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[ "Acute Kidney Injury (AKI) and Continuous Renal Replacement Therapy (CRRT) are critical areas in nephrology.", "The effectiveness of ChatGPT in simpler, patient education-oriented questions has not been thoroughly assessed.", "This study evaluates the proficiency of ChatGPT 4.0 in responding to such questions, subjected to various linguistic alterations.", "Eighty-nine questions were sourced from the Mayo Clinic Handbook for educating patients on AKI and CRRT.", "These questions were categorized as original, paraphrased with different interrogative adverbs, paraphrased resulting in incomplete sentences, and paraphrased containing misspelled words.", "Two nephrologists verified the questions for medical accuracy.", "A chi-squared test was conducted to ascertain notable discrepancies in ChatGPT 4.0's performance across these formats.", "ChatGPT provided notable accuracy in handling a variety of question formats for patient education in AKI and CRRT.", "Across all question types, ChatGPT demonstrated an accuracy of 97% for both original and adverb-altered questions and 98% for questions with incomplete sentences or misspellings.", "Specifically for AKI-related questions, the accuracy was consistently maintained at 97% for all versions.", "In the subset of CRRT-related questions, the tool achieved a 96% accuracy for original and adverb-altered questions, and this increased to 98% for questions with incomplete sentences or misspellings.", "The statistical analysis revealed no significant difference in performance across these varied question types (p-value: 1.00 for AKI and 1.00 for CRRT), and there was no notable disparity between the AI's responses to AKI and CRRT questions (p-value: 0.71).", "ChatGPT 4.0 demonstrates consistent and high accuracy in interpreting and responding to queries related to AKI and CRRT, irrespective of linguistic modifications.", "These findings suggest that ChatGPT 4.0 has the potential to be a reliable support tool in the delivery of patient education, by accurately providing information across a range of question formats.", "Further research is needed to explore the direct impact of AI-generated responses on patient understanding and education outcomes." ]

[ "Acute kidney injury (AKI) is a common and devastating complication of hospitalization.", "Here, we identified genetic loci associated with AKI in patients hospitalized between 2002-2019 in the Million Veteran Program and data from Vanderbilt University Medical Center's BioVU.", "AKI was defined as meeting a modified KDIGO Stage1 or more for two or more consecutive days or kidney replacement therapy.", "Control individuals were required to have one or more qualifying hospitalization without AKI and no evidence of AKI during any other observed hospitalizations.", "Genome-wide association studies (GWAS), stratified by race, adjusting for sex, age, baseline estimated glomerular filtration rate (eGFR), and the top ten principal components of ancestry were conducted.", "Results were meta-analyzed using fixed effects models.", "In total, there were 54,488 patients with AKI and 138,051 non-AKI individuals included in the study.", "Two novel loci reached genome-wide significance in the meta-analysis: rs11642015 near the FTO locus on chromosome 16 (obesity traits) (odds ratio 1.07 (95% confidence interval, 1.05-1.09)) and rs4859682 near the SHROOM3 locus on chromosome 4 (glomerular filtration barrier integrity) (odds ratio 0.95 (95% confidence interval, 0.93-0.96)).", "These loci colocalized with previous studies of kidney function, and genetic correlation indicated significant shared genetic architecture between AKI and eGFR.", "Notably, the association at the FTO locus was attenuated after adjustment for BMI and diabetes, suggesting that this association may be partially driven by obesity.", "Both FTO and the SHROOM3 loci showed nominal evidence of replication from diagnostic-code-based summary statistics from UK Biobank, FinnGen, and Biobank Japan.", "Thus, our large GWA meta-analysis found two loci significantly associated with AKI suggesting genetics may explain some risk for AKI." ]

[ "Acute laryngitis is a common disease with self-limiting nature.", "Since the leading cause is attributed to viral infections and thus self-limiting, many affected individuals do not seek professional medical help.", "However, because the major symptom of hoarseness imposes a substantial burden in everyday life, it might be speculated that web-based search interest on this condition follows incidence rates, with highest peaks during winter months.", "The aim of this study was to evaluate global public health-information seeking behaviour on laryngitis-related search terms.", "We utilized Google Trends to assess country-specific, representative laryngitis-related search terms for English and non-English speaking countries of both hemispheres.", "Extracted time series data from Australia, Brazil, Canada, Germany, the United Kingdom, and the United States of America, covering a timeframe between 2004 and 2019 were first assessed for reliability, followed by seasonality analysis using the cosinor model.", "Direct comparisons revealed different, representative laryngitis-related search terms for English- and non-English speaking countries.", "Extracted data showed a trend of higher reliability in countries with more inhabitants.", "Subsequent graphical analysis revealed winter peaks in all countries from both hemispheres.", "Cosinor analysis confirmed these seasonal variations to be significant (all P < 0.001).", "Public interest in laryngitis-related, online health information displayed seasonal variations in countries from both hemispheres, with highest interest during winter months.", "These findings emphasize the importance to optimize the distribution of reliable, web-based health education in order to prevent the spread of misinformation and to improve health literacy among general populations." ]

[ "Acute leukaemias are life-threatening haematological cancers characterised by the infiltration of transformed immature haematopoietic cells in the blood and bone marrow.", "Prompt and accurate diagnosis of the three main acute leukaemia subtypes (ie acute lymphocytic leukaemia [ALL], acute myeloid leukaemia [AML], and acute promyelocytic leukaemia [APL]) is of utmost importance to guide initial treatment and prevent early mortality but requires cytological expertise that is not always available.", "We aimed to benchmark different machine-learning strategies using a custom variable selection algorithm to propose an extreme gradient boosting model to predict leukaemia subtypes on the basis of routine laboratory parameters.", "This multicentre model development and validation study was conducted with data from six independent French university hospital databases.", "Patients aged 18 years or older diagnosed with AML, APL, or ALL in any one of these six hospital databases between March 1, 2012, and Dec 31, 2021, were recruited.", "22 routine parameters were collected at the time of initial disease evaluation; variables with more than 25% of missing values in two datasets were not used for model training, leading to the final inclusion of 19 parameters.", "The performances of the final model were evaluated on internal testing and external validation sets with area under the receiver operating characteristic curves (AUCs), and clinically relevant cutoffs were chosen to guide clinical decision making.", "The final tool, Artificial Intelligence Prediction of Acute Leukemia (AI-PAL), was developed from this model.", "1410 patients diagnosed with AML, APL, or ALL were included.", "Data quality control showed few missing values for each cohort, with the exception of uric acid and lactate dehydrogenase for the cohort from Hôpital Cochin.", "679 patients from Hôpital Lyon Sud and Centre Hospitalier Universitaire de Clermont-Ferrand were split into the training (n=477) and internal testing (n=202) sets.", "731 patients from the four other cohorts were used for external validation.", "Overall AUCs across all validation cohorts were 0·97 (95% CI 0·95-0·99) for APL, 0·90 (0·83-0·97) for ALL, and 0·89 (0·82-0·95) for AML.", "Cutoffs were then established on the overall cohort of 1410 patients to guide clinical decisions.", "Confident cutoffs showed two (0·14%) wrong predictions for ALL, four (0·28%) wrong predictions for APL, and three (0·21%) wrong predictions for AML.", "Use of the overall cutoff greatly reduced the number of missing predictions; diagnosis was proposed for 1375 (97·5%) of 1410 patients for each category, with only a slight increase in wrong predictions.", "The final model evaluation across both the internal testing and external validation sets showed accuracy of 99·5% for ALL diagnosis, 98·8% for AML diagnosis, and 99·7% for APL diagnosis in the confident model and accuracy of 87·9% for ALL diagnosis, 86·3% for AML diagnosis, and 96·1% for APL diagnosis in the overall model.", "AI-PAL allowed for accurate diagnosis of the three main acute leukaemia subtypes.", "Based on ten simple laboratory parameters, its broad availability could help guide initial therapies in a context where cytological expertise is lacking, such as in low-income countries.", "None." ]

[ "Acute pancreatitis (AP) is a complex and unpredictable condition, of which hypertriglyceridemia (HTG) is the third most prevalent cause.", "This study aimed to conduct a retrospective analysis of clinical data from hospitalized AP patients to uncover a potential correlation between triglyceride (TG) levels and the necessity for intensive care unit (ICU) admission.", "This retrospective cohort study utilized the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV) critical care dataset, incorporating data from 698 patients with hypertriglyceridemic acute pancreatitis (HTG-AP).", "The analysis employed the RCS model along with univariate and multivariate logistic regression methods to affirm the association between triglyceride levels and ICU admission.", "Subgroup analysis was performed to investigate specific populations.", "The study included 698 patients with AP, 42.41% of whom experienced HTG during hospitalization.", "RCS analysis revealed a linear association between TG levels and risk of ICU admission (p for nonlinear = .219, p for overall = .009).", "Multivariate logistic regression analysis indicated an increased risk of ICU admission in the TG range of 1.7-5.65 mmol/L (aOR = 1.83, 95% CI 1.12-2.99, P = .015) and TG >11.3 mmol/L (aOR = 5.69, 95% CI 2.36-13.74, P < .001) compared to the normal group.", "Similar results were observed across the various subgroups.", "As triglyceride levels increased, there was a corresponding increase in ICU admissions.", "Patients within the 1.7 to 5.65 mmol/L and > 11.3 mmol/L triglyceride groups exhibited higher rates of ICU admissions.", "Moreover, we observed a higher risk of ICU hospitalization even with mild TG elevation." ]

[ "Acute respiratory distress syndrome (ARDS) is a heterogeneous condition with two subphenotypes identified by different methodologies.", "Our group similarly identified two ARDS subphenotypes using nine routinely available clinical variables.", "However, whether these are associated with differential response to treatment has yet to be explored.", "Are there differential responses to positive end-expiratory pressure (PEEP) strategies on 28-day mortality according to subphenotypes in adult patients with ARDS?", "We evaluated data from two prior ARDS trials (ALVEOLI and ART) that compared different PEEP strategies.", "We classified patients into one of two subphenotypes as previously described.", "We assessed the differential effect of PEEP with a Bayesian hierarchical logistic model for the primary outcome of 28-day mortality.", "We analyzed data from 1559 ARDS patients.", "Compared to lower PEEP, a higher PEEP strategy resulted in higher 28-day mortality in subphenotype A patients in ALVEOLI (OR, 1.61 [95% CrI 0.90 to 2.94]) and ART (OR 1.73 [ 95% CrI 1.01 to 2.98]), with a probability of harm from higher PEEP in this subphenotype of 94.3% and 97.7% in ALVEOLI and ART, respectively.", "Higher PEEP was not associated with mortality in subphenotype B patients in each trial (OR, 0.95 [95% CrI, 0.51 to 1.73]) and (OR, 1.00 [95% CrI 0.63 to 1.55]); probability of benefit of 56.4% and 50.7% in ALVEOLI and ART, respectively.", "These effects were not modified by PaO2/FiO2 ratio, driving pressure, or the severity of illness for the cohorts.", "We found evidence of differential response to PEEP strategies across two ARDS subphenotypes, suggesting possible harm with a higher PEEP strategy in one subphenotype.", "These observations may assist with predictive enrichment in future clinical trials." ]

