Oro-facial function and quality of life in children and adolescents with large horizontal maxillary overjet-A case-control study

BACKGROUND

Large horizontal maxillary overjet (overjet) is associated with reduced bite force (BF) and number of contacts, which influence the chewing effectivity (CE). Oral health, oro-facial function (OF) and malocclusion have great impact on psychological well-being and quality of life (QoL).

OBJECTIVES

The aims of the study were to examine OF, temporomandibular disorders (TMD), BF, CE, QoL and well-being in children and adolescents with large overjet.

METHODS

The study was a case-control study including healthy children with large overjet in the study group compared to a control group of healthy children with neutral occlusion, all 9-14 years old. OF was examined by use of Nordic Orofacial Test-Screening (NOT-S), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and registration of morphological and functional occlusion. QoL and well-being were examined using KIDSCREEN-10 and Strengths and Difficulties Questionnaire.

RESULTS

The study and control groups included 37 and 32 participants, respectively. Significantly increased NOT-S score (p < .001) and reduced BF (p = .011), numbers of contacts (p < .001) and CE (p = .005) were found in the study group. BF, numbers of contacts and CE were negatively associated with erupting canines and premolars. No significant difference was found in age, gender, dental eruption, TMD diagnosis or QoL between the groups. Significantly increased emotional symptoms (p = .007), hyperactivity (p = .043) and total difficulties score (p = .009) were found in the study group.

CONCLUSION

The study group showed higher NOT-S score and reduced BF, number of contacts and CE. No difference in QoL were found between the groups, although reduced well-being and increased emotional symptoms, hyperactivity and total difficulties were found in the study group.

How do surrogates make treatment decisions for patients with dementia: An experimental survey study

Despite the growing need for surrogate decision-making for older adults, little is known about how surrogates make decisions and whether advance directives would change decision-making. We conducted a nationally representative experimental survey that cross-randomized cognitive impairment, gender, and characteristics of advance care planning among hospitalized older adults through a series of vignettes. Our study yielded three main findings: first, respondents were much less likely to recommend life-sustaining treatments for patients with dementia, especially after personal exposure. Second, respondents were more likely to ignore patient preferences for life-extending treatment when the patient had dementia, and choose unwanted life-extending treatments for patients without dementia. Third, in scenarios where the patient's wishes were unclear, respondents were more likely to choose treatments that matched their own preferences. These findings underscore the need for improved communication and decision-making processes for patients with cognitive impairment and highlight the importance of choosing a surrogate decision-maker with similar treatment preferences.

Machine learning-based prediction of tear osmolarity for contact lens practice

PURPOSE

This study addressed the utilisation of machine learning techniques to estimate tear osmolarity, a clinically significant yet challenging parameter to measure accurately. Elevated tear osmolarity has been observed in contact lens wearers and is associated with contact lens-induced dry eye, a common cause of discomfort leading to discontinuation of lens wear.

METHODS

The study explored machine learning, regression and classification techniques to predict tear osmolarity using routine clinical parameters. The data set consisted of 175 participants, primarily healthy subjects eligible for soft contact lens wear. Various clinical assessments were performed, including symptom assessment with the Ocular Surface Disease Index and 5-Item Dry Eye Questionnaire (DEQ-5), tear meniscus height (TMH), tear osmolarity, non-invasive keratometric tear film break-up time (NIKBUT), ocular redness, corneal and conjunctival fluorescein staining and Meibomian glands loss.

RESULTS

The results revealed that simple linear regression was insufficient for accurate osmolarity prediction. Instead, more advanced regression models achieved a moderate level of predictive power, explaining approximately 32% of the osmolarity variability. Notably, key predictors for osmolarity included NIKBUT, TMH, ocular redness, Meibomian gland coverage and the DEQ-5 questionnaire. In classification tasks, distinguishing between low (<299 mOsmol/L), medium (300-307 mOsmol/L) and high osmolarity (>308 mOsmol/L) levels yielded an accuracy of approximately 80%. Key parameters for classification were similar to those in regression models, emphasising the importance of NIKBUT, TMH, ocular redness, Meibomian glands coverage and the DEQ-5 questionnaire.

CONCLUSIONS

This study highlights the potential benefits of integrating machine learning into contact lens research and practice. It suggests the clinical utility of assessing Meibomian glands and NIKBUT in contact lens fitting and follow-up visits. Machine learning models can optimise contact lens prescriptions and aid in early detection of conditions like dry eye, ultimately enhancing ocular health and the contact lens wearing experience.

How and why do people with chronic low back pain modify their physical activity? A mixed-methods survey

BACKGROUND

This study investigated the impact of Chronic Low Back Pain (CLBP) on individuals' physical activity (PA) behaviours, specifically, how they modify, cease, or continue PA when experiencing CLBP. The primary aim was to explore the relationship between CLBP and PA and how this is influenced in different contexts (e.g., necessity of a task).

METHODS

A mixed-methods survey was administered to 220 participants, including self-reported outcomes, and capturing responses to three distinct questions related to PA and CLBP. The data was analysed via a content analysis.

RESULTS

The findings revealed that individuals with CLBP are most likely to modify PA in work-related contexts and least likely to cease it in the same setting. Housework emerged as the most common domain for cessation of PA, while work/study activities were predominantly continued. Reasons for these trends were typically task-based rather than health or enjoyment based and influenced by the perceived necessity of the task in question.

CONCLUSION

The study highlights the role of occupational and educational settings in individual responses to CLBP. The findings also highlight a gap in public awareness regarding effective CLBP management strategies, emphasising the need for increased education and awareness programs.

Positive Emotions, Hope, and Life Satisfaction in Chinese Older Adults: An Application of Broaden-and-Build Model

According to the broaden-and-build theory, positive emotions can broaden our awareness and build psychological resources, which leads to better psychological outcomes. Previous studies demonstrated that hope partially mediates the association between positive emotions and life satisfaction in college students. Yet, there has no similar model been tested among older adults. The objective of the current study was to evaluate the mediating role of hope agency and pathways in the association between positive emotions and life satisfaction. Three hundred and forty-one Chinese community-dwelling older adults (mean = 70.83, SD = 9.16) were asked to complete a survey questionnaire comprising measures assessing positive emotions, hope, life satisfaction, and other sociodemographic variables. Results showed that hope agency, but not hope pathways, partially mediated the relationship between positive emotions and life satisfaction. We discussed the importance of these initial findings concerning positive emotions and hope as predictors of life satisfaction in the older adult population.

Do Divine Struggles Moderate the Association Between Interpersonal Conflict at Work and Worker Well-Being in Singapore?

The purpose of this study is to examine how divine struggles moderate the association between interpersonal workplace conflict and worker well-being in Singapore. Using data from the Work, Religion, and Health survey (2021), the analyses show that interpersonal workplace conflict is positively associated with psychological distress and negatively associated with job satisfaction. Although divine struggles fail to function as a moderator in the former, these moderate its association in the latter. Specifically, the negative association between interpersonal conflict at work and job satisfaction is stronger for those with higher levels of divine struggles. These findings support the idea of stress amplification, indicating that troubled relationships with God may exacerbate the deleterious psychological effects of antagonistic interpersonal relationships at work. Ramifications of this aspect of religion, job stressor, and worker well-being will be discussed.

Core Descriptor Sets for Rectal Prolapse Outcomes Research Using a Modified Delphi Consensus

BACKGROUND

There is wide variation in prolapse care.

OBJECTIVE

To determine core descriptor sets for rectal prolapse to enhance outcomes research.

DESIGN

Descriptors for patients undergoing rectal prolapse surgery were generated through a systematic review and expert opinion. Stakeholders were recruited internationally via listserv and social media. Experts were encouraged to consider the minimum descriptors that could be considered during clinical care, and descriptors were grouped into core descriptor sets. Consensus was defined as greater than 70% agreement.

