of collecting brief behavioural data, but online data collection was preferable to most participants and more likely to be complete. Data collected in retrospective sexual behaviour questionnaires were found to agree substantially with data collected through weekly self-reported diaries. [ABSTRACT FROM AUTHOR]

Due to sampling restrictions in the analysis of cultural heritage materials, non-destructive approaches are intensively sought for. While NIR spectrometry has rarely been used for this purpose due to the complexity of the spectra, chemometric methods can be used to extract the necessary information. For the purpose of determination of mechanical properties of historical paper, partial least squares approach was used and it is shown that tensile strength, and tensile strength after folding, can be estimated based on NIR spectra. As the mechanical properties of paper-based objects define their accessibility, a new dispersive portable instrument was built, which will enable us to rapidly survey the condition of library and archival collections. [ABSTRACT FROM AUTHOR]

The article offers information on reduction of disease activity in axial spondyloarthritis from High intensity exercise for three months, as compared with standard care.

The article discusses the approaches for gluteal tendinopathy which includes education plus exercise and corticosteroid injection.

The article discusses the airway pressure for infants with meconium aspiration syndrome which includes mechanical ventilation and medical care .

Williamson G.R. (2003) Journal of Advanced Nursing 44(3), 278–288 Misrepresenting random sampling? A systematic review of research papers in the Journal of Advanced Nursing This paper discusses the theoretical limitations of the use of random sampling and probability theory in the production of a significance level (or P-value) in nursing research. Potential alternatives, in the form of randomization tests, are proposed. Research papers in nursing, medicine and psychology frequently misrepresent their statistical findings, as the P-values reported assume random sampling. In this systematic review of studies published between January 1995 and June 2002 in the Journal of Advanced Nursing, 89 (68%) studies broke this assumption because they used convenience samples or entire populations. As a result, some of the findings may be questionable. The key ideas of random sampling and probability theory for statistical testing (for generating a P-value) are outlined. The result of a systematic review of research papers published in the Journal of Advanced Nursing is then presented, showing how frequently random sampling appears to have been misrepresented. Useful alternative techniques that might overcome these limitations are then discussed. This review is limited in scope because it is applied to one journal, and so the findings cannot be generalized to other nursing journals or to nursing research in general. However, it is possible that other nursing journals are also publishing research articles based on the misrepresentation of random sampling. The review is also limited because in several of the articles the sampling method was not completely clearly stated, and in this circumstance a judgment has been made as to the sampling method employed, based on the indications given by author(s). Quantitative researchers in nursing should be very careful that the statistical techniques they use are appropriate for the design and sampling methods of their studies. If the techniques they employ are not appropriate, they run the risk of misinterpreting findings by using inappropriate, unrepresentative and biased samples. [ABSTRACT FROM AUTHOR]

Nowadays, ensuring the quality of network services has become increasingly vital. Experts are turning to knowledge graph technology, with a significant emphasis on entity extraction in the identification of device configurations. This research paper presents a novel entity extraction method that leverages a combination of active learning and attention mechanisms. Initially, an improved active learning approach is employed to select the most valuable unlabeled samples, which are subsequently submitted for expert labeling. This approach successfully addresses the problems of isolated points and sample redundancy within the network configuration sample set. Then the labeled samples are utilized to train the model for network configuration entity extraction. Furthermore, the multi-head self-attention of the transformer model is enhanced by introducing the Adaptive Weighting method based on the Laplace mixture distribution. This enhancement enables the transformer model to dynamically adapt its focus to words in various positions, displaying exceptional adaptability to abnormal data and further elevating the accuracy of the proposed model. Through comparisons with Random Sampling (RANDOM), Maximum Normalized Log- Probability (MNLP), Least Confidence (LC), Token Entrop (TE), and Entropy Query by Bagging (EQB), the proposed method, Entropy Query by Bagging and Maximum Influence Active Learning (EQBMIAL), achieves comparable performance with only 40% of the samples on both datasets, while other algorithms require 50% of the samples. Furthermore, the entity extraction algorithm with the Adaptive Weighted Multi-head Attention mechanism (AW-MHA) is compared with BILSTM-CRF,Mutil_Attention-Bilstm-Crf, Deep_Neural_Model_NER and BERT_Transformer, achieving precision rates of 75.98% and 98.32% on the two datasets, respectively. Statistical tests demonstrate the statistical significance and effectiveness of the proposed algorithms in this paper. [ABSTRACT FROM AUTHOR]

Background The US Food and Drug Administration has established a policy of substantially discounting the health benefits of reduced smoking in its evaluation of proposed regulations because of the cost to smokers of the supposed lost pleasure they suffer by no longer smoking. This study used data from nine countries of the former Soviet Union (fSU) to explore this association in a setting characterised by high rates of (male) smoking and smoking-related mortality. Methods Data came from a cross-sectional populationbased study undertaken in 2010/2011 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Information was collected from 18 000 respondents aged ≥18 on smoking status (never, ex-smoking and current smoking), cessation attempts and nicotine dependence. The association between these variables and self-reported happiness was examined using ordered probit regression analysis. Results In a pooled country analysis, never smokers and ex-smokers were both significantly happier than current smokers. Smokers with higher levels of nicotine dependence were significantly less happy than those with a low level of dependence. Conclusions This study contradicts the idea that smoking is associated with greater happiness. Moreover, of relevance for policy in the fSU countries, given the lack of public knowledge about the detrimental effects of smoking on health but widespread desire to quit reported in recent research, the finding that smoking is associated with lower levels of happiness should be incorporated in future public health efforts to help encourage smokers to quit by highlighting that smoking cessation may result in better physical and emotional health. [ABSTRACT FROM AUTHOR]

Objective The aim of the present work was to examine adult smokers' awareness of and receptivity to an electronic nicotine delivery system (ENDS) television advert, and whether viewing the advert influenced urge to smoke and intention to try ENDS. Methods A television advert for ENDS brand blu eCigs was shown to an online convenience sample of 519 Florida adult smokers. We measured current smokers' awareness of and receptivity to the advert, and whether seeing the advert influenced their thoughts about smoking or quitting, urge to smoke and intention to try ENDS. Results were stratified by prior ENDS use. Results Approximately 62.3% of current smokers were aware of the advert. Smokers found the advert informative (73.8%), attention grabbing (67.5%) and innovative (64.5%), with prior ENDS users rating the advert more favourably than non-users. Seeing the advert elicited an urge to smoke (mean 42.1, SD=1.9) and thoughts about smoking cigarettes (75.8%) as well as quitting (74.6%). Prior END users were significantly more likely than non-users to report thinking about smoking cigarettes after seeing the advert (P<0.05). Most smokers said ENDS were ‘made for people like them' (88.6%) and they would try ENDS in the future (66.0%). Conclusions Smokers are receptive to ENDS television adverts and report intention to try ENDS after viewing the advert. Future studies should monitor ENDS advertising and examine how exposure to ENDS adverts influences smokers' use of ENDS, dual use with cigarettes and cessation behaviour. [ABSTRACT FROM AUTHOR]

Objectives This study examines the influence that smokefree workplaces, restaurants and bars have on the adoption of smokefree rules in homes and cars, and whether there is an association with adopting smokefree rules in homes and cars. Methods Bivariate probit models were used to jointly estimate the likelihood of living in a smokefree home and having a smokefree car as a function of law coverage and other variables. Household data were obtained from the nationally representative Social Climate Survey of Tobacco Control 2001, 2002 and 2004-2009; clean indoor air law data were from the American Nonsmokers' Rights Foundation Tobacco Control Laws Database. Results ‘Full coverage’ and ‘partial coverage’ smokefree legislation is associated with an increased likelihood of having voluntary home and car smokefree rules compared with ‘no coverage’. The association between ‘full coverage’ and smokefree rule in homes and cars is 5% and 4%, respectively, and the association between ‘partial coverage’ and smokefree rules in homes and cars is 3% and 4%, respectively. There is a positive association between the adoption of smokefree rules in homes and cars. Conclusions Clean indoor air laws provide the additional benefit of encouraging voluntary adoption of smokefree rules in homes and cars. [ABSTRACT FROM AUTHOR]

