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Many of the theories used in behavioral cybersecurity research have been applied with a nomothetic approach, which is characterized by cross-sectional data (e.g., one-time surveys) that identify patterns across a population of individuals. Although this can provide valuable between-person, point-in-time insights (e.g., employees who use neutralization techniques, such as denying responsibility for cybersecurity policy violations, tend to comply less), it is unable to reveal within-person patterns that account for varying experiences and situations over time. This paper articulates why an idiographic approach, which undertakes a within-person analysis of longitudinal data, can: (1) help validate widely used theories in behavioral cybersecurity research that imply patterns of behavior within a given person over time and (2) provide distinct theoretical insights on behavioral cybersecurity phenomena by accounting for such within-person patterns. To these ends, we apply an idiographic approach to an established theory in behavioral cybersecurity research--neutralization theory--and empirically test a within-person variant of this theory using a four-week experience sampling study. Our results support a more granular application of neutralization theory in the cybersecurity context that considers the behavior of a given person over time. We conclude the paper by highlighting the contexts and theories that provide the most promising opportunities for future behavioral cybersecurity research using an idiographic approach. [ABSTRACT FROM AUTHOR]

Drawing upon the literatures in information privacy, developmental psychology, and family science, this research investigates how parental online privacy concerns can be passed on to adolescents and affect their self-disclosure on social networking sites. We propose that parental privacy concerns decrease adolescents' self-disclosure both directly (i.e., compliance) and indirectly through adolescents' privacy concerns (i.e., internalization) and that such effects are moderated by parent-child privacy dissonance, parental internet evaluative mediation, and adolescents' gender. To test the research model, we collected matched parent-child data from 726 families in China. The results show the indirect effect of parental privacy concerns on adolescents' self-disclosure via their influence on adolescents' privacy concerns. In addition, parent-child privacy dissonance weakens the effect of adolescents' privacy concerns on selfdisclosure. The extent to which parents employ internet evaluative mediation to guide adolescents' online activities reinforces the effect of parental privacy concerns on adolescents' privacy concerns. Statistical analyses further revealed that the mediating effect of adolescents' privacy concerns is weakened by parent-child privacy dissonance but strengthened by internet evaluative mediation. We also found that parental privacy concerns affect sons and daughters through different paths, especially when parents employ high internet evaluative mediation. Under high internet evaluative mediation, parental privacy concerns affect sons' self-disclosure primarily through an indirect path (via sons' privacy concerns), but influence daughters' self-disclosure both directly and indirectly via daughters' privacy concerns. We conclude by discussing theoretical contributions and practical implications. [ABSTRACT FROM AUTHOR]

Increased ventilator use during the COVID-19 pandemic resurrected persistent questions regarding mechanical ventilation including the difference between physiological and artificial breathing induced by ventilators (i.e., positive- versus negative-pressure ventilation, PPV vs NPV). To address this controversy, we compare murine specimens subjected to PPV and NPV in ex vivo quasi-static loading and quantify pulmonary mechanics via measures of quasi-static and dynamic compliances, transpulmonary pressure, and energetics when varying inflation frequency and volume. Each investigated mechanical parameter yields instance(s) of significant variability between ventilation modes. Most notably, inflation compliance, percent relaxation, and peak pressure are found to be consistently dependent on the ventilation mode. Maximum inflation volume and frequency note varied dependencies contingent on the ventilation mode. Contradictory to limited previous clinical investigations of oxygenation and end-inspiratory measures, the mechanics-focused comprehensive findings presented here indicate lung properties are dependent on loading mode, and importantly, these dependencies differ between smaller versus larger mammalian species despite identical custom-designed PPV/NPV ventilator usage. Results indicate that past contradictory findings regarding ventilation mode comparisons in the field may be linked to the chosen animal model. Understanding the differing fundamental mechanics between PPV and NPV may provide insights for improving ventilation strategies and design to prevent associated lung injuries.

Background Methods Results Conclusion This study evaluated the hemodynamic performance of arterial and venous cannulae in a compliant pediatric extracorporeal membrane oxygenation (ECMO) mock circuit in pulsatile and non‐pulsatile flow conditions.The ECMO setup consisted of an oxygenator, diagonal pump, and standardized‐length arterial/venous tubing with pressure transducers. A validated left‐heart mock loop was adapted to simulate pediatric conditions. The pulsatile flow was driven by a computer‐controlled piston pump set at 120 bpm. A roller pump was used for non‐pulsatile conditions. The circuit was primed with 40% glycerol‐based solution. The cardiac output was set to 1 L/min and the aortic pressure to 40–50 mmHg. Four arterial cannulae (8Fr, 10Fr, 12Fr, 14Fr) and five venous cannulae (12Fr, 14Fr, 16Fr, 18Fr, 20Fr) (Medtronic, Inc., Minneapolis, MN, USA) were tested at increasing flow rate in 12 combinations.The pulsatile condition required lower ECMO pump speeds for all cannulae combinations at a given flow rate, inducing a significantly smaller increase of flow in the mock loop. Under non‐pulsatile conditions, the aortic and arterial pressures in the cannulae were higher (p < 0.01) while no significant differences in pressure drop and pressure‐flow characteristics (M‐number) were observed. The total hemodynamic energy was higher in case of non‐pulsatile flow (p < 0.01).Under non‐pulsatile conditions, the system was characterized by overall higher pressures, resulting in higher support to the patient. The consequent increase of potential energy compensates for increases of kinetic energy, leading to a higher total hemodynamic energy. Pressure gradients and M number are independent of the testing conditions. Pulsatile testing conditions led to more physiological testing conditions, and it is recommended for ECMO testing. [ABSTRACT FROM AUTHOR]

Background: Encouraging compliance with recommended levels of exercise for older adults is a public health challenge. A minimal-resource solution is telephone coaching. Objectives: Primary aim: to compare timed up and go (TUG) performance 6 months after beginning a home exercise program between a group of older individuals who received additional telephone coaching, and a control group performing the home exercise program alone. Secondary aims: to compare functional and fall-related outcomes between groups at 6 and 12 months. Methods: Multicentre, assessor-blinded, randomised, controlled, open label, prospective study. Inclusion criteria included age ≥ 65 years, ≥ 1 fall in the past year, and discharged home from hospital rehabilitation or outpatient physiotherapy. All participants received a home exercise booklet and were asked to perform a set of exercises as often as possible (daily). The coaching group additionally received a monthly telephone call (total 5 calls) from their previous physiotherapist. Primary outcome was TUG performance at 6 months. Outcomes were measured at inclusion, and at 6 and 12 months. The primary outcome was analysed using a linear mixed model adjusted for the baseline value. Results: In total, 99 individuals were included (coaching group n = 50, control group, n = 49; mean [SD] age 83.1 [5.8] years and 77% women). TUG performance did not differ between groups at 6 months (adjusted difference 1.37, SE 1.32, 95% CI 1.26 to 4.01, p = 0.30). Secondary outcomes did not differ between groups at 6 or 12 months except compliance to the exercise program was higher in the coaching than the control group at 6 months (adjusted difference 1.0, SE 0.5, 95% CI 0.02 to 2.0, p = 0.05). Conclusions: The lack of difference between the groups in the time taken to complete the TUG at 6 months suggests that the monthly telephone coaching sessions did not improve the effectiveness of a home exercise programme in elderly people who had suffered at least one fall. The trial was registered on ClinicalTrials.gov (NCT02828826; 11th of july 2016, last modification 16th of September 2024). [ABSTRACT FROM AUTHOR]