SETTING

A 3-round Delphi process using a 9-point Likert scale based on expert results was distributed via survey. The final interactive meeting used a polling platform.

PARTICIPANTS

The Pelvic Floor Disorders Consortium interdisciplinary group convened to advance the clinical care of pelvic floor disorders.

MAIN OUTCOME MEASURES

To achieve expert consensus for core descriptor sets for rectal prolapse using a modified Delphi method.

RESULTS

A total of 206 providers participated, with survey response rates of 82% and 88%, respectively. Responders were from North America (56%), Europe (29%), and Latin America, Asia, Australia, New Zealand, and Africa (15%). Ninety-one percent of participants identified as colorectal surgeons and 80% reported >5 years of experience (35% reported >15 years). Fifty-seven attendees participated in the final meeting and voted on core descriptor sets. Ninety-three percent of participants agreed that descriptors such as age, BMI, frailty, nutrition, and the American Society of Anesthesiology score correlated to physiologic status. One hundred percent of participants agreed to include baseline bowel function. One hundred percent of participants reported willingness to complete a synoptic operative report. Follow-up intervals 1, 3, and 5 years after surgery (76%) with a collection of recurrence and functional outcomes at those time periods reached an agreement.

LIMITATIONS

Individual bias, self-identification of experts, and paucity of knowledge related to rectal prolapse.

CONCLUSIONS

This represents the first steps toward international consensus to unify language and data collection processes for rectal prolapse. See Video Abstract .

CONJUNTOS DE DESCRIPTORES BSICOS PARA LA INVESTIGACIN DE RESULTADOS DE PROLAPSO RECTAL MEDIANTE UN CONSENSO DELPHI MODIFICADO

ANTECEDENTES:Existe una amplia variación en la atención del prolapso.OBJETIVO:Determinar conjuntos de descriptores básicos para el prolapso rectal para mejorar los resultados de la investigación.DISEÑO:Los descriptores para pacientes sometidos a cirugía de prolapso rectal se generaron a través de una revisión sistemática y la opinión de expertos. Las partes interesadas fueron reclutadas internacionalmente a través de listas de servicio y redes sociales. Se animó a los expertos a considerar los descriptores mínimos que podrían considerarse durante la atención clínica, y los descriptores se agruparon en conjuntos de descriptores básicos. El consenso se definió como > 70% de acuerdo.AJUSTE:Se distribuyó mediante encuesta un proceso Delphi de tres rondas que utiliza una escala Likert de 9 puntos basada en resultados de expertos. La reunión interactiva final utilizó una plataforma de votación.PARTICIPANTES:El grupo interdisciplinario del Consorcio de Trastornos del Suelo Pélvico se reunió para avanzar en la atención clínica de los trastornos del suelo pélvico.MEDIDAS PRINCIPALES DE RESULTADOS:Lograr el consenso de expertos para los conjuntos de descriptores básicos para el prolapso rectal utilizando un método Delphi modificado.RESULTADOS:Participaron 206 proveedores con tasas de respuesta a la encuesta del 82% y 88% respectivamente. Los encuestados procedían de América del Norte (56%), Europa (29%) y América Latina, Asia, Australia, Nueva Zelanda y África (15%). El noventa y uno por ciento se identificó como cirujanos colorrectales y el 80% reportó más de 5 años de experiencia (35% > 15 años). Cincuenta y siete asistentes participaron en la reunión final y votaron sobre conjuntos de descriptores básicos. El noventa y tres por ciento estuvo de acuerdo en que descriptores como edad, índice de masa corporal, fragilidad, nutrición y puntuación de la Sociedad Estadounidense de Anestesiología se correlacionaban con el estado fisiológico. El cien por ciento estuvo de acuerdo en incluir la función intestinal inicial. El 100% refirió disposición para realizar un informe operativo sinóptico. Los intervalos de seguimiento 1,3,5 años después de la cirugía (76%) con un conjunto de recurrencias y los resultados funcionales en esos períodos de tiempo coincidieron.LIMITACIONES:Sesgo individual, autoidentificación de los expertos y escasez de conocimientos relacionados con el prolapso rectal.CONCLUSIONES:Esto representa los primeros pasos hacia un consenso internacional para unificar el lenguaje y los procesos de recolección de datos para el prolapso rectal. (Traducción-Yesenia Rojas-Khalil ).

Exploring User Perceptions of a Mobile App for Religious Practices

The purpose of this study was to explore the usage patterns of USA subscribers of an online religious/spiritual application (i.e., app; Pray.com) and the associations of app usage with physical health, mental health, spiritual health, and well-being outcomes. A total of 1031 subscribers participated in the survey about their engagement with the Pray.com app. Most of the respondents had been using the app between one and two years, and more than half were high-frequency users. Although many individuals engaged with the app experienced spiritual growth, many also reported retrospective improvement in mental and physical health. This research serves as an initial examination of how religious-based apps may be associated with self-reported improvements in physical, mental, and spiritual health outcomes.

Automatic speaking valve in tracheo-esophageal speech: treatment proposal for a widespread usage

PURPOSE

Aim of this study was to calculate the percentage of the Automatic Speaking Valve (ASV) use in a large cohort of laryngectomized patients with voice prosthesis (VP) and to analyze the main reasons for non-use. Subsequently, a specific rehabilitation training was proposed.

METHODS

One hundred-ten laryngectomized patients with VP were enrolled in the first phase of the study (census). Among them, 57 patients were included in the second phase (intervention), in which a training based on moving phonatory exercises was proposed. Structured questionnaires were used before and after training in order to investigate ASV use rate (days/week and hours/day; reasons for impeding the ASV use), average adhesive life-time during ASV use; hands-free speech duration; skin irritation. Patients also expressed their degree of on a VAS scale from 0 to 100.

RESULTS

In the census phase the percentage of use of ASV (everyday, without problems) was equal to 17.27% (19/110 patients). The main causes of disuse concerned excessive fatigue and poor durability of the adhesives. The analysis of the results pre vs. post-training showed a statistically significant increase (p < 0.05) in all the investigated parameters. Patients reported a good level of treatment compliance (average frequency of performing exercises equal to 4.2 ± 2.5 days/week for 1.4 ± 1.01 h/day) and high degrees of satisfaction. After treatment, the percentage of use of AVS increased by 43% reaching a rate of 60% (66/110 patients).

CONCLUSION

A specific and targeted approach that simulate the phonatory and breathing difficulties of everyday life can increase the ASV usage rate.

Improving the professionalization level of a new generation of construction workers to reduce their unsafe behaviour: an empirical study in China

Objectives. Improvement of the professionalization level for the new generation of construction workers (NGCWs) is critical to upgrade the construction industry. It also provides a new approach to reduce their unsafe behaviour. The purpose of this study is to analyse the correction mechanism of the professionalization level on NGCWs' unsafe behaviour. We examined the mediating role of work-family conflict and job burnout on impacting NGCWs' unsafe behaviour. The moderation effect of the NGCWs' perceived organizational support was also examined. Methods. The cross-sectional study was conducted based on structural equation modelling, confirmatory factor analysis and regression analysis with a sample of 496 NGCWs in China. Results. The professionalization level can effectively correct NGCWs' unsafe behaviour. Job burnout can independently mediate the relationship between professionalization level and unsafe behaviour and act as a serial mediator for work-family conflict. Moreover, the high level of perceived organizational support will effectively suppress the effect of work-family conflict on job burnout. Conclusions. Improving the professionalization level is an effective way to correct NGCWs' unsafe behaviour. Moreover, management should help the NGCWs balance work and family, to alleviate burnout. Additionally, it is suggested that management should ensure the NGCWs perceive the organizational support.

Longitudinal examination of alcohol demand and alcohol-related reinforcement as predictors of heavy drinking and adverse alcohol consequences in emerging adults

BACKGROUND AND AIMS

Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol-related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross-sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol-related reinforcement in relation to heavy drinking days and alcohol problems.