Background Tobacco endgame policies are increasingly advocated to end tobacco use. This study investigated public support for a total ban on tobacco sales, use and possession in Hong Kong. Methods A telephone survey was conducted among 1537 randomly selected residents in 2012 to assess their support for a total ban on tobacco sales, usage and possession. Information on sociodemographic characteristics, smoking, and second hand smoke exposure were collected. Logistic regression was used to investigate factors associated with support for a total ban. Results Most of the never smokers (75.3%), ex-smokers (63.9%), and nearly half of current smokers (48.9%) backed some form of a total ban on tobacco. A total ban on tobacco sales was the most popular option among the three groups, with over half (64.8%) of all respondents supporting a ban within 10 years. Current smoking and higher educational attainment were associated with less support for a total ban on tobacco sales. Among current smokers, having quit intentions and attempts to quit were associated with support for a total ban. Conclusions A total ban on tobacco sales was supported by most respondents. Ex-smokers and current smokers also voiced substantial support, although less than never smokers. A total ban on tobacco sales before 2022 should be the goal as it is supported by most of the respondents. Interim tobacco control measures, such as tax increases, expansion of smoking cessation services and plain packaging should be implemented to help current smokers quit and reduce smoking initiation before implementation of the ban. [ABSTRACT FROM AUTHOR]

Background This analysis estimates the association between smoking-related knowledge and smoking behaviour in a Chinese context. To identify the specific knowledge most directly related to smoking status, we used a novel latent variable analysis approach to adjust for the high correlations between different measures of knowledge about tobacco smoking. Method Data are from the Global Adult Tobacco China Survey, a nationally representative sample of 13 354 household-dwelling individuals 15 years of age or older. Multinomial logistic regressions estimated the association between smoking status (ie, never smoked, current smoker or past smoker) and four smoking-related beliefs: whether or not smoking causes lung cancer, heart attack and stroke, and whether or not low-tar cigarettes are less harmful. A latent variable approach reassessed these associations while taking into account the general level of knowledge about smoking. Results After demographic variables and general knowledge about smoking had been controlled for, the belief that low-tar cigarettes are not less harmful was more prevalent in persons who had never smoked than in current smokers (OR=1.3 (95% CI 1.0 to 1.7) in men and OR=2.8 (95% CI 1.3 to 5.9) in women); this association was even stronger when past smokers and current smokers were compared (OR=2.1 (95% CI 1.5 to 3.0) in men and OR=5.0 (95% CI 1.3 to 20.1) in women). Conclusions Compared with those who have never smoked and those who have ceased smoking, current smokers in China are more likely to believe that low-tar cigarettes are less harmful than regular cigarettes. [ABSTRACT FROM AUTHOR]

Background On 11 January 2009, Taiwan expanded its smoke-free legislation to all indoor public places and workplaces. This study examined the impact of this policy on secondhand smoke (SHS) exposure in adult non-smokers, across gender and socioeconomic status groups (SES). Methods An annual sample of about 13 000-14 000 non-smokers was drawn from cross-sectional nationwide data of Taiwan Adult Tobacco Behavior Surveys during 2005-2011. Logistic regressions were used to analyse the aggregate data to estimate the association between the 2009 smoke-free legislation and SHS exposures in homes and workplaces. Interaction terms were used to examine the impact of the 2009 smoke-free policy on reducing differences in SHS exposure across gender, education and income groups. Results The 2009 policy reduced the odds of SHS exposure in homes in 2009 (OR=0.76, 95% CI 0.68 to 0.84) and in workplaces (year 2009: OR=0.49, 95% CI 0.39 to 0.62; year 2010: OR=0.79, 95% CI 0.66 to 0.95). The model with interaction terms showed that men were more likely than women to be exposed to workplace SHS (OR=2.02, 95% CI 1.80 to 2.27) but were less likely to be exposed to home SHS (OR=0.79, 95% CI 0.73 to 0.86). SHS exposure in homes was significantly related to lower socioeconomic status, but the 2009 smoke-free policy reduced the difference in SHS exposure across education levels. Conclusions The 2009 smoke-free policy reduced the SHS exposure for non-smokers. However, this impact on home SHS did not persist after 2009, and the effect of protection was unequal across gender and SES groups. Thus, further enforcement of smoking restrictions would be needed to reduce the risk of SHS exposure and improve protection against SHS risk among parts of the population with lower socioeconomic status. [ABSTRACT FROM AUTHOR]

Copyright of Arab Journal for Quality Assurance in Higher Education is the property of University of Science & Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patients with borderline personality disorder is unknown.Objective: This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cards in DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility.Methods: This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants were recruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in a mobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. A cost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years (QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability. All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industry representatives to discuss the potential advantages and disadvantages of using a mobile diary app.Results: A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the paper group dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, and suicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference -0.054; SE 0.03) and reduction in depression severity (adjusted difference -1.11; SE 1.57). The between-group difference in total costs ranged from US $107.37 to US $322.10 per participant during the 12 months. The use of services in the health care sector was similar across both time points and groups (difference: psychiatric hospitalization <5 and <5; general practice -1.32; SE 3.68 and 2.02; SE 3.19). Overall, the patients showed high acceptability and considered the app as being easy to use. Therapists worried about potential negative influences on the therapist-patient interaction from new work tasks accompanying the introduction of the new technology but pointed at innovation potential from digital database registrations.Conclusions: This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT compared with paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness.Trial Registration: ClinicalTrials.gov NCT03191565; http://clinicaltrials.gov/ct2/show/NCT03191565.International Registered Report Identifier (irrid): RR2-10.2196/17737. [ABSTRACT FROM AUTHOR]