Background: Denosumab and alendronate had a positive impact on bone mineral density (BMD) preservation after kidney transplantation. However, the cost-effectiveness of these agents in the context of kidney transplantation remains largely unexplored. We have conducted a cost-effectiveness analysis to compare the cost and the clinical outcomes of adding subcutaneous (SC) 60 mg denosumab every 6 months vs. oral weekly 70 mg Alendronate, to the standard care therapy (vitamin D and calcium) in renal transplant recipients (RTRs). The impact of both drugs on BMD t-score improvement and fracture prevention was investigated. A decision-analysis model from a health care payer perspective was applied. Results: The cost-effectiveness analysis has shown that alendronate add-on to the standard therapy was the most cost-effective regimen, in terms of BMD improvement and fracture prevention with an incremental cost-effectiveness ratio (ICER) of $154/patient/year. The one-way sensitivity analyses have delineated the change in cost-effectiveness when alendronate retail unit price was increased by 25% and 50%, or when denosumab retail unit price was decreased by 25% and 50%. The model was sensitive to the uncertainties (95% confidence interval) in the probabilities of fracture prevention and the probabilities of attaining the desired outcome. Conclusion: The model suggests that oral once weekly alendronate add-on regimen to standard therapy seems to be substantially more cost effective than twice yearly SC denosumab in terms of BMD improvement and fracture prevention in RTRs. Longer time horizon models with longer follow-up periods for fracture risks and adverse events are warranted to validate these data. [ABSTRACT FROM AUTHOR]

AbstractThis study examines the factors driving student non-compliance with AI use declarations in academic assessments at King’s Business School, where 74% of students failed to declare AI usage despite declaration being a requirement of a mandatory coursework coversheet. Utilising the Theory of Planned Behaviour (TPB) as a framework, the research combines service evaluation survey data and semi-structured interviews to explore how attitudes, subjective norms, and perceived behavioural control influence compliance. Findings reveal that fear of academic repercussions, ambiguous guidelines, inconsistent enforcement, and peer influence are key barriers to AI use declaration. These factors complicate the declaration process, undermine transparency, and challenge academic integrity. The study extends the TPB model by highlighting the ethical and practical dilemmas posed by generative AI, which blur traditional norms of academic integrity. This research offers critical insights for policymakers, suggesting that clear, consistent, and trust-based policies are crucial in fostering ethical AI use. The findings underscore the importance of transparent communication and supportive institutional cultures to improve compliance. Ultimately, this study informs policy development by evaluating the effectiveness of declaration mechanisms and providing actionable recommendations to promote a culture of academic integrity in the evolving landscape of AI technologies. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effectiveness of current strategies oriented to increase adherence to physical therapy in subjects with knee and hip osteoarthritis (OA). Material and methods: A systematic review of electronic databases was conducted from inception until March 2023. Studies with experimental interventions using strategies to increase adherence to physical therapy programs in subjects with knee or hip OA were included. A meta-analysis compared the effects of such interventions with usual care for adherence-related measures (primary outcome), and functional and pain outcomes, using standardized mean differences (SMD) with a 95% confidence interval (CI). GRADE was used to determine the strength of the resultant evidence and the external validity of the findings. Results: Fifteen articles, assessing 1,818 participants, were included. The interventions included cognitive-behavior strategies, telephone calls, internet-based interventions, communication technologies, and booster sessions. A meta-analysis revealed that the experimental interventions increased adherence over usual care with a moderate effect size of SMD = 0.39 (95%CI = 0.08–0.71) and moderate certainty in this evidence Conclusion: Overall, this review supports that the strategies to promote adherence to physical therapy in individuals with knee and hip OA are effective. However, the positive impact on adherence rates does not always translate into improved clinical outcomes. IMPLICATIONS FOR REHABILITATION: Strategies such us behavioral programs, phone reminders, telerehabilitation and equipment based on new technologies can be employed to enhance adherence to physical therapy among individuals with knee and hip osteoarthritis. These interventions may be also beneficial for improving self-reported functionality; however, their impact on performance-based function and pain appears to be limited. The potential for longer-duration interventions to enhance adherence in the long-term is a subject of speculation but requires further reinforcement through additional studies. [ABSTRACT FROM AUTHOR]

Background: With the high influx of low-cost plastic toys on the market, there is growing concern about the safety of such toys. Some of these plastic toys contains hazardous chemicals like polybrominated diphenyl ethers (PBDEs) due to the use of recycled plastics in new toy manufacturing. Here, we investigated if toys marketed in Europe are compliant with EU directives to assess the safety of currently used children's toys and identify implications of PBDE content in toys. Results: Eighty-four toys purchased from international toy retailers were screened for bromine using X-ray fluorescence (XRF), and 11 of those with bromine content higher than 500 µg/g were analyzed for ten PBDEs using GC–HRMS. PBDEs were detected in all 11 toys. Ʃ10PBDE concentrations ranged up to 23.5 mg/g (with a median concentration of 8.61 mg/g), with BDE-209 being the most abundant compound (4.40 mg/g). Eight samples exceeded the EU's Low POP Content Limit (LPCL) of 500 µg/g for the Ʃ10PBDEs by 6–47 times and the Unintentional Trace Contaminant (UTC) limits of 10 µg/g for Deca-BDE by 12–800 times. Conclusions: PBDEs were up to percent levels, suggesting direct recycling of flame retarded plastic, e.g., e-waste plastics, into toy components. This is a call for concern and requires intervention from all stakeholders involved in the toy market. Overall, the occurrence of non-compliant toys in the EU market, as indicated in this study is primarily attributed to gaps in regulations, inadequate legislation for recycled plastics, the rise of online sales, complexities in global and national supply chains, and economic challenges. Failure to address these issues will hinder the efforts of the plastics industry to transition into a circular economy. This suggests that more actions are needed to address gaps in cross-border enforcement, and stricter sanctions are required for toy manufacturers who fail to adhere to regulations and safety standards. [ABSTRACT FROM AUTHOR]

