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Studies on the treatment of attention-deficit/hyperactivity disorder (ADHD) in adolescence indicate small to moderate treatment effects (e.g., of parent training). Self-help interventions might overcome structural and personal barriers to treatment utilization. The present proof-of-concept study examined the feasibility and effectiveness of a twelve-month, telephone-assisted self-help (TASH) intervention for caregivers of adolescents with ADHD. This intervention comprised 8 booklets on the management of ADHD-related problems and 14 telephone counseling sessions. Sixty-six caregivers participated in the study with a one-group pretest-posttest design (intention-to-treat sample). Of these, forty-three families completed the intervention in accordance with the study protocol (per-protocol sample). Compared to families with early discontinuation (n = 23, drop-out sample), adolescents in the per-protocol sample demonstrated a higher level of caregiver-rated emotional problems and a lower level of quality of life at pre-assessment. Caregivers in the per-protocol sample showed high adherence and reported high satisfaction with the intervention. Analyses of the per-protocol sample yielded significant, moderate to large pre-to-post improvements in caregiver-rated ADHD symptoms (primary outcome; d = 0.81, 95% confidence interval [0.51, 1.11]), oppositional, emotional and behavioral problems and quality of life of the adolescents, and caregiver self-efficacy during the intervention. In intention-to-treat analyses, which considered data of all 66 participants who had originally participated in the study, the pre-post differences in ADHD symptoms, emotional and behavioral problems, and quality of life remained at their significant level. These results provide initial support for the feasibility and effectiveness of the TASH intervention. Its efficacy compared to control conditions remains to be examined. Highlights: Clinical guidelines recommend the use of parent training in the treatment of adolescents with ADHD. In case of barriers to treatment utilization, low-threshold self-help interventions might be a viable treatment alternative. This study evaluated a twelve-month telephone-assisted self-help intervention for caregivers of adolescents with ADHD using a pre-post design. Per-protocol analyses revealed pre-post improvements in several outcomes, inter alia caregiver-rated ADHD symptoms. Caregivers indicated high satisfaction. The study provides initial support for the feasibility and effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

Background and Objectives Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020–December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. Research Design and Methods This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. Results The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. Discussion and Implications HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations. [ABSTRACT FROM AUTHOR]

Objectives While ethnic minorities in Europe are disproportionally affected by cardiovascular disease (CVD), little is known about how general practitioners (GPs) perceive differences in risk or care needs across ethnic minority groups. Therefore, we explored GPs' views on whether ethnicity influences cardiovascular risk, whether a culturally sensitive approach is warranted, on potential barriers in the provision of such care, and to find potential opportunities to improve cardiovascular prevention for these groups. Methods We conducted a qualitative study by interviewing GPs practising in The Netherlands. The interviews were semistructured, audio-recorded, and analysed by 2 researchers using thematic analysis. Results We interviewed 24 Dutch GPs (50% male). GPs' views on the impact of ethnicity on CVD risk varied widely, yet it was generally recognized as a relevant factor in cardiovascular prevention for most minority groups, prompting earlier case-finding of high-risk patients. While GPs were aware of sociocultural differences, they emphasized an individualized approach. Perceived limitations were language barriers and unfamiliarity with sociocultural customs, leading to a need for continuing medical education on culturally sensitive care and reimbursement of telephone interpreting services. Conclusion Dutch GPs have differing views on the role of ethnicity in evaluating and treating cardiovascular risk. Despite these differences, they emphasized the importance of a personalized and culturally sensitive approach during patient consultations and expressed a need for continuing medical education. Additional research on how ethnicity influences CVD risk may strengthen cardiovascular prevention in increasingly diverse primary care populations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Governance & Administrative Reform is the property of Universitas Airlangga 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.)

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing 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.)

This article describes the journey of a health equity research study that changed course due to challenges associated with the COVID-19 pandemic and the precarity of the population of focus. Although the mixed methods intervention and dance/movement therapy protocol did not transpire as intended, we gained much relevant insight from the 12-month process. We here highlight the original six-week protocol, recruitment efforts and important clinical observations during the recruitment phase, as well as a detailed synopsis in form of a case study of the one participant who completed the study. We also take a critical look at the limitations of clinical human research and raise the question when to pivot from or abort a project, keeping in mind what ultimately matters, the respect, value, and care of an individual. We close with implications for engaging in research with vulnerable communities. [ABSTRACT FROM AUTHOR]

This contribution discusses the ambivalent role of the telephone in commodity futures trading. On one hand, the telephone proved to be useful in commodity futures trading since it was easier to use than the telegraph; on the other, it helped to spread prejudices about the commodity futures business. Indeed, this became a political issue in the 1890s as reforms were demanded. The large agrarians of Prussia in the East were particularly interested in these reforms. Above all, the marginal trading deriving from commodity futures was accused of being 'unfair business' and provoked great controversy among jurists before 1891. The prevailing view was that marginal trading 'was the equivalent of a lottery contract' and thus could not be litigated in court. Max Weber argued forcefully against this view in his work on stock markets, and the view was eventually rendered obsolete by a judgement from the Supreme Court of the Reich, which prompted law makers to act. Although the telephone benefited commodity trading, it also aroused perceptions of unproductive activity which were easy to associate with the view of commodity futures trading as a form of lottery. This was particularly the case because the self worth of workers rested at the end of the 19th century on 'hard physical labour', so that the impression of idleness was not tolerated. This is supported by Popitz's essay "Was tun wir, wenn wir spielen" from 2000: 'The actions of gamblers do not [leave behind] a product. [Rather], when they play, they are being creative in an unproductive way.' As such, the telephone helped commodity futures trading to communicate quickly, but at the same time it was also a symbol of unproductive activity and thereby fed the widespread mistrust of the commodity futures business and its associated marginal trading. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to understand the experiences of nurses who were newly appointed to a position of leadership including facilitators and barriers to success and what they considered important for the development of their role. Methods: We used a qualitative descriptive research design. The study was conducted in Norway with 10 nurses who had been appointed to a leadership position within the last 2 years. Participants were interviewed with individual qualitative interviews which were transcribed and subsequently analysed using thematic analysis. Results: The following four main themes were identified from the data: I feel lonely in the leadership position, I am not confident as a leader, I am unsure of the requirements and expectations of me, and I need support and supervision. Conclusion: The results underscore the challenges reported by new leaders in nursing and their advocacy for mentorship as a facilitator for success. The qualifications of mentors were emphasised with a need for a comprehensive leadership skill set to address the multifaceted aspects of leadership development. [ABSTRACT FROM AUTHOR]