[ "Acute Respiratory infection accounts for 94,037000 disability adjusted life years and 1.9 million deaths worldwide.", "Acute respiratory infections is the most common causes of under-five illness and mortality.", "The under five children gets three to six episodes of acute respiratory infections annually regardless of where they live.", "Disease burden due to acute respiratory infection is 10-50 times higher in developing countries when compared to developed countries.", "The aim of this study was to assess risk factors of acute respiratory infection among under-five children attending Public hospitals in Southern Tigray, Ethiopia 2016/2017.", "Institution based case control study was conducted from Nov 2016 to June 2017.", "Interviewer administered structured questionnaire was used to collect data from a sample of 288 (96 cases and 192 controls) children under 5 years of age.", "Systematic random sampling was used to recruit study subjects and SPSS version 20 was used to analyze the data.", "Bivariate and multivariate analysis were employed to examine statistical association between the outcome variable and selected independent variables at 95% confidence level.", "Level of statistical Significance was declared at p < 0.05.", "Tables, figures and texts were used to present data.", "One hundred sixty (55.6%) and 128 (44.4%) of the participants were males and females respectively.", "Malnutrition (AOR = 2.89; 95%CI: 1.584-8.951; p = 0.039), cow dung use (AOR =2.21; 95%CI: 1.121-9.373; p = 0.014), presence of smoker in the family (AOR = 0.638; 95% CI: 0.046-0.980; p = 0.042) and maternal literacy (AOR = 3.098; 95%CI: 1.387-18.729; p = 0.021) were found to be significant predictors of acute respiratory infection among under five children.", "According to this study maternal literacy, smoking, cow dung use and nutritional status were strongly associated with increased risk of childhood acute respiratory infection.", "Health care providers should work jointly with the general public, so that scientific knowledge and guidelines for adopting particular preventive measures for acute respiratory infection are disseminated." ]

[ "Acute-on-chronic liver failure (ACLF) is a major public health concern.", "We aimed to assess the definitions, etiological spectrum, organ failure (OF), and outcomes of ACLF globally.", "Three databases were searched for studies on ACLF from 1990 till September 2022.", "Information regarding definitions, acute precipitants, underlying chronic liver disease (CLD), OF, and mortality were extracted.", "Meta-analyses were performed for pooled prevalence rates (95% confidence interval, CI) using random effects model for each definition of ACLF.", "Of the 11,451 studies identified, 114 articles (142 cohorts encompassing 210,239 patients) met the eligibility criteria.", "Most studies (53.2%) used the European Association for the Study of the Liver (EASL) definition, followed by Asia-Pacific Association for the Study of the Liver (APASL) (33.3%).", "Systemic infection was the major acute precipitant and alcohol use was the major cause of CLD in EASL-defined studies while alcohol was both, the major acute precipitant and cause of CLD in APASL-defined studies.", "Liver failure was the major OF in APASL-based studies, while renal failure was predominant in EASL-based studies.", "Thirty-day mortality varied across definitions: APASL: 38.9% [95%CI 31.2-46.9], EASL: 47.9% [95%CI 42.2-53.5] and NACSELD: 52.2% [95%CI 51.9-52.5].", "Diagnostic overlap between definitions ranged from 7.7% to 80.2%.", "Meta-regression suggested that the WHO region influenced 30-day mortality in studies using EASL definition.", "Heterogeneity in the definition of ACLF proposed by different expert societies and regional preferences in its use result in differences in clinical phenotype and outcomes.", "A uniform definition would enhance the comparability and interpretation of global data." ]

[ "Addressing disparities in living kidney donation requires making information accessible across literacy levels, especially important given that the average American adult reads at an 8th-grade level.", "This study evaluated the effectiveness of ChatGPT, an advanced AI language model, in simplifying living kidney donation information to an 8th-grade reading level or below.", "We used ChatGPT versions 3.5 and 4.0 to modify 27 questions and answers from Donate Life America, a key resource on living kidney donation.", "We measured the readability of both original and modified texts using the Flesch-Kincaid formula.", "A paired t-test was conducted to assess changes in readability levels, and a statistical comparison between the two ChatGPT versions was performed.", "Originally, the FAQs had an average reading level of 9.6 ± 1.9.", "Post-modification, ChatGPT 3.5 achieved an average readability level of 7.72 ± 1.85, while ChatGPT 4.0 reached 4.30 ± 1.71, both with a p-value <0.001 indicating significant reduction.", "ChatGPT 3.5 made 59.26% of answers readable below 8th-grade level, whereas ChatGPT 4.0 did so for 96.30% of the texts.", "The grade level range for modified answers was 3.4-11.3 for ChatGPT 3.5 and 1-8.1 for ChatGPT 4.0.", "Both ChatGPT 3.5 and 4.0 effectively lowered the readability grade levels of complex medical information, with ChatGPT 4.0 being more effective.", "This suggests ChatGPT's potential role in promoting diversity and equity in living kidney donation, indicating scope for further refinement in making medical information more accessible." ]

[ "Addressing obstacles such as logistical complexities, social stigma, and the impact of historical traumas is essential for the successful inclusion of underrepresented groups in health research.", "This article reviews engagement and interview techniques used to ethically engage recently settled Afghan refugees in Oklahoma and rural Mexican-born women in Illinois in research.", "The paper concludes with a reflective discussion on the challenges and lessons learned.", "Creative strategies to engage hard-to-reach populations in research included considering the participants' socioeconomic and cultural contexts in their interactions and developing community partnerships to establish trust and obtain reliable data.", "Other engagement strategies were communicating in the participants' preferred language, providing assistance with reading and responding to study questions for those with low literacy, employing research staff from the population of interest, and recruiting in specific locations where the populations of interest live.", "Community engagement is essential at all stages of research for building trust in hard-to-reach populations, achieving inclusivity in health research, and ensuring that interventions are culturally sensitive and effective." ]

[ "Addressing the imbalance of the health workforce between metropolitan and rural areas requires a clear understanding of trends in choices of work location of health care staff.", "Here, we provide an automated and highly reproducible protocol to examine the location of health care workers over multiple years using medical graduates as a case study.", "Data linkage cohort study.", "The study cohort examined was University of Wollongong Medical graduates from 2010 to 2021 who were registered to practice in Australia.", "The main outcome measure was graduate location of practice in Modified Monash regsions MM1 or MM2-7 across multiple postgraduate years.", "This protocol used R Markdown.", "An automated and reproducible protocol was used to analyse choices of work location for the University of Wollongong's medical graduates.", "Over 90% of graduates were registered with AHPRA.", "Around 25%-30% of graduates were found to work in MM2-7 regions across their careers, exceeding the national average.", "The protocol presented allows for a fast and reproducible analysis of work location by region for health care workers.", "This will allow comparisons of outcomes between universities or health professions." ]

[ "Addressing the ongoing needs of individuals with diabetes, particularly in low- and middle-income countries like the Philippines, requires a focus on regular follow-ups with healthcare teams, adherence to healthy behaviors, and effective patient education to prevent long-term complications.", "The aim of this study was to ascertain the impact of a comprehensive educational program for those living with diabetes in the Philippines.", "In a prospective study, a convenience sample of patients living with diabetes attending a cardiac rehabilitation or an outpatient diabetes clinic in the Philippines received a 12-week education intervention.", "Participants completed surveys at pre- and post-intervention assessing disease-related knowledge, health literacy, dietary habits, and tobacco use.", "Physical activity was measured by steps taken per day using wearable devices and by self-report of minutes of moderate or vigorous-intensity exercise per week.", "Satisfaction with the educational materials was also evaluated by a survey composed of Likert-type scale and open-ended questions.", "Descriptive statistics, paired t-tests or chi-square were used for data analysis.", "Overall, 184 individuals living with diabetes type 2 (mean age = 54.4 ± 12.4, 32% female) completed both assessments.", "There was significant improvement in disease-related knowledge (p < 0.001), daily steps measured by a wearable device and self-reported minutes of moderate/vigorous-intensity exercise (p < 0.001), and the number of fruit and vegetable servings consumed per day (p = 0.001).", "No significant changes were observed in health literacy levels.", "One participant stopped using tobacco at post-education.", "Educational materials were highly satisfactory to participants.", "Lack of time, family responsibilities, and poor internet access were the main barriers to learning reported by participants.", "Suggestions to improve the education provided included assessment of information needs at the start of the education, having short summaries about the topics, follow-ups post-intervention, and inviting family members to sessions.", "Results of this study demonstrated the positive effects a comprehensive structured patient education intervention on disease-related knowledge and behaviour changes among people living with type 2 diabetes in the Philippines." ]

[ "Adequate ehealth literacy is one of the key instruments safeguarding people against unreliable health-related information obtained from the Internet.", "This paper presents an assessment of the reliability and the validity of a Polish version of the ehealth literacy scale (Pl-eHEALS).", "The assessment was carried out on the basis of two nationally representative samples of the Polish population.", "In the first survey of adults at least 50 years old, the technique of computer-assisted telephone interviewing (CATI) was applied.", "In the second survey of young adult women (18-35 years old), the technique of computer-assisted web interviewing (CAWI) was used.", "The reliability and the validity of the Pl-eHEALS was analyzed.", "There were no floor or ceiling effects revealed in either sample.", "The Cronbach's alpha coefficients were 0.90 and 0.88, and Guttman split-half coefficients were 0.89 and 0.81, respectively.", "Exploratory factors analysis revealed single factor models in both cases.", "The sum of squared loadings in the first survey was 6.090 and accounted for 58.72% of the variance.", "In the second survey, the sum was 5.927 and was responsible for 55.06% of the variance.", "Hypothesis testing showed that, for older adults, higher ehealth literacy was prevalent in the respondents who used the Internet more frequently.", "Among young adult women, higher readiness to use the Internet as a primary source of health-related information and to undertake specific internet health-related activities was associated with higher ehealth literacy.", "The analysis reported in this paper confirmed the reliability and the validity of the instrument.", "It should be stressed that, prior to this study, there was no validated Polish version of the eHEALS that could be used with Polish-speaking respondents." ]