Background: In recent years, mobile medical technology has made great progress in chronic disease management, but its application in patients with atrial fibrillation (AF) still needs to be clarified. Objective: This study aims to determine whether the newly developed smartphone app for patients with AF (Alfalfa App) can improve anticoagulation knowledge, drug treatment compliance, and satisfaction of AF patients. Methods: Alfalfa App integrates the functions of patient education, remote consultation, and medication reminder through a simple user interface. From June 2020 to December 2020, patients with AF were recruited in five large tertiary hospitals in China. Patients were randomly divided into the Alfalfa App or routine nursing groups. Patients’ knowledge, medication adherence, and satisfaction with anticoagulation were assessed using validated questionnaires at baseline, 1 month, and 3 months. Results: In this randomized controlled trial, 113 patients with AF were included, 57 patients were randomly assigned to the Alfalfa App group, and 56 patients were randomly assigned to the routine nursing group. Forty-eight patients in the Alfalfa App group completed a three-month follow-up, and 48 patients in the routine nursing group completed a three-month follow-up. Basic demographic data were comparable between the two groups. The average age of AF patients was 61.65 ± 11.01 years old, and 61.5% of them were male. With time (baseline to 3 months), the knowledge scores of the Alfalfa App group (P<.001) and the routine nursing group (P =.002) were significantly improved, the compliance scores of the routine nursing group(P<.001) and Alfalfa App group(P<.001) significantly improved. Compared with the routine nursing group, patients’ knowledge level and medication compliance using the Alfalfa App at 1 month and 3 months were significantly higher (all P <.05). There were significant differences in knowledge and compliance scores between the two groups with time (all P <.05). The satisfaction degree of drug treatment in the Alfalfa App group was significantly better than that in the routine nursing group (all P <.05). Conclusions: Alfalfa App significantly improved the anticoagulation knowledge, drug treatment compliance, and satisfaction of AF patients. In oral anticoagulation management for AF patients, mobile medical technology that integrates the functions of patient education, remote consultation, and medication reminder may be helpful. Trial registration: Registration number, ChiCTR1900024455. Registered on July 12, 2019. [ABSTRACT FROM AUTHOR]

Introduction: Understanding police legitimacy among children and youth is important for building a just and democratic society. Although the volume of studies on police legitimacy among underaged persons has grown in recent decades, the findings on the relationships between police legitimacy and procedural justice and their definitions, associated determinants, and consequences remain heterogeneous across studies and across political and legal contexts. Given these heterogeneities, the conclusions and implications generated by this research are far from comprehensive. Method: This scoping review offers readers a comprehensive and comparative understanding of this topic by answering the following questions. (1) How can we define police legitimacy and procedural justice for children and youth? (2) What are the determinants of police procedural justice and legitimacy for children and youth? (3) What are the consequences of police procedural (in)justice and (il) legitimacy for children and youth? (4) Among children and youth, who are the vulnerable groups receiving less legitimate and unjust treatment from the police? A scoping review of the literature published between January 1, 1990 and May 31, 2022 was conducted based on four databases: PubMed, Web of Science, Scopus, and ProQuest. Guided by the scoping review screening framework proposed by Arksey and O'Malley, that is, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and the checklist provided by the Joanna Briggs Institute for quality assessment, 47 publications, consisting of 38 quantitative studies and 9 qualitative studies, were retained in the final sample. Results: The results synthesize the operational and subjective interpretations of police legitimacy offered by the respondents in the studies reviewed which is followed by the discussion of conceptual and measurement issues. The key correlates of police legitimacy identified in these studies were police procedural justice and behavior, followed by experience and contact with the police, relationships with other authority figures, and personal competence in moral reasoning and self-control. In addition to compliance and cooperation, cynicism, trust, and health were related to police (il)legitimacy. Discussion: We argue that in addition to building and maintaining police legitimacy, it is vital to remedy the negative consequences of injustice in police-youth encounters. [ABSTRACT FROM AUTHOR]

Background: Adequate diet and lifestyle practices are postulated to improve health and enhance wellbeing of cancer survivors. Despite the heavy cancer burden in Lebanon, little is known about the diet quality of survivors. This cross-sectional study assessed the compliance of survivors in remission with the American Cancer Society/American Institute Research Fund (ACS/AICR) diet and physical activity guidelines. Methods: Cancer survivors in remission for at least 3 months and attending oncology clinics in two referral centers in Beirut, Lebanon were recruited. Adherence to the ACS/AICR was assessed by examining the compliance to guidelines promoting fruits, vegetables and whole grain and discouraging elevated alcohol, meat and energy dense foods intake. Dietary data was assessed through food frequency and lifestyle questionnaires administered face to face and through phone interviews. Anthropometrics, food security and sociodemographic data was also collected. Univariate and bivariate descriptive and logistic regressions were used to determine predictors of adherence rates to the ACS/AICR score. Results: A total of 268 participants were recruited (mean age = 59 ± 23 years, 83% females, 70% breast cancer). Mean time since remission was 3.2 ± 4 years and the majority (72%) had food insecurity. Low physical activity and overweight/obesity were present in 65% and 67% of the survivors, respectively. Median adherence score with the ACS/AICR score was 9.0 out of 15. The majority of survivors had complete adherence to the moderate meat and alcohol consumption guidelines. However, 98% were noncompliant with the whole grains' consumption guidelines. Cancer type, site of recruitment and education were the significant predictors of the ACS/AICR diet adherence score. Conclusion: This study highlights the elevated rates of overweight/obesity, physical inactivity and the alarmingly low adherence with the whole grains consumption guideline among cancer survivors in remission. Policy makers ought to use study findings to redirect government subsidization and educational interventions in the country and physicians should stress the importance of adherence to a healthy diet during remission through counseling and timely referral. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a particularly crucial period of physical, emotional, and social development and adaptation, rendering these formative years rather challenging for individuals with chronic conditions like type 1 diabetes (T1D). Despite rapid improvement in diabetes therapies, adolescents with T1D are characterized by poorer adherence to treatment regimens compared with other pediatric age groups. Insufficient adherence is strongly related to low diabetes control, increasing morbidity, and risk for premature mortality. This study aimed to provide a comprehensive overview of adolescents' most common barriers to T1D adherence, stressing the need for a deep and comprehensive understanding of these barriers. The complexity of these barriers is underscored by the diverse factors contributing to poor T1D adherence in adolescents. Methods: A narrative review was conducted, surveying four databases (PubMed, Scopus, EMBASE, and Web of Science) for full-text articles in the English language published up to June 2024. All studies related to barriers to T1D adherence in adolescents were considered. The literature was selected using selection and exclusion criteria and extracted and organized using Mendeley. Exclusion criteria included studies with insufficient data and non-peer-reviewed articles. This review revealed that adolescents face numerous obstacles to T1D adherence related to psychological factors, flux in family dynamics, perceived social pressures, therapy-related factors, transitioning responsibility, risk-taking behaviors, and pubertal changes. Conclusions: Navigating the adaptations to the different aspects of T1D, from treatment to complications and adolescents' personal growth, effectively requires a thorough understanding of the barriers of a treatment regimen that patients at this critical age face. [ABSTRACT FROM AUTHOR]