COVID-19 started in 2019 and spread rapidly throughout the world. The pandemic has presented a lot of public health challenges globally. The virus mostly affected the respiratory system, so tobacco consumers (smoke/smokeless) were at a higher risk of developing severe illnesses due to COVID-19. National Tobacco Quit Line Services (NTQLS) plays an important role in tobacco cessation. However, due to the COVID-19 pandemic, it was challenging to run these services. There were several challenges faced by the NTQLS during the lockdown. The data from the NTQLS team was retrieved to analyze if the work from home and the pandemic had affected the number of attended calls and quitters during the pandemic (2020) and compared it with before the pandemic (2019). The results showed that before the pandemic, the attended calls were 36.4% whereas, during the pandemic, they were 27%. Quit-date set decreased during the pandemic (29.2%) compared to before the pandemic (41.8%). Furthermore, the number of quitters decreased during the pandemic (27.5%) compared to before the pandemic (35.9%). Telephone counseling is effective in various countries to increase the quit attempts among the individuals during the pandemic, however, these services were jeopardized due to COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Clinical trial participation in the United States remains low, hampering development of and access to novel therapies. To assist patients and their oncologists with identifying relevant and available blood cancer clinical trials and reducing enrollment barriers, The Leukemia & Lymphoma Society created its Clinical Trial Support Center (CTSC), a free, telephone-based service led by nurse navigators. Objectives: To understand patient-and caregiver-reported perceptions and experiences with this navigation service. Methods: Eligible participants were English-speaking, adult blood cancer patients or caregivers who resided in the United States or Canada and had a telephone interaction with the CTSC between May 2018 and April 2019. A 53-item survey assessed demographics, clinical characteristics, experiences, satisfaction, and enrollment outcomes. Interviews were conducted with a subset of survey respondents to capture individual narratives. Results: Of 474 eligible patients/caregivers, 131 completed the survey (28% response rate). Most patients/caregivers reported contacting the CTSC to identify a trial they might be eligible for (81.7%), for general information about clinical trials (78.6%), about a trial recommended by a healthcare provider (21.4%), or one found through another source (19.1%). In addition to seeking help with identifying trials and learning about trials, patients/ caregivers reported discussing with the nurse navigator insurance/coverage issues (25%) and how to talk with their healthcare provider about trial participation (24%). More than 93% of respondents reported that the nurse navigator gave them the information and support needed to make an informed decision about trial participation. After speaking to a nurse navigator, nearly 29.6% reported enrolling in a trial; the most common reasons for nonenrollment were that their doctor did not recommend it (33.7%), not eligible for any existing trial (30.3%), no trial available at a convenient location (24.7%), and chose a different type or plan of treatment than offered by trial(s) (23.6%). Interview respondents (n=10) described how the navigation enhanced their sense of control over the treatment decision-making process. Conclusion: Amid an overwhelming treatment landscape and continued low clinical trial enrollment rates, this clinical trial navigation service effectively provides blood cancer patients and caregivers support with identifying relevant trial options and facilitating enrollment if the patient so chooses in collaboration with their healthcare team. Further inquiry is needed to understand how to integrate independent navigation programs such as this directly into clinical workflows so that more patients and oncologists can be assisted, especially among patients from groups underrepresented in clinical trials. [ABSTRACT FROM AUTHOR]

Objective To assess accuracy of telephone triage in identifying need for emergency care among those with suspected COVID- 19 infection and identify factors which affect triage accuracy. Design Observational cohort study. Setting Community telephone triage provided in the UK by Yorkshire Ambulance Service NHS Trust (YAS). Participants 40 261 adults who contacted National Health Service (NHS) 111 telephone triage services provided by YAS between 18 March 2020 and 29 June 2020 with symptoms indicating COVID- 19 infection were linked to Office for National Statistics death registrations and healthcare data collected by NHS Digital. Outcome Accuracy of triage disposition was assessed in terms of death or need for organ support up to 30 days from first contact. Results Callers had a 3% (1200/40 261) risk of serious adverse outcomes (death or organ support). Telephone triage recommended self- care or non- urgent assessment for 60% (24 335/40 261), with a 1.3% (310/24 335) risk of adverse outcomes. Telephone triage had 74.2% sensitivity (95% CI: 71.6 to 76.6%) and 61.5% specificity (95% CI: 61% to 62%) for the primary outcome. Multivariable analysis suggested respiratory comorbidities may be overappreciated, and diabetes underappreciated as predictors of deterioration. Repeat contact with triage service appears to be an important under- recognised predictor of deterioration with 2 contacts (OR 1.77, 95% CI: 1.14 to 2.75) and 3 or more contacts (OR 4.02, 95% CI: 1.68 to 9.65) associated with false negative triage. Conclusion Patients advised to self- care or receive nonurgent clinical assessment had a small but non- negligible risk of serious clinical deterioration. Repeat contact with telephone services needs recognition as an important predictor of subsequent adverse outcomes. [ABSTRACT FROM AUTHOR]

The article focuses on the need for developing an evidence-based dispatcher algorithm for providing telephone advice on first aid during hypoglycemia emergencies. It highlights the increasing prevalence of diabetes and the associated rise in hypoglycemia cases, which pose significant risks and contribute to the burden on emergency medical services (EMS).

"Visions of a Digital Nation" by Jacob Ward explores the history of British telecommunications, focusing on the period between the 1950s and 1984 when British Telecommunications (BT) was privatized. The book delves into the development of an integrated digital network by the Post Office, highlighting the transformation of technology and its impact on the political economy. Ward's work emphasizes technological transformation and the intersection of ideas and technology, providing a comprehensive overview of the evolution of telecommunications in Britain. The book is a valuable resource for those interested in the history of technology and its societal implications. [Extracted from the article]

Background: Personalised Care and Support Planning (PCSP) replaces conventional annual reviews for people with long-term conditions. It is designed to help healthcare professionals (HCPs) and patients engage in conversations as equals and collaboratively plan actions oriented to each patient's priorities, alongside biomedical concerns. Little is known about how the shift to remote consulting initiated with COVID-19 restrictions has impacted PCSP. Aim: To investigate HCPs' experiences of conducting PCSP conversations remotely and consider implications for the fulfilment of PCSP ambitions as remote consulting continues beyond COVID-19 restrictions. Methods: 19 semi-structured interviews with HCPs in England and Scotland; interpretive analysis. Results: HCPs' accounts made clear that COVID-19 restrictions impacted multiple aspects of PCSP delivery, not just the mode of conversation. Broader disruption to general practice systems for gathering and sharing information ahead of PCSP conversations, and moves to 'wide window' appointment times, made it harder for patients to be prepared for PCSP conversations. This constrained scope to achieve PCSP ambitions even with the best professional communication skills. Most remote PCSP conversations were conducted by telephone. In the absence of visual communication with patients, it was sometimes harder to achieve the ambitions of PCSP conversations, including to balance patient and professional agendas, fulfil key planning activities, and foster a relational ethos of equal, collaborative partnership. The challenges were particularly severe when working with new patients and people with complex clinical and social problems. Although options for telephone appointments now offer valued flexibility, sustained experience of struggling to achieve PCSP ambitions via remote consulting led some HCPs to lower their standards for judging a "good" PCSP conversation, and to diminished professional satisfaction. Conclusions: There are significant challenges to fulfilling the ambitions of PCSP via telephone, especially when preparatory support is limited. This study provides grounds for scepticism about how compatible telephone appointments can be with this person-centred model of working, especially for people who are socially disadvantaged and live with complex health conditions. These threats to the provision of person-centred support for people with long-term conditions warrant careful attention going forward if the PCSP model and its benefits are to be sustained. [ABSTRACT FROM AUTHOR]