[ "Adequate nutrition and the nutritional status of pregnant women are critical for the health of both the mother and the developing foetus.", "Research has shown a significant impact of nutrition on the child's health and the future risk of developing chronic noncommunicable diseases (NCDs), such as obesity, diabetes, hypertension, and cardiovascular disease.", "There is currently no data on the level of nutritional knowledge of Czech pregnant women.", "This survey aimed to evaluate their level of nutritional knowledge and literacy.", "An analytical cross-sectional study was conducted in two healthcare facilities in Prague and Pilsen between April and June 2022.", "An anonymous self-administered paper-form questionnaire for assessing the level of nutritional knowledge (40 items) and the Likert scale for assessing nutrition literacy (5 items) were used.", "A total number of 401 women completed the questionnaire.", "An individual's nutritional knowledge score was calculated and compared with demographic and anamnestic characteristics using statistical methods.", "The results showed that only 5% of women achieved an overall nutritional score of 80% or more.", "University education (p < 0.001), living in the capital city (p < 0.001), experiencing first pregnancy (p = 0.041), having normal weight and being overweight (p = 0.024), and having NCDs (p = 0.044) were statistically significantly associated with a higher nutritional knowledge score.", "The lowest knowledge scores were found in the areas of optimal energy intake, optimal weight gain, and the role of micronutrients in diet during pregnancy.", "In conclusion, the study shows limited nutrition knowledge of Czech pregnant women in some areas of nutrition.", "Increasing nutritional knowledge and nutrition literacy in Czech pregnant women is crucial for supporting their optimal course of pregnancy and the future health of their offspring." ]

[ "Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children.", "Among breastfeeding mother-child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns.", "For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk - which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age.", "For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being - with important impacts on their taste perception, microbiome composition, and immune function.", "According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups still provide significant challenges to achieving adequate nutrition during these early life stages.", "For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US.", "For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, dairy-based infant formulas are considered the next best option for meeting nutritional needs.", "Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development.", "Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities - some of which may have lifelong consequences on physical and mental health.", "A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life.", "However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children.", "Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed.", "This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population." ]

[ "Adequate sodium and potassium intake, along with adherence to the Mediterranean diet (MedDiet), are key factors for preventing hypertension and cerebrovascular diseases.", "However, data on the consumption of these nutrients within the MedDiet are scarce.", "This cross-sectional study aims to assess the association between MedDiet adherence and sodium/potassium intake in the MIND-Matosinhos randomized controlled trial, targeting Portuguese adults at a high risk of dementia.", "Good adherence to the MedDiet was defined using the Portuguese Mediterranean Diet Adherence Screener questionnaire (≥10 points), and both sodium/potassium intakes were estimated from 24-hour urine collections.", "The association between MedDiet adherence and these nutrients' intake (dichotomized by the median) was quantified by calculating odds ratios (OR) and respective 95% confidence intervals (95% CI) using a logistic regression.", "A total of 169 individuals (60.9% female; median age: 70 years; range: 36-85 years) were included.", "Good adherence to the MedDiet was observed among 18.3% of the sample.", "After adjusting for sex, age, education and using antihypertensive drugs, good MedDiet adherence was associated with higher sodium (OR = 3.11; 95% CI: 1.27-7.65) and potassium intake (OR = 9.74; 95% CI: 3.14-30.26).", "Increased adherence to the MedDiet may contribute to a higher potassium intake but seems to have limited effects on the adequacy of sodium levels." ]

[ "Adequate staffing is crucial for high quality patient care and nurses' wellbeing.", "Nurses' professional assessment on adequacy of staffing is the gold standard in measuring staffing adequacy.", "However, available measurement instruments lack reliability and validity.", "To develop and psychometrically test an instrument to measure nurses' perceived adequacy of staffing (PAS) of general hospital wards.", "A multicenter cross-sectional psychometric instrument development and validation study using item response theory.", "Ten general nursing wards in three teaching hospitals in the Netherlands.", "A sample of 881 participants, including third and fourth year nursing students and nurse/care assistants.", "The 13-item self-reported questionnaire was developed based on a previous Delphi study and two focus groups.", "We interviewed five nurses to evaluate the content validity of the instrument.", "The field test for psychometric evaluation was conducted on ten general wards of three teaching hospitals in the Netherlands.", "Structural validity of the item bank was examined by fitting a graded response model (GRM) and inspecting GRM fit.", "Measurement invariance was assessed by evaluating differential item functioning (DIF) of education level and work experience.", "We examined convergent validity by testing the hypothesis that there was at least a moderate correlation between the PAS instrument and a single item measuring adequacy of staffing.", "Internal consistency and reliability across the scale were also examined.", "A total of 881 measurements were included in the analysis.", "The data fitted the GRM adequately and item fit statistics were good.", "DIF was detected for work experience for the protocols item, but the impact on total scores was negligible.", "The hypothesis was confirmed and the item bank reliably measured two standard deviations around the mean.", "The Nurse Perceived Adequacy of Staffing Scale (NPASS) for nurses of general hospital wards in the Netherlands has sufficient reliability and validity and is ready for use in nurse staffing research and practice." ]

[ "Adequate training of anaesthetists in regional anaesthesia is important to ensure optimal patient access to regional anaesthesia.", "We undertook a national survey of UK trainee anaesthetists and Royal College of Anaesthetists (RCoA) tutors to assess experiences of training in regional anaesthesia.", "We performed descriptive statistics for baseline characteristics, and logistic regression of training indices and tutor confidence that their hospital could provide regional anaesthesia training at all three stages of the RCoA 2021 curriculum.", "A total of 492 trainees (19.2%) and 114 tutors (45.2%) completed the survey.", "Trainees were less likely to have received training in chest/abdominal wall compared with upper/lower limb blocks {erector spinae vs femoral block (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.16-0.39), P<0.001}, or achieved >20 chest/abdominal wall blocks by Stage 3 of training (chest vs lower limb block [OR 0.09, 95% CI 0.05-0.15, P<0.001].", "There was a strong association between training received, number of blocks performed (>20 vs 0-5 blocks), and self-reported ability to perform blocks independently, OR 20.9 (95% CI 9.38-53.2).", "24/182 (13%) and 10/182 (5.5%) of trainees had performed ≥50 non-obstetric lumbar and thoracic epidurals, respectively, by Stage 3 training.", "There was a positive association between having a lead clinician for regional anaesthesia, particularly those with paid sessions, and reported confidence to provide regional anaesthesia training at all stages of the curriculum (Stage 3 OR 7.27 [95% CI 2.64-22.0]).", "Our results confirm the importance of clinical experience and access to training in regional anaesthesia, and support the introduction of departmental regional anaesthesia leads to improve equity and quality in training opportunities." ]

[ "Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) post-stroke is often problematic, despite potential benefits.", "This study aimed to evaluate CPAP adherence in patients with OSA post-stroke based on the Andersen behavioral model of health services utilization.", "A total of 227 eligible participants were recruited from a Chinese hospital.", "After baseline assessment, participants were followed for 6 months to determine short-term CPAP adherence.", "Those with good short-term adherence were followed for an additional 6 months to explore long-term adherence and influencing factors.", "Short-term CPAP adherence rate was 33%.", "Being married or living with a partner, having an associate degree or baccalaureate degree or higher, and stronger health beliefs independently predicted short-term CPAP adherence.", "Only 25% of participants from the adherent group showed good long-term adherence.", "The factor associated with long-term CPAP adherence was participants not using alcohol.", "Adherence to CPAP is suboptimal among patients having OSA post-stroke.", "Addressing unfavorable predisposing factors and modifying health beliefs are suggested." ]

[ "Adherence to medication is an essential factor in controlling and reducing the side effects of non-communicable diseases, particularly hypertension.", "Medication adherence varies in older adults due to the effects of various factors.", "The research aimed to examine the determinants of medication adherence among older adults with hypertension.", "This cross-sectional study was performed among 300 people aged 60 years or older referring to health centers in Sarab, Iran, between February and May 2023.", "To collect data, valid and reliable tools were applied.", "There was a significant association between age groups, level of education, and monthly income status with adherence to medication (p-value <0.05).", "According to the results of hierarchical regression, demographic variables collectively explained 3.2% of the variance in adherence to therapeutic regimens (p-value = 0.143).", "The inclusion of illness perception at step 2, along with demographic variables, led to a further significant increase in 9.6% of the variance (p-value <0.001).", "In the final step, health literacy dimensions were added, which explained an additional 8.7% of the variance (p-value <0.001).", "In total, demographic variables, illness perception, and HL dimensions explained 21.5% of the variance in adherence to therapeutic regimens.", "According to the results, demographic variables, illness perception, and HL dimensions were the main determinants of medication adherence among older adults.", "Health educators should focus on creating interventions that improve medication adherence by addressing illness perception and health literacy dimensions in this particular population." ]

[ "Adherence to physiotherapeutic treatment and recommendations is crucial to achieving planned goals and desired health outcomes.", "This overview of systematic reviews synthesises the wide range of additional interventions and behaviour change techniques used in physiotherapy, exercise therapy and physical therapy to promote adherence and summarises the evidence of their efficacy.", "Seven databases (PEDro, PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO and CINAHL) were systematically searched with terms related to physiotherapy, motivation, behaviour change, adherence and efficacy (last searched on January 31, 2023).", "Only systematic reviews of randomised control trials with adults were included.", "The screening process and quality assessment with AMSTAR-2 were conducted independently by the two authors.", "The extracted data was synthesised narratively.", "In addition, four meta-analyses were pooled in a panoramic meta-analysis.", "Of 187 reviews identified in the search, 19 were included, comprising 205 unique trials.", "Four meta-analyses on the effects of booster sessions, behaviour change techniques, goal setting and motivational interventions showed a significantly small overall effect (SMD 0.24, 95% CI 0.13, 0.34) and no statistical heterogeneity (I2 = 0%) in the panoramic meta-analysis.", "Narrative synthesis revealed substantial clinical and methodological diversity.", "In total, the certainty of evidence is low regarding the efficacy of the investigated interventions and techniques on adherence, due to various methodological flaws.", "Most of the RCTs that were included in the reviews analysed cognitive and behavioural interventions in patients with musculoskeletal diseases, indicating moderate evidence for the efficacy of some techniques, particularly, booster sessions, supervision and graded exercise.", "The reviews provided less evidence for the efficacy of educational and psychosocial interventions and partly inconsistent findings.", "Most of the available evidence refers to short to medium-term efficacy.", "The combination of a higher number of behaviour change techniques was more efficacious.", "The overview of reviews synthesised various potentially efficacious techniques that may be combined for a holistic and patient-centred approach and may support tailoring complex interventions to the patient's needs and dispositions.", "It also identifies various research gaps and calls for a more holistic approach to define and measure adherence in physiotherapy.", "PROSPERO CRD42021267355." ]