Traditional topology optimization methods only consider a limited number of loads in the optimization procedure, neglecting load variations common in real-world scenarios. To incorporate real load scenarios, robust topology optimization considers uncertainties in load directions while minimizing compliance, generating structures capable of withstanding variations in the load. This paper incorporates the angles of the load directions as parameters into the optimization formulation to design structures that perform well under a range of load directions. Additionally, the formulation is extended to incorporate local volume constraints to balance the solution distribution throughout a domain, achieving more complex designs with proper material distribution as the angle of the loads and the number of sub-regions increases while maintaining consistency in the worst-case scenario. Two and three-dimensional examples demonstrate that topology-optimized designs are susceptible to loads that vary in direction and magnitude, and by considering realistic loading conditions, this formulation yields robust, reliable designs, markedly enhancing their suitability for actual engineering applications. [ABSTRACT FROM AUTHOR]

Traditional healthcare systems have suffered from different data communication, security, data processing, and compliance issues. The traditional systems are also not well equipped to handle the new technologies like Artificial Intelligence (AI) by enabling more accurate diagnostics, personalized treatment plans, and improved patient outcomes. The existing data communication and security protocols and compliance are also not fully implemented to tackle the system's challenges. This article proposes a Tri‐Tier architecture by using data communication, AI data generative, and regulation and compliance tiers. The data communication tier is based on advanced sensing and monitoring technologies like cloud and edge‐based systems integrated with security detection mechanisms. The edge and cloud layer provides the all functions of the perception layer like smart sensing, visual sensing, and monitoring services, and can control the device's perception and behaviour. The second tier provides the AI data generative functionalities to handle real‐time synthetic medical images for predictive analytics to enhance patient care. This tier also automates routine tasks, such as administrative work and data analysis, which can free up healthcare professionals to focus on more complex tasks. The last regulation and compliance tier is responsible for handling the standards and compliance for healthcare systems. Experiments are conducted to test the data communication and security level of the proposed architecture. The results showed the suitability of existing solutions and synchronization with the proposed architecture. [ABSTRACT FROM AUTHOR]

Introduction: The Centers for Medicare & Medicaid Services (CMS) required a shared decision‐making (SDM) interaction, with an "independent" physician, before left atrial appendage closure (LAAC). The purpose of this study is to better understand how this requirement is implemented in clinical practice. Methods: We surveyed LAAC‐performing centers. The characteristics of respondent and nonrespondent hospitals were compared using the CMS Provider of Services File for 2017. Results: We received 86 responses out of 269 surveys mailed (32%). Respondent and nonrespondent hospital affiliations were similar: mean hospital size 525 beds, 15% for‐profit, and 34% teaching hospitals. Thirty‐four respondents (39.5%) stated that the implanting physician conducts some or all of the SDM interactions. The percentage of patients who decide not to undergo LAAC after the SDM interaction was estimated at 8.1%. Out of 72 responses to an open‐ended question about the benefit of the SDM interaction, 44 (61%) described the requirement in negative terms, of which most felt the requirement was burdensome for patients and providers. Only 28 respondents (39%) described the requirement in positive or mixed terms. Conclusion: In violation of the letter of the CMS policy for LAAC, implanting physicians perform the SDM interaction at nearly 40% of responding hospitals. Most respondents felt the SDM requirement was burdensome for patients. More detailed guidance from CMS on how to comply with the policy may result in better alignment between the intent of the policy and how it is implemented. [ABSTRACT FROM AUTHOR]

Aims: Abiraterone treatment requires regular drug intake under fasting conditions due to pronounced food effect, which may impact patient adherence. The aim of this prospective study was to evaluate adherence to abiraterone treatment in patients with prostate cancer. To achieve this aim, an abiraterone population pharmacokinetic model was developed and patients' adherence has been estimated by comparison of measured levels of abiraterone with population model‐based simulations. Methods: A total of 1469 abiraterone plasma levels from 83 healthy volunteers collected in a bioequivalence study were analysed using a nonlinear mixed‐effects model. Monte Carlo simulation was used to describe the theoretical distribution of abiraterone pharmacokinetic profiles at a dose of 1000 mg once daily. Adherence of 36 prostate cancer patients treated with abiraterone was then evaluated by comparing the real abiraterone concentration measured in each patient during follow‐up visit with the theoretical distribution of profiles based on simulations. Patients whose abiraterone levels were ˂5th or ˃95th percentile of the distribution of simulated profiles were considered to be non‐adherent. Results: Based on this evaluation, 13 patients (36%) have been classified as non‐adherent. We observed significant association (P =.0361) between richness of the breakfast and rate of non‐adherence. Adherent patients reported significantly better overall condition in self‐assessments (P =.0384). A trend towards a higher occurrence of adverse effects in non‐adherent patients was observed. Conclusions: We developed an abiraterone population pharmacokinetic model and proposed an advanced approach to medical adherence evaluation. Due to the need for administration under fasting conditions, abiraterone therapy is associated with a relatively high rate of non‐adherence. [ABSTRACT FROM AUTHOR]