Background: Video streaming in emergency medical communication centers (EMCC) from caller to medical dispatcher has recently been introduced in some countries. Death by trauma is a leading cause of death and injuries are a frequent reason to contact EMCC. We aimed to investigate if video streaming is associated with recognition of a need for first aid during calls regarding injured patients and improve quality of bystander first aid. Methods: A prospective observational study including patients from three health regions in Norway, from November 2021 to February 2023 (registered in clinical trials 10/25/2021, NCT05121649). Cases where video streaming had been used as a supplement during the medical emergency call were compared to cases where video streaming was not used during the call. Patients were included by ambulance personnel on the scene of accident if they met the following criteria: 1. Ambulance personnel arrived at a patient who had an injury, 2. One or more bystanders had been present before their arrival, 3. One or more of the following first aid measures had been performed by bystander or should have been performed: airway management, control of external bleeding, recovery position, and hypothermia prevention. Ambulance personnel assessed quality of first aid performed by bystander, and information concerning use of video streaming and patient need for first aid measures recognized by dispatcher was collected through EMCC audio logs and patient charts. We present descriptive data and results from a logistic regression analysis. Results: Data was collected on 113 cases, and dispatchers used video streaming in addition to standard telephone communication in 12/113 (10%) of the cases. The odds for the dispatcher to recognize a need for first aid during a medical emergency call were more than five times higher when video streaming was used compared to no use of video streaming (OR 5.30, 95% CI 1.11-25.44). Overall quality of bystander first aid was rated as "high". The odds ratio for the patient receiving first aid of higher quality were 1.82 (p-value 0.46) when video streaming was used by dispatcher during the call. Conclusion: Our findings show that video streaming is not frequently used by dispatchers in calls regarding patients with injuries, but that video streaming is associated with improved recognition of patients' first aid needs. We found no statistically significant difference in first aid quality comparing the calls where video streaming as a supplement were used with the calls with audio only. [ABSTRACT FROM AUTHOR]

Background: Because the cases are quite scarce, we aimed to review cases of foreign body impaction penetrating the neck through the esophagus to analyze the characteristics of these cases. The open surgery skills of the surgeon, the treatment procedure and the surgeons' experience in the rare diseases were analyzed. Methods: We collected and analyzed all cases from 2015–2020 in our hospital. Surgical skills and procedures for fasting and anti-infection treatment were reviewed retrospectively. Follow-up was telephone communication. Results: Our series included 15 cases. Tenderness in the pre-cervical site was a physical sign for screening. Thirteen cases underwent a lateral neck open surgery with the incision including the left side of neck and only two cases were incised from the right side of the neck. Pus was found 3 days after the impaction in one case, the shortest time observed in our series. The esophageal laceration was only sutured primarily in 5 cases (33.33%) among all fifteen cases. After sufficient drainage (average more than 9 days), antibiotic treatment and fasting (normally 2–3 weeks), patients gradually began to switch to solid foods from fluids after complete blood counts and confirmations from esophageal radiography result. No severe complications occurred, and all the patients have no swallowing dis-function and recovered well. Conclusion: Surgery should be performed as soon as possible after impaction. Lateral neck approach surgery and the therapeutic procedure described in this article are safe and effective treatments. [ABSTRACT FROM AUTHOR]

There have been no nationwide studies of patient opinions regarding telehealth in Saudi Arabia to identify the factors that might influence patients' perceptions and satisfaction. This was a prospective cross-sectional study of adults in the general population who last engaged with a healthcare practitioner via a virtual appointment. The participants were recruited by convenience sampling across Saudi Arabia between November 2023 and January 2024, completing a questionnaire that gathered data on (i) basic demographic and virtual consultation information and (ii) telehealth service delivery and technology based on the Telehealth Usability Questionnaire. Of the 916 participants, 53.7% were female, with a mean age of 47.2 (14.1) years. Nearly half attended primary care appointments, with the remainder attending a range of hospital specialties. Over 90% preferred having a virtual appointment over an in-person visit. About half had telephone consultations, while about a third had video calls through hospital-provided platforms; >90% found virtual appointments useful and convenient, easy to use, effective, reliable, and produced a favorable clinical interaction; and 97.4% were satisfied with their remote consultation experience despite the technical interruptions. The individuals who were less happy with their virtual consultation were significantly younger, lived in urban areas, attended specialty clinics, were seen by a psychologist, preferred in-person appointments, and had consultations by telephone. These data provide momentum to continue with and expand telehealth, especially through video calls, supported by educational initiatives. [ABSTRACT FROM AUTHOR]

Advancements in the treatment and management of patients with cancer have extended their survival period. To honor such patients' desire to live in their own homes, home-based supportive care programs have become an important medical practice. This study aims to investigate the effects of a multidimensional and integrated home-based supportive care program on patients with advanced cancer. SupporTive Care At Home Research is a cluster non-randomized controlled trial for patients with advanced cancer. This study tests the effects of the home-based supportive care program we developed versus standard oncology care. The home-based supportive care program is based on a specialized home-based medical team approach that includes (1) initial assessment and education for patients and their family caregivers, (2) home visits by nurses, (3) biweekly regular check-ups/evaluation and management, (4) telephone communication via a daytime access line, and (5) monthly multidisciplinary team meetings. The primary outcome measure is unplanned hospitalization within 6 months following enrollment. Healthcare service use; quality of life; pain and symptom control; emotional status; satisfaction with services; end-of-life care; advance planning; family caregivers' quality of life, care burden, and preparedness for caregiving; and medical expenses will be surveyed. We plan to recruit a total of 396 patients with advanced cancer from six institutions. Patients recruited from three institutions will constitute the intervention group, whereas those recruited from the other three institutions will comprise the control group. [ABSTRACT FROM AUTHOR]

Background: Coronary heart disease has a high incidence rate, a high mortality rate, a high recurrence rate, and a high medical cost. In addition, some patients need to undergo percutaneous coronary artery stent implantation (CASI), which is a kind of traumatic treatment. Patients can easily experience negative emotions such as anxiety and depression after surgery, which seriously affects quality of life. Objectives: The aim of this study was to evaluate the effectiveness of an empowerment-based telephone follow-up intervention on resilience and quality of life in patients who underwent CASI. Design: The design of the study is a randomized controlled trial. Methods: A total of 92 patients were recruited after CASI from the Internal Medicine Cardiovascular Department of a Grade A tertiary hospital in Xi'an, China. The patients were randomly divided into a control group and an intervention group. The control group performed routine care, whereas the intervention group developed a telephone follow-up program based on empowerment theory while carrying out routine care. Patients were investigated using the coronary heart disease-related knowledge questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the 36-Item Short-Form Health Survey (SF-36) to compare the effects of the intervention before and after 1 month of intervention. Results: After a 1-month telephone follow-up intervention based on the empowerment theory for patients after CASI, the variations in knowledge related to coronary heart disease and all of its subscale scores were greater in the intervention group than in the control group. Except for the three dimensions of risk factor, induction factor, and rehabilitation-related knowledge, the variations in knowledge related to coronary heart disease and the other subscale scores were significantly different between the two groups (p < 0.05). The variations in resilience and scores on the three subscales in the intervention group were greater than those in the control group, and the difference between the two groups was statistically significant (p < 0.05). The variations in the quality of life and overall health, emotional functions, and social functions were significantly greater in the intervention group than in the control group (p < 0.05). Conclusions: A telephone follow-up intervention based on the empowerment theory can effectively improve the resilience and quality of life of patients after CASI. This follow-up approach can provide a theoretical basis and practical reference for hospitals and communities to carry out targeted continuing nursing for patients after CASI. The long-term effects of the intervention and its underlying mechanisms require further study. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain is a prevalent issue among older adults in the United States that impairs quality of life. Physical activity has emerged as a costeffective and non-pharmacological treatment for chronic pain, offering benefits such as improved physical functioning, weight loss, and enhanced mood. However, promoting physical activity in older individuals with chronic pain is challenging, given the cyclical relationship between pain and sedentary behavior. The Mobile Intervention to Reduce Pain and Improve Health (MORPH) trial was designed as an innovative, mobile health (mHealth) supported intervention to address this issue by targeting daylong movement, weight loss, and mindfulness to manage pain in older adults with chronic multisite pain. The objective of this paper is to provide the result of a qualitative analysis conducted on post-intervention interviews with MORPH participants. Methods: At the conclusion of the MORPH study, 14 participants were interviewed regarding their experience with the program. All interviews were conducted by phone before being transcribed and verified. A codebook of significant takeaways was created based on these accounts. Summaries were further synthesized into themes using the principles of thematic analysis. Results: Three key themes of the MORPH intervention emerged from the qualitative interviews: MORPH technology (smart scales, Fitbit, MORPH Companion App) facilitated program adherence and accountability; MORPH intervention components (food tracking and mindfulness activities) facilitated program adherence and awareness, respectively; and, group meetings provided motivational support and accountability. Mobile health technologies, including a dedicated MORPH app, facilitated self-monitoring strategies, helped to break the cycle of old habits, and provided participants with immediate feedback on successes; however, technical issues required timely support to maintain engagement. Food tracking contributed to adherence and accountability for weight loss. Mindfulness activities increased participants' awareness of anxiety provoking thoughts and pain triggers. Finally, social support via group meetings and connection, played a crucial role in behavior change, but participants noted consistency in the delivery medium was essential to fostering genuine connections. Conclusion: Overall, the study results highlight the key considerations related to program technology, intervention components, and the value of social support that can help to guide the development of future interventions similar to MORPH. [ABSTRACT FROM AUTHOR]