[ "Adherence to preventive measures is of the utmost importance for limiting the spreading of the coronavirus.", "Many predictors of adopting preventive behaviors have been analyzed in different countries during the COVID-19 pandemic.", "Objectives: The study’s main aim was to assess the roles of health (HL) and e-health literacy (eHL), conspiracy beliefs, political sympathy, and religious practices in the adherence to COVID-19 preventive measures after adjusting for sociodemographic factors.", "The analysis was based on the data obtained from a survey conducted among 2410 adult Internet users in Poland in October 2020.", "The survey was performed with a computer-assisted web-based interviewing technique.", "Survey data were analyzed through uni- and multivariable linear regression models.", "The multivariable regression model revealed that after adjusting for sociodemographic variables, the preventive measures score (PMS) was significantly associated with HL (B = 0.04, p < 0.001), eHL (B = 0.03, p < 0.001) and the COVID-19-related conspiracy beliefs score (C19CBS) (B = −0.24, p < 0.001).", "There was also a significant statistical relationship between PMS and political sympathies and religious practices.", "HL and eHL are key factors eligible for modification through appropriate interventions and showing positive effects in compliance with preventive measures.", "Conspiracy beliefs, political sympathy and religious beliefs are independently associated with the adherence." ]

[ "Adjuvant endocrine therapy has a vital role in reducing breast cancer mortality.", "The beliefs in adjuvant endocrine therapy is a very important factor in the medication adherence of breast cancer survivors.", "Therefore, it is necessary to develop a standardized scale for assessment of adjuvant endocrine therapy.", "The purpose of this study was to identify the attributes of adjuvant endocrine therapy beliefs, and to evaluate adjuvant endocrine therapy beliefs scale psychometric properties.", "A hybrid model was applied to identify the concept of adjuvant endocrine therapy beliefs and measurement question were developed by the scale development process.", "Statistical analysis using validity analysis and Rasch analysis based on item response theory were performed.", "A total of 228 breast cancer survivors in South Korea participated in the study.", "The finally developed adjuvant endocrine therapy beliefs scale consisted of 22 items.", "The items extracted by 4 factors explained 59.72% of the total variance.", "The model fit showed an acceptable level.", "The adjuvant endocrine therapy beliefs scale was excellent in convergent and discriminant validity with reliability.", "This scale is expected to be practical and useful in identifying adjuvant endocrine therapy beliefs and developing intervention strategies to promote adjuvant endocrine therapy adherence.", "In addition, continuous education and support should be accompanied so that breast cancer survivors can maintain positive beliefs in adjuvant endocrine therapy adherence." ]

[ "Adolescence has always been regarded as a period of rapid psychological and behavioral change.", "Adolescents are subject to more difficult behaviors, and those difficult behaviors have a great impact on co-parenting and parenting burnout.", "In order to reveal the relationship between these factors, this study investigated the mediating effect of difficult adolescent behaviors on that relationship by constructing a theoretical model and examined the moderating effect of family functioning.", "In order to provide a scientific basis for preventing and intervening in adolescents' problematic behaviors and improving parents' parenting burnout, we conducted a study on the parents of 1638 teenagers in a junior high school in Huanggang City, China in May 2023, with a questionnaire filled out by the parents.", "The research tools included a parenting burnout questionnaire, Parental collaborative parenting Scale (PPCR), Adolescent Strengths and Difficult Behaviors Questionnaire (Parental Version), Family Function Scale, etc.", "An independent sample t test and ANOVA test were used to analyze whether there are certain demographic variables in parenting burnout, and SPSS27.0 was used for descriptive statistics, reliability and validity tests, correlation analysis and common method deviation tests.", "The adjusted mediation model was tested by using the SPSS macro program Process4.0.", "Results: The variance in the explanatory capacity of the largest factor in this study was 21.955%, which did not exceed the critical value of 40%, so there was no obvious common method deviation in the data of this study.", "The independent sample t test and ANOVA test showed that there are certain differences in parental rearing burnout dependent on parental gender, the main caregivers, family economic income and demographic variables.", "The results of the adjusted mediation model test by Process4.0 show the following: (1) Adolescent difficult behavior plays an intermediary role between parental collaborative parenting and parenting burnout; (2) the indirect effect of collaborative parenting on parenting burnout through adolescents' problematic behaviors is regulated by family functions; (3) the relationship between adolescent difficult behavior and parenting burnout is regulated by family function; (4) the direct influence of collaborative parenting on parenting burnout is also regulated by family function.", "Conclusion: Adolescents' difficult behavior partially mediates the influence of parents' collaborative parenting on parenting burnout.", "In addition, family function not only mediates the front and back ends of mediation, but also mediates the direct influence of collaborative parenting on parenting burnout.", "These findings are instructive for improving family parenting problems and promoting adolescent development.", "The results of this study may be helpful in enhancing parents' awareness of parenting of adolescents in China, which will provide reference for some teachers in China to understand adolescent behavior.", "At the same time, the results may provide new enlightenment for mental health professionals and enable them to fully understand the parenting contradictions between parents and adolescents in China." ]

[ "Adolescence is a critical phase marked by distinct health and developmental needs and rights.", "It represents a pivotal time for the acquisition of knowledge, skills, emotional regulations, and relationship management.", "However, a recent surge in internet usage among adolescents has been observed, leading to a concerning decline in physical activity.", "This study aims to evaluate the level of physical activity and its correlation with internet use among adolescents.", "A cross-sectional study, conducted within educational institutions in Beni, Nepal, utilized a self-structured questionnaire to collect data on physical activity levels and associated factors.", "The relationship between physical activity and independent variables was assessed through the chi-square test, and regression analysis was employed to quantify the strength of this association.", "The study revealed that 75.3% of adolescents (out of 385) exhibited inadequate physical activity levels.", "Notably, late adolescents were more susceptible to insufficient physical activity than their middle adolescent counterparts were.", "Adolescents from nuclear families (UOR = 2.689, C.I = 4.074-22.822), those with higher monthly family income (UOR = 3.318, C.I = 1.209-9.105), and individuals using Wi-Fi (UOR = 1.801, C.I = 1.117-2.904) demonstrated a higher likelihood of internet addiction.", "Moreover, these groups were more prone to engage in inadequate physical activity (UOR = 1.1740, C.I = 0.938-3.226) compared to their counterparts not addicted to the internet.", "The study concludes that over two-thirds of adolescents were addicted to the Internet, and three-fourths were inadequately physically active, with late adolescents being more affected than middle adolescents.", "Inadequate physical activity was associated with various factors, including family type, monthly family income, monthly pocket money, father's occupation, type of school, type of internet access, and Internet Addiction Test (IAT) score.", "Internet-addicted adolescents were found to be more likely to be physically inactive." ]

[ "Adolescence phase has high intrinsic and instrumental relevance.", "The Transformative Action for Rural Adolescents intervention delivered PACE++ curriculum with innovations to introduce a) health and nutrition sessions and b) delivery of the content in community settings of rural Bihar.", "This paper examines impact of the intervention showcasing establishment of intergenerational community connect for empowering and invigorating adolescent girls on gender attitude, empowerment and adolescent health and nutrition.", "The impact evaluation is based on a two-arm (intervention and comparison groups) cluster randomized controlled design with two rounds of representative cross-sectional surveys.", "The baseline and endline sample comprised of 2327 and 2033 adolescent girls (15-19 years), respectively.", "Descriptive statistical, difference-in-differences and propensity score matching methods are used to confirm the program impact.", "The DID and PSM analyses confirm high significance of impact on gender equity norms, diets and nutritional knowledge and understanding of employee related rights and responsibilities.", "School-going adolescent girls performed better than those who have discontinued formal education.", "The intervention showcases the importance of delivering the modified PACE curriculum in rural settings through leveraging community platforms.", "The findings call for greater policy attention on scaling up of similar initiatives for empowerment and social capital development of adolescent girls." ]

[ "Adolescent athletes' values ​regarding health behaviors, including their attitudes toward doping, are largely derived from those of their parents.", "Therefore, clarifying the factors that affect parents' intentions regarding their children's medicine intake and nutrition can help elucidate the process of forming values ​​of healthy behaviors in young athletes.", "Between March 8 and March 9, 2021, an online questionnaire survey was conducted via an Internet research company; data from 2,000 residents in Japan were collected.", "Participants were male and female residents aged 30-59 years with children in elementary or high school and belonging to sports clubs.", "The survey items included respondent's and child's basic information, respondent's health literacy, and level of sports in which the respondent and child were (or are) engaged.", "Respondents were also asked if they would like their children to receive prescription drugs, over-the-counter drugs, herbal medicines, vaccines, supplements, or energy drinks.", "Logistic regression analysis was performed to analyze the relationship between respondents' basic information and health literacy and their intention to receive prescription and over-the-counter drugs, herbal medicines, vaccines, supplements, and energy drinks.", "Higher parental health literacy was associated with higher children's willingness to receive prescription drugs (odds ratio [OR] = 1.025, 95% confidence interval [CI]: 1.016-1.035), over-the-counter drugs (OR = 1.012, 95% CI: 1.003-1.021), prescription herbal medicines (OR = 1.021, 95% CI: 1.021-1.030), over-the-counter herbal medicines (OR = 1.012, 95% CI: 1.003-1.021), and vaccines (OR = 1.025, 95% CI: 1.016-1.035).", "Conversely, the children's intention to receive energy drinks (OR = 0.990, 95% CI: 0.980-1.000) decreased significantly.", "As the child's athletic level increased, parents' willingness for their children to receive oral prescription medicines decreased (OR = 0.886, 95% CI: 0.791-0.992) and that to receive supplements (OR = 1.492, 95% CI: 1.330-1.673) and energy drinks significantly increased (OR = 1.480, 95% CI: 1.307-1.676).", "Health literacy of adolescent athletes' parents is associated with their children's willingness to receive medicines.", "Healthcare providers should counsel parents of adolescent athletes to allow their children to receive necessary drug treatments and prevent doping violations caused by supplement intake." ]

[ "Adolescent developmental outcomes can vary significantly by differences in ethnicity.", "While previous studies have examined the impacts of adolescents' own ethnicity on their development, little research has been conducted about the impacts of the ethnicity of both parents as an important family background factor which is likely to expose adolescents to a variety of growth environments.", "Using nationally representative data from the China Family Panel Studies (CFPS) surveys, we examine the relationship between parental ethnicity (including both monoethnic families and interethnic families with intermarried Han and ethnic minority groups) and adolescent developmental outcomes, measured by academic performance, cognitive development, and health.", "Our results show that adolescents with interethnic parents had higher scores in literacy and mathematics tests than those of monoethnic non-Han parents, but their scores were not statistically significantly different from those in monoethnic Han families.", "Adolescents with interethnic parents also performed better in fluid intelligence assessments and had lower obesity rates than those with monoethnic ethnic minority parents.", "Our results further suggest that socioeconomic status, parental education, and education expectations partially mediate the association between interethnic parents and adolescent development.", "Moreover, parental ethnic composition acts as a potential moderator that influences the effects of parents' non-agricultural work on adolescent development.", "Our study expands the growing body of empirical evidence on the relationship between parental ethnicity and adolescent development and is conducive to policy recommendations for interventions in the development of adolescents with ethnic minority parents." ]