This study sought to advance our understanding of how observed child self-regulation, parenting, and their interaction were associated with children's dynamic physiological stress reactivity indexed by respiratory sinus arrhythmia (RSA) reactivity trajectories. Participants were 85 three-year-old children (54% female) and their mothers oversampled for lower income, higher stressful life events, and higher child maltreatment risk. Child behavioral regulation, assessed as compliance and noncompliance, and maternal supportive parenting were observed during a challenging dyadic puzzle task. Results showed that child RSA exhibited quadratic change across the task on average, characterized by an expected initial decrease and subsequent recovery. Child behavioral regulation and its interaction with maternal supportive parenting were associated with interindividual differences in child RSA reactivity trajectories after controlling for child resting RSA. Children with higher compliance or lower noncompliance showed RSA decreases in response to task stressors but exhibited subsequent RSA recovery only when mothers displayed higher supportive parenting. Children with lower compliance or higher noncompliance displayed negligible RSA changes overall across the task, suggesting blunted or compromised RSA reactivity, regardless of supportive parenting levels. These findings demonstrate novel evidence that preschoolers' better behavioral regulation is related to their more adaptive physiological reactivity to stressors and that supportive parenting is needed to facilitate physiological recovery even in relatively better-regulated preschoolers. Public Significance Statement: This study demonstrates that during challenging mother–preschooler interactions, preschoolers who exhibit better behavioral regulation with mothers and experience higher levels of supportive parenting show the most adaptive physiological reactivity to stressors and efficient physiological recovery after stressors have passed. Child self-regulation and parenting in challenging interactions are potential intervention targets to promote adaptive physiology and behaviors. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the relationship between treatment adherence, visual acuity, quality of life (QoL), depression, and anxiety levels in individuals with Behçet's uveitis (BU). Methods: A total of 55 BU patients and 55 healthy controls completed sociodemographic questionnaires, the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), World Health Organization Quality of Life Questionnaire-BREF version (WHOQOL-BREF), Self-reported Questionnaire About Treatment Compliance, and the Morisky Medication Adherence Scale (MMAS). The scores obtained from these scales were analyzed to assess the relationship between treatment adherence, visual acuity, QoL, depression, and anxiety levels. Results: The results revealed that 36 (65.4%) of the 55 BU patients exhibited depressive symptoms, while 45 (81.8%) of them experienced symptoms of anxiety. Patients with BU demonstrated significantly higher BAI and BDI scores compared to the healthy control group (p < 0.001). Furthermore, the patient group reported lower mean scores across multiple domains of the WHOQOL-BREF questionnaire, including general health, psychological health, social relationships, and environment (p < 0.05). Moreover, a significant association was observed between low treatment adherence and lower values of best-corrected visual acuity (BCVA) (p < 0.05), as well as a higher frequency of uveitis attacks (p = 0.005). Conclusion: Poor treatment adherence in BU patients has a negative effect on final visual acuity outcomes. Moreover, BU patients experience lower QoL and higher rates of depression and anxiety compared to the healthy control group. These findings highlight the importance of addressing treatment adherence and psychological well-being in the management of BU. [ABSTRACT FROM AUTHOR]

Aim This article determines the compliance rates with low-dose aspirin (LDA) and outcomes in a group of pregnant women identified at high risk for preeclampsia (PE) and fetal growth restriction (FGR) at 11 to 14 gestational weeks (GWs) in a rural district of central India. Methods A single, experienced fetal radiologist assessed all enrolled pregnant women using trimester-specific antenatal screening protocols that included mean arterial blood pressure assessment, and fetal ultrasound and Doppler studies. A trimester-specific individualized risk for preterm PE and FGR was estimated for each woman. Pregnant women categorized as high risk for preterm PE or FGR based on a 1 in 150 criteria at 11 to 14 GW were recommended LDA 150 mg once daily at bedtime. Outcome measures included compliance with LDA assessed, incidence of PE and FGR, preterm delivery (<37 GW), birth weight, stillbirths, and perinatal mortality. Results The data of 488 pregnant women with longitudinal trimester-specific assessments from 11 to 14 GW till childbirth was analyzed. At the third trimester assessment, 215 (80.83%) of the high-risk women were compliant with LDA. The incidence of PE, FGR, and preterm births was significantly higher in LDA noncompliant women, and the mean birth weight was significantly higher in LDA-compliant high-risk women. Conclusion Good compliance for LDA is possible in rural populations with adequate counseling. Starting LDA at 11 to 14 GW for high-risk pregnant women lowered the incidence of PE, FGR, and preterm birth rates and improved birth weight in the study population. [ABSTRACT FROM AUTHOR]

Research on real-world patterns of substance use increasingly involves intensive longitudinal data (ILD) collection, requiring long assessment windows. The present study extends limited prior research examining event- and person-level influences on compliance and response consistency by investigating how these behaviors are sustained over time in an ILD study of alcohol and cannabis co-use in college students. Participants (n = 316) completed two 28-day bursts of ILD comprising five daily surveys, which included a morning survey of prior-day drinking. We used linear mixed effects models in a multilevel interrupted time series framework to evaluate the associations of time and measurement burst with (a) noncompliance (count of missed surveys) and (b) response consistency (difference between same-day report of drinking and morning report of prior-day drinking). We observed that time was positively associated with noncompliance, with no discontinuity associated with measurement burst. The slope of time was more positive in the second burst. Neither time nor measurement burst were significantly associated with consistent reporting. However, survey nonresponse and consistency of responding appeared to be impacted by the same-day use of substances. Overall, compliance decreased while consistency was stable across the duration of a lengthy ILD protocol. Shorter assessment windows or adaptive prompting strategies may improve overall study compliance. Further work examining daily burden and context is needed to inform future ILD design. Public Significance Statement: This study examined compliance and consistency of reporting in a lengthy, intensive longitudinal data protocol spanning 56 days of data collection across two measurement bursts. Results showed that compliance decreased over time, with no change associated with the discontinuity between bursts, while consistency remained constant and of moderate magnitude. Findings inform the design and handling of missing data in future intensive longitudinal research. [ABSTRACT FROM AUTHOR]

Background: Lymphatic Filariasis (LF) is endemic in 83 countries and territories, with more than a billion people at risk of infection. Filariasis has been a major public health problem in India next only to Malaria. Present study was done to assess coverage and compliance of mass drug administration (MDA) against lymphatic Filariasis in Kalaburgi district. Methods: A coverage evaluation survey was done in one urban and three rural clusters in Kalaburgi district. The data was compiled, tabulated and analyzed using proportions. Results: Among total of 683 subjects who were interviewed, 54.61%. were male subjects and only 406 (62.08% ) of the participants have received the drugs. Out of the 406 persons who have received the drugs, 76.6% persons have consumed the drugs. Only 3.54% of study subjects consumed tablets in front of health workers. A total of 277 subjects did not consume the tablets. The reasons for non consumption of tablets were, 66.06% told drug distributor did not visit, 8.3% said that they were out of station and 7.94% subjects were not aware. Among the total only 9 persons suffered from nausea and vomiting. Conclusions: There is an urgent need for more effective drug delivery strategies and also proper Information Education and Communication (IEC) should be done to educate and to improve the coverage and compliance in the districts. [ABSTRACT FROM AUTHOR]