This is Part IV in the series Nursing Power through Advocacy. Its purpose is to help advocates develop a strong voice for children's safety in relation to gun violence in schools while talking with legislators and other stakeholders. The advocate must understand the facts surrounding an issue, both positive and negative, to provide effective evidence supporting their thoughts. [ABSTRACT FROM AUTHOR]

Background: Telephone advice lines have been recommended internationally to support around-the-clock care for people living at home with advanced illness. While they undoubtedly support care, there is little evidence about what elements are needed for success. A national picture is needed to understand, improve and standardise service delivery/care. Aim: To explore telephone advice lines for people living at home with advanced illness across the four UK nations, and to construct a practical framework to improve services. Design: A cross-national evaluation of telephone advice lines using structured qualitative interviews. A patient and public involvement workshop was conducted to refine the framework. Setting/participants: Professionals with responsibilities for how palliative care services are delivered and/or funded at a local or regional level, were purposively sampled. Results: Seventy-one interviews were conducted, covering 60 geographical areas. Five themes were identified. Availability : Ten advice line models were described. Variation led to confusion about who to call and when. Accessibility, awareness and promotion : It was assumed that patients/carers know who to call out-of-hours, but often they did not. Practicalities : Call handlers skills/expertise varied, which influenced how calls were managed. Possible responses ranged from signposting to organising home visits. Integration/continuity of care : Integration between care providers was limited by electronic medical records access/information sharing. Service structure/commissioning : Sustained funding was often an issue for charitably funded organisations. Conclusions: Our novel evidence-based practical framework could be transformative for service design/delivery, as it presents key considerations relating to the various elements of advice lines that may impact on the patient/carer experience. [ABSTRACT FROM AUTHOR]

The article highlights the role of digital platforms in legal assistance for displaced populations, mentioning the experience of the Norwegian Refugee Council with the KOBLI platform. The transformative potential of these platforms is emphasized, but the importance of ethical considerations and avoiding harm is also warned. The need to address inequalities in access to technology and connectivity is mentioned. Additionally, the article discusses the legal assistance program in Lebanon that uses KOBLI as a complement to in-person and telephone assistance. It is emphasized that the digitization of legal assistance can promote security and dignity, but also presents risks in terms of accuracy, security, and perception of impersonality. The article concludes by mentioning that the Norwegian Refugee Council is exploring opportunities to expand access to the KOBLI platform internationally. [Extracted from the article]

Aims: To study the safety and feasibility of enhanced recovery after surgery (ERAS) protocol in pediatric colostomy closure. Materials and Methods: Retrospective observational study of children who underwent colostomy closure. Data were collected from the electronic medical records and telephonic follow-up calls of patients from October 2013 to October 2023, in the Department of Pediatric Surgery of a Tertiary level Medical College. The parameters obtained were age, gender, type of stoma, primary diagnosis, discrepancy in luminal diameters, time to reach full feeds, postoperative hospital stay, and complications. The protocol followed for colostomy closure included the following-no bowel preparation or nasogastric tube, no overnight fasting, single dose of antibiotic prophylaxis, avoiding opioids, packing proximal stoma till mobilization and starting early oral feeds postoperatively. The continuous parameters were expressed as mean ± standard deviation or median (range) while the descriptive parameters were expressed as number and percentage. Results: A total of 90 patients were included in the study. Most of the patients had colostomy for anorectal malformation. Five of them had significant luminal discrepancy of 4 or more times. Full feeds were reached within 2 days in 79 patients. Postoperative hospital stay was 2-3 days in 62 patients. Six patients stayed for more than 5 days, due to complications requiring further management. We noted surgical site infection in 6 patients all of whom were managed with regular wound dressings and fecal fistula in 4 cases, two of which resolved spontaneously. Conclusion: ERAS protocol in colostomy closure reduces the hospital stay and is cost effective, with early recovery and no added complications. [ABSTRACT FROM AUTHOR]

Background: Caregivers of children who require medical technology of tracheostomies and feeding tubes provide intensive and specialized care at home. They have extensive training in the hospital prior to their child's discharge; however, there is limited education about their child's care once they are at home. The Creating Opportunities for Personal Empowerment: Symptom and Technology Management Resources intervention focused on commonly experienced symptoms and technology used at home by caregivers. Objective: We present the findings from the intervention exit interviews to gain insight about the intervention from caregiver perspectives, notably their perceptions of usefulness, ease of use, and acceptability. Methods: A qualitative descriptive design was used to examine caregivers' perceptions of the intervention in exit interviews. These interviews were conducted upon completion of the intervention as part of feasibility testing. Results: Sixteen caregivers completed the study and participated in exit interviews. Caregivers described the themes of the best that you can do, a reminder that I am doing it the right way, and I wish I had these when my child first had the tracheostomy and feeding tube. Caregivers also provided feedback about the intervention's usefulness and suggestions for further refinement and future adaptations of the intervention. Conclusions: Caregivers provided valuable insights about the intervention, describing its usefulness to them, the potential for usefulness for other caregivers of these children, and their experiences with care of their children at home. Future plans include efficacy testing and modifications to enhance the intervention based on caregiver feedback. [ABSTRACT FROM AUTHOR]

Poor cognition increases risk for negative health outcomes, and this may be explained by associations with systemic inflammation. Previously, amount of repetitive thought (Total RT) interacted with IQ to predict interleukin-6 (IL-6) in older adults. This study continued the investigation of repetitive thought (RT) as an element involved in the effect of cognition on inflammation. Participants (N = 164) came from the Midlife in the United States Refresher project (Mage = 45.33, SD = 11.51, ranges = 25–74; 48.2% female; 85% Caucasian). Cognition was assessed via telephone, inflammatory biomarkers (IL-6, C-reactive protein (CRP), and tumour-necrosis factor-alpha (TNF- α)) analysed after blood draw, and RT derived from daily diary data. Cognition significantly interacted with RT valence (p =.009) to explain CRP after covariate adjustment. Better cognition and more negative RT valence was associated with lower CRP (β = −0.190 [-.387,.008]). Worse cognition and more negative RT valence was associated with higher CRP (β = 0.133 [−.031,.297]). No significant effects were found for IL-6 or TNF-α. RT may interact with cognition to affect different inflammatory biomarkers. Those with worse cognition may benefit more from skills related to regulating thought than those with better cognition. [ABSTRACT FROM AUTHOR]