We determined how the quality of trial design and its reporting in scientific papers published in Anaesthesia has changed in the last 25 years. All articles between the years 1983–87 and 2003–07 were reviewed and classified according to methodology. Reporting and trial design of all prospective, comparative clinical interventional trials were compared between the two time periods using 12 criteria. Fewer articles now originate from the United Kingdom and Ireland than 25 years ago. Although fewer human interventional trials are now published in Anaesthesia, the quality of these trials has improved in terms of study design, bias control and proper disclosure. Significant improvements were observed in all criteria of trial design except for the declaration of non-primary adverse outcomes and the minimisation of the risk of type I errors. Further improvements could still be made with respect to sample size calculation, description of the method of randomisation, and blinding. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a highly prevalent malignancy leading to death across the world. However, patient survival is greatly affected by making a diabetes diagnosis. The present assessed the association between diabetes mellitus and the five-year survival rate of breast cancer patients at the cancer treatment centers. Methods: This retrospective follow‐up study was conducted on 534 diabetic women with breast cancer who had been diagnosed during 1999-2013 referring to cancer treatment centers of Mashhad University of Medical Sciences. Demographic and clinical data of patients were collected through questionnaires in these centers searching the patient’s available medical files. Notably, the patients were selected via systematic random sampling, and also the five-year survival of the patients was assessed during the follow-up period up to 2018. Results: In breast cancer patients, the diabetes prevalence was 12.7%. Of note, the mean and median five-year survival were 9.95 and 13, respectively. No significant difference was observed in the survival rate of the diabetic and non-diabetic patients (95% CI: 0.431-1.334; hazard ratio [HR]: 0.758; P=0.34). The survival time increased in the patients receiving metformin as a treatment protocol (95% CI: 0.226-0.950; HR: 0.5; P=0.04). Conclusion: Based on the results, training diabetic patients regarding risk factors of breast cancer and effective therapies in controlling hyperglycemia that need to screen in the early diagnosis of breast cancer are essential to improve health and increase survival rate in diabetic patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite a long history of discrimination and persisting racial disparities in smoking prevalence, little research exists on the relationship between discrimination and smoking in South Africa. METHODS: This analysis examined chronic (day-to-day) and acute (lifetime) experiences of racial and non-racial (eg, age, gender or physical appearance) discrimination and smoking status among respondents to the South Africa Stress and Health study. Logistic regression models were constructed using SAS-Callable SUDAAN. RESULTS: Both chronic racial discrimination (RR=1.45, 95% CI 1.14 to 1.85) and chronic non-racial discrimination (RR=1.69, 95% CI 1.37 to 2.08) predicted a higher risk of smoking, but neither type of acute discrimination did. Total (sum of racial and non-racial) chronic discrimination (RR=1.46, 95% CI 1.20 to 1.78) and total acute discrimination (RR=1.28, 95% CI 1.01 to 1.60) predicted a higher risk of current smoking. CONCLUSIONS: Racial and non-racial discrimination may be related to South African adults' smoking behaviour, but this relationship likely varies by the timing and frequency of these experiences. Future research should use longitudinal data to identify the temporal ordering of the relationships studied, include areas outside of South Africa to increase generalisability and consider the implications of these findings for smoking cessation approaches in South Africa. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Describe tobacco companies' marketing strategies targeting low socioeconomic status (SES) females in the USA. METHODS: Analysis of previously secret tobacco industry documents. RESULTS: Tobacco companies focused marketing on low SES women starting in the late 1970s, including military wives, low-income inner-city minority women, 'discount-susceptible' older female smokers and less-educated young white women. Strategies included distributing discount coupons with food stamps to reach the very poor, discount offers at point-of-sale and via direct mail to keep cigarette prices low, developing new brands for low SES females and promoting luxury images to low SES African-American women. More recently, companies integrated promotional strategies targeting low-income women into marketing plans for established brands. CONCLUSIONS: Tobacco companies used numerous marketing strategies to reach low SES females in the USA for at least four decades. Strategies to counteract marketing to low SES women could include (1) counteracting price discounts and direct mail coupons that reduce the price of tobacco products, (2) instituting restrictions on point-of-sale advertising and retail display and (3) creating counteradvertising that builds resistance to psychosocial targeting of low SES women. To achieve health equity, tobacco control efforts are needed to counteract the influence of tobacco industry marketing to low-income women. [ABSTRACT FROM AUTHOR]

Background The Tea Party, which gained prominence in the USA in 2009, advocates limited government and low taxes. Tea Party organisations, particularly Americans for Prosperity and FreedomWorks, oppose smoke-free laws and tobacco taxes. Methods We used the Legacy Tobacco Documents Library, the Wayback Machine, Google, LexisNexis, the Center for Media and Democracy and the Center for Responsive Politics (opensecrets.org) to examine the tobacco companies' connections to the Tea Party. Results Starting in the 1980s, tobacco companies worked to create the appearance of broad opposition to tobacco control policies by attempting to create a grassroots smokers' rights movement. Simultaneously, they funded and worked through third-party groups, such as Citizens for a Sound Economy, the predecessor of AFP and FreedomWorks, to accomplish their economic and political agenda. There has been continuity of some key players, strategies and messages from these groups to Tea Party organisations. As of 2012, the Tea Party was beginning to spread internationally. Conclusions Rather than being a purely grassroots movement that spontaneously developed in 2009, the Tea Party has developed over time, in part through decades of work by the tobacco industry and other corporate interests. It is important for tobacco control advocates in the USA and internationally, to anticipate and counter Tea Party opposition to tobacco control policies and ensure that policymakers, the media and the public understand the longstanding connection between the tobacco industry, the Tea Party and its associated organisations. [ABSTRACT FROM AUTHOR]

Background Despite efforts to reduce exposure to secondhand smoke (SHS), only 5% of the world's population enjoy smoke-free restaurants and bars. Methods Lifetime excess risk (LER) of cancer death, ischaemic heart disease (IHD) death and asthma initiation among non-smoking restaurant and bar servers and patrons in Minnesota and the US were estimated using weighted field measurements of SHS constituents in Minnesota, existing data on tobacco use and multiple dose-response models. Results A continuous approach estimated a LER of lung cancer death (LCD) of 18×10−6 (95% CI 13 to 23×10−6 ) for patrons visiting only designated non-smoking sections, 80×10−6 (95% CI 66 to 95×10−6 ) for patrons visiting only smoking venues/sections and 802×10−6 (95% CI 658 to 936×10−6 ) for servers in smoking-permitted venues. An attributable-risk (exposed/ non-exposed) approach estimated a similar LER of LCD, a LER of IHD death about 10−2 for non-smokers with average SHS exposure from all sources and a LER of asthma initiation about 5% for servers with SHS exposure at work only. These risks correspond to 214 LCDs and 3001 IHD deaths among the general non-smoking population and 1420 new asthma cases among non-smoking servers in the US each year due to SHS exposure in restaurants and bars alone. Conclusions Health risks for patrons and servers from SHS exposure in restaurants and bars alone are well above the acceptable level. Restaurants and bars should be a priority for governments' effort to create smoke-free environments and should not be exempt from smoking bans. [ABSTRACT FROM AUTHOR]

Introduction Tobacco manufacturers' aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential countermarketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. Methods In a pretest-post-test experiment, 1836 adult current and recently former smokers from a national sample were randomised to view one of six antismokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Results Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with antitobacco industry themes significantly decreased favourable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Conclusions Measures of perceived effectiveness of antitobacco ads need to be augmented with measures of actual effectiveness to assess countermarketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco. [ABSTRACT FROM AUTHOR]

Background The implementation of comprehensive smoke-free laws has been associated with reductions in second-hand smoke exposure at home in several high income countries. There is little information on whether these benefits extend to low income and middle income countries with a growing tobacco-related disease burden such as India. Methods State and individual-level analysis of cross-sectional data from the Global Adult Tobacco Survey India, 2009/2010. Associations between working in a smoke-free indoor environment and living in a smoke-free home were examined using correlation at the state level, and multivariate logistic regression at the individual level. Results The percentage of respondents employed indoors (outside the home) working in smoke-free environments who lived in a smoke-free home was 64.0% compared with 41.7% of those who worked where smoking occurred. Indian states with higher proportions of smoke-free workplaces had higher proportions of smoke-free homes (rs=0.54, p<0.005). In the individual-level analysis, working in a smoke-free workplace was associated with a significantly higher likelihood of living in a smoke-free home (adjusted OR=2.07; 95% CI 1.64 to 2.52) after adjustment for potential confounders. Conclusions Implementation of smoke-free legislation in India was associated with a higher proportion of adults reporting a smoke-free home. These findings further strengthen the case for accelerated implementation of Article 8 of the Framework Convention on Tobacco Control (FCTC) in low and middle income countries. [ABSTRACT FROM AUTHOR]