Key Takeaways: While the Safe Drinking Water Act (SDWA) applies to all public water systems in the United States, the severity and prevalence of violations vary among locations. A study investigated drinking water quality, indicated by statistics of the SDWA in the 13 Appalachian states from 2010 to 2022, to identify any differences in violations. The need for better water system management and infrastructure in economically disadvantaged regions is clear, along with public education and effective policies. [ABSTRACT FROM AUTHOR]

Background and Aims: Nurse interns may be at a similar or higher risk than registered nurses. The key elements and mechanisms involved in the effects of safety climate on safety performance are not well understood. This study explores the relationship between the perceived hospital safety climate and compliance with occupational safety practices among nurse interns. Methods: A cross‐sectional study was conducted among 178 nurse interns in three tertiary university hospitals in Chongqing city, China. The Chinese version of the Hospital Safety Climate Scale (HSCS) was used to measure the perceived hospital safety climate of nurse interns. Compliance behavior was measured using the Compliance with Occupational Safety Practice Scale (COSPS). Canonical correlation analysis and multiple linear regression modeling were used to examine their relationship. Results: Total scores for the HSCS and COSPS were 92 (80,100) and 185 (175,185) [M (P25, P75)], respectively. Canonical correlation coefficients for canonical variates 1 and 2 were 0.636 (p < 0.001) and 0.414 (p < 0.001), respectively. Nurse interns' compliance with occupational safety practices was mainly influenced by management support, feedback/training, personal protective and engineering control equipment availability, and absence of job hindrance. Multiple linear regression showed that management support of HSCS accounted for 37.1% of the variance in compliance (β = 0.283, p = 0.039). Conclusion: Nurse interns reported high levels of perceived hospital safety climate and compliance with occupational safety practices. Younger nurse interns reported a lower level of perceived hospital safety climate. Nurse educators can improve interns' compliance by promoting better management support, feedback/training, personal protective and engineering control equipment availability, and fewer job hindrance. [ABSTRACT FROM AUTHOR]

Background and Objectives: The objective of this paper is to determine the rate and predictors of non-adherence to antiseizure medications in Saudi Arabia. Materials and Methods: A cross-sectional study which involved questionnaires and data collection from patients' medical records was conducted at neurology clinics. The rate of non-adherence to antiseizure medications was measured using "the Medication Adherence Rating Scale" (MARS). Predictors of non-adherence to antiseizure medications were evaluated using a multidimensional questionnaire specific to epilepsy. Results: One hundred and sixty-two patients participated in the study. The mean (SD) age was 34.1 (10.4) years, and 56% were male. Epilepsy was controlled (i.e., seizure-free ≥ 1 year) in 42% of patients. The mean ± SD (range) MARS scores were 7.80 ± 1.59 (2–10). Out of 162 patients, 58 (36%) patients had MARS scores ≤ 7 out of 10. The most frequently rated predictor for non-adherence was poor seizure control, which was reported by around 36% of patients. Forgetfulness, dosing frequency, and social stigma were also among the commonest predictors of non-adherence to antiseizure medications that were rated by approximately 27%, 24%, and 22% of the patients, respectively. The impacts of several socio-demographic and clinical factors on adherence were assessed. In the regression analysis, the odds of non-adherence in a patient who experienced adverse effects were twice that of a patient who did not have adverse effects (p = 0.113). Furthermore, females, employers, and patients who had comorbidity, those with focal epilepsy, those on polytherapy of antiseizure medication, and those receiving multiple doses per day, were all more likely (but not significantly, p > 0.05) to be non-adherent compared to their counterparts. Conclusions: The significance of this study is that it reveals that adherence to antiseizure medications is suboptimal in Saudi Arabia. Poor seizure control, forgetfulness, dosing frequency, and social stigma were the primary patient-reported predictors of non-adherence in epilepsy. This emphasizes the importance of routine evaluation of adherence in practice to identify and address what individual patients perceive as a barrier to adherence with antiseizure medications. [ABSTRACT FROM AUTHOR]

Across the globe, an ongoing urban food system (UFS) transformation has made street food trade (SFT) fundamental for urban food security (FS). It also highlights the central role of city governance in SFT. However, large gaps exist in understanding of the regulatory arena, that constrains policy discussion, hinders traders, and inhibits access, affordability, and availability of safe street food. This paper examines implications of SFT regulations on FS and urban livelihoods. We focus on a cross-section of 260 street food enterprises (SFEs) in urban Kumasi, Ghana, and explore interactions of compliance with SFT regulations, adoption of improved practices, enterprise performance and their links to FS in UFSs. We find that though vendors are generally aware and willing to invest in improved practices, compliance levels with regulations are below average due mainly to insufficient, inconsequential, and uneven regulatory enforcement. We also find that compliance costs are high whilst detected non-compliance neither bears sufficient legal nor financial consequences. Lastly, compliance requirements negatively impact urban FS such that, annual compliance costs inhibit the supply of over 103,000 food servings from the UFS whilst compliance-induced innovations siphon out over half a million food servings from it annually. The later also increases prices of street-vended food by about 6%. From a modern urban food policy perspective, our findings suggest urban food policy and city management efforts could enhance the FS role of SFT, if they prioritize promoting improved practices, simplifying regulations, and assisting vendors in compliance. [ABSTRACT FROM AUTHOR]

Background and Objectives: Behavior management as a set of clinical techniques to induce desirable clinical treatment and subsequent compliance behaviors in children and families varies internationally based on professional training, access to care, health literacy, and societal norms. This report proposes non-typical diagnostic considerations of additional inherent behavioral conditions and familial and social qualifiers that may help predict success both at the chairside and in compliance with home self-care behaviors to reduce caries susceptibility. Methods: A review of the medical and dental literature provides ample support for the consideration of changing characteristics of both the patient and the environment. Results: The current recommendations for choice of behavior guidance in direct clinical care, as used in the USA, often fall short of efficacy for a variety of reasons including the provider limitations, the extent and difficulty of treatment, and most recently appreciated, the complexity of negative childhood experiences, subclinical behavioral disorders, and immutable negative determinants of health outside the dental setting affecting interaction with health professionals. These same factors, such as family dysfunction and societal stresses, also impact compliance with out-of-clinic preventive efforts that many oral health care providers rely upon to help mitigate treatment limitations in reaching children. There are also behavioral elements of compliance and attitudes toward health that dentists need to recognize. Conclusions: A broader, more inclusive concept of behavior guidance to include factors beyond those typically associated with a dental patient affecting treatment and compliance with preventive behaviors may be beneficial. Every population and patient will have differing characteristics and require individualized care. [ABSTRACT FROM AUTHOR]