[ "Adolescent health is currently undergoing a serious deterioration.", "The aim of this study was to identify the self-care practices in adolescents between 15 and 18 years of age attending secondary schools in four departments of the interior of the province of La Rioja, Argentina.", "descriptive cross-sectional and analytical study; data collected between October and November 2022 by non-probabilistic convenience sampling, with analysis of absolute and relative frequencies, multivariate logistic regression analysis and Odds ratio with 95% CI statistical significance of p= ˂0.05.", "Exploratory factor analysis (EFA) using the Principal Components method as extraction and the Orthogonal Varimax method as rotation.", "Analysis software, SPSS version 26.", "There are discordances between the self-perception of health care and the practice carried out by the adolescents.", "Gender disparity in self-care is identified.", "The factors that increase self-care are the use of digital health applications, annual or shorter medical check-ups, and maintaining positive thinking habits.", "The main concern in relation to self-care among adolescents was the consumption of alcoholic beverages." ]

[ "Adolescent mental ill-health is a common international challenge affecting both high- and lower-middle-income countries.", "The Republic of the Philippines enacted its first mental health law in 2019, underlining the importance of the promotion of adolescent mental health education in schools.", "In Japan, course instructions about mental ill-health were formulated in a Course of Study that reflects governmental curriculum guidelines.", "Embedded since 2022, the Course of Study aimed to promote an understanding of current issues of adolescent health.", "The National Center for Global Health and Medicine in Japan has been sharing experience of promoting public health practices and advancing medical technology in low- and middle-income countries, especially in the Western Pacific region.", "This paper describes the development process and content of these resources by an interdisciplinary team from Japan and the Philippines.", "The interdisciplinary team created an embedded mental health education programme using animated videos for the Philippine school curriculum to improve mental health literacy in adolescents.", "Two six-minute animated videos of age-relevant stories were created.", "The animation scenarios illustrate: 1) mental health problems and recovery; and 2) major symptoms of mental illnesses, including depression, anxiety, and schizophrenia.", "Each animated video presents several items for discussion among students and/or teachers, both in class and online for students unable to attend school.", "Our efforts may provide good opportunities for enhancing adolescents' mental health activities in the Philippines.", "In the following steps, we should investigate the effectiveness of school-based MHL using these animated videos with rigorous evaluation methods." ]

[ "Adolescent overweight and obesity are growing public health concerns in developing nations like Ethiopia.", "They are closely linked to an increased risk of non-communicable diseases, a deterioration in health-related quality of life, subpar academic performance, and a decline in social and emotional well-being.", "There is, however, little research in this field.", "Thus, this study aimed to assess overweight and obesity and associated factors among public and private secondary school adolescent students in Harar city, Eastern Ethiopia.", "A school-based comparative cross-sectional study was conducted among 781 secondary school adolescents in Harar city from February to March 2022.", "Multi-stage sampling was used to identify 781 study participants (586 in public and 195 in private schools).", "Anthropometric measures and self-administered structured questionnaires were used to obtain the data.", "Bivariate and multivariate logistic regression were used to determine the association between independent variables and overweight and obesity.", "Statistical significance was declared at P < .05.", "The overall magnitude of overweight and obesity was 9.3% [95% confidence interval (CI) = 7.2-11.4%] with 16.2% in private schools.", "Being female [adjusted odd ratio (AOR) = 2.04, 95% CI: 1.17-3.55], late adolescent age [AOR = 0.53, 95% CI: 0.31-0.90], bigger family size [AOR = 0.55, 95% CI: 0.31-0.97], high paternal education level [AOR = 2.03, 95% CI: 1.08-3.81], eating meat [AOR = 3.41, 95% CI: 1.27-9.17] and not consuming breakfast daily [AOR = 2.13, 95% CI: 1.24-3.67] were factors associated with overweight and obesity among all secondary school adolescents.", "A high maternal educational level, not eating breakfast and dinner daily in private secondary school adolescents and having a feminine gender, eating eggs, and not walking or riding a bicycle for at least 10 minutes continuously in public secondary school adolescents were factors associated with overweight and obesity.", "The extent of overweight and obesity was notably higher in the study area.", "Communities and educational institutions should work together to promote healthy lifestyle choices among adolescents, with a special emphasis on girls and students enrolled in private schools." ]

[ "Adolescent pregnancy is a critical public health issue, particularly in developing regions like Nepal, where it poses significant risks to maternal and child health and perpetuates the cycle of poverty.", "This study focused on the marginalized Chepang community, which is endangered and faces unique challenges.", "The study aimed to explore the factors associated with adolescent pregnancy among Chepang women in Ichchhakamana Rural Municipality, Chitwan, Nepal, and also assessed their reproductive health-seeking behavior.", "A cross-sectional analytical study was conducted with 217 Chepang women aged 15-20 years, and data was collected through face-to-face interviews using a semi-structured questionnaire.", "The collected data was entered and analyzed using IBM SPSS version 20.", "Descriptive statistical tools like frequency, and percentage were used to express the results.", "Pearson chi-square test, Fisher exact test were used for bivariate analysis to determine the presence of association between the dependent and independent variables.", "Binary logistic regression was used for further analysis.", "The prevalence of current adolescent pregnancy was 8.3%(18), while one-fourth had experienced prior pregnancies during their adolescence.", "Factors significantly associated with adolescent pregnancy included lack of education among the women and their mothers, as well as living in joint families.", "Additionally, number of antenatal visits and consumption of iron tablets seemed to be lower among Chepang women in comparison to the national data.", "Chepang women had high adolescent pregnancy rates, with low education level and joint family structure being important risk factors for it.", "They also had inadequate reproductive health seeking behavior.", "Addressing these problems requires strategies that prioritize education and raise awareness about reproductive health." ]

[ "Adolescent self-reported psychotic experiences are associated with mental illness and could help guide prevention strategies.", "The Community Assessment of Psychic Experiences (CAPE) was developed over 20 years ago.", "In a rapidly changing society, where new generations of adolescents are growing up in an increasingly digital world, it is crucial to ensure high reliability and validity of the questionnaire.", "In this observational validation study, we used unique transgenerational questionnaire and health registry data from the Norwegian Mother, Father, and Child Cohort, a population-based pregnancy cohort.", "Adolescents, aged ~14 years, responded to the CAPE-16 (n = 18,835) and fathers to the CAPE-9 questionnaire (n = 28,793).", "We investigated the psychometric properties of CAPE-16 through factor analyses, measurement invariance testing across biological sex, response before/ during the COVID-19 pandemic, and generations (comparison with fathers), and examined associations with later psychiatric diagnoses.", "One third (33·4%) of adolescents reported lifetime psychotic experiences.", "We confirmed a three-factor structure (paranoia, bizarre thoughts, and hallucinations) of CAPE-16, and observed good scale reliability of the distress and frequency subscales (ω = ·86 and ·90).", "CAPE-16 measured psychotic experiences were invariant to biological sex and pandemic status.", "CAPE-9 was non-invariant across generations, with items related to understanding of the digital world (electrical influences) prone to bias.", "CAPE-16 sum scores were associated with a subsequent psychiatric diagnosis, particularly psychotic disorders (frequency: OR = 2·06; 97·5% CI = 1·70-2·46; distress: OR = 1·93; 97·5% CI = 1·63-2·26).", "CAPE-16 showed robust psychometric properties across sex and pandemic status, and sum scores were associated with subsequent psychiatric diagnoses, particularly psychotic disorders.", "These findings suggest that with certain adjustments, CAPE-16 could have value as a screening tool for adolescents in the modern, digital world.", "European Union's Horizon 2020 Programme, Research Council of Norway, South-Eastern Norway Regional Health Authority, NIMH, and the KG Jebsen Stiftelsen." ]

[ "Adolescents and young adults (AYAs) diagnosed with cancer experience physical, cognitive, and psychosocial effects from cancer treatment that can negatively affect their ability to remain engaged in education or work through cancer treatment and in the long term.", "Disengagement from education or work can have lasting implications for AYAs' financial independence, psychosocial well-being, and quality of life.", "Australian AYAs with cancer lack access to adequate specialist support for their education and work needs and report a preference for web-based support that they can access from anywhere, in their own time.", "However, it remains unclear what web-based resources exist that are tailored to support AYAs with cancer in reaching their educational or work goals.", "This study aimed to determine what web-based resources exist for Australian AYAs with cancer to (1) support return to education or work and (2) identify the degree to which existing resources are age-specific, cancer-specific, culturally inclusive, and evidence-based; are co-designed with AYAs; use age-appropriate language; and are easy to find.", "We conducted an environmental scan by searching Google with English search terms in August 2022 to identify information resources about employment and education for AYAs ever diagnosed with cancer.", "Data extraction was conducted in Microsoft Excel, and the following were assessed: understandability and actionability (using the Patient Education and Materials Tool), readability (using the Sydney Health Literacy Laboratory Health Literacy Editor), and whether the resource was easy to locate, evidence-based, co-designed with AYAs, and culturally inclusive of Aboriginal and Torres Strait Islander peoples.", "The latter was assessed using 7 criteria previously developed by members of the research team.", "We identified 24 web-based resources, comprising 22 written text resources and 12 video resources.", "Most resources (21/24, 88%) were published by nongovernmental organizations in Australia, Canada, the United States, and the United Kingdom.", "A total of 7 resources focused on education, 8 focused on work, and 9 focused on both education and work.", "The evaluation of resources demonstrated poor understandability and actionability.", "Resources were rarely evidence-based or co-designed by AYAs, difficult to locate on the internet, and largely not inclusive of Aboriginal and Torres Strait Islander populations.", "Although web-based resources for AYAs with cancer are often available through the websites of hospitals or nongovernmental organizations, this environmental scan suggests they would benefit from more evidence-based and actionable resources that are available in multiple formats (eg, text and audio-visual) and tailored to be age-appropriate and culturally inclusive." ]

[ "Adolescents and young adults are the main target population for human papillomavirus (HPV).", "The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio-ecological perspective.", "A questionnaire survey was conducted in three secondary schools and three colleges in China.", "A total of 1756 students aged 14-22 years participated in this study.", "Among the 1756 participants, 182 students have received the HPV vaccine.", "For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors.", "Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self-efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured.", "Only 182 (10.4%) had received the HPV vaccine among the 1756 participants.", "Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine.", "Binary logistic regression analysis showed that students who were female, had lower self-efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine.", "Students had high HPV vaccination intentions while had low vaccination rate.", "Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention.", "Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake." ]