Aim: To explore family caregivers' experiences of contributing to self‐care of patients with chronic obstructive pulmonary disease (COPD). Design: A qualitative description study. Methods: Individual semi‐structured interviews were conducted face‐to face, by telephone or video calls in a purposive sample of 17 family caregivers of patients with COPD recruited in Italy, and analysed through content analysis. The consolidated criteria for reporting qualitative studies (COREQ) checklist was used for study reporting. Results: Ten subcategories were derived from 106 codes grouped into three main categories: family caregiver contributions to maintaining disease stable and ensuring a normal life for patients; family caregiver contributions to disease monitoring; and family caregiver contributions to coping with disease exacerbations. Family caregivers provided practical and emotional support, and their contribution was essential to improve treatment adherence, to enable the patient to continue living a normal life, and to have access to the healthcare services. Family caregivers were constantly vigilant and monitored patients daily to detect worsening conditions, and they managed exacerbations especially when patients were unable to do it due to their critical conditions. Conclusion: This study broadens knowledge of family caregivers' contributions to patients' self‐care in COPD, describing the different ways family members provide daily care to patients and the many responsibilities they take on. Impact: Family caregivers perform a variety of behaviours when supporting patients with COPD in self‐care, especially when patients are more dependent and the disease more severe. Nurses should acknowledge the various contributions provided by family caregivers and develop educational interventions aiming to support them in patient care and improve patient outcomes. Patient or Public Contribution: Researchers shared the draft study report with participants for validation and feedback. This helped to strengthen the study design and results. [ABSTRACT FROM AUTHOR]

We aimed to evaluate differences in dietary factors between young-onset (diagnosed at ages <50) and older-onset colorectal cancer (CRC). CRC patients diagnosed from 1998 to 2018 reported to the Puget Sound Surveillance, Epidemiology, and End Results registry were recruited using mail and telephone. Consented patients completed questionnaires assessing demographics, medical history, and CRC risk factors, including dietary factors. We used multi-variable logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing dietary intake in young-onset vs. older-onset CRC. Analyses included 1,087 young- and 2,554 older-onset CRC patients. Compared to older-onset CRC, young-onset CRC patients had lower intake of vegetables (OR for highest intake vs. lowest = 0.59 CI: 0.55, 0.64) and fruit (OR for highest intake vs. lowest = 0.94 CI: 0.88, 0.99) and higher intake of processed meat (OR for highest intake vs. lowest = 1.82 CI: 1.11, 2.99) and spicy food (OR for highest intake vs. lowest = 1.69 CI: 1.09, 2.61). There was no statistically significant difference between young- and older-onset CRC patients for red meat consumption. Dietary patterns differed between young- and older-onset CRC; young-onset CRC patients had lower intake of vegetables and fruit and higher intakes of processed meat and spicy food. [ABSTRACT FROM AUTHOR]

Critical test results in clinical laboratories are crucial for timely patient care, serving as indicators of potentially life-threatening conditions. Despite their importance, a notable heterogeneity in management practices exists globally. This study investigates the current practices of managing critical results at Danish clinical biochemistry laboratories and identifies areas prone for improvement. A comprehensive online survey was distributed to all 21 Danish clinical biochemistry laboratories regarding their critical result management, including documentation practices, critical limit selection, and quality assurance measures. A total of 17 laboratories (81%) responded. The answers revealed a generally uniform approach to managing critical results, with all laboratories having 24-h reporting, local instructions and using the telephone as communication channel. However, variations were noted in documentation practices and critical limit selection. Notably, 23.5% of the laboratories reported that one out of every ten critical results was not reported, indicating a significant risk of delayed critical results. This is further complicated by the limited use of predefined timeframes for reporting and also, only few laboratories actively monitored response times. The findings emphasize the need for more standardized documentation and evaluation practices to align with international standards and to enhance patient safety. While the laboratories showed a commitment to standardized procedures, the study emphasizes the necessity of a National or Nordic guideline to supplement the ISO 15189:2022. This study is a step towards optimizing critical result management, not only in Danish clinical biochemistry laboratories but also across various laboratory specialties, thereby improving overall laboratory quality, efficiency, and patient safety. [ABSTRACT FROM AUTHOR]

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Purpose: Lifelong dietary adherence is very important in celiac disease. Several factors may affect adherence to a gluten-free diet (GFD). In this study, it was aimed to determine the adherence to a glutenfree diet (GFD) and the factors affecting social life in adults with celiac disease. Material and Methods: This cross-sectional study was conducted on 98 adults diagnosed with celiac disease, using the telephone interview method of data collection. The level of adherence to GFD was accepted as the dependent variable. Several factors including age, gender, economic status, educational level, and marital status were considered as independent variables. Quantitative variables were compared using the student's t-test, while the Chi-square test was used for qualitative variables. Multiple logistic regression analysis was performed to determine related factors associated with "excellent" adherence to GFD. Results: 53.1% of the celiac patients reported their adherence to GFD was "excellent", 46.9% was "poor". The celiac patients' 61.2% reported difficulties about to access GFPs and 49.0% of them never consume commercial GFPs. Before eating out, 67.3% of the celiac patients call the restaurant to ask if they have a gluten-free menu. The celiac patients' 69.4% reported that they use a gluten-scanner application. The rate of "excellent" adherence to GFD of the celiac patients who had =4 family members were significantly lower (OR: 0.112 CI: 0.15-0.832, p=0.017). The celiac patients with =10 diagnosis years had significantly lower adherence to GFD (OR: 0.053 CI: 0.010-0.292, p=0.001). Gluten-scanner applications non-users had 0.163-fold lower "excellent" adherence to GFD (OR: 0.163 CI: 0.034-0.779, p=0.016). Conclusion: This study emphasizes that having nuclear family, new diagnosis, and use of mobile applications positively affect adherence to GFD. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the use of after‐visit instructions (AVIs) in an academic rheumatology clinic and assess the impact of standardized AVIs (sAVIs) and teach‐back (TB) on comprehension of health information. Methods: A retrospective review of adult patients seen between October 1 and 8, 2021, at the rheumatology clinic collected data on patient demographics, clinical features, and the presence, content, and readability of AVIs. During a subsequent prospective proof‐of‐concept study, routinely scheduled patients seen at the rheumatology clinic were randomized into three groups: control (received standard of care), received sAVIs only, and received sAVIs plus TB. Patients completed a health literacy questionnaire, satisfaction survey, and a one‐ to two‐week postvisit telephone survey to assess AVI comprehension. Results: Out of 316 retrospective patient visits, 82 (25.9%) received AVIs. Among 210 of 316 patients (66.5%) with management changes, 76 (36.1%) received AVI, with 74.2% of the instructions considered concordant with the provider's note. Use of AVIs was higher with management changes, new patient visits, and medical trainee/teaching clinics. AVIs were written at a median 6.8 grade level. A total of 75 patients completed the prospective study: 31 (41.3%) were in the control group, 19 (25.3%) were in the group that received sAVIs only, and 25 (33.3%) were in the group that received AVIs with TB. There were no differences in overall postvisit survey comprehension/retention scores among the three patient groups evaluated. Conclusion: Although a lack of AVI use was identified, implementation of sAVIs did not appear to impact patient retention or comprehension of discharge health information. [ABSTRACT FROM AUTHOR]