Objective We sought to determine the relative frequency and nature of personal display of cigarette packs by smokers in two Australian cities where 30% front-of-pack and 90% back-of-pack health warnings have been used since 2006 and comprehensive tobacco marketing restrictions apply. Methods An observational study counted patrons, active smokers and tobacco packs at cafés, restaurants and bars with outdoor seating. Pack orientation and use of cigarette cases were also noted. Results Overall, 18 954 patrons, 1576 active smokers and 2153 packs were observed, meaning that one out of every 12.0 patrons was actively smoking, and one of every 8.8 patrons displayed a pack. Packs were more frequently observed in lower socio-economic neighbourhoods, reflecting the higher prevalence of smoking in those regions. Packs were displayed less often in venues where children were present, suggesting a greater tendency not to smoke around children. Most packs (81.4%) were oriented face-up, permitting prominent brand display. Only 1.5% of observed packs were cigarette cases, and 4.2% of packs were concealed by another item, such as a phone or wallet. Conclusions Tobacco packs are frequently seen on table-tops in café strips, providing many opportunities for other patrons and passers-by to be incidentally exposed to cigarette brand names and imagery. Use of cigarette cases is rare, suggesting that smokers eventually habituate to pictorial warnings on branded packs and/or find repeated decanting of each newly purchased branded pack into a case to be inconvenient. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to determine to what extent Chinese media coverage of tobacco issues in 17 Chinese cities comprises messaging known to motivate healthy behaviour. Methods This study involved a content analysis of 4821 articles that contained at least one full paragraph focused on tobacco issues from newspapers published in cities that participated in the Tobacco-Free City—Gates Tobacco Control Project in China between 1 January 2008 and 30 June 2011. Results The number of tobacco-focused articles increased over the study period. The number of articles varied considerably among different newspapers and cities. Education, prevention and cessation programs (35%) were the most frequent theme. There was also considerable variation in the volume of coverage each month. News articles were the most frequent article type (70%). The majority of the articles (72%) were positive for tobacco control. There were significant differences between party newspapers and local newspapers in prominence, article type, slant and fear appeal. One quarter (n=729) of the articles mentioned the severity of tobacco use, while only 10% of the articles referred to susceptibility to the threat. Conclusions The coverage of events was predominantly positive toward tobacco control. However, media reports could better support tobacco control efforts if they did a better job at provoking an emotional response to the harms of tobacco use and promoting a sense among smokers that they can succeed in quitting smoking. [ABSTRACT FROM AUTHOR]

Background and aim In recent years, new non-traditional, potentially reduced exposure products (PREPs), claiming to contain fewer harmful chemicals than the traditional products, have been introduced in the market. Little is known about socioeconomic, demographic and smoking-related determinants of the likelihood of using these products among smokers. The aim of this study was to examine these determinants. Methods Data from the 2006-2007 Tobacco Use Supplement to the Current Population Survey was used. We limited the analysis to current smokers (n=40 724). Multivariate logistic regression analyses were conducted to estimate the association between covariates and the probability of the use of PREPs. Results We found that younger age, lower education, higher nicotine addiction and having an intention to quit are associated with higher likelihood of the use of PREPs. The likelihood of using these products was found to be higher among respondents who are unemployed or have a service, production, sales or farming occupation than those with a professional occupation. Smokers living in the midwest, south or west, were found to have a greater likelihood of the use of PREPs than those living in the northeast. Conclusions Because there is little evidence to suggest that PREPs are less harmful that other tobacco products, their marketing as harm-minimising products should be regulated. Smokers, in particular those who are younger, have a lower socioeconomic status, and are more nicotine-dependent, should be the target of educational programmes that reveal the actual harm of PREPs. [ABSTRACT FROM AUTHOR]

Background: Difficulties in parent-child interaction are easily observed and are a potential target for early intervention. This review aimed to assess the utility of current observational methods used to assess parent-child interactions–within the first year of life–and their ability to screen and identify children from low-risk samples most at risk of developing childhood psychopathology. Methods: Six bibliographic databases were searched, and reference lists screened. All peer reviewed papers studying the association between an independent observation of parent-child interaction and later childhood psychopathology in community-based samples were included. Included studies were those recruiting from population or community-based birth cohort data, which we define as 'low-risk'. Studies based on populations known to have a diagnosis of psychiatric illness or developmental disorder, or at high genetic or environmental risk of being diagnosed with such disorder, were excluded. Results were synthesised qualitatively due to high heterogeneity. Results: 20,051 papers were identified, nine were included in this study. Childhood psychopathology was associated with fewer positive parent-infant interactions, lower parent vocalisation frequency and lower levels of adult speech and activity. Maternal sensitivity was inversely related to separation anxiety and oppositional defiant/conduct disorders were associated with lower shared look rates. Disruptive behaviour disorders were associated with higher frequency of child vocalisation. Conclusion: Assessment of parent-child interactions, particularly the level of maternal activity, may be an early indicator of later childhood psychopathology in low-risk samples. Further longitudinal, population-based studies are required. Trial registration: PROSPERO review registration: CRD42020162917https://www.google.com/search?client=firefox-b-d&q=CRD42020162917. [ABSTRACT FROM AUTHOR]

Objectives: To compare data based on computerized and paper versions of health status questionnaires (HSQs) for sampling patient-reported outcomes (PROs) in patients with fibromyalgia (FM). In addition, to examine associations between patient characteristics (age, education, computer experience) and differences between versions. Finally, to evaluate the acceptability of computer-based questionnaires among patients with FM.Method: The study population comprised female patients diagnosed with FM. All patients completed six HSQs: the Fibromyalgia Impact Questionnaire (FIQ), the Major Depression Inventory (MDI), the 36-item Short Form Health Survey (SF-36), the painDETECT questionnaire (PDQ), the Coping Strategies Questionnaire (CSQ), and the Generalized Anxiety Disorder Self-Assessment Questionnaire (GAD-10), both on paper and using a touch screen. One HSQ was tested at a time in a repeated randomized cross-over design. The two versions were completed with a 5-min interval and between each HSQ the participants had a 5-min break. Means, mean differences with 95% confidence intervals (CIs), medians, median differences, and intraclass correlation coefficients (ICCs) were calculated for all HSQs, including relevant subscales. Associations between patient characteristics and differences between versions were explored using Spearman's correlation coefficients.Results: Twenty women, mean age 48.4 years, participated in the study. Except for one item, ICCs between touch-screen and paper versions of the HSQs examined indicated acceptable agreement (ICC = 0.71-0.99). Overall, mean and median differences revealed no differences between versions. No significant associations were observed for patient characteristics. None of the participants preferred paper questionnaires over computerized versions.Conclusions: The computerized HSQs using a touch screen gave comparable results to answers given on paper and were generally preferred by the participants. [ABSTRACT FROM AUTHOR]

Background and Aims: Increasing numbers of school‐based drug surveys are transitioning data collection to electronic tablets from paper‐and‐pencil, which may produce a survey mode effect and consequent discontinuity in time trends for population estimates of drug prevalence. This study tested whether (a) overall, self‐reported drug use prevalence is higher on electronic tablets versus paper‐and‐pencil surveys, (b) socio‐demographics moderate survey mode effects and (c) levels of missing data are lower for electronic tablet versus paper‐and‐pencil modes. Design A randomized controlled experiment. Setting: Results are nationally representative of students in the contiguous United States. Participants: A total of 41 866 8th, 10th and 12th grade students who participated in the 2019 Monitoring the Future school‐based survey administration. Intervention and comparator: Surveys were administered to students in a randomly selected half of schools with electronic tablets (intervention) and with paper‐and‐pencil format (comparator) for the other half. Measurements Primary outcome was the total number of positive drug use responses. Secondary outcomes were the percentage of respondents completing all drug questions, percentage of drug questions unanswered and mean number of missing drug items. Findings The relative risk (RR) for total number of positive drug use responses for electronic tablets versus paper‐and‐pencil surveys were small and their 95% confidence intervals (CI) included the value of one for reporting intervals of life‐time (RR = 1.03; 95% CI, 0.93–1.14), past 12 months (RR = 1.01; 95% CI, 0.91–1.11), past 30 days (RR = 1.05; 95% CI, 0.93–1.20) and for heavy use (RR = 1.10; 95% CI, 0.93–1.29). Multiplicative interaction tests indicated no moderation of these relative risks by race (white versus non‐white), population density, census region, public/private school, year of school participation, survey version or non‐complete drug responses. Levels of missing data were significantly lower for electronic tablets versus paper‐and‐pencil surveys. Conclusions: Adolescent drug prevalence estimates in the United States differed little across electronic tablet versus paper‐and‐pencil survey modes, and showed little to no effect modification by socio‐demographics. Levels of missing data were lower for electronic tablets. [ABSTRACT FROM AUTHOR]