[ "Adolescents are currently becoming sexually active before their 18th birthday during which they have to battle with unsafe sexual behaviours, teenage pregnancies, sexually transmitted infections (STIs), and school dropouts.", "The trend is linked with low soft skills (self-esteem and assertiveness skills) for them to make informed, reasoned, and responsible decisions over sexual activities.", "This study designed and tested the effect of integrated reproductive health (RH) lesson materials in a problem-based pedagogy (PBP) to enhance soft skills for safe sexual behaviour among adolescents in Tanzania.", "A double-blinded clustered randomized controlled trial was conducted between September 2019 and September 2020 among 660 randomly selected adolescents.", "A Sexual-risk Behaviour Beliefs and Self-esteem Scale adopted from previous studies measured soft skills for safe sexual behaviour.", "A descriptive statistical analysis was performed by using the statistical analysis software programme version 9.4.", "The effect of the intervention was determined using Linear Mixed Model set at α error probability = 5% significance level (95% confidence interval) and a β error probability = 0.80.", "Adolescents' mean age was 15±1.869 with 57.5% females.", "The end-line findings indicated that the coefficient of soft skills was significantly higher among adolescents in the hybrid PBP (β=9.0986, p<0.01; 95%CI: 4.7772, 14.2311) and pure PBP (β =8.7114, p<0.01; 95%CI: 3.9990, 10.1208) than in the control group.", "The retention rate of soft skills was still significantly higher at 3-months follow-up (β=2.0044; p<0.01; 95%CI: 1.0234, 4.1182) and at 6-months follow-up (β=1.9803; p<0.01; 95%CI: 0.8399, 3.1099) compared to the baseline and immediate post-intervention assessments.", "The intervention substantially enhanced soft skills for safe sexual behaviour among adolescents of both sex.", "Despite the fact that scores for soft skills varied across the study timelines, adolescents demonstrated significant intentions to abstain from sexual intercourse, delay sexual relationships, negotiate condom use, and withstand sexual coercions.", "The PBP may need to be incorporated in ordinary level secondary school curricula as a formal guide to teachers and or health workers to optimally prepare adolescents for their healthy adulthood." ]

[ "Adolescents are particularly vulnerable to inadequate provision of mental health and addictions care, as services have been traditionally conceptualized to serve the needs of children or adults.", "Additionally, rural communities have been largely excluded from research investigating mental healthcare access and exhibit unique barriers that warrant targeted interventions.", "Finally, perspectives from the target population will be most important when understanding how to optimize adolescent mental health and addictions care.", "Therefore, the purpose of this study was to identify what adolescents in a rural town perceive as barriers to accessing mental health services.", "We conducted a cross-sectional survey study with high school students to generate ranked lists of the top perceived individual-level, community-level, and overall barriers.", "A total of 243 high school students responded to the survey.", "Perceived barriers were predominantly at the community level.", "Overall, the top barriers reported were a lack of awareness and education regarding mental health, resources, and the nature of treatment.", "Students who had previously accessed mental health services identified primary barriers related to mental health professionals, whereas students who had not accessed care reported fear and uncertainty as primary barriers.", "Modifiable community-level factors related to (1) mental health literacy and (2) mental healthcare professionals were identified by adolescents as the main perceived barriers to accessing mental health and addiction services in a rural town.", "The findings of this preliminary study should inform intervention strategies and further rigorous research for this traditionally underserved target population." ]

[ "Adolescents are required to take increased responsibility for their health.", "Although health literacy is implicated in adults' health decision-making and health behaviors, little is known about adolescents' health literacy and its relationship to their health behaviors.", "Furthermore, adolescent health literacy research overlooks adolescent development-specific needs and skills.", "Therefore, we qualitatively explored adolescents' (1) definitions of health literacy, preventive health behaviors, and health risk behaviors; and (2) perception of the health literacy/health behavior relationship.", "Six semi-structured focus groups were conducted with adolescents (N = 37) who answered questions about their perceptions of health literacy, preventive health behaviors, and health risk behaviors.", "Focus groups were coded using thematic analysis.", "Themes representing adolescents' definitions of health literacy were secondarily coded for alignment with definitions in the literature.", "Some of adolescents' health literacy definitions aligned with the adult health literacy literature.", "They considered health literacy a tool for informed decision-making, but acknowledged not always using these skills.", "Adolescents' definitions of health literacy were multidimensional, going beyond numeracy and literacy skills.", "Developmental characteristics and adolescents' definition of health risk behaviors were related to use of health literacy skills.", "Opportunities for adolescents to develop and practice health literacy skills are discussed." ]

[ "Adolescents increasingly view cannabis as a substance with limited harm.", "Their propensity to engage in risky driving, combined with their relative driving inexperience, places adolescents at heightened risk for harm resulting from impaired driving.", "Driver education provides an opportunity to help prevent and reduce these risks, yet few interventions address cannabis-impaired driving, especially impairment from simultaneous use of both cannabis and alcohol.", "We adapted a single-session primary care brief intervention (CHAT) for driver education programs.", "First, we conducted two focus groups with adolescents aged 15-17 years (n = 6; n = 5) enrolled in driver education programs.", "Their feedback was integrated into a prototype of an online intervention called webCHAT that focuses on preventing alcohol and cannabis-impaired driving.", "Next, we recruited a new sample of adolescents who user tested webCHAT (n = 8) and provided qualitative and survey feedback.", "We analyzed qualitative data using classic content analysis and grouped themes according to the feasibility and acceptability of webCHAT.", "Participants suggested that webCHAT should have adolescent narrators in short, informal, and interactive videos.", "In satisfaction surveys (n = 8), 88% of participants would recommend webCHAT to a friend and 88% reported that they learned helpful skills regarding impaired driving.", "General acceptability was also reflected in interviews (n = 6; 100% would recommend the intervention to a friend, 100% indicated overall positive impressions, and 67% stated it was easy to use).", "Participants reported that it was helpful to learn about the negative effects of both cannabis and alcohol on driving behavior, voicing that webCHAT would help adolescents make more informed decisions.", "Soliciting adolescent perspectives is critical when developing interventions targeting cannabis use because of increasingly permissive attitudes and perceptions of minimal risk associated with use.", "The current study highlights how feedback can help increase both the feasibility and acceptability of interventions." ]

[ "Adolescents need both information about sexual behaviours and potential risks in order to make the right choices.", "This study compared adolescents' level of awareness and predictors of knowledge of condoms and dual protection where a multi-component sexual and reproductive health (SRH) intervention was implemented and in communities where the intervention was not implemented, so as to understand the effect of the intervention on awareness and knowledge and also identify predictors of knowledge of contraception methods.", "The study was an intervention study that was undertaken in six local government areas (three rural and three urban LGAs) in Ebonyi state, southeast Nigeria.", "Data were collected from 855 adolescent boys and girls, using a pre-tested interviewer administered questionnaire.", "Systematic random sampling technique was used to select eligible households from which adolescents were interviewed Analysis of data was carried out using bivariate and multivariate linear regression analyses.", "The level of statistical significance was determined by a p value of < 0.05.", "The level of awareness of condoms and dual protection was similar in the intervention and non-intervention communities.", "However, the predictors of knowledge about condoms and dual protection were different between the intervention and non-intervention groups.", "The multivariate linear regression showed that the higher the level of education, the higher the level of awareness of contraception methods among adolescents (p < 0.05).", "Likewise, increasing age by one year and working for pay increased the awareness of condoms and dual protection(p < 0.05).", "There was no difference in the level of awareness of pregnancy prevention methods, knowledge of condoms and dual protection in both arms of the study.", "Higher level of education, increasing age, and working for pay are factors associated with awareness of condom and dual protection.", "These factors should be prioritized for effective Adolescent sexual and reproductive health (ASRH) programming." ]

[ "Adolescents who are unaware of infertility risk factors and the long-term health effects of their lifestyle choices may participate in unsafe sexual and lifestyle behaviors.", "Their reproductive goals and health may be affected by such behaviors.", "Adolescents' awareness of male and female infertility risk factors was assessed, along with lifestyle risk variables related to sexual behavior and psychoactive substance use.", "The causes of inconsistent condom use were also examined.", "In 2022, a cross-sectional survey was undertaken involving 598 sexually active university students from Nigeria (18.6 years±0.9), the majority of whom were female (57.2 %).", "Descriptive statistics, bivariate analysis, and binary logistic regression were utilized in the data analysis to determine the influence of lifestyle factors and levels of knowledge on fertility.", "Most participants had a moderate understanding of male and female infertility risk factors.", "The results showed that female students were more informed.", "Multiple sexual partners and psychoactive substance use were common lifestyle variables.", "Younger female students, those with several partners, and participants who frequently used alcohol and narcotics used condoms inconsistently.", "The study emphasizes the need for fertility health and lifestyle risk education for Nigerian youth.", "Despite moderate knowledge, lifestyle implications on fertility are unclear.", "Fertility health education in schools could help students make informed reproductive choices and lower the risk of infertility and chronic diseases.", "Research is needed to confirm findings and inform nationwide targeted interventions." ]

[ "Adolescents who experience potentially traumatic experiences (PTEs) have an increased risk of psychopathology.", "PTEs often co-occur and may form interrelated patterns of exposure.", "This study investigated underlying classes of PTE exposure among Norwegian adolescent participants in the youth@hordaland study, and whether such classes were associated with contact with child and adolescent mental health services (CAMHS) and psychiatric diagnoses.", "The data stem from the population-based youth@hordaland study conducted in 2012 which was linked to the Norwegian Patient Registry (NPR, n = 8845).", "Exposure to PTEs was assessed by adolescent self-report whereas psychiatric disorders (Axis 1) were derived from the NPR.", "Latent Class Analysis was used to identify distinct classes of PTE exposure-patterns in the data.", "Logistic regression analyses were performed to investigate associations between classes of PTEs and contact with CAMHS and psychiatric diagnoses.", "Three classes of PTE exposure were identified based on model fit indices and theoretical considerations.", "Compared with participants in the low trauma class (88% of participants), those in the Situational-(6%) and Interpersonal trauma class (6%) had higher odds-ratios (ORs) for contact with CAMHS (OR = 2.27 (95% CI [1.78, 2.87])) and (OR = 3.26 (95% CI [2.61, 4.04])) respectively, and for being diagnosed with a psychiatric disorder in CAMHS (ORs ranged from 2.19 - 10.4) after adjusting for sex and parental education.", "There were more participants diagnosed with ADHD within the Interpersonal trauma class compared to the Situational trauma class when adjusting for sex and parental education (OR = 2.22 (95% CI [1.17, 4.40])).", "Three relatively homogeneous PTE classes, consisting of distinct patterns of trauma exposure were associated with a higher odds of contact with CAMHS and of being diagnosed with a psychiatric disorder in CAMHS.", "The study highlights the co-occurrence of PTEs and their impact across the diagnostic spectrum." ]