DESIGN

Longitudinal cohort with assessments every 4 months for 20 months.

SETTING

Ontario, Canada.

PARTICIPANTS

Emerging adults reporting regular heavy episodic drinking (n = 636, Mage = 21.44; 55.8% female).

MEASUREMENTS

Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol-related reinforcement (Activity Level Questionnaire).

FINDINGS

Linear mixed effects models revealed that behavioral economic indicators and alcohol-related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross-lagged panel models revealed significant between-person relationships, such that higher alcohol demand and alcohol-related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187-0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, Omax) and proportionate alcohol-related reinforcement significantly forecasted changes in HDD at all time points (|βs| = 0.063-0.103, Ps < 0.05) in cross-lagged relationships, with bidirectional associations noted for the rate of change in elasticity (βs = -0.085 to -0.104, Ps < 0.01). Proportionate alcohol-related reinforcement also significantly forecasted changes in alcohol problems at all time points (βs = 0.072-0.112, Ps < 0.01).

CONCLUSIONS

Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol-related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories.

Increasing lifetime and past 30-day marijuana use among middle school students regardless of recreational marijuana sales

PURPOSE

This study investigated whether adult use marijuana sales were associated with changes in lifetime and past 30-day (P30D) marijuana use among middle school students in Nevada (NV), which had adult-use marijuana sales during the study period, compared to New Mexico (NM), which did not have adult-use marijuana sales during the study period.

METHODS

Data were drawn from the middle school 2017 and 2019 NV Youth Risk Behavior and NM Youth Risk and Resiliency Surveys. Difference-in-difference analyses compare changes in lifetime and P30D marijuana use in NV (adult-use sales implemented July 2017) vs. NM (no adult-use sales during the study period).

RESULTS

There was no difference in lifetime (aOR 1.11; 95% CI 0.91,1.36) and P30D (aOR 1.17; 95% CI 0.91,1.51) marijuana use by adult-use sales status. The odds of lifetime and P30D marijuana use increased in both states, particularly among students who were female, older, non-White, or attending a Title 1 school.

DISCUSSION

Adult-use sales were not associated with an increase in lifetime or P30D marijuana use. State-level prevention efforts should focus on sub-populations with increasing lifetime and P30D use regardless of adult-use sales status.

Social participation and functional disability trajectories in the last three years of life: The Japan Gerontological Evaluation Study

BACKGROUND

Functional disability has various patterns from onset until death. Although social participation is a known protective factor against functional disability among older individuals, it is unclear whether social participation is associated with the trajectory patterns of functional disability prior to death. This study assessed the association between social participation, specifically in horizontal and vertical groups, and the trajectories of functional disability prior to death.

METHODS

We used survey data from the 2010 Japan Gerontological Evaluation Study for functionally independent older adults combined with public long-term care insurance system data from 2010 to 2016 (n = 4,502). The outcome variables included five previously identified trajectory patterns using group-based trajectory modeling. As the explanatory variable, we used three definitions of social participation: any group, horizontal group (e.g., sports, hobbies), or vertical group (e.g., political, religious), at least once a month. We used a multinomial logistic regression analysis to calculate odds ratios with 95 % confidence intervals for the identified trajectory patterns.

RESULTS

Participation in any groups was significantly less likely to belong to "Accelerated disability" (OR=0.74 [95 % CIs 0.60-0.92]), "Persistently mild disability" (0.68 [0.55-0.84]), and "Persistently severe disability" (0.67 [0.50-0.83]) compared to "Minimum disability." Although participation in horizontal groups was similarly associated with trajectories regardless of gender, vertical groups was not associated with trajectories among males.

CONCLUSIONS

Social participation among older adults may be associated with an extended period of living without disabilities before death. This association may differ by gender and social participation group and requires further research.

Burnout Mediates the Association Between Workaholism and Substance Use: Findings from a French National Company

To examine the mediation effect of burnout on the association between workaholism and tobacco and alcohol use. A total of 2199 workers from the French national electricity company fulfilled an online questionnaire. Smoking status, alcohol use disorder based on the Alcohol Use Disorders Identification Test-Consumption and workaholism based on the Work Addiction Risk Test were used as binary variables. Burnout was assessed as a continuous variable with the Copenhagen Burn-Out Inventory. Mediation analyses tested the direct effect of the associations between workaholism and each substance use, as well as the indirect effect passing through burnout, while adjusting for sociodemographic factors (gender, age, occupational grade and marital life), work stress using the effort-reward imbalance and overcommitment. When testing the mediation effect of burnout on the relation between workaholism and smoking, there was a significant direct effect of workaholism on smoking (Estimated effect of 0.27 [95% CI 0.01; 0.54]) and a significant indirect effect passing through burnout (Estimated effect of 0.09 [95% CI 0.02; 0.15]). When testing the mediation effect of burnout on the relation between workaholism and alcohol use, the direct effect of workaholism on alcohol use was not significant (Estimated effect of 0.21 [95% CI - 0.01; 0.44]) while the indirect effect passing through burnout was significant (Estimated effect of 0.10 [95% CI 0.04; 0.17]). Information and prevention regarding substance use should be reinforced among workers exposed to workaholism, especially if their workaholism led to a high level of burnout. Preventing the emergence of burnout among workaholics might have some benefits on their tobacco and alcohol use.

Applying the theory of behavioral choice to plant-based dietary intentions

Improving understanding of the intention to choose plant-based food is an important element of climate change mitigation. A cross-sectional survey of 454 North American adults was used to predict their dietary-change intentions from the theory of planned behavior (TPB) and the more-recently proposed theory of behavioral choice (TBC). The TPB accounted for 65 percent of the variance in intentions and the TBC accounted for a significantly greater (80 percent) proportion of variance. The strongest predictors of intention were the TBC's sense of obligation, attitude-values-affect (AVA), and habit, and the TBP's social norms. Five interactions also contributed in small but significant ways toward the accounting of the participants' food-choice intentions. Policy implications are discussed.

NeoTalk: Communication Skills Training for Neonatal Clinicians

BACKGROUND

Despite proven benefit, pediatric subspecialists often have not been offered formal serious illness communication skills training. We sought to: 1) develop and evaluate the impact of a communication skills course, based on the VitalTalk framework, on Neonatal Intensive Care Unit (NICU) clinicians; 2) evaluate provider comfort with key serious illness communication skills and frequency of use of those skills, before and after "NeoTalk" and; 3) explore differences and similarities between adult and pediatric serious illness communication skills courses.

METHODS

We developed a NICU specific communication skills course and surveyed course participants to evaluate comfort with key communication skills before and after course participation, and frequency of use of key skills before and 2 months after our course. Wilcoxon signed rank tests and Kruskal-Wallis tests were performed to compare participant responses across time points.

RESULTS

34 providers completed NeoTalk training. Complete pre- and post-course data was available for 29 participants. Participants reported increased comfort with skills including 'sharing difficult news' (P = .018), and 'responding to emotion' (P = .002). Participants did not report increased frequency in using target skills 2 months after training.

CONCLUSIONS

A multi-disciplinary cohort of NICU providers endorsed increased confidence in key communication skills but not increased skill application 2-months post-course completion. While a single course can successfully teach skills, additional exposure may be necessary to build new communication habits. Our experience developing NeoTalk helped elucidate some of the ways in which conversations about seriously ill infants may be different from conversations about seriously ill adults.