Discovery environments are ubiquitous in academic libraries but studying their effectiveness and use in an academic environment has mostly centered around user satisfaction, experience, and task analysis. This study aims to create a quantitative, reproducible framework to test the relevancy of results and the overall success of Washington State University's discovery environment (Primo by Ex Libris). Within this framework, the authors use bibliographic citations from student research papers submitted as part of a required university class as the proxy for relevancy. In the context of this study, the researchers created a testing model that includes: (1) a process to produce machine-generated keywords from a corpus of research papers to compare against a set of human-created keywords, (2) a machine process to query a discovery environment to produce search result lists to compare against citation lists, and (3) four metrics to measure the comparative success of different search strategies and the relevancy of the results. This framework is used to move beyond a sentiment or task-based analysis to measure if materials cited in student papers appear in the results list of a production discovery environment. While this initial test of the framework produced fewer matches between researcher-generated search results and student bibliography sources than expected, the authors note that faceted searches represent a greater success rate when compared to open-ended searches. Future work will include comparative (A/B) testing of commonly deployed discovery layer configurations and limiters to measure the impact of local decisions on discovery layer efficacy as well as noting where in the results list a citation match occurs. [ABSTRACT FROM AUTHOR]

This article comments on the research paper "A hypothesis about Spiegel et at's 1989 paper on psychosocial intervention and breast cancer survival" by Bernard H. Fox. Dr. Fox underestimates the importance of randomization done by present author. The reason that the authors have done randomized trials is because any attempt to match a study sample with some other comparison sample is open to the possibility of bias. The fundamental premise of randomized clinical trials is that the only thing that systematically distinguishes intervention from control patients is their randomization status. If this is the case, prognostic variables, such as site of metastasis, tumor type, and other potential confounds, are unlikely (but not unable) to account for the differences observed. Dr. Fox assumes improbable results as fact in his analysis of the study conducted by authors of the present article. There is a bit of a bias in Dr. Fox's analysis of sample differences.

Aiming at the problem that the traditional rapidly exploring random tree (RRT) algorithm only considers the global path of unmanned vehicles in a static environment, which has the limitation of not being able to avoid unknown dynamic obstacles in real time, and that the traditional dynamic window approach (DWA) algorithm is prone to fall into a local optimum during local path planning, this paper proposes a path planning method for unmanned vehicles that integrates improved RRT and DWA algorithms. The RRT algorithm is improved by introducing strategies such as target-biased random sampling, adaptive step size, and adaptive radius node screening, which enhance the efficiency and safety of path planning. The global path key points generated by the improved RRT algorithm are used as the subtarget points of the DWA algorithm, and the DWA algorithm is optimized through the design of an adaptive evaluation function weighting method based on real-time obstacle distances to achieve more reasonable local path planning. Through simulation experiments, the fusion algorithm shows promising results in a variety of typical static and dynamic mixed driving scenarios, can effectively plan a path that meets the driving requirements of an unmanned vehicle, avoids unknown dynamic obstacles, and shows higher path optimization efficiency and driving stability in complex environments, which provides strong support for an unmanned vehicle's path planning in complex environments. [ABSTRACT FROM AUTHOR]

Background: Existing evidence suggests that clinician and organization engagement in research can improve healthcare processes of care and outcomes. However, current evidence has considered the relationship across all healthcare professions collectively. With the increase in allied health clinical academic and research activity, it is imperative for healthcare organizations, leaders and managers to understand engagement in research within these specific clinical fields. This systematic review aims to identify the effect of engagement in research by allied health professionals (AHPs) and organizations on healthcare performance. Methods: This systematic review has a two‐stage search strategy. The first stage will be to screen a previous systematic review examining the effectiveness of engagement in research in health and social care to identify relevant papers published pre‐2012. The search strategy used in the previous review will then be rerun, but with a specific focus on allied health. This multi‐database search will identify publications from 2012 to date. Only studies that assessed the effectiveness of allied health engagement in research will be included. All stages of the review will be conducted by two reviewers independently, plus documented discussions with the wider research team when discrepancies occur. This systematic review protocol follows the EQUATOR reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses for Protocols (PRISMA‐P). Discussion: The findings of this review will make a significant contribution to the evidence base around the effect of allied health engagement in research on healthcare performance. It will provide insights for clinicians and managers looking to understand the consequences of developing AHP research capability and capacity. The findings of this review will also aim to make recommendations for future evaluation approaches for engagement in research interventions. Trial registration: This systematic review protocol has been registered with PROSPERO, registration number CRD42021253461. What this paper adds: What is already known on the subject: This study will provide valuable evidence for professionals and policymakers seeking to understand engagement in research in the allied health disciplines. Where supported by the data, there may be recommendations for future research regarding specific variables to be considered when planning and evaluating engagement in research in allied health practice. What this paper adds to existing knowledge: A previous systematic review identified a positive association between clinician and organization engagement in research and improved processes of care and health outcomes. The reviews' findings have been used as a justification for clinicians and organizations to increase research capacity. That review evaluated literature published before 2012 and the studies that were identified predominantly reported on engagement in research by medics and nurses. An updated review is now required to include research published since 2012. This review will specifically focus on the effect of engagement in research within allied health disciplines. What are the potential or actual clinical implications of this work?: Research activity among AHPs is gaining momentum. Given this growth in AHP research activity and the rise in dedicated clinical academic roles, a contemporary review to identify the specific effect of AHP engagement in research on healthcare performance is prudent. The findings will inform clinicians, clinical managers and leaders of the potential impact of research activities by AHP clinicians and organizations. This will support the planning and development of initiatives focused on research capacity, capability and culture within allied health. [ABSTRACT FROM AUTHOR]

Background: Multiple Sclerosis (MS) is affected by cognitive and emotional factors. The aim of this study was to investigate the relationship between sensitivity to anxiety and executive functions and the Quality of Life (QoL) of MS patients using path analysis. Methods: This descriptive correlational research was done on all patients with MS in Gorgan MS Association in 2020. The sample size was considered to be 290 people according to the sample selection formula and based on the values obtained from the previous study selected by simple random sampling. To collect data, the Executive Functions Questionnaire of Nejati (2013), QoL questionnaire of McGuigan & Hutchinson (2004), and Sensitivity to Anxiety Questionnaires of Taylor and Cox (1998) were used. Path analysis with SPSS v. 18 and AMOS v. 23 software was used to analyze the data. Results: The results showed that the executive functions had a positive relationship with QoL in MS patients and sensitivity to anxiety had a negative relationship with QoL in MS patients. Also, mediating role of the anxiety sensitivity variable in the relationship between executive functions with QoL in MS patients was confirmed (P≤0.01). Conclusion: The present study indicated the importance of cognitive factors, such as executive functions, and emotional factors, such as sensitivity to anxiety in explaining the QoL in MS patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools). Design: Cross-sectional telephone survey. Setting and Participants: Schools in Alberta, Canada. Principals from 357 schools. Main Outcome Measure: Barriers to adopting the nutrition guidelines. Analysis: A 19-question telephone survey, including open- and closed-ended questions, was used to obtain information regarding schools' characteristics and barriers to adopting the guidelines. Qualitative data were coded according to common themes a priori, based on constructs from the Diffusion of Innovations framework. Results: Schools reported many barriers related to the relative advantage, compatibility, and complexity of adopting the guidelines. Parents' resistance to change and cost were the key reported barriers. Lack of knowledge, student preferences, the physical location of the school, and barriers related to the provision of healthful food were also reported. Conclusions and Implications: Disseminating guidelines without providing adequate support for their implementation may not promote change within the school setting. School nutrition initiatives need to involve the parents and have access to sufficient financial and human resource support. [ABSTRACT FROM AUTHOR]

A number of farmed species are characterized by breeding populations of large full-sib families, including aquaculture species and outcrossing plant species. Whole genome association studies in such species must account for stratification arising from the full-sib family structure to avoid high rates of false discovery. Here, we demonstrate the value of selective genotyping strategies which balance the contribution of families across high and low phenotypes to greatly reduce rates of false discovery with a minimal effect on power. [ABSTRACT FROM AUTHOR]