[ "Adolescents' mental health literacy is a topic of growing interest and studies have begun to explore the factors that influence adolescents' mental health literacy.", "This study investigated the relationship between parents' mental health literacy and adolescents' mental health literacy, as well as the mediating roles of parent-child relationship, and the moderating roles of school mental health service.", "Questionnaires were distributed to adolescents and their parents at two time points with an interval of one month.", "In the first survey, 835 parents completed a mental health literacy scale and a parent-child relationship scale.", "In the second, 841 adolescents completed a school mental health service questionnaire and an adolescent mental health literacy assessment questionnaire.", "A total of 617 paired data points were matched (parents' age: M = 40.47, SD = 5.10; adolescents' age: M = 13.34, SD = 0.99).", "Bootstrapping results showed that parents' mental health literacy was positively associated with adolescents' mental health literacy.", "In addition, parent-child intimacy mediated the relationship between parents' mental health literacy and adolescents' mental health literacy.", "School mental health service moderated the relationship between parents' mental health literacy and parent-child intimacy and adolescents' mental health literacy.", "Intergenerational transmission of mental health literacy from parents to adolescents and its conditions were revealed.", "These findings provide new insights for the intervention of adolescents' mental health literacy, and may lead future research to investigate the role of parents within the family context, as well as the influence of home-school cooperation on adolescents' mental health literacy." ]

[ "Adopting change is something that is often resisted, as is often the case in the adoption of electronic health records (EHRs) in healthcare organizations.", "Embracing this will require computer knowledge to handle the system for the management of patients and their care.", "This study aims to determine the computer skills required for the uptake of electronic health records (EHR) by healthcare workers in an annex of the state teaching hospital, Okela Health Centre (OHC) Ado-Ekiti.", "The study uses a cross-sectional research design with a structured questionnaire distributed to 30 healthcare workers across seven disciplines working in the hospital.", "Descriptive statistics of frequency tables and percentages were used to ascertain the relationship between computer skill usage and the adoption of EHR.", "The majority of respondents were only efficient in Microsoft Word (MW), email, and WhatsApp, with efficiency rates of 63.4%, 76.6%, and 73.3%, respectively.", "The majority were not efficient in Microsoft Excel (ME) and Microsoft Access (MA), at 56.7% and 70%, respectively.", "Computer appreciation is an important basis for the adoption of EHR in hospitals." ]

[ "Adoption is frequently viewed as a way to complete the family because of the infertility that some families experience and the desire for kids and teenagers, especially orphans, to have a loving family.", "This work intends to identify and propose adaptation solutions to address the psychological problems faced by adoptive families.", "By doing so, it is hoped that the mental health and overall well-being of individuals and society as a whole will be enhanced.", "In the first stage of this study, the grounded theory approach based on Strauss and Corbin's methodology was used to interview representatives of adoptive families in Iran in 2022 and identify the problems they experience.", "In the second stage, the same approach and methodology were used to interview representatives of experts.", "In the second stage, the results of the first stage were presented to a sample of purposefully selected experts, who subsequently proposed solutions for the families to adapt to their problems.", "Data analysis was conducted using MAXQDA 2020 software (VERBI Software, Berlin, Germany).", "Ethical requirements were followed at every stage of the study.", "Four problem categories were identified in the first step of the study: legal-psychological problems, problems related to the growth of the child in an environment of social harm, attitude and worldview, and the resilience of the adoptive couple.", "In the second step of the study, four groups of solutions for psychological adjustment were extracted: explaining the issue of what, how, and why of adoption (correct identification of the problems faced by adoptive families, clarification of concepts and demystification, the need for research to address other gaps in the knowledge infrastructure, and the importance of critical thinking education), operational solutions (supervising the adoption database to become more efficient, unitization of adoption national institutes in each province, selection of officials based on both factors of professional and complete mental health, alignment of the provisions and other related legal matters between the involved institutions, and utilization of media influence are recommended, interactional solutions for family resilience (cognitive-therapeutic interactions for mental health based on flexibility, raising the family's social capacity through active counseling, improving problem-solving skills, fostering family self-efficacy, creating purposefulness, and appropriate beliefs to predict a bright future), attitude-changing solutions (redefining social norms and facilitating the adoption of desired attitudes by employing social psychology principles, exploiting the power of media and influential figures, employing techniques derived from the psychology of learning, establishing conducive conditions within the framework of individuals' cognitive dissonance to modify their attitudes, and employing persuasion strategies).", "Legislators and law enforcers, adoptive families, psychologists and consultants working in this field, and physicians specializing in infertility treatment can benefit from the findings of this study." ]

[ "Adult education targeting health literacy (HL) may bring added value in the form of improved health.", "This study evaluated the effects of a HL program as part of an adult education curriculum for adults with low literacy and numeracy.", "This was a partial-cluster randomized controlled trial among 308 adults enrolled in basic education programs in Australia.", "Of the 308 participants, 141 (46%) were randomized to either the standard program (language, literacy, and numeracy [LLN]), or the HL intervention (LLN with embedded health content); the remainder (n = 167) were allocated to standard intervention programs by the education provider at the class level.", "The main outcomes were functional HL, self-reported confidence, patient activation, generic HL (ie, HLQ, health knowledge, and self-reported health behavior).", "Data were collected at baseline, immediately after, and at 6 months post-intervention.", "Of the 308 participants, 71% had limited literacy and 60% spoke a language other than English at home.", "Both interventions benefited participants, with improvements from baseline to immediate follow up on individual-level functional HL (e.g., reading a thermometer; HL group 18.4% vs. standard group 7.2%; p = .001), confidence (HL group 0.34 vs. standard group 0.06; p = .014) and health literacy questionnaire (HLQ) subscales.", "At 6 months, improvements in confidence (p < .001) and some HLQ measures were retained.", "A consistent pattern of increased improvement in the HL program was observed compared to the standard program, although only some measures reached statistical significance: reading a food label (HL group 6.03/10 correct vs. standard group 5.49/10 correct; p = .022); confidence (p = .008); ability to actively manage health (HLQ) (p = .017), and health knowledge at 6 months (HL group 68% vs. standard group 60% correct, p = .052).", "HL participants reported being more likely to share course information and rated the program more useful to understand their health.", "Improving language, literacy, and numeracy generally has potential public health benefits that are retained at 6 months.", "Integrating health content adds further value to adult basic learning, is feasible, and potentially scalable.", "[HLRP: Health Literacy Research and Practice.", "2019;3(Suppl.):S42-S57.].", "We compared the effect of an adult education-based health literacy (HL) program versus a standard language, literacy, and numeracy program on students' HL skills and psychosocial outcomes.", "Although students in both trial arms improved their skills, students in the HL program had better outcomes with higher HL, greater confidence, and higher health knowledge scores at 6 months." ]

[ "Adult health outcomes are linked to childhood factors such as socioeconomic status via cultural health capital (CHC).", "Specifically, these factors shape opportunities for developing skills for navigating health environments via experience and the intergenerational transfer of health-related knowledge and skills.", "Health literacy (HL) is considered a part of and/or result of CHC.", "HL develops similarly to CHC via opportunities and experiences.", "Most research to date has ignored the effect of childhood factors on adult HL.", "The purpose of this study was to explore how childhood factors are related to adult HL.", "Data were collected from adults (N = 736, mean age = 40.65 years, standard deviation [SD] = 15.39; 52% female; 53.8% White, 31.3% Hispanic and Latino/a/e) in the United States using Qualtrics Panel.", "Multivariate ordinal and binary logistic regressions predicting HL (as measured by the Newest Vital Sign and Single-Item Literacy Scale) from childhood factors and accounting for demographic covariates were estimated.", "After accounting for covariates, such as the presence of an employed adult in a white-collar (odds ratio [OR] = 3.34) or blue-collar (OR = 3.68) occupation (versus unknown/not employed) increased the odds of being categorized as possible limited literacy and adequate literacy (versus limited literacy) as measured by the Newest Vital Sign.", "Similarly, having an employed adult during childhood who had a blue-collar occupation (vs. unknown/not employed) increased the odds of being categorized as adequate literacy (OR = 2.06) as measured by the Single-Item Literacy Scale.", "Because the adult's employment played a role in the child's adult HL after accounting for other factors and demographics, these findings support using a lifespan approach to assess and identify risk factors for lower HL.", "This study contributes to the growing body of evidence of how HL is interconnected with social determinants of health across the lifespan and the need to address HL skills in those with poor social determinants of health.", "[HLRP: Health Literacy Research and Practice.", "2024;8(2):e79-e88.", "]." ]

[ "Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality.", "Screening of psychosocial risk is prioritized by the Joint Commission.", "We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event.", "We conducted a prospective cohort study to test the prognostic utility of validated patient-reported measures, including health literacy, social support, health behaviors and disease management, and socioeconomic status.", "Cox survival analyses of mortality were conducted over a median of 3.5 years.", "Among 2977 adults hospitalized for either acute coronary syndrome or acute decompensated heart failure, the mean age was 53 years, and 60% were male.", "After adjusting for demographic, clinical, and other psychosocial factors, mortality risk was greatest among patients who reported being unemployed (hazard ratio [HR]: 1.99, 95% confidence interval [CI]): 1.30-3.06), retired (HR: 2.14, 95% CI: 1.60-2.87), or unable to work due to disability (HR: 2.36, 95% CI: 1.73-3.21), as compared to those who were employed.", "Patient-reported perceived health competence (PHCS-2) and exercise frequency were also associated with mortality risk after adjusting for all other variables (HR: 0.86, 95% CI: 0.73-1.00 per four-point increase in PHCS-2; HR: 0.86, 95% CI: 0.77-0.96 per 3-day increase in exercise frequency, respectively).", "Patient-reported measures of employment status, perceived health competence, and exercise frequency independently predict mortality after a cardiac hospitalization.", "Incorporating these brief, valid measures into hospital-based screening may help with prognostication and targeting patients for resources during post-discharge transitions of care." ]

[ "Adults with rare autoimmune rheumatic diseases face unique challenges and struggles to navigate health-care systems designed to manage common conditions.", "Evidence to inform an optimal service framework for their care is scarce.", "Using systemic vasculitis as an exemplar, we aimed to identify and explain the key service components underpinning effective care for rare diseases.", "In this mixed-methods study, data were collected as part of a survey of vasculitis service providers across the UK and Ireland, interviews with patients, and from organisational case studies to identify key service components that enable good care.", "The association between these components and patient outcomes (eg, serious infections, mortality) and provider outcomes (eg, emergency hospital admissions) were examined in a population-based data linkage study using routine health-care data obtained from patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis from national health datasets in Scotland.", "We did univariable and multivariable analyses using Bayesian poisson and negative binomial regression to estimate incident rate ratios (IRRs), and Cox proportional hazards models to estimate hazard ratios (HRs).", "People with lived experiences were involved in the research and writing process.", "Good care was characterised by service components that supported timely access to services, integrated care, and expertise.", "In 1420 patients with ANCA-associated vasculitis identified from national health datasets, service-reported average waiting times for new patients of less than 1 week were associated with fewer serious infections (IRR 0·70 [95% credibility interval 0·55-0·88]) and fewer emergency hospital admissions (0·78 [0·68-0·92]).", "Nurse-led advice lines were associated with fewer serious infections (0·76 [0·58-0·93]) and fewer emergency hospital admissions (0·85 [0·74-0·96]).", "Average waiting times for new patients of less than 1 week were also associated with reduced mortality (HR 0·59 [95% credibility interval 0·37-0·93]).", "Cohorted clinics, nurse-led clinics, and specialist vasculitis multi-disciplinary team meetings were associated with fewer serious infections (IRR 0·75 [0·59-0·96] for cohorted clinics; 0·65 [0·39-0·84] for nurse-led clinics; 0·72 [0·57-0·90] for specialist vasculitis multi-disciplinary team meetings) and emergency hospital admissions (0·81 [0·71-0·91]; 0·75 [0·65-0·94]; 0·86 [0·75-0·96]).", "Key components were characterised by their ability to overcome professional tensions between specialties.", "Key service components associated with important health outcomes and underpinning factors were identified to inform initiatives to improve the design, delivery, and effectiveness of health-care models for rare autoimmune rheumatic diseases.", "Versus Arthritis." ]