Moral distress and moral sensitivity in clinical nurses

Health care providers are expected to have a certain moral sensitivity (MS) to make an ethical assessment. Moral distress (MD) is a common phenomenon in nursing. It can negatively affect nurses physically, psychologically, socially, and spiritually. This study aimed to investigate the relationship between MD and MS among nurses using a cross-sectional descriptive design. The study was conducted in two stages. The first stage was a methodological study that analyzed validity and reliability of the Measure of MD-Healthcare Professionals. The second stage was a descriptive- predictive analysis that investigated the relationship between MD and MS. The MD intensity and frequency scores of the participants were high and moderately high, respectively. There was no direct effect on the total score and frequency of MS and MD. However, a direct and significant negative effect of MS was seen on the intensity of MD. Based on the results of this study, MS should be considered as a measure in studies aimed at understanding MD among clinical nurses. Empowerment programs should be established to increase the awareness of health workers about ethical and moral situations and to support them to cope with the problems they experience in these areas.

Short term Outcomes of COVID-19 Vaccines Among Lactating Mother and Child Dyads in Bangladesh: A Multi-centre, Cross-sectional Study

INTRODUCTION

The aims of the study are to: (1) determine the short-term reactogenicity of WHO-approved COVID-19 vaccines (i.e., Pfizer-BioNTech, Moderna, Sinovac, Oxford-AstraZeneca, Johnson and Johnson, Covaxin) amongst lactating women and their children, and 2) evaluate lactation-related outcomes following the same vaccines in Bangladesh.

METHODS

This was a multi-centre, self-reported, cross-sectional study of lactating woman-child dyads in Bangladesh. Demographics, past medical history, breastfeeding history and clinical outcomes of lactating woman-child dyads at least 7 days after the last dose of vaccine were determined through a structured questionnaire.

RESULTS

There were 750 participants from four centres. The mean age of lactating women and children surveyed were 27.6 (SD ± 4.6) years and 10.3 (SD ± 6.7) months, respectively. Majority (81.2%; 608 of 750) received 2 doses of COVID-19 vaccinations while lactating. Almost all (99.9%; 749 of 750) vaccinated lactating women surveyed reported no change in human milk supply. More than half of the participants (56.9%; 373 of 656) reported no symptoms after both doses of COVID-19 vaccines. There were no serious adverse events such as anaphylaxis or hospital admission. Majority of the lactating women (98.9%; 742 of 750) reported that the children whom they breastfed had no symptoms such as fever or cough.

DISCUSSION

This large study of lactating woman-child dyads in Bangladesh, who received a diverse range of WHO-approved COVID-19 vaccines, showed no serious short-term adverse effects.

The association between participant-reported ratings of comfort, dryness and vision quality in soft contact lens wearers

INTRODUCTION

Previous literature has indicated an association between participant-reported perceptions (e.g., ratings) of comfort, dryness and vision quality during soft contact lens wear. However, these reports do not account for participant- and lens-specific factors which may impact the interpretation of these results. The purpose of this project was to quantify the association between these participant-reported ratings while accounting for both participant- and lens-specific factors.

METHODS

Participant-reported ratings (scale 0-100) of comfort, dryness and quality of vision for 675 soft contact lens wearers (1207 eyes) were aggregated across 31 studies completed at Indiana University. Linear mixed-effects regression modelling was performed on each outcome rating individually. Covariate-adjusted models incorporated both participant- (e.g., age, sex) and lens-related (e.g., lens material, edge and optics) factors. The models were statistically adjusted for the duration of lens wear in hours and cumulative days of exposure.

RESULTS

Consistent with estimates from covariate-adjusted regression models, pairwise Spearman correlations [95% CI] between dryness and comfort (rs = 0.71, [0.69, 0.74]), vision quality and comfort (rs = 0.53, [0.49, 0.57]) and vision quality and dryness (rs = 0.49, [0.42, 0.54]) were all positive and had p < 0.001. Average participant-reported ratings of comfort, dryness and vision quality decreased by (bs [95% CI]) = -0.81 [-1.15, -0.46] -0.34 [-0.67, 0.0005] and -0.90 [-1.19, -0.60] rating units, respectively, for each hour of lens wear.

CONCLUSIONS

Significant positive associations were found between participant-reported measures of comfort, dryness and vision quality during soft contact lens wear. The associations between these ratings and the participant- and lens-related factors that drive them should be considered by clinicians and manufacturers when fitting and designing soft contact lenses.

Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

Safety of an inactivated COVID-19 vaccine (CoronaVac) in children aged 7-14 years in Taizhou, China

Our study aimed to evaluate the safety of CoronaVac, an inactivated vaccine made by Sinovac, in children aged 7-14. We conducted a parent-administered online survey to monitor adverse reactions after vaccinating children in Taizhou, China, from February 15, 2021, to January 19, 2022. 767 parents completed the survey after receiving a questionnaire via WeChat. Overall, 15.3 % (117/767) of children experienced adverse effects after the first dose, and 12.2 % (88/724) after the second. Muscle pain was the most common adverse reaction post-first dose (10.0 %), while localized pain or itching at the injection site was most common after the second dose (7.6 %). In conclusion, the vaccine has a low incidence of side effects. The mild to moderate, transient, and common nature of these effects further boosts parents' confidence in vaccinating their children.

Assessing patient information needs for new antidiabetic medications to inform shared decision-making: A best-worst scaling experiment in China

BACKGROUND

Shared decision-making (SDM) is a patient-centred approach to improve the quality of care. An essential requirement for the SDM process is to be fully aware of patient information needs.

OBJECTIVES

Our study aimed to assess patient information needs for new antidiabetic medications using the best-worst scaling (BWS) experiment.

METHODS

BWS tasks were developed according to a literature review and the focus group discussion. We used a balanced incomplete block design and blocking techniques to generate choice sets. The final BWS contains 11 attributes, with 6-choice scenarios in each block. The one-to-one, face-to-face BWS survey was conducted among type 2 diabetic patients in Jiangsu Province. Results were analyzed using count-based analysis and modelling approaches. We also conducted a subgroup analysis to observe preference heterogeneity.

RESULTS

Data from 539 patients were available for analysis. The most desired information domain was the comparative effectiveness of new antidiabetic medications. It consists of the incidence of macrovascular complications, the length of extended life years, changes in health-related quality of life, the incidence of microvascular complications, and the control of glycated haemoglobin. Of all the attributes, the incidence of macrovascular complications was the primary concern. Patients' glycemic control and whether they had diabetes complications exerted a significant influence on their information needs.

CONCLUSIONS

Information on health benefits is of critical significance for diabetic patients. Patients have different information needs as their disease progresses. Personalized patient decision aids that integrate patient information needs and provide evidence of new antidiabetic medications are worthy of being established.

PATIENT OR PUBLIC CONTRIBUTION

Before data collection, a pilot survey was carried out among diabetic patients to provide feedback on the acceptability and intelligibility of the attributes.

Influence of Religiosity on Youths' Attitudes Towards People with Disabilities in the United Arab Emirates

This cross-sectional survey investigates the influence of youths' religiosity on their attitude towards people with disabilities. The Muslim religiosity questionnaire and multidimensional attitudes scale towards persons with disabilities were used to survey 733 youths from the federal university in the United Arab Emirates. The results indicated that the youths were religious and had positive attitudes towards people with disabilities. An increase in religiosity is associated with a positive attitude towards disability, and both religiosity and total family income positively impacted the attitude towards people with disabilities. Reducing inequalities by including persons with disabilities is one of the UN 2030 Agenda for Sustainable Development objectives. Policies should aim to enhance curriculum, improvise public guidelines and partner with associated faith-based leaders to build an inclusive society for people with disabilities, thus helping to achieve sustainable development goals.

Age-friendly Environment and Aging in Place: Finding from Latent Profile Analysis

Older adults prefer ageing in place (AIP) rather than institutionalized facilities. Although its advantages, AIP can be challenging when communities are unable to meet residents' needs. This study aims to identify the relationship between the level of age-friendliness of community and AIP. We used AARP Age-friendly Community Survey data with 6670 older adults in the USA. We used responses from 63 items assessing various aspects of a community's age-friendliness to identify different types of age-friendly communities (AFCs) through latent profile analysis (LPA). We then ran multinomial logistic regression to examine whether the types of AFC were associated with AIP. LPA revealed three types of AFC: Underdeveloped, developing, and developed. Regression results showed older adults living in underdeveloped and developing communities are less likely to AIP compared to those in the developed community. These results show a positive impact of AFC on intention to AIP. Policymakers should consider expanding AFC initiatives for the growing number of older adults.