Due to their lack of periodontal ligaments (PLs) and the differences between dental implants and natural teeth, it is necessary to improve and generate a new occlusal scheme to prolong the life of implants and prostheses. The age and the sex of patients must be considered because of their effects on the stomatognathic system's physiology. Operators must manage all the changes to obtain good sensations during mastication and a better occlusal scheme for implanting fixed partial prostheses. Dentists should try to protect this type of prosthesis using adjacent teeth and the PL. This is why new digital systems were created. The combination of T-Scan® (digital software for occlusal analysis) and electromyography (EMG) could allow doctors to find areas where it is necessary to act and to find suitable solutions for the problems generated by using conventional methods of occlusal analysis (such as articulating paper). In this study, a new method for establishing occlusion on fixed partial implant prostheses has been created, combining digital systems with conventional articulating paper. This method consists of asking the patient to bite down with different forces and situations in an attempt to achieve Implant-Protected Occlusion (IPO). The use of digital systems has been shown to be more effective than using only conventional systems. This new method allows a safer mode of occlusion which protects implants and prostheses, saving all the differences between them and natural teeth, and increasing the satisfaction of patients. This method also helps to overcome the changes in the stomatognathic system as age increases, adjusting the occlusion to changes in PLs with age. [ABSTRACT FROM AUTHOR]

Aim: To identify the learning barriers, nursing students encounter throughout distinct stages of simulation‐based education. Design: Qualitative study exploring learning barriers in simulation training. Methods: Data were collected through interviews with 13 fourth‐year nursing students at Dongnam Health University, divided into four groups. These students had prior simulation experience with a variety of medical scenarios, including shortness of breath, chest pain, preterm labor, postoperative pain management, and neonatal care. Interviews were conducted using a semistructured format and lasted approximately one hour per group. We then used content analysis to identify primary and secondary themes. Results: Three main themes and 13 subthemes were identified, highlighting learning challenges across different stages of simulation training: limitations in integrating theoretical foundations during the prebriefing phase, the impact of psychological stress on clinical reasoning abilities during the scenario phase, and constraints in reflective thinking during the debriefing phase. Conclusion: This paper highlights significant learning obstacles across the simulation training process and advocates for targeted educational strategies to overcome these barriers. Specific recommendations include implementing additional measures to enhance student immersion, ensuring psychological safety, and enhancing debriefing sessions to encourage reflective thinking. Implications: This paper emphasizes the need for immersive and realistic training in nursing education. It suggests enhancements in applying theoretical knowledge, managing stress‐induced clinical reasoning, and fostering reflective thinking to better prepare students for clinical realities. It also acknowledges that the sample size may limit generalizability and recommends further studies with larger cohorts. Impact: This study aims to better prepare nursing students for the complexities of clinical practice by emphasizing the development of holistic patient care and adaptive problem‐solving skills. The research implications suggest a potential transformation in nursing education and practice, aiming to improve healthcare outcomes. [ABSTRACT FROM AUTHOR]

Background: Family caregivers have a vital role to play in palliative care for chronically ill patients. In Taiwan, caregiver demographics are evolving, with the number of male caregivers increasing. Gender differences influence psychosocial behaviours, thought processes and communication styles. In healthcare, acknowledgement of gender differences facilitates effective delivery of high‐quality care. Aim: The aim of this study is to explore male caregivers' decision‐making process for palliative care for chronically ill family members. Methods: This study employed grounded theory to generate a substantive theory of male caregivers' decision‐making process for palliative care for chronically ill family members. We recruited 22 male participants from three inner‐city teaching hospitals in Taiwan. Findings: Regarding the decision‐making process of palliative care of chronic ill family, where male caregivers do not want their loved ones suffering anymore, the male caregivers' decision‐making process was impacted, first, by caregivers' views on the last stage of life; second, by their wish for good care during the end of life; and third, by their conviction that the patients' wishes should be respected. Furthermore, caregivers' philosophy of life and death is also a supportive ground for decision‐making. This philosophy was influenced by their education in palliative care, financial status and religious beliefs and practices. The core category emerging from this study is encapsulated by a participant's assertion, 'How difficult is it? There are no male and female differences'. Conclusion: We found that palliative care experiences of male caregivers are important for the decision‐making process for palliative care for their chronically ill family members. Caregivers want their loved ones to receive good care as the last step in life, to respect their wishes and no more suffering for the patient. Therefore, health professionals should be familiar with the palliative care process that caregivers go through to offer updated information when needed. Summary statement: What is already known about this topic? Taiwanese philosophy of end‐of‐life care focuses on family values and shares the power of making critical decisions between patients and their relatives.Due to cultural preferences, the dedicated family caregiver often becomes the only channel for honouring the patient's wishes.Male and female caregivers can have different coping mechanisms; males are less likely to seek support and are more stressed by financial burdens. What this paper adds? The patient and the whole family should be considered in the discussion of end‐of‐life care.Male caregivers indicated palliative care should be linked to comfort care, avoidance of suffering and respecting patients' wishes. The implication of this paper: Male caregivers should be well supported, good care for their loved ones and fulfil the patient's wishes and no more suffering.Education in palliative care and religious and financial support should be provided along with palliative care services to both male caregivers. [ABSTRACT FROM AUTHOR]