Objective: Human milk is the preferred source of nutrition for infants in their first 6 months of life. A majority of American women will initiate breastfeeding, but many will not continue due to the many challenges that arise, creating a significant gap between initiation and the long-term exclusivity rate. This quality improvement project aimed to increase postpartum lactation support encounters, fostering the mother's knowledge and self-efficacy, which are known predictors for breastfeeding success. Methods: Program participants received proactive lactation support via telephone every 24–72 hours throughout the first 2 weeks postpartum. Breastfeeding knowledge, self-efficacy, and exclusivity pre- and postprogram were assessed. Results: All outreach attempts to participants were made as planned. Eight out of 20 enrolled participants completed the program and maintained breastfeeding exclusivity at 2 weeks. Breastfeeding knowledge scores were significantly higher at the completion of program compared with preprogram scores. Pre- and postprogram breastfeeding self-efficacy scores were not statistically significantly different; however, the mean was high for all participants, exceeding 65 both pre- and post-program. Conclusions: Transferrable knowledge from this quality improvement project will support sustainable improvement of lactation support across other institutions. [ABSTRACT FROM AUTHOR]

Introduction: The life-saving procedure, Cardiopulmonary resuscitation (CPR), is only applied in 30% of cardiac arrest cases as a result of many factors, such as lack of knowledge and fear of causing further damage. Due to the importance of immediate application of CPR, some National First Aid Centres around the world provide the necessary instructions to the potential rescuer by telephone to overcome any obstacles and difficulties (Telecommunication CPR - TCPR) appear. Aims: The aim of the study was to investigate the knowledge and experience of the subjects' participation in a simulated cardiac arrest scenario in which they applied CPR guided by telephone instructions. Methodology: This was a cross-sectional study of subjects who were asked to perform CPR, with chest compressions only, following telephone instructions in response to a simulated cardiac arrest incident scenario. Before and after their participation, they completed specific questionnaires measuring their opinion and knowledge about CPR. The statistical package SPSS ver.24 was used to analyse the results. The significance level was set at p<0.05. Results: The sample was consisted of 151 people with an average age of 38 years (58,9% male VS 41,1% female). The 90.7% (n=137) were not health professionals as well as the 83.4% of respondents (n=126) knew what CPR was. The 76.2% of participants had no previous training in CPR. The 97.7% (n=138) felt that the telephone instructions were easy to understand while among those who had previously been trained in CPR, the 33 (91.7%) said that the previous knowledge they had was helpful in combination with the provided telephone instructions. Finally, 57% (n=86) of the participants experienced anxiety. Conclusions: Overall, through the current research it is demonstrated that the telephone instructions are easy to understand and implement as the overall process was described as easy, although more than half of the participants experienced anxiety. It is important to note that the majority of the participants with previous training in CPR, stated that their previous knowledge combined with the telephone instructions, helped them cope with the experiment. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the relationship between the 2nd and 4th finger measurement ratio (2d:4d) ratio of university students' internet addiction level through phone use. Material and Method: 322 students were questioned about their demografic data, dominant extremity, and the device while using the internet. Hand width (HW), length (HL), grip strength (HGS), 2d:4d measurements were taken. Young Internet Addiction Scale (YIAS) was used for internet addiction, Smartphone Addiction Scale-Short Form (SAS) was used for smartphone addiction. Results: In men, it was determined that there was a statistically significant difference between the groups in terms of Right-Left HL, Left HGS, Right/4d, YIAS and SAS values. In addition, it was determined that the device preference, HL right, HL left, HGS left and Right/4d parameters originated from normal and dependent groups. It was determined that there was a statistically significant difference between the groups in women in terms of Left HL, Right/2d, Right/4d, Left/2d, Left/4d, Young and SAS values. It was determined that the device preference was due to individuals falling into the normal group of Left HL according to the YIAS, and the statistical difference of the Right/2d, Right/4d, Left/2d and Left/4d parameters. It was determined that there was a moderately strong negative correlation between SAS and Right/2d, Right/4d, Left/2d, Left/4d parameters in addicted men. Conclusion: The gender relations of the accepted scales regarding phone and internet addiction may be due to the length of the left hand and the movement function of the right 4d to provide control in phone use, rather than the 2d:4d finger ratios. [ABSTRACT FROM AUTHOR]

Objectives: To learn about the use patterns of dental hygienist services, by the 65+ age group in Israel and to identify the main barriers facing different population groups. Methods: Telephone interviews with a representative sample of 512 older adults aged 65 and over were conducted from February to April 2020. Results: About 50% of the older adults aged 65 and over visited a dentist (2.9 visits on average) and 35% visited a dental hygienist in the year preceding the interviews. 17% reported never visiting a dentist and 45% never received care from a dental hygienist. Dental care use rates are lower in the outlying areas of the country, among non‐Jews and among those who find it difficult to cover monthly household expenses. Those who regularly visit a dental hygienist maintain a preventive oral health routine, including tooth brushing and visits to the dentist for periodic preventive check‐ups. They are aware of the harmful effects of eating sweets in between meals. Most of the older adults aged 65 and over are unaware of the reform under which hygienist' care was included in the basket of services provided by health plans. Conclusions: There is underutilization of dental hygienist services and lack of awareness of proper oral health behaviour in the lower socioeconomic group. As less than 50% of older adults are aware of the legal rights for dental care, there is a need to raise awareness of the reform and the services provided under it. [ABSTRACT FROM AUTHOR]

Purpose: This study examines immigrant Latinas' (ILs') help-seeking behaviors, types of support systems, and access to intimate partner violence (IPV) services during a global health crisis (COVID-19) at a community-based agency in a Northeastern state. Method: Nineteen immigrant Latinas who had prior IPV-related services such as legal aid, advocacy, and support within 1–3 years were recruited for the study. Spanish-speaking telephone interviews averaging between 30 and 45 min were conducted with each participant. Content analysis was the method employed to review the data and generate themes of the participants' experiences. Results: Participants' qualitative responses included an increase of intimate partner violence during the pandemic. Types of support systems included reaching out to police departments, hospitals and health-care settings, and community-based agencies. Findings indicated a 47% positive response rate when working with police officers (e.g., bilingual Spanish-English speaking police officers), and the participants reported being supported by the agency staff where they received services. Conclusion: Recommendations are provided to the community-based agency and other service providers regarding ongoing delivery of services and best practices for ILs throughout the pandemic transitions and beyond. [ABSTRACT FROM AUTHOR]

We evaluated outcomes from a telephone-based transitional patient navigation (TPN) service for people living with hepatitis C virus (HCV) upon returning to the community after incarceration in New York City (NYC) jails. NYC Health + Hospitals/Correctional Health Services offered referrals for TPN services provided by the NYC local health department patient navigation staff. We compared rates of connection to care among people referred for TPN services with those who were not referred. People living with HIV had a higher connection to care rate at three months (65.0% vs 39.8%, p≤.05) and people with opioid use disorder had a higher connection rate at six months (55.1% vs 36.1%, p≤.05) compared with people without these conditions. However, there was not an improved connection to HCV care associated with referral to TPN services for the overall cohort. Further research, including qualitative studies, may inform improved strategies for connection to HCV care after incarceration. [ABSTRACT FROM AUTHOR]