Spiritual Care Competencies and the Frequency of Spiritual Care Practices of Nurses in Turkey

This descriptive study aimed at determining the spiritual care competencies and the frequency of spiritual care practices of nurses. A total of 119 nurses working in the palliative care unit, oncology services, and intensive care units of a state hospital in Turkey participated in the study. The data were collected by the  Participant Information Form, Spiritual Care Competence Scale, and Nurse Spiritual Care Therapeutics Scale. Spiritual care competencies of the nurses were found to be high; the frequency of spiritual care practices was determined as moderate. We found a positive correlation between the spiritual care competencies and the frequency of spiritual care practices of nurses. There was a significant difference between nurses' received spiritual care training status and their scale scores. In addition, nurses who believed that spiritual care was an important part of nursing care, and an important need of patients, had higher scale scores.

Spiritual Care Support Perception and Spiritual Care Competence of Nursing Students in Turkey: A Quasi-Experimental Study

This study aimed to assess the spiritual care support perception and spiritual care competence of nursing students, and the effect of a spiritual care course on their perceptions and competence in this regard. The study was conducted within the Faculty of Health Sciences, Department of Nursing located in the south of Turkey. Data were collected through the Descriptive Characteristics Form, Spiritual Support Perception Scale, and Spiritual Care Competence Scale. The results of this study show that; there was a significant difference between the total spiritual care competence scale score averages of the control group students and the experimental group students. There was a significant difference between the total spiritual support perception scale score averages of the control group students and the experimental group students. Based on this study, it is recommended to further extend this study by adding spiritual care course content to the curriculum for junior and senior students to reveal the differences between the years, and to evaluate the knowledge of the students.

Determining the Effects of Ramadan Fasting on Risky Behaviors of Turkish Nursing Students

The aim of this study was to determine the effect of nursing students' fasting during Ramadan on their risky behaviors. This study was conducted in a university located in 2022 using the prospective cohort study method. The data were collected from the nursing department students through face-to-face questionnaires. The sample of the study consisted of 186 nursing students. The data were obtained using a descriptive information form, which consists of questions regarding the descriptive characteristics of the nursing students, and the risky behaviors form, created by the researchers, to evaluate the effect of fasting during Ramadan on nursing students' risky behaviors. According to the findings of the research, it has been determined that the students who always fast during Ramadan have regular sahur. When the students' level of religious faith and fasting and having sahur status were compared with their risky behaviors, the mean scores of exercise and nutrition increased significantly, and the mean scores of interpersonal relationships decreased significantly. It was determined that the majority of students had a high level of religious faith, fasted and had sahur during Ramadan. Consequently, while Ramadan fasting negatively affected students' physical activity, nutrition and sleep patterns, it positively affected their interpersonal relationship status.

The Association Between Religious Belief and Postoperative Psychological Status and Quality of Life of Parents of Children with Congenital Heart Disease: A Single Center Experience in Southeast China

This study aimed to investigate the association of religious belief on the postoperative psychological status and quality of life of parents of children with congenital heart disease (CHD). This was a cross-sectional study conducted at a provincial children's hospital in Fujian Province, China. Parents of postoperative children with CHD in the early postoperative period were included in this study between January 2020 and September 2020. The parents were divided into a religious belief group (n = 39) and a nonreligious belief group (n = 42) depending on whether they had religious beliefs. The Religious Coping Questionnaire, WHOQOL-BREF scale, Self-rating depression scale (SDS), and Self-rating anxiety scale (SAS) were used to evaluate psychological status and quality of life. The results showed that the SDS and SAS scores in the religious belief group were significantly lower than those in the nonreligious belief group (P = 0.012 and P = 0.003, respectively). The WHOQOL-BREF scale results showed that the religious belief group's score was significantly higher than those in the nonreligious belief group on the subscale scores of physiology, psychology, social relations, and environment on the WHOQOL-BREF. The total score of quality of life in the religious belief group was significantly higher than that in the nonreligious belief group. Religious belief was associated with lower SDS score (β = - 0.324, P = 0.005) and SAS score (β = - 0.245, P = 0.026), while religious belief was positively correlated with the score of WHOQOL-BREF (β = 0.506, P < 0.001). In this study, we concluded that comparing to those with no religious beliefs, parents with religious belief experienced more positive emotions and higher quality of life when taking care of children in the early postoperative period after congenital heart surgery.

Cerebral palsy registers around the world: A survey

AIM

To provide a description of cerebral palsy (CP) registers globally, identify which aim to report on CP epidemiology, and report similarities and differences across topics of importance for the sustainability and collaboration between registers.

METHOD

Representatives of all known CP registers globally (n = 57) were invited to participate. The online survey included 68 questions across aims, methodologies, output/impact, and stakeholder involvement. Responses were analysed using descriptive statistics.

RESULTS

Forty-five registers participated, including three register networks. Twenty were newly established or under development, including 12 in low- and middle-income countries (LMICs). An epidemiological aim was reported by 91% of registers. Funding is received by 85% of registers, most often from not-for-profit organizations. CP definitions are comparable across registers. While the minimum data set of a register network is used by most registers, only 25% of identified items are collected by all three register networks. Ninety per cent of registers measure research activities/output, and 64% measure research impact. People with lived experience are involved in 62% of registers.

INTERPRETATION

There has been a recent surge in CP registers globally, particularly in LMICs, which will improve understanding of CP epidemiology. Ongoing efforts to address identified methodological differences are essential to validate comparison of results and support register collaboration.

WHAT THIS PAPER ADDS

Cerebral palsy (CP) registers represent an increasing number of regions, including low- and middle-income, worldwide. Most registers collect the minimum data set of a CP register network. Research activities/output and impact are measured by most registers. The majority of registers involve people with lived experience in operation or research.

Impacts of ergonomic risk factors on the well-being and innovation capability of employees in the manufacturing industry

Objectives. Although various studies have examined the relationship between ergonomic factors and employee well-being, the impacts of ergonomic factors on workers' capability for innovation have not yet been studied in the manufacturing industry. This study advances understanding of the relationship between ergonomic risk factors and employees' capability to innovate and to feel good at work in the manufacturing sector. Methods. The analysis uses the structural equation modeling technique based on cross-sectional data collected from 200 experienced workers in manufacturing industries using self-administered close-ended questionnaires. Results. Findings from this research show that the main ergonomic factors influencing the well-being and innovation capability of employees in the manufacturing industry are neutral awkward posture, psychological risk factors and effective utilization of information and communications technology infrastructures. Thus, ergonomic factors are significantly correlated to the innovation capability of employees. Conclusion. As there have been no studies addressing the integration of ergonomic risk factors and the capability for innovation of employees in the manufacturing industry, this study provides a unique contribution to the body of knowledge. Further research is also required to develop an in-depth understanding of the relationship among components of each ergonomic risk factor, and the well-being and innovation capability of employees.

Ergonomic risks and problems of the musculoskeletal system for physiotherapists: comparison of employees in the fields of pediatric and adult care

Objectives. The aim of this study is to compare the ergonomic risk levels, musculoskeletal complaints and quality of life of physiotherapists (PTs) according to their field of work. Methods. A total of 107 volunteer PTs participated in the study, whose information was recorded. Ergonomic risk levels were determined using rapid entire body assessment (REBA). Complaints about the musculoskeletal system of PTs were evaluated with the Cornell musculoskeletal discomfort questionnaire (CMDQ) and quality of life was evaluated by the Nottingham health profile. Results. PTs who worked with pediatric patients (Grouppediatric; n = 47) were younger (p<0.001). PTs who worked with adult patients (Groupadult; n = 60) had a higher daily number of patients (p<0.001). The REBA score did not make a difference between the groups (p = 0.379). The difference was found in the upper back region of the CMDQ (p<0.05). There was no difference between groups for quality of life (p>0.05). Conclusions. Grouppediatric may be working in ergonomically demanding positions, although there is no statistical difference. The injury sites of the musculoskeletal system can differ. However, the reflection of musculoskeletal system problems on quality of life does not show any difference between the groups of PTs.