Aim: To assess heart rate variability (HRV) as a measure to assess job stress and sleep quality among nurses in the post‐COVID‐19 period. Background: The COVID‐19 pandemic significantly affected nurses, with heightened job stress and impaired sleep quality impacting their well‐being and effectiveness in patient care. HRV could offer insights for supporting strategies in the pandemic aftermath. Design: A quantitative cross‐sectional study. Methods: This study involved 403 clinical nurses recruited from a teaching hospital in Taiwan. Data on job stress, work frustration, sleep quality and HRV were collected and analysed. Results: Among the nurses surveyed during the COVID‐19 pandemic, 72.7% reported poor sleep quality (PSQI = 9.369). Job stress emerged as a strong predictor of work frustration. High stress levels and poor sleep quality were correlated with significantly decreased HRV, indicating a potential physiological impact of stress on the nurses' health and well‐being. Conclusions: HRV is a valuable and cost‐effective measure for monitoring and managing nurses' well‐being in the post‐COVID‐19 era. Targeted interventions can be implemented to support nurses' overall performance and promote their well‐being by identifying those at high risk of job stress and poor sleep quality. Summary statement: What is already known about this topic? The COVID‐19 pandemic significantly impacted medical care capacity, leading to heightened physical and mental distress among frontline nurses. This has resulted in a marked increase in job stress, presenting a significant challenge to occupational health.The substantial changes in the medical environment caused by the pandemic are likely to induce job stress, which, in turn, can detrimentally affect sleep quality. This aspect is crucial, as sleep quality is a key determinant of nurses' ability to deliver optimal medical care to patients. What this paper adds? Job stress significantly impacts nurses' sleep quality and is a key predictor of work frustration, surpassing the sole influence of work frustration.The study highlights a significant link between high stress levels, reduced sleep quality and decreased heart rate variability in nurses. It further reveals that nurses with moderate COVID‐19‐related anxiety show heightened heart rate variability, indicating sympathetic nervous system activation to maintain alertness in emergency medical situations. The implications of this paper: Moderate anxiety as a positive factor: moderate levels of anxiety among nurses can contribute to maintaining alertness, reducing errors and lowering the risk of contracting COVID‐19.HRV as a monitoring and management measure: heart rate variability is a valuable and cost‐effective measure for monitoring and managing the health of nurses in the post‐COVID‐19 era. By identifying nurses with high work stress and poor sleep quality, targeted interventions can be implemented to support their overall performance and promote their well‐being.Targeted interventions for improved well‐being: the implementation of specific interventions aimed at supporting nurses' overall performance and enhancing their well‐being is crucial in maintaining a high standard of patient care. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the feasibility of implementing a psychological first aid intervention for psychological distress, resilience capacity, quality and meaning of life among survivors affected by earthquake adversity in Northern Syria. Methods: A quasi‐experimental, pre‐posttest, two‐group research design was utilized. A convenience sample of 95 survivors (46 in the study group and 49 in the control group) was recruited for the psychological First Aid intervention at a 1:1 ratio. The psychological first aid intervention was delivered in 10 sessions, twice weekly, followed by 3‐month follow‐up. Results: A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared with the control group. Conclusion: Our work verified the suitability of implementing psychological first aid following the catastrophic temblors which struck Northern Syria. Given that the psychological first aid intervention is grounded in psychological safety, cognitive reframing, mobilization of social support and installation of hope, the feasibility of its path following public health emergency, traumatic events or even a personal crisis can be favourable. Summary statement: What is already known about this topic? On 6 February 2023, a massive earthquake devastated large portions of war‐torn northwest Syria and southern Turkey, leaving millions in these regions battling to reconstruct their lives.In northwest Syria, strong aftershocks left more than 4500 people dead, injured hundreds more and demolished at least 10 000 structures.Disasters such as earthquakes can have a significant impact on the mental health and well‐being of those affected. Survivors may experience high levels of psychological distress and other negative mental health recovery outcomes.There is a need for psychologically supportive interventions such as the psychological first aid intervention to help survivors cope with the aftermath of such disasters.What this paper adds? A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared to the control group.Our work verified the suitability of implementing the psychological first aid intervention following the catastrophic temblors which struck Northern Syria.The implications of this paper: Being ready for disasters is critical; health care professionals, including nurses, are one of the most frequently requested actors in disaster interventions.Nurses are an indispensable part in ascertaining the psychological repercussions of disasters on survivors, families and communities.Due to their training and professional experience, nurses can take the lead in reducing health‐threatening risks. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to investigate the status of self‐management behaviour and illness perceptions and to examine illness perceptions in relation to self‐management behaviour in elderly patients with chronic obstructive pulmonary disease (COPD). Methods: A cross‐sectional study was conducted, and 152 elderly COPD patients were recruited via the convenience sampling method. The COPD Self‐Management Scale and the Revised Illness Perception Questionnaire for COPD patients were used to examine self‐management behaviour and illness perceptions. Pearson correlation analysis, univariate analysis and hierarchical linear regression analysis were used to explore illness perceptions in relation to self‐management behaviour. Results: The mean overall score for self‐management behaviour was 2.90 ± 0.39. Among the subscales of self‐management behaviour, information management had the lowest score of 2.20 ± 0.76. Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be significant determinants of self‐management behaviour. After controlling for these variables, several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self‐management behaviour. Conclusions: This study confirmed that elderly COPD patients' self‐management behaviour was unsatisfactory and that illness perceptions were significant determinants of self‐management behaviour. The findings may contribute to the development of self‐management interventions for elderly COPD patients. Summary statement: What is already known about this topic? Self‐management behaviour plays an essential role in managing COPD.Illness perceptions are predictors of self‐management behaviours in COPD patients, but little is known about how illness perceptions influence self‐management behaviour in elderly patients with COPD. What this paper adds? Several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self‐management behaviour.Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be determinant of self‐management behaviour. The implications of this paper: The findings may contribute to developing tailored interventions that help patients establish beneficial illness perceptions to improve their self‐management behaviour. [ABSTRACT FROM AUTHOR]

Aims: This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. Background: Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. Design: This cross‐sectional study was designed based on the theory of unpleasant symptoms. Methods: Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) Results: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. Conclusion: The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self‐coping and symptom management for kidney transplant recipients. Summary statement: What is already known about this topic? Fatigue is a common symptom of kidney transplant recipients and can impair postoperative recovery, reemployment, quality of life, social activities and physical and mental states, causing the body to be in a state of chronic energy consumption.Owing to the imperceptible physical injury upon kidney transplant recipients, fatigue is often underappreciated or even disregarded. What this paper adds? It was found that the rate of fatigue in kidney transplant recipients was high.The risk factors for fatigue in kidney transplant recipients based on the theory of unpleasant symptoms were analysed in three ways: physiological, psychological and situational. The results showed that sleep quality, duration after transplantation, serum potassium level, anxiety, depression, education level, financial burden and social support were associated with fatigue in kidney transplant recipients. The implications of this paper: Clinical nurses should conduct timely and multidimensional fatigue evaluations of kidney transplant recipients and pay more attention to those with a high level of fatigue.The findings can provide a scientific basis for kidney transplant specialist nurses to conduct targeted interventions and facilitate fatigue management for kidney transplant recipients. They can also help to develop fatigue intervention models based on the displeasure symptom theory to improve fatigue in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Aim: To assess the psychometric properties of the Thai version of Caregiver Contribution to Self‐Care of Chronic Illness Inventory version 2 (CC‐SC‐CII‐v2) among primary caregivers of individuals with any single or multiple chronic illnesses. Background: The instrument encompasses three scales that evaluate Caregiver Contribution to Self‐Care (CC‐SC) Maintenance, Monitoring and Management. Methods: The English version CC‐SC‐CII‐v2 was translated and adapted for Thai context, and a cross‐sectional multicenter study involved 430 caregivers from 16 primary care centres in Thailand. Structural validity, internal consistency reliability and test–retest reliability were examined. Results: The original two‐factor CC‐SC Maintenance scale required a re‐specified model for good fit, while the CC‐SC Monitoring and CC‐SC Management scales fit well. The simultaneous model of three scales demonstrated satisfactory fit. The CC‐SC Maintenance and CC‐SC Management scales both had a composite reliability index of 0.85, with omega coefficients of 0.86 and 0.83, respectively. CC‐SC Monitoring had an alpha coefficient of 0.89. The intraclass correlation coefficients ranging from 0.84 to 0.91, indicating good test–retest reliability. Conclusion: The Thai CC‐SC‐CII‐v2 is a valid and reliable instrument that can provide clinicians and investigators with an evaluation of the contributions of caregivers to the self‐care of patients with chronic illnesses. Summary statement: What is already known about this topic? The Caregiver Contribution to Self‐Care of Chronic Illness Inventory (CC‐SC‐CII) is a theoretical‐based instrument initially created in the Western context.This inventory consists of three separate but interconnected scales for assessing caregiver involvement in patient self‐care maintenance, monitoring and management.Rigorous psychometric assessments conducted in Western contexts have affirmed the validity, reliability and effectiveness of the CC‐SC‐CII. What this paper adds? The introduction of the updated version, CC‐SC‐CII‐v2, likely presents challenges linked to cultural adaptation when applying it within the Thai context.This research constitutes a novel contribution to the field of caregiving studies in Thailand and the broader Asian region.The study offers new insights into the validity and reliability of the CC‐SC‐CII‐v2 within the context of Thai caregiving. The implications of this paper: The CC‐SC‐CII‐v2 proves to be a valid and reliable instrument for evaluating caregiver involvement in the self‐care of patients with chronic illnesses.Its applicability extends to various culture, including Thai context, and it may be considered suitable for application in other Asian backgrounds as well. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the effectiveness of the bladder stimulation technique (BST) to collect urine samples from newborns and its effects on physiological parameters and comfort of the newborn. Design: This was a randomized controlled trial conducted in a NICU. A total of 64 newborns were divided into 2 groups: 32 newborns in the experimental group and 32 newborns in the control group. Methods: Newborns in the experimental group (EG) were subjected to the BST, and in the control group (CG), urine collection was via sterile urine bags, which is routine practice. Procedural success was defined as the collection of urine samples within 3 min of beginning the stimulation technique in the experimental group and of placing the sterile urine bag in the control group. Results: The success rate of the procedure in 3 min was 62.5% in the EG and 28% in the CG (P = 0.006, absolute difference: 35%, 95% confidence interval 27% to 42%, NNT: 3). According to the comparison of the overall mean COMFORTneo scale and pain and distress subscale scores at the 1‐ and 3‐min marks, there was a significant difference between the EG and CG (p < 0.05). The mean scores in the EG were higher than those in the CG. The mean oxygen‐saturation was significantly lower in the EG than in the CG (p < 0.05), and the increase in heart rate was significantly higher in the EG (p = 0.018). Conclusions: BST is a more successful method within 3 min for collecting urine samples from newborns compared to sterile urine bags. However, the newborns' comfort levels minimally decreased at 3 min, and they had moderate pain and distress, while the BST was being implemented. This increase in physiologic parameters was statistically significant but not clinically significant. Summary statement: What is already known about this topic? Urinary tract infection is a commonly diagnosed bacterial infection in young infants with fever. However, the symptoms of this infection are non‐specific, so urine samples are needed to accurately diagnose and exclude it.There are multiple methods available for collecting urine samples, each with its own advantages and disadvantages.The bladder stimulation technique is a noninvasive and efficient method for collecting urine samples. However, few studies have examined the pain and distress effects of this technique, and these studies have reported varying results. What this paper adds? This study found that bladder stimulation techniques were more effective than sterile urine bags in collecting urine samples within 3 min from newborns.The bladder stimulation technique led to decreased saturation and comfort levels, increased heart rate, and increased pain and distress in the newborns during urine sampling; these increases in physiologic parameters were statistically significant but not clinically significant. The implications of this paper: The bladder stimulation technique is an effective noninvasive method for quickly collecting urine samples.Considering the pain and distress‐increasing properties of the technique, it may be recommended before invasive interventions (bladder catheterization and suprapubic aspiration) when urine sample collection with urine bags is not possible; it can be used in cases where urgent urine collection is required. [ABSTRACT FROM AUTHOR]