The aim is to pilot a low-touch program for reducing benzodiazepine receptor agonist (BZRA; benzodiazepines, z-drugs) prescriptions among older veterans. Pilot randomized controlled trial consists of 2,009 veterans aged ≥ 65 years who received BZRA prescriptions from a Veterans Health Administration pharmacy (Colorado or Montana) during the prior 18 months. Active: Arm 1 was a mailed brochure about BZRA risks that also included information about a free, online cognitive behavioral therapy for the insomnia (CBTI) program. Arm 2 was a mailed brochure (same as arm 1) and telephone reinforcement call. Control: Arm 3 was a mailed brochure without insomnia treatment information. Active BZRA prescriptions at follow-up (6 and 12 months) were measured. In logistic regression analyses, the odds of BZRA prescription at 6- and 12-month follow-ups were not significantly different for arm 1 or 2 (active) versus arm 3 (control), including models adjusted for demographics and prescription characteristics (p-values >0.36). Although we observed no differences in active BZRA prescriptions, this pilot study provides guidance for conducting a future study, indicating a need for a more potent intervention. A full-scale trial testing an optimized program would provide conclusive results. Mailing information about BZRA risks and CBTI did not affect BZRA prescriptions. [ABSTRACT FROM AUTHOR]

Dementia is recognised as one of the major global health and social care challenges of present times. When the onset of dementia occurs in midlife, there is an increased possibility that there are children and young adults involved who are dependent on the parent concerned. The aim of the study was to describe health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. A qualitative descriptive approach was carried out with individual interviews of health and social care professionals, using a semistructured interview guide. Thirteen participants in rural and urban areas in Sweden were interviewed. The overarching theme, advocating a forgotten group with three categories were identified. They combine and reflect health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. Health and social care professionals who encountered children and young adults with a parent with dementia described how they were not sufficiently trained in supporting this group and identified a general shortage of available appropriate support services. The children and young adults were also described as a forgotten and overlooked group in need of affirmation and support in a more systematic way. [ABSTRACT FROM AUTHOR]

Background: Patient Reported Outcomes Measures (PROMs) are being used increasingly to measure health problems in stroke clinical practice. However, the implementation of these PROMs in routine stroke care is still in its infancy. To understand the value of PROMs used in ischemic stroke care, we explored the patients' experience with PROMs and with the consultation at routine post-discharge follow-up after stroke. Methods: In this prospective mixed methods study, patients with ischemic stroke completed an evaluation questionnaire about the use of PROMs and about their consultation in two Dutch hospitals. Additionally, telephone interviews were held to gain in-depth information about their experience with PROMs. Results: In total, 63 patients completed the evaluation questionnaire of which 10 patients were also interviewed. Most patients (82.2–96.6%) found completing the PROMs to be feasible and relevant. Half the patients (49.2–51.6%) considered the PROMs useful for the consultation and most patients (87.3–96.8%) reported the consultation as a positive experience. Completing the PROMs provided 51.6% of the patients with insight into their stroke-related problems. Almost 75% of the patients found the PROMs useful in giving the healthcare provider greater insight, and 60% reported discussing the PROM results during the consultation. Interviewed patients reported the added value of PROMs, particularly when arranging further care, in gaining a broader insight into the problems, and in ensuring all important topics were discussed during the consultation. Conclusions: Completing PROMs appears to be feasible for patients with stroke attending post-discharge consultation; the vast majority of patients experienced added value for themselves or the healthcare provider. We recommend that healthcare providers discuss the PROM results with their patients to improve the value of PROMs for the patient. This could also improve the willingness to complete PROMs in the future. [ABSTRACT FROM AUTHOR]

Background: Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health literacy level and its related factors among married college students at Mazandaran University of Medical Sciences (MAZUMS). Methods: A web-based cross-sectional online study was conducted on married college students at Mazandaran University of Medical Sciences between January and November 2020. All students were included in the study by census, and the study method was explained by telephone. If they agreed to participate in the study, the online link to the questionnaire, including sociodemographic and clinical information and Sexual Health Literacy for Iranian Adults (SHELIA), was emailed. The Statistical Package for the Social Sciences (SPSS) software version 26 was used for data analysis. Univariate and multivariate logistic regression tests were used to assess factors related to sexual health literacy. Results: The sample consisted of 277 male and 123 female students. Sexual Health Literacy Level and all subscales are at the sufficient level (66.1–88). Among the participants, 20.5% had limited sexual health literacy. Multivariate analysis found factors related to sexual health literacy among students: economic status (OR 0.03; 95% CI 0.0–0.55) and faculty (OR 0.07; 95% CI 0.01–0.52) is related to decrease and subscription to social media for sexual health (OR 3.27; 95% CI 1.53–7.01), information source of channels and cyberspace (OR 3.23; 95% CI 1.41–7.39), educational level (OR 16.39; 95% CI 2.16–32.70), Internet search information source (OR 1.91; 95% CI 1.00–3.64) is related to increase, were statistically significant factors. Conclusion: In Iran, medical sciences college students, who constitute a significant portion of the country's population, are responsible for sexual health education. Government agencies, with the collaboration of all stakeholders, should develop policies and programs for implementing and evaluating integrated and comprehensive sexual health literacy promotion programs for them. [ABSTRACT FROM AUTHOR]

Background: Clarifying the dimensions and characteristics of obstetric telephone triage is important in improving the quality of services in the health system because researchers can evaluate the effectiveness of treatment, care and diagnostic measures in the form of obstetric telephone triage by developing a guideline. Therefore, this study aimed to design an Obstetric Telephone Triage Guideline (OTTG) using a mixed-method study. Methods: The present study was carried out using an exploratory sequential mixed method study in two qualitative and quantitative phases. An inductive-deductive approach was also used to determine the concept of obstetric telephone triage. In this respect, a qualitative study and a literature review were used in the inductive and deductive stages, respectively. Moreover, the validity of the developed guideline was confirmed based on experts' opinions and results of the AGREE II tool. Results: The guideline included the items for evaluating the severity of obstetric symptoms at five levels including "critical", "urgent", "less urgent", "no urgent", and "recommendations". The validity of the guideline was approved at 96%, 95%, 97%, 95%, 93%, and 100% for six dimensions of AGREE II including scope and purpose, stakeholder involvement, the rigor of development, clarity of presentation, applicability, and editorial independence, respectively. Conclusion: The OTTG is a clinically comprehensive, easy-to-use, practical, and valid tool. This guideline is a standardized tool for evaluating the severity of symptoms and determining the urgency for obstetrics triage services. By using this integrated and uniform guideline, personal biases can be avoided, leading to improved performance and ensuring that patients are not overlooked. Additionally, the use of OTTG promotes independent decision-making and reduces errors in triage decision-making. [ABSTRACT FROM AUTHOR]

Background: Research exploring nurse-parent relationships in children's hospices is rare. Aim: To investigate how children's hospice nurses manage emotional labour and professional integrity in their long-term relationships with parents. Methods: A purposive sample of six children's nurses, from hospices across England, recorded audio diaries and participated in telephone interviews. Narratives were thematically analysed. Findings: Three overarching, cross-cutting themes were identified—purposeful positioning; balancing personability and professionalism; coping with and counterbalancing emotional labour. All themes were indicative of and/or built upon emotional intelligence constructs, such as self-awareness, self-regulation, appropriate (managed) empathy, social skills and intrinsic motivation. Innate features of children's hospice work were important for perpetuating intrinsic motivation and satisfaction. Conclusion: This study provided an insight into the management of emotional labour and professional integrity by experienced children's hospice nurses. The identification of emotional intelligence skills merits further exploration in this environment, as well as other children's palliative care settings. [ABSTRACT FROM AUTHOR]