Citizen attitudes towards present and future beef consumption before and after the COVID-19 pandemic

There's been a change in citizens' attitudes towards beef consumption in high-income countries, resulting in a decline in its consumption. The COVID-19 pandemic may have impacted citizens' attitudes and behaviours towards beef consumption. This study aimed to investigate Chilean citizens' attitudes towards beef consumption during the initial 18 months of the pandemic. Socio-demographic characteristics and attitudes towards beef consumption were asked in two questionnaires done in 2020 (n = 1142) and 2021 (n = 1221). Citizens' attitudes to beef eating and production did not change between the start and more than a year after the outbreak of the COVID-19 pandemic. Participants not related with animal production, female, young, and non-meat consumers demonstrated more negative attitudes towards beef consumption and production. Half of the participants agreed that beef is bad for the environment, but only 30% agreed that beef is bad for human health. Half of participants had reduced beef consumption and 48% expressed intentions to reduce beef consumption in the future, primarily motivated by concerns related to animal welfare, the environment, and human health. The majority of participants (80%) thought that their fellow citizens should reduce their beef consumption but only 50% had confidence that this will occur. We conclude that Chilean consumers' attitudes to beef eating did not change due to the outbreak of the COVID-19 pandemic. Participants expressed strong concern about beef consumption both individually and socially, due to environmental, animal and health concerns, and believed Chileans should reduce beef consumption in the future but had low confidence that this will happen.

Rumination, psychological capital and academic procrastination among nursing students: A cross-sectional study

BACKGROUND

Academic procrastination is common among college students, which affects their learning status and even their physical and mental health. Rumination, psychological capital, and academic procrastination are closely related, but for nursing students, there are few studies reporting on their levels and relationships.

OBJECTIVE

The aim of this study was to investigate the levels of rumination, psychological capital, and academic procrastination among nursing students, and examine the mediating role of psychological capital in rumination and academic procrastination.

DESIGN

A cross-sectional study.

SETTING

The study sampled three medical colleges in Sichuan Province, China.

PARTICIPANTS

A convenience sampling method was used to select 556 nursing students from April to June 2023.

METHODS

556 nursing students were asked to complete questionnaires regarding social-demographic information, rumination, psychological capital, and academic procrastination. Descriptive statistics, Pearson correlation analysis and structural equation model were used in this study.

RESULTS

The scores of rumination, psychological capital, and academic procrastination among nursing students were 46.08 ± 13.61, 108.28 ± 19.50 and 55.32 ± 12.30, respectively. Additionally, structural equation modeling showed that psychological capital mediated the relationship between rumination and academic procrastination with the partial mediating effect of 0.425.

CONCLUSION

Our results suggest that nursing students exhibit moderate levels of rumination, psychological capital and academic procrastination. Moreover, rumination can not only directly affect academic procrastination, but also indirectly through psychological capital. Nursing educators should strengthen their attention to the mental health and learning status of nursing students, take measures to help them adapt to campus life, alleviate rumination, enrich psychological capital, and reduce the risk of academic procrastination.

Effects of an unfolding case study on clinical reasoning, self-directed learning, and team collaboration of undergraduate nursing students: A mixed methods study

BACKGROUND

Clinical reasoning is an essential nursing competency that students must develop to provide safe patient care. Developing and utilizing unfolding case studies, which present constantly changing patient conditions to improve students' clinical reasoning and to foster communication and self-reflection, can help to achieve that imperative.

OBJECTIVES

To develop an unfolding case study and to test its effectiveness in improving clinical reasoning, team collaboration, and self-directed learning.

DESIGN

A mixed methods design.

SETTING

One university in Southern Taiwan.

PARTICIPANTS

Forty nursing students.

METHODS

An unfolding case study was developed based on the clinical reasoning model and unfolding cases model. The Nurses Clinical Reasoning Scale, Self-Directed Learning Instrument, and Questionnaire of Group Responsibility and Cooperation in Learning Teams were used. Forty nursing students completed questionnaires and nine of them participated in focus group discussions. Wilcoxon signed-rank, Spearman correlation, regression, and inductive content analysis were used to analyze data.

RESULTS

Students' abilities in clinical reasoning, self-directed learning, and team collaboration were statistically significantly improved after implementation of the unfolding case study. Emergent themes included "patient-centered communication," "group inspiration and learning," "thinking critically and reflecting on oneself," and "applying theoretical knowledge in care to meet patients' changing needs."

CONCLUSIONS

Unfolding case studies provide a safe environment in which nursing students may learn and apply knowledge to safe patient care.

Meta-analysis: eHealth literacy and attitudes towards internet/computer technology

OBJECTIVE

To explore the relationship between eHealth literacy and attitudes towards internet/computer (I/C) technology use in healthcare.

METHODS

Analysis of data from 16 cross-sectional studies, involving literature search from databases like PubMed, EBSCO, JMIR, up to April 2023. Studies were selected based on a quantitative cross-sectional design, with no restrictions on participant characteristics.

RESULTS

A significant positive correlation (0.36; 95% CI 0.37-0.38, p < 0.05) was found between eHealth literacy and positive attitudes towards I/C technology use. Age and regional differences, especially in participants over 50 and from Asian and Middle Eastern countries, were notable.

CONCLUSION

Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions.

HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV

Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.

Development and psychometric testing of the actualisation of evidence-based nursing instrument

AIM

To describe the development of the Actualisation of Evidence-Based Nursing instrument targeted at nurses working in clinical practice (ActEBN-nurses), meant for evaluating the actualisation of individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations, and to test its validity and reliability.

DESIGN

Cross-sectional survey.

METHODS

The FinYHKÄ model was used as the theoretical background of the instrument development and supplemented with the JBI Model of Evidence-Based Healthcare, previous literature and items from a previous instrument, the Evidence-Based Practice Process Assessment Scale, with permission of the copyright holders. After two rounds of expert panel and piloting, a national survey was conducted with the instrument in 2021. The target group consisted of nurses working in clinical practice. Psychometric testing included internal consistency (Omega, item analysis) confirmatory factor analysis and t-test for comparison of two groups' differences (sensitivity).

RESULTS

A new instrument, ActEBN-nurses was developed, comprising two parts: Individual-level (32 items, 5-point Likert-scale) and Organisational-level support structures for evidence-based nursing (37 items, 5-point Likert-scale). In total, 1289 nurses participated in the survey. The ActEBN-nurses proved to have good internal consistency in both parts (Omega ω .931 and .966), structural validity and sensitivity based on the two educational levels within the sample. The structure of both parts was slightly modified, based on the CFA modification indices, considering the impact of the reverse worded items in part Individual and redundant items within both parts.

CONCLUSION

The ActEBN-nurses has promising psychometrics, and it can be used for evaluating individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Evaluation of the support structures within social and healthcare organisations is needed to recognise shortcomings in current structures and advance evidence-based nursing across different contexts.