This article investigates how the identities of frontline professionals are (re)constructed in their talk about their everyday work activities. Based on a study of a mental health and addiction counselling service organization in Ontario, we illustrate that when talking about acting in accordance with their organizational policies, the social workers' identities are disciplined by and appropriated from addressing the practices of documentation and regular meetings with their supervisors that constitute the routine processes of organizing. However, when discussing instances where they override the organizationally sanctioned rules, their identities are disciplined by the aspiration of fabricating a client-centred caregiver identity adopted from the dominant discourse in their profession. We, therefore, counterbalance the understanding that professionals' identity work related to their deliberate micro-emancipation acts are merely an expression of agency and argue that their preferred resistant identities pertaining to their self-declared apparent deviation from the organizational order are also made within frameworks of disciplinary power. By delineating that both discursive conformity and resistance cut across the boundaries between acting in alignment with and against organizational guidelines, we unveil an underexplored complexity of conducting professional identity work associated with the interrelationships between practices of talk and action that has largely been overlooked in prior scholarship. We, therefore, offer an action-related analysis of discursive identity work that extends beyond the context of this study and informs future research. [ABSTRACT FROM AUTHOR]

The institutional design of voluntary sustainability standards (VSS) has been recognized as an important determinant of compliance with VSS rules, which partly explains heterogeneity in VSS sustainability impacts. However, the current understanding of how VSS institutional design generates compliance is scattered and lacks systematic operationalization. This paper brings together different strands of literature and identifies three main mechanisms through which VSS institutional design can generate compliance: enforcement, market incentives, and capacity‐building. We propose an integrated analytic framework that operationalizes these mechanisms into specific, identifiable design attributes. We apply it in an empirical analysis of 13 agrifood and forestry VSS to assess the extent to which these mechanisms are used in VSS institutional design. While enforcement appears necessary for VSS to operate, we find heterogeneity in how these mechanisms are used and combine, which is partly explained by contextual factors. This provides avenues for analyzing their respective effectiveness in generating compliance. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate three‐dimensional movements of maxillary teeth during headgear treatment in Class II growing children, using digital analytical tools, and to determine the effects of compliance on these movements. Materials and Methods: A 9‐month parallel‐group randomized controlled trial was carried out on 40 children with Class II malocclusion, aged 8‐12 years, half assigned to receive a cervical headgear and half to a no‐treatment group, using block randomization. Subjects in the treatment group were instructed to wear the headgear for 12 hours daily and monitored using an electronic module. After 9 months, the following dental outcomes were measured: first maxillary molar distalisation, rotation, tip and torque, arch depth, and interpremolar and intermolar distances. Caregivers and participants were not blinded to group assignments, but those assessing outcomes were. Linear regression models were used to detect differences between groups and correlation coefficients to find correlations between compliance and dental outcomes. Results: All 40 included patients were analysed. A significant difference in molar distalisation was observed between the treatment (1.2 mm) and control groups (−0.2 mm). Arch depth change was also increased to a larger extent in the treatment groups (1.3 mm vs 0.1 mm), as was the interpremolar distance (1.9 mm vs 0.4 mm). In contrast, no significant differences in molar rotation or torque change were observed. With regard to compliance, average compliance was 55%. A significant correlation was found between molar distalisation and compliance in the treatment group. Conclusions: Headgear therapy has significant effects on molar distalisation, arch depth, and arch width. Compliance has a significant positive effect on molar distalisation. [ABSTRACT FROM AUTHOR]

While voluntary responsible business standards are more flexible than regulation and thus more responsive to changes in society, revising standards can have negative effects on compliance rates. We hypothesize that when non-compliance is visible to external stakeholders and participating firms receive a clear signal that their products are non-compliant, the firms will respond by re-certifying their products, which will raise their certification rates. We tested our hypothesis by conducting a multi-level regression on the certification rates before and after the revision of a voluntary label for healthier food products, active in the Dutch market from 2006 until 2015 in the Dutch market (76 firms, 22 product categories, 1354 firm-category-year observations). Our results show the opposite effect than hypothesized: after standards' revision, firms with decertified products significantly decrease their certification rates compared to firms without decertified products. We conclude that making standards stricter over time is not always a successful strategy to maintain compliance. We argue that this decrease in compliance after standards' revisions can be explained by the low behavioural visibility of non-compliance, restricting stakeholder pressure both at the product level by consumers as well as at the firm level by other stakeholders. [ABSTRACT FROM AUTHOR]