Appropriate speech-in noise assessment is challenging in multilingual populations. This study aimed to assess whether first preferred language affected performance on an English Digits-in-noise (DIN) test in the local Asian multilingual population, controlling for hearing threshold, age, sex, English fluency and educational status. A secondary aim was to determine the association between DIN test scores and hearing thresholds. English digit-triplets in noise testing and pure-tone audiometry were conducted. Multiple regression analysis was performed with DIN scores and hearing thresholds as dependent variables. Correlation analysis was performed between DIN-SRT and hearing thresholds. 165 subjects from the Singapore Longitudinal Ageing Study, a population-based longitudinal study of community-dwellers over 55 years of age. Mean DIN speech reception threshold (DIN-SRT) was −5.7 dB SNR (SD 3.6; range 6.7 to −11.2). Better ear pure tone average and English fluency were significantly associated with DIN-SRT. DIN performance was independent of first preferred language in a multilingual ageing Singaporean population after adjusting for age, gender and education. Those with poorer English fluency had a significantly lower DIN-SRT score. The DIN test has the potential to provide a quick, uniform method of testing speech in noise in this multilingual population. [ABSTRACT FROM AUTHOR]

Introduction:The ability to access telepsychiatry through audio–video technology versus audio-only (telephone) technology potentially leads to inequitable outcomes. This study examines the characteristics of patients who relied on the telephone to complete outpatient telepsychiatry visits in a large health system. Methods:This is a retrospective analysis of all telepsychiatry outpatient visits conducted from May 1, 2020, to December 31, 2021. Demographic, clinical, and socioeconomic factors were extracted from the electronic health record. Two-sample t tests were used for continuous variables and χ2 tests for categorical variables for bivariate analyses. Multiple logistic regression was used to examine the association between only telephone visits and all input variables. Results:Eight hundred ninety-four (8.9%) patients completed all visits only by telephone during the study period. In bivariate analyses, factors associated with telephone-only visits included male sex, non-English primary language, Black race, unmarried status, non-Hispanic ethnicity, older age, Medicare enrollment, uninsured status, and higher social vulnerability index (SVI). Psychiatric diagnoses associated with only telephone visits included substance use disorders and psychotic disorders. In multivariate analyses, factors associated with higher odds of only telephone visits included older age, inactive patient portal, comorbid diabetes, higher SVI, and higher broadband adoption. Psychiatric diagnoses associated with higher odds of completing only telephone visits included psychotic disorders, substance use disorders, or intellectual/developmental disabilities. Conclusions:Several patient-level factors are associated with a reliance on the telephone to complete telepsychiatry appointments. [ABSTRACT FROM AUTHOR]

Background:Most of the Veterans Administration (VA) population is either overweight or obese, which is a serious health concern. Medical weight management visits have traditionally occurred through in-person clinics. However, the COVID-19 pandemic forced care delivery to virtual platforms. Methods:We compared weight loss with in-person versus telephone-based medical weight management (lifestyle counseling coupled with pharmacotherapy) delivered by physician and nurse practitioner visits during the pandemic. We designed a program evaluation utilizing a naturalistic (pragmatic) observational study structure, including both newly enrolled and previously established participants in the Minneapolis VA MOVE! program between 2017 and 2021. A "transition" cohort (n = 74) received in-person care from March 2019 to March 2020, and then transitioned to virtual care. A "new start" virtual care cohort (n = 149) enrolled after March 2020 was compared to a separate historical group (n = 180) that received in-person care between January 2017 and December 2019. Weight loss was accessed over a 9-month period in both cohorts. Results:Mean weight loss over 9 months was −6.5 ± 18.2 and −2.5 ± 13.3 lbs in the in-person and virtual phases of the transition cohort, respectively, without significant difference between the two phases (p = 0.22). Mean weight loss over 9 months in the new start (virtual) cohort was −14.4 ± 17.0 lbs compared to −16.7 ± 21.0 lbs in the historical cohort, without significant difference between groups (p = 0.44). Conclusions:In our naturalistic study in a single-site VA clinic setting, weight loss with telephone-based medical weight management during the pandemic was comparable to in-person care. These findings are important for veterans living in rural and/or underserved areas. [ABSTRACT FROM AUTHOR]

Background: Hospitals often lack bereavement programs. Bereaved families often navigate grief support on their own. This problem was complicated by the early COVID-19 pandemic. Objective: Describe a cost neutral pilot to support next of kin (NOK) of deceased patients from our communicable disease response unit (CDRU) and palliative care unit (PCU). Design:Ad hoc pilot leveraging chaplains and a social worker (SW) to call NOK for grief support using a templated guide, referring interested NOK to bereavement support agencies. Setting/Subjects: NOK of patients who died in the CDRU and PCU at a metropolitan, quaternary care, hospital over five months. Results: One hundred eighty-six patients died. Eighty-one NOK were called, 51 calls were considered complete. Fourteen NOK accepted a referral for bereavement support. Conclusions: This cost neutral pilot successfully connected 81 NOK with either a pilot chaplain or SW for bereavement support. Fourteen NOK accepted referral for a community bereavement resource. [ABSTRACT FROM AUTHOR]

Objectives: The National Health Service Digital Diabetes Prevention Programme is a nine-month behavioural intervention for adults in England at risk of type 2 diabetes. This qualitative study aimed to explore how service users engaged with the group support available within the programme. Methods: The majority of participants (n = 33), all service users, were interviewed twice via telephone, at 2–4 months into the programme, and at the end of the programme at 8–10 months. Semi-structured interviews covered participants' experiences of online group support functions and how such groups served as a route of support to aid participants' behavioural changes. Data were analysed using manifest thematic analysis. Results: The majority of participants valued the format of closed group chats, which provided an interactive platform to offer and receive support during their behaviour change journey. However, engagement with group chats reduced over time, and some participants did not find them useful when there was a lack of common interests within the group. Health coaches helped to promote engagement and build rapport among participants within the group chats. Participants reported mixed experiences of discussion forums. Conclusions: Programme developers should consider how to optimise online group support to help service users make behavioural changes, in terms of format, participant composition and use of health coach moderators. Further research is required to better understand who might benefit most from 'group chat' or 'discussion forum' support. Health coach moderation of online support groups is likely to facilitate engagement. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify changes over time in suicidal tendencies among crisis hotline service users in Japan before and during the COVID-19 pandemic. We analyzed telephone consultation data from January 2017 to June 2021 held by Inochi No Denwa, a leading organization providing a telephone crisis hotline in Japan. The number of monthly consultations by gender and the monthly counts of consultations identified by counselors as suicidal were collected, and we calculated trends over time in the proportion of suicidal calls by month using Joinpoint regression analysis. The results indicated that the use of telephone crisis hotlines by suicidal callers increased significantly in Japan during the second wave of the pandemic in June to October 2020. These trends were also observed for both male and female users, although the increase began 1 month earlier for females than for males. Previous studies reported that mental health deteriorated and suicide risk increased significantly during the second wave of COVID-19 in Japan. These trends are consistent with the present findings, suggesting increased use of the crisis hotline by individuals at high suicide risk. Suicidal calls to crisis hotline in Japan increased rapidly from June to October 2020. Suicidal calls began to increase 1 month before the suicide rate increased for women. A sharp increase, not seen in the suicide rate for men, was observed in suicidal calls. [ABSTRACT FROM AUTHOR]