Aim: The research was conducted to measure the effect of health literacy‐grounded web‐based education program on health literacy, nutrition and exercise behaviours in adolescents. Background: The increasing prevalence of obesity in adolescents is explained by a sedentary lifestyle and unhealthy diet. Health literacy is essential for adolescents to maintain their healthy behaviours. Methods: The research was conducted as a parallel group randomized controlled trial. The study was completed by 114 adolescents (experimental = 42, control = 72). The Personal Information Form, the Health Literacy Scale for School‐Age Children and the Nutrition and Exercise Subscales were used to collect data. A web‐based education program was implemented. Two‐way mixed design ANOVA with Bonferroni test was used to examine the group, time and group * time interaction of the measurements. Results: There was no statistically significant difference between the experimental and control groups regarding health literacy level, nutrition and exercise behaviours pre‐test mean scores (p > 0.05). In the post‐test, the mean scores of health literacy and nutrition behaviours in the experimental group were higher than the control group (p < 0.001). However, there was no significant difference in exercise behaviours (p > 0.05). The power and effect size in mean scores changes for health literacy (99.8%, η2 = 0.039) and nutrition (99.8%, η2 = 0.039) were moderate. Conclusion: The study concluded that health literacy‐grounded web‐based education program increased the health literacy levels of adolescents and improved their nutritional behaviours; however, there was no sufficient change in exercise behaviours. Summary statement: What is already known about the topic? The health literacy level of adolescents is inadequate or limited.Obesity and sedentary lifestyle are more common problems among adolescents.Interventions such as wellness coaching and health education were used to improve nutrition or exercise behaviours. What this paper adds? Health literacy‐grounded web‐based education program helps to increase the health literacy levels of adolescents.Health literacy‐grounded web‐based education program was found effective in improving nutrition behaviours. The implications of this paper: Nurses could implement web‐based education programs to prevent the negative consequences of unhealthy behaviours of adolescents.Nurses could provide opportunities to access health‐related information via web‐based interventions.Nurses could collaborate with school administrators to integrate nutrition and exercise behaviours into comprehensive and coordinated school‐based programs. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to determine the impact of problematic mobile phone use on negative mental health outcomes among nursing students in India, highlighting the necessity for targeted interventions and support mechanisms to enhance the overall well‐being and adaptability of future healthcare professionals. Methods: A cross‐sectional survey was conducted in three randomly selected nursing colleges in South India, employing validated and standardized tools such as the Mobile Phone Problematic Use Scale, Patient Health Questionnaire, Insomnia Severity Index Scale, Satisfaction with Life Scale and Rosenberg Self‐Esteem Scale. Results: The study included 402 nursing students with an average age of 20.47 years, revealing a 39% prevalence of severe problematic mobile phone usage. Positive correlations were observed between mobile phone problematic use and age, depression and insomnia. Additionally, strong negative correlations were found between satisfaction with life and self‐esteem. Depression and satisfaction with life served as chain mediators in the impact of self‐esteem on problematic mobile phone use, and both self‐esteem and satisfaction with life negatively predicted problematic mobile phone use. Conclusion: The study highlights a prevalent issue of problematic mobile phone use among nursing students, indicating a pressing need for timely intervention, as it correlates with depression, sleep insomnia, low self‐esteem and life dissatisfaction. Summary statement: What is already known about this topic? Over the last decade, using mobile phones has been prevalent among today's children and young people, coinciding with an increase in poor mental health in this population.Problematic mobile phone use may consist of various issues, including addiction/dependence, financial troubles, risky use (i.e. while driving) and restricted use (i.e. in prohibited places).From an epidemiological standpoint, prevalence rate estimates vary widely and there is little research and understanding regarding the aetiology of problematic and addicted mobile phone usage, particularly its progression. What this paper adds? The prevalence of severe problematic mobile phone use among nursing students is very high and needs immediate attention.There is a negative impact of mobile phone use on the mental health outcomes of nursing students.Positive life satisfaction and self‐esteem are protective variables that negatively predict problematic mobile phone use, while their influence is mediated by a chain reaction involving reduced depression, emphasizing the interconnected psychological dynamics. The implications of this paper: Further research is needed on the influencing factors of problematic mobile phone use and interventions to prevent mobile phone addiction among nursing students.The influence of mobile phone use on the mental health outcomes of nursing students can affect their clinical practice and productive life therefore the appropriate policies should be implemented.Implementation of short and rapid counselling services for the nursing students by the nurse educators should incorporate into the curriculum to achieve a better quality of nurses. [ABSTRACT FROM AUTHOR]

Aims: This study was conducted to examine the effect of monthly telephone message reminders after training on women's beliefs and practice behaviours regarding breast self‐examination. Methods: This randomized controlled study was conducted with 83 women aged 20–69 years living in Turkey between September 2021 and July 2022. Women were randomly assigned (1:1) to the intervention (n = 41) or control group (n = 42), both groups received online breast self‐examination training, and the intervention group received monthly reminders on their mobile phones for 3 months. Participants completed the Champion's Health Belief Model Scale and breast self‐examination practice evaluation form at baseline and 3 months after intervention. Results: After the intervention, the mean scores of the benefits and self‐efficacy subscales of Champion's Health Belief Model Scales were significantly higher in the intervention group compared to the control group, and the mean score of barriers was lower. The rate of performing breast self‐exam regularly and at the appropriate time was higher in the intervention group. The rate of forgetting to perform breast self‐examination was higher in control group. Conclusion: A monthly reminder message may be recommended to increase women's belief in breast self‐examination and increase regular practice. Summary statement: What is already known about this topic? Breast cancer is common, it is a type of cancer that progresses slowly and can be treated with early diagnosis and regular application of breast self‐examination is one of the effective non‐invasive screening methods for early diagnosis of breast cancer among women.Studies have found that forgetfulness and neglect, lack of awareness about BSE techniques and lack of knowledge are important obstacles to breast self‐examination. What this paper adds? Breast self‐examination training and then a monthly phone message reminder approach was used in women.It has been observed that the monthly telephone reminder message is an intervention that increases the belief in breast self‐examination in women, along with an increase in the rate of regular and timely examination practice and a decrease in the rate of forgetting to do so. The implications of this paper: The importance of regular phone message reminders about breast self‐examination should be included in the in‐service training given to all health professionals, especially midwives and nurses working in the delivery of primary health care services.A central message system could be developed to remind women of breast self‐examination at the national level. [ABSTRACT FROM AUTHOR]