Background: The International Code of Marketing of Breast-milk Substitutes, or 'the Code,' sets standards to regulate marketing of commercial milk formula (CMF) to protect breastfeeding. World Health Organization member states are advised to legislate the Code into national law, but understanding of its implementation outcomes is limited. This systematic review aimed to examine implementation outcomes in countries implementing the Code as national law. Methods: We systematically searched five academic databases in September 2022 for articles published in English from 1982 to 2022. We double-screened titles/abstracts and then full texts for eligible articles reporting implementation outcomes of the Code in 144 eligible countries. We used the Mixed Methods Appraisal Tool for quality assessment and synthesized data thematically. We applied the Proctor et al. framework to guide synthesis of implementation outcomes, organizing our findings according to its taxonomy. Results: We included 60 eligible articles of the 12,075 screened, spanning 28 countries. Fifty-seven articles focused on legal compliance, 5 on acceptability, and 1 on feasibility. Compliance was assessed across multiple sources, including mothers, health workers, media, points of sale, and product labels. Maternal exposure to CMF promotion remained widespread, with reports of mothers receiving free samples and coupons, and encountering media advertisements. Compliance of health workers varied across countries, with many reporting contact with CMF companies despite legal prohibitions. Public hospitals generally showed better adherence to the national law than private ones. While implementing the Code as national law effectively regulated the promotion of CMF for infants aged 0–12 months in public settings and in the media, it remains insufficient in addressing the promotion of unregulated products like growing-up milk, which are often marketed through emerging strategies such as cross-promotion and digital advertising. Point-of-sales compliance was inconsistent, with many countries reporting non-compliant price-related promotions. Conclusion: To enhance legal compliance, robust monitoring and reporting systems are necessary. Utilizing technology-assisted solutions for monitoring compliance can be an option for countries with limited human resources. Adequate training for health workers and communication strategies targeting shop managers about national law are also essential in enhancing their acceptability and compliance. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are rising rapidly in low- and middle-income countries, leading to increased morbidity and mortality. Reducing sedentary behavior (SB) and increasing physical activity (PA) offer numerous health benefits. Workplaces provide an ideal setting for promoting SB/PA interventions; however, understanding the barriers and enablers is crucial for optimizing these interventions in workplace environments. Methods: Nested within a cluster randomised controlled trial (the SMART-STEP trial), the present study employed in-depth interviews with 16 office workers who have completed 24 weeks of two distinct (technology assisted and traditional) workplace SB/PA interventions. Using a deductive analysis, semi-structured interviews were administered to explore the barriers and enablers to the SB/PA interventions at individual, interpersonal and organisational level using the socio-ecological model. Results: Several individual (poor goal setting, perceived health benefits & workload, attitude, intervention engagement), interpersonal (lack of peer support) and organisational (task prioritisation, lack of organisational norm and material or social reward) barriers were identified. Indian women engaged in desk-based office jobs often find themselves burdened with intense home and childcare responsibilities, often without sufficient support from their spouses. A primary concern among Indian office workers is the poor awareness and absence of cultural norms regarding the health risks associated with SB. Conclusions: Raising awareness among workplace stakeholders—including office workers, peers, and the organization—is crucial before designing and implementing SB/PA interventions in Indian workspaces. Personalized interventions for Indian female office workers engaged in desk-bound work are warranted. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers are a high-risk group for COVID-19 and protecting them is crucial for healthcare delivery. Limited studies have explored compliance with infection prevention and control (IPC) practices among Somali healthcare workers. This study aimed to determine compliance with IPC practices among healthcare workers in De Martino Public Hospital, Somalia. Methods: A cross-sectional study was conducted at the De Martino Public Hospital, Mogadishu, Somalia from August to October 2022, with the participation of 204 healthcare workers (response rate = 97%). Compliance was assessed using responses to 25 questions on a five-point Likert-type scale, and a median score of 20 was used to dichotomize compliance scores. A chi-square test and logistic regression analysis were performed to check the associations between healthcare workers' socio-demographic information, IPC-related factors, work conditions and practices on COVID-19, and IPC compliance during healthcare interventions using SPSS 23 version. Results: In total, 58.3% of the participants had good compliance with IPC. There were significant associations between IPC compliance and the type of healthcare worker (doctors and doctor assistants: 72.3%, nurses and paramedical staff: 67.3%, non-clinical staff: 5.7%, p < 0.01). After adjusting for potential confounding factors, compared to non-clinical staff, doctors and doctor assistants (OR: 12.11, 95% CI: 2.23–65.84) and nurses and paramedical staff (OR: 21.38, 95% CI: 4.23–108.01) had higher compliance with IPC measures. There were no significant associations between compliance and sex, marital status, vaccination status, or smoking (p > 0.05 for all). Conclusions: Low levels of compliance with COVID-19 IPC measures were observed among hospital workers. Prioritizing awareness campaigns and behavior change interventions, especially among non-clinical staff, is crucial for effective COVID-19 infection prevention and control within hospitals. [ABSTRACT FROM AUTHOR]

Feminist activism persisted even in the isolating times of the COVID-19 pandemic. But how did the crisis shape feminist solidarity, especially for subjects facing multiple marginalities? In this article, based on in-depth interviews and participant observation, I examine how women tech workers in India – as gendered labour in the Global South – participated in various online groups to overcome their isolation. These women ostensibly acted as compliant neoliberal and heteronormative subjects, but their compliance paved the way for feminist solidarity. I theorize this paradox as the ‘praxis of compliance.’ As a theoretical framework, ‘praxis of compliance’ foregrounds the structural barriers to women workers’ participation in collective feminist activism. It also reveals some alternative strategies of building feminist solidarity within the constraints of the neoliberal economy as well as local and global crises that deepen inequality. I identify three potential areas of praxis of compliance for women tech workers in India: professional, personal and labour activism. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionsExercise training (ET) is a promising rehabilitation approach for long-term negative consequences of traumatic brain injury (TBI). However, little is known regarding overall rates of attrition, adherence, and compliance to ET in TBI.The purpose of this systematic review was to estimate average attrition, adherence, and compliance rates in ET studies in persons with TBI.Databases were searched from inception to April 15, 2024. Two authors independently extracted data related to attrition, adherence, compliance, and possible moderators identified a priori.The average rate of attrition from 45 studies was 14.4%, although the majority of studies had small sample sizes (i.e. n < 42). Based on hierarchical linear regression, the most influential predictors of attrition were sample size and study design. A minority of studies reported adherence (44.4%) or compliance (22.2%) but those that did reported good average adherence (85.1%) and compliance (77.7%). These studies support the ability of persons with TBI to complete an ET intervention as prescribed.Researchers can use this information to ensure adequate power to detect a true effect of ET in persons with TBI. Researchers conducting ET studies in persons with TBI should clearly and thoroughly report data on attrition, adherence, and compliance. [ABSTRACT FROM AUTHOR]

Background: Medical fear is a common psychological reaction in hospitalized children, especially during radiotherapy for central nervous system (CNS) cancers. This fear not only causes negative emotions such as anxiety and depression but also affects children's quality of life and treatment outcomes. It is exacerbated by factors such as unfamiliar environments during radiation therapy and separation from parents. Child Life, as a professional service, offers physical and mental support to children through medical understanding and psychological preparation, addressing their social and psychological needs, among other things. This study aims to construct a comprehensive Child Life intervention program (CCLIP), consisting of four key components: psychological adjustment and preparation, therapeutic play, pain management and coping strategies, and family support. The integration of effective intervention methods aims to reduce medical fear in children undergoing radiotherapy, promote psychological well-being, improve treatment compliance, and enhance quality of life. Methods: This study is a protocol for a randomized controlled trial. Using a random number table method, we plan to recruit 38 eligible children who meet the inclusion criteria and then randomize them into two distinct groups: the intervention group and the control group. The intervention group will receive the CCLIP, and the control group will receive standardized care. Data will be collected through questionnaires and on-site assessments during the one-month intervention period at four distinct time points: the day of admission (T0), the first radiotherapy positioning (T1), mid-radiotherapy (T2), and postradiotherapy (T3). The primary outcome measure is the effectiveness of the CCLIP in reducing medical fear among children receiving radiation treatment for CNS cancers. Secondary outcomes include anxiety, depression, radiation adherence, quality of life among children, and parental satisfaction. Discussion: This study aims to alleviate medical fear among children with CNS tumors undergoing radiotherapy through the implementation of the CCLIP while enhancing their mental health and quality of life. The expected outcomes of this research include providing effective intervention strategies for clinical practice, improving the treatment experience and long-term prognosis of children, and having positive impacts on children and their families. Trial registration: This study is registered at the Chinese Clinical Trial Registry, ChiCTR2400082622. Registered 2 April, 2024. [ABSTRACT FROM AUTHOR]