REPORTING METHOD

The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Stigmatizing clinical setting erodes physician-patient interaction quality for sexual minority men through perceived HIV stigma and HIV infection concerns in Zambia

This study investigated whether perceived HIV stigma and HIV infection concerns among healthcare providers (HCPs) mediate the association between stigmatizing clinical setting and their interaction quality with sexual minority men (SMM) patients in Zambia. In 2021, a cross-sectional survey was conducted with 91 HCPs offering HIV-related services to SMM in Zambia. Path analysis was conducted to examine the potential mediation effect of "perceived HIV stigma" and "HIV infection concern" among HCPs in the association between "stigmatizing clinical setting" and their "interaction quality with SMM". Mediators i.e., "perceived HIV stigma" and "HIV infection concern" among HCPs, were associated positively with the stigmatizing clinical setting (β = 0.329, p < .01, β = 0.917, p < 0.01), and negatively with physician-patient interaction quality (β = -0.167, p = 0.051; β = -0.126, p < 0.05). Stigmatizing clinical setting had a significant and negative indirect effect on HCPs interaction quality with SMM through increased perceived HIV stigma (z = -1.966, p < 0.05) and increased HIV infection concern (z = -1.958, p = 0.050). To improve physician-patient interaction quality, stigma reduction interventions among HCPs, who serve SMM in Zambia, should target development of development of inclusive policies and the cultivation of cultural norms that are supportive and respectful to SMM, and protection of HCPs from enacted stigma due to offering care to SMM.

Factors impacting nursing assistants to accept a delegation in the acute care settings: A mixed method study

AIMS

To investigate the experience of nursing assistants being delegated nursing tasks by registered nurses.

DESIGN

Mixed method explanatory sequential design.

METHODS

A total of 79 nursing assistants working in an acute hospital in Australia completed surveys that aimed to identify their experience of working with nurses and the activities they were delegated. The survey data were analysed using descriptive statistics. Interviews with 11 nursing assistants were conducted and analysed using Braun and Clarke's thematic analysis. Results were triangulated to provide a richer understanding of the phenomena.

RESULTS

Most nursing assistants felt supported completing delegated care activities. However, there was confusion around their scope of practice, some felt overworked and believed that they did not have the right to refuse a delegation. Factors impacting the nursing assistant's decision to accept a delegation included the attitude of the nurses, wanting to be part of the team and the culture of the ward. Nursing assistants who were studying to be nurses felt more supported than those who were not.

CONCLUSIONS

Delegation is a two-way relationship and both parties need to be cognisant of their roles and responsibilities to ensure safe and effective nursing care is provided. Incorrectly accepting or refusing delegated activities may impact patient safety.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Highlights the need for implementing strategies to support safe delegation practices between the registered and unregulated workforce to promote patient safety.

IMPACT

Describes the experiences of nursing assistants working in the acute care environment when accepting delegated care from nurses. Reports a range of factors that inhibit or facilitate effective delegation practices between nurses and nursing assistants. Provides evidence to support the need for stronger education and policy development regarding delegation practices between nurses and unregulated staff.

REPORTING METHOD

Complied with the APA Style JARS-MIXED reporting criteria for mixed method research.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The Relationship Between Pharmacist Resilience, Burnout, and Job Performance

Background: Resilience aids healthcare professionals in navigating through and bouncing back from stressful situations in the workplace. Resilience can increase job satisfaction, work motivation, and professional commitment while decreasing burnout, and ultimately job turnover. More resilient employees experience lower instances of burnout and greater life satisfaction. Objective: The primary study objective is to determine the relationship that pharmacist resilience has on burnout and job performance. Methods: Licensed pharmacists in Florida were sent a Qualtrics survey (Qualtrics, Provo, UT) via email, which included demographics data, and valid and reliable assessment tools for resilience, burnout, and job performance. Linear regressions were used to test if resilience significantly predicted each of the output variables: burnout and job performance. Results: Survey responses were received from 942 pharmacists. The regressions showed that resilience significantly predicted both burnout (β1 = -.701, P < .001) and job performance (β1 = .35, P < .001). As resilience increased, the levels of burnout decreased, and job performance increased. Resilience explained 29% of the variance in burnout, and 11% of the variance in job performance. Conclusion: The results of this study suggest that resilience significantly predicts both pharmacist work-related burnout and job performance. The more resilient the pharmacist, the lower the chances of work-related burnout and the higher the likelihood of better job performance. Organizations should pursue opportunities to educate healthcare workers on methods to increase resilience and to bring attention to the importance of this topic.

The relationship between cumulative risk and health-related quality of life in youth with sickle cell disease: Moderating effects of secondary control engagement coping

BACKGROUND

Youth with sickle cell disease (SCD) often experience low health-related quality of life (HRQOL). Engagement in resilience-promoting processes, such as secondary control engagement (SCE) coping, or adapting to stressors, may be linked to contextual risk factors (e.g., poverty status). This study aims to illuminate relationships between a cumulative risk index (CRI), SCE coping, and HRQOL in youth with SCD and test whether SCE coping moderates the relationship between CRI and HRQOL.

PROCEDURE

Participants in this cross-sectional study included 63 youth ages 8-18 with SCD. Participants completed measures to assess SCE coping use (Responses to Stress Questionnaire) and HRQOL (PedsQL SCD Module). Six variables from the electronic medical record were compiled in a CRI. Correlational and regression analyses examined relationships between primary variables and moderating effects of SCE coping, respectively.

RESULTS

Model results show that SCE coping and CRI explain variation in HRQOL (p = .001), and a significant interaction exists between SCE and CRI (β = -.29, p = .02), with a stronger inverse relationship between CRI and HRQOL for higher SCE values. This suggests that lower CRI is associated with greater HRQOL for those with higher SCE coping relative to lower SCE coping.

CONCLUSIONS

SCE coping may selectively benefit children with SCD experiencing lower cumulative risk, warranting encouragement of this strategy in clinical settings. Findings do not support SCE coping benefits for youth with higher risk, suggesting that the strategy may not be useful when risk-related stressors are especially pervasive; alternative protective factors should be identified for this risk group.

Relationship of emotional intelligence and capability of answering higher-order knowledge questions in physiology among first-year medical students

Emotional intelligence (EI) has a positive correlation with the academic performance of medical students. However, why there is a positive correlation needs further exploration. We hypothesized that the capability of answering higher-order knowledge questions (HOQs) is higher in students with higher EI. Hence, we assessed the correlation between EI and the capability of medical students to answer HOQs in physiology. First-year undergraduate medical students (n = 124) from an Indian medical college were recruited as a convenient sample. EI was assessed by the Schutte Self-Report Emotional Intelligence Test (SSEIT), a 33-item self-administered validated questionnaire. A specially designed objective examination with 15 lower-order and 15 higher-order multiple-choice questions was conducted. The correlation between the examination score and the EI score was tested by Pearson's correlation coefficient. Data from 92 students (33 females and 59 males) with a mean age of 20.14 ± 1.87 yr were analyzed. Overall, students got a percentage of 53.37 ± 14.07 in the examination, with 24.46 ± 9.1 in HOQs and 28.91 ± 6.58 in lower-order knowledge questions (LOQs). They had a mean score of 109.58 ± 46.2 in SSEIT. The correlation coefficient of SSEIT score with total marks was r = 0.29 (P = 0.0037), with HOQs was r = 0.41 (P < 0.0001), and with LOQs was r = 0.14 (P = 0.19). Hence, there is a positive correlation between EI and the capability of medical students to answer HOQs in physiology. This study may be the foundation for further exploration of the capability of answering HOQs in other subjects.NEW & NOTEWORTHY This study assessed the correlation between emotional intelligence (EI) and the capability of medical students to answer higher-order knowledge questions (HOQs) in the specific context of physiology. The finding reveals one of the multifaceted dimensions of the relationship between EI and academic performance. This novel perspective opens the door to further investigations to explore the relationship in other subjects and other dimensions to understand why students with higher EI have higher academic performance.

'Look up from the waiting list and see the bigger picture': a qualitative analysis of clinical specialist physiotherapist perspectives on low back pain care in Ireland

INTRODUCTION

Healthcare systems are struggling to deliver high-quality low back pain (LBP) care. In 2012 specialist physiotherapist-led musculoskeletal (MSK) triage services were introduced in Irish hospitals to expedite patient care and alleviate pressure on elective orthopaedic/ rheumatology consultant clinics. Specialist physiotherapists have expertise to inform health service improvement and reform, but their perspectives of LBP healthcare delivery have received scant attention.

OBJECTIVES

To explore specialist physiotherapists' perspectives on LBP care in Ireland, the barriers and facilitators to quality LBP care and the development of MSK interface services in primary care settings.

DESIGN

Cross-sectional observational study using an anonymous electronic survey with thematic framework analysis of response data from open-ended questions.

PARTICIPANTS

Thirty-four clinical specialist physiotherapists in Irish MSK triage services.

RESULTS

Thematic analysis resulted in six overarching themes, grouped into two categories. One category pertained to LBP healthcare in Ireland with the following three themes: 1) Inadequate health services for patients with LBP; 2) Need for defined LBP clinical pathways; 3) Need for a multisectoral approach to spine health. Themes in the second category, pertaining to the development of community-based MSK interface services, were: 4) Concern regarding isolation from secondary care services; 5) Unrealistic expectations of MSK triage; 6) Improved communication and collaboration with primary care services.

CONCLUSION

Specialist physiotherapists have concerns regarding LBP health services and persistence of a biomedical, secondary care-led approach. They advocate for investment in primary care multi-disciplinary teams, enhanced integration across primary and secondary care, development of a national clinical pathway and a multisectoral approach. CONTRIBUTION OF PAPER.

Refitting contact lens dropouts into a modern daily disposable contact lens

PURPOSE

To determine the number of previous contact lens (CL) wearers who could be comfortably refitted into delefilcon A (DAILIES TOTAL1®) CLs.

METHODS

This was a 6-month, three-visit study that recruited subjects who discontinued CLs within the past 2 years because of discomfort or dryness symptoms. Subjects were required to have Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire scores ≤3 and to be able to wear spherical study CLs. Subjects were asked to complete a ±50 comfort visual analogue scale (VAS) at 1 month and a Likert questionnaire after 1 and 6 months of CL wear to understand the subjects' CL experience.

RESULTS

All 60 subjects who were fitted with the study CLs were still wearing them after 1 month, while one subject had dropped out by 6 months. Subjects had a median (interquartile range) age of 24.0 (7.0) years (71.7% female). They reported a median VAS score of 44.0 (8.0) units at the 1-month visit, with all reporting a comfortable score. At the 1-month/6-month visits, 98.3%/93.2%, 86.5%/78.0% and 93.2%/91.5% of subjects responded that they were very satisfied or satisfied with their vision, their end-of-day CL comfort and overall CL comfort, respectively. The same subjects responded that they were very likely or likely to continue to wear the study CLs at 1 (89.6%) and 6 months (80.7%) and to recommend the study CLs to a friend at 1 (98.3%) and 6 months (93.2%).

CONCLUSIONS

The results suggest that when encountering a CL dropout, a practitioner could educate a patient about trying an alternative CL and consider delefilcon A lenses as an option.

The Relationship Between Religious Attitude, Compassion and Spiritual Care in Nursing Students: The Case of Türkiye

In the present descriptive study, we aimed to examine the relationship between the levels of religious attitude, compassion and spiritual care perception among nursing students. Data were obtained from 135 nursing students using the Socio-Demographic Diagnosis Form, the Ok-Religious Attitude Scale, the Compassion Scale, and the Spiritual Care-Giving Scale. The data were analyzed using the Kruskal-Wallis H test, the Spearman correlation test, and the Mann-Whitney U test. A positive correlation was found between the scores of the Ok-religious attitude scale and cognition sub-dimension, emotion sub-dimension, behavior sub-dimension, god sub-dimension and compassion scale and spiritual care-giving scale scores. Furthermore, we observed that some socio-demographic, and nursing profession and spiritual care characteristics of the students affected their religious attitudes, compassion and spiritual care perception. The sub-dimension scores of compassion and awareness of sharing among female students and the mindfulness scores of students with nuclear families were high. Our data suggest that the course contents for spiritual care, which is an integral part of holistic nursing care, should be included in the nursing curriculum. Moreover, we recommend that efforts be made to maintain a high level of compassion while considering the socio-demographics of the students and their opinions on the nursing profession. Finally, the data presented here has the potential to serve as a valuable resource for the development of novel approaches to the provision of spiritual care within nursing education programs.

Identity Matters: Religious Experiences of US based Transgender Young People

Research centered on the socioemotional benefits of religion and religious congregations for young people has highlighted largely positive outcomes for both young people and religious congregations. However, fewer studies have explored whether transgender young people receive those same socioemotional benefits from being religiously affiliated. Using secondary quantitative data from the 2015 US Transgender Survey, this study examined the religious experiences of transgender young people (aged 18-24). The data indicate that individual demographics (e.g., race, gender identity, sexual orientation, religious affiliation) affected the religious experiences of transgender young people, including leaving their congregations due to the fear of being rejected. More research is needed on the socioemotional benefits of religious affiliation for transgender young people.

The Interplay Between Workplace Incivility, Religiosity and Well-Being: Insights from Jordan and the United Arab Emirates

Drawing on the Job Demands-Resources (JD-R) theory, this study examines the relationship between workplace incivility and workers' psychological well-being. A related aim is to examine the link between workers' religiosity and their well-being, with workplace incivility moderating this nexus. Data were collected from 247 employees identified from private sectors (in Jordan and the UAE) via online-survey questionnaire. Factor analysis and hierarchical moderated multiple regression models were used to test the hypotheses. Study results show that workers' religiosity is positively and significantly associated with their psychological well-being, while workplace incivility is negatively (but insignificantly) associated with workers' psychological well-being. In addition, and contrary to our expectations and prior studies, our results suggest that workplace incivility strengthens the direct relationship between religiosity and well-being. The mechanism of this intersection may propose that rude and uncivil treatments positively predict self-blame, something that may lead the targets to become more religious to get recovery from different types of incivility and stressful life events. This study highlights the contextual applicability and possible extension of the JD-R theory through extending its model to religiosity and well-being of employees in a diverse cultural context in the Middle East.

A Community-Based Study of Cognitive Impairment Caregiving Outcomes Pre- and During the COVID-19 Pandemic

The impact of the COVID-19 pandemic on informal caregiving was examined in a Mexican American (MA) and Non-Hispanic White (NHW) population-based cohort. 395 participants age > 65 years were recruited via door-to-door and phone recruitment as part of the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C) project. Both recipients and caregivers answered questions regarding the recipient's health and the COVID-19 pandemic. 15% of caregivers saw their caregiving recipient less than before the pandemic and 18% saw their recipient more than before. 55% of caregivers reported a slight to severe impact of the pandemic on their caregiving, and 45% reported no impact. For most caregivers, their caregiving role did not change markedly during the pandemic. MA and NHW caregivers had similar survey responses.

The Mediating Effect of Social Anxiety on the Relationship Between Internet Addiction and Aggression in Teenagers

The purpose of this study was to investigate the effect of "internet addiction level" on "aggression level" among teenagers and to examine the mediating role of "social anxiety level" on this effect. The study participants consisted of 958 students attending private teaching institutions for university preparation in Turkey. Data was collected from voluntary participants through data collection forms delivered to the management of these institutions. "Sociodemographic Characteristics Questionnaire Form", "Young's Internet Addiction Test", "Buss-Perry Aggression Questionnaire" and "Social Anxiety Scale" were used as data collection tools. A regression analysis based on the bootstrap method was implemented to test whether "social anxiety level" had a mediating role on the influence of students' "internet addiction level" on "aggression level". According to the findings, it was determined that the indirect effect of "internet addiction" on "aggression" was significant, and therefore, "social anxiety level" mediated the relationship between "internet addiction" and "aggression".