[ "Advance care planning enables people to record their future health and care wishes and appoint someone as an advocate.", "An advance directive can be made in the event that a person is incapacitated, so that their wishes are still upheld.", "The beliefs of the nephrology team might affect patients' choices and willingness to sign an advance directive.", "To increase the number of dialysis patients who have signed an advance directive, it is necessary to educate the nephrology medical staff.", "To explore the intention to sign an advance directive and its related factors among nephrology medical staff.", "A cross-sectional and correlational design was used.", "This study recruited 160 nephrology medical staff.", "Data were analysed by using the Statistical Package for Social Science 21.0 for Windows.", "The results found that the longer someone has worked as part of the nephology medical staff, the more knowledgeable they were about an advance directive.", "This led to them being more likely to want to sign an advance directive for themselves.", "In order to improve the knowledge and awareness of advance directives among nephrology medical staff, hospital managers should provide continuing education on this topic." ]

[ "Advance care planning is vital for ensuring individuals receive end-of-life care that is consistent with their care preferences and improves patient quality of life and satisfaction with care; however, only 11% of Americans have discussed advance care planning with a healthcare provider.", "Individuals with limited health literacy are even less likely to participate in advance care planning due to difficulty comprehending complex health information.", "The purpose of this review was to identify randomized controlled trials designed to address the effects of limited health literacy on advance care planning, evaluate the quality of these studies, and summarize evaluation data to inform future studies.", "This systematic review examined randomized controlled trials published from January 1997 to July 2020 using the PubMed, CINAHL, PsycINFO, and Scopus databases.", "Data were extracted and two reviewers independently evaluated the quality of studies using the Joanna Briggs Institute Critical Appraisal Tool.", "The database search yielded 253 studies and five studies were included in the final review.", "Studies were conducted in mostly White patients in outpatient clinics in the United States.", "Researchers wrote text at lower reading levels, added images to materials, and created videos to enhance communication.", "Health literacy interventions increased participant knowledge, preference for comfort care, engagement, and care documentation; however, several methodological issues were identified, including baseline differences in treatment and control groups, issues with blinding, lack of valid and reliable outcome measures, and inappropriate statistical analyses.", "More high-quality intervention studies that address the effects of limited health literacy on advance care planning in diverse populations and settings are needed.", "Future intervention studies should use reliable and valid instruments to measure advance care planning outcomes.", "Clinicians should use materials appropriate for their patients' health literacy levels to address their advance care planning needs." ]

[ "Advanced diagnostic bronchoscopy includes endobronchial ultrasound (EBUS) guided transbronchial lung and lymph node biopsies, CT navigation and robotic bronchoscopy.", "Interventional bronchoscopy refers to procedures performed for therapeutic purposes such as balloon dilation of the airway, tissue debulking, cryotherapy, removal of foreign bodies and insertion of endobronchial valves [1].", "For adult patients, these procedures are standard of care [2, 3].", "Despite a lack of formalized training, there are numerous case reports and case series describing the use of advanced diagnostic and interventional bronchoscopy techniques in children.", "The safety and feasibility of EBUS-TBNA, cryotherapy techniques, endobronchial valves among other techniques have been demonstrated in these publications [1, 4-9].", "We sought to better understand the current practices and perspectives on interventional and advanced bronchoscopy among pediatric pulmonologists through surveys sent to pediatric teaching hospitals across the United States.", "We received 43 responses representing 28 programs from 25 states.", "The highest bronchoscopy procedure volume occurred in the 0-5 years age group.", "Among our respondents, 31% self-identified as a pediatric interventional/advanced bronchoscopist.", "79% believe that advanced and interventional training is feasible in pediatric pulmonology and 77% believe it should be offered to pediatric pulmonary fellows.", "This is the first study to characterize current practices and perspectives regarding advanced diagnostic and interventional bronchoscopy procedures among pediatric pulmonologists in the United States.", "Pediatric interventional pulmonology (IP) is in its infancy and its beginnings echo those of the adult IP where only certain centers were performing these procedures." ]

[ "Advanced hybrid closed loop (AHCL) therapy can improve glycaemic control in pregnant women with type 1 diabetes.", "However, data are needed on the efficacy and safety of AHCL systems as these systems, such as the MiniMed 780G, are not currently approved for use in pregnant women.", "We aimed to investigate whether the MiniMed 780G can improve glycaemic control with less hypoglycaemia in pregnant women with type 1 diabetes.", "CRISTAL was a double-arm, parallel-group, open-label, randomised controlled trial conducted in secondary and tertiary care specialist endocrinology centres at 12 hospitals (11 in Belgium and one in the Netherlands).", "Pregnant women aged 18-45 years with type 1 diabetes were randomly assigned (1:1) to AHCL therapy (MiniMed 780G) or standard insulin therapy (standard of care) at a median of 10·1 (IQR 8·6-11·6) weeks of gestation.", "Randomisation was done centrally with minimisation dependent on baseline HbA1c, insulin administration method, and centre.", "Participants and study teams were not masked to group allocation.", "The primary outcome was proportion of time spent in the pregnancy-specific target glucose range (3·5-7·8 mmol/L), measured by continuous glucose monitoring (CGM) at 14-17 weeks, 20-23 weeks, 26-29 weeks, and 33-36 weeks.", "Key secondary outcomes were overnight time in target range, and time below glucose range (<3·5 mmol/L) overall and overnight.", "Analyses were conducted on an intention-to-treat basis.", "This trial is registered with ClinicalTrials.gov (NCT04520971).", "Between Jan 15, 2021 and Sept 30, 2022, 101 participants were screened, and 95 were randomly assigned to AHCL therapy (n=46) or standard insulin therapy (n=49).", "43 patients assigned to AHCL therapy and 46 assigned to standard insulin therapy completed the study.", "At baseline, 91 (95·8%) participants used insulin pumps, and the mean HbA1c was 6·5% (SD 0·6).", "The mean proportion of time spent in the target range (averaged over four time periods) was 66·5% (SD 10·0) in the AHCL therapy group compared with 63·2% (12·4) in the standard insulin therapy group (adjusted mean difference 1·88 percentage points [95% CI -0·82 to 4·58], p=0·17).", "Overnight time in the target range was higher (adjusted mean difference 6·58 percentage points [95% CI 2·31 to 10·85], p=0·0026), and time below range overall (adjusted mean difference -1·34 percentage points [95% CI, -2·19 to -0·49], p=0·0020) and overnight (adjusted mean difference -1·86 percentage points [95% CI -2·90 to -0·81], p=0·0005) were lower with AHCL therapy than with standard insulin therapy.", "Participants assigned to AHCL therapy reported higher treatment satisfaction.", "No unanticipated safety events occurred with AHCL therapy.", "In pregnant women starting with tighter glycaemic control, AHCL therapy did not improve overall time in target range but improved overnight time in target range, reduced time below range, and improved treatment satisfaction.", "These data suggest that the MiniMed 780G can be safely used in pregnancy and provides some additional benefits compared with standard insulin therapy; however, it will be important to refine the algorithm to better align with pregnancy requirements.", "Diabetes Liga Research Fund and Medtronic." ]

[ "Advanced practice registered nurses (APRNs) and physician assistants (PAs) are integral to health care delivery in the United States.", "However, the cultivation of APRNs and PAs relies heavily on the model of precepting.", "Advanced practice registered nurses and PAs frequently precept students or new hires, yet limited data are available to describe the motivations, incentives, and barriers associated with precepting.", "The purpose of this mixed-method, cross-sectional study was to better understand APRN and PA preceptors' perceived levels of support during precepting, facilitating factors, and barriers to the precepting process.", "An electronic survey was distributed via REDCap to a convenience sample of APRN and PA preceptors at an academic medical center.", "Data collected from the survey were analyzed using both descriptive statistics and qualitative thematic analysis.", "One hundred fifty-four participants completed the survey.", "Motivating factors for precepting included \"giving back\" to the profession, and barriers included inadequate time to precept while in the clinical role.", "Participants indicated that financial incentives, heightened communication, protected teaching time, preceptor training, meaningful recognition, and organizational support could enhance the precepting process.", "This study demonstrated that altruistic intentions frequently motivate APRN and PA preceptors, however, navigating multiple clinical responsibilities while precepting serves as a barrier to the precepting process.", "Preceptor training, ongoing education, dedicated time for precepting, enhanced communication, and organizational or professional incentives may optimize the APRN and PA precepting process.", "Further research should focus on how to optimally incorporate education, professional development, support, and incentives into the APRN and PA preceptor role." ]

[ "Advanced therapies offer unprecedented opportunities for treating rare neurological disorders (RNDs) in children.", "However, health literacy, perceptions and understanding of novel therapies need elucidation across the RND community.", "This study explored healthcare professionals' and carers' perspectives of advanced therapies in childhood-onset RNDs.", "In this mixed-methodology cross-sectional study, 20 healthcare professionals (clinicians, genetic counsellors and scientists) and 20 carers completed qualitative semistructured interviews and custom-designed surveys.", "Carers undertook validated psychosocial questionnaires.", "Thematic and quantitative data analysis followed.", "Participants described high positive interest in advanced therapies, but low knowledge of, and access to, reliable information.", "The substantial 'therapeutic gap' and 'therapeutic odyssey' common to RNDs were recognised in five key themes: (i) unmet need and urgency for access; (ii) seeking information; (iii) access, equity and sustainability; (iv) a multidisciplinary and integrated approach to care and support and (v) difficult decision-making.", "Participants were motivated to intensify RND clinical trial activity and access to advanced therapies; however, concerns around informed consent, first-in-human trials and clinical trial procedures were evident.", "There was high-risk tolerance despite substantial uncertainties and knowledge gaps.", "RNDs with high mortality, increased functional burdens and no alternative therapies were consistently prioritised for the development of advanced therapies.", "However, little consensus existed on prioritisation to treatment access.", "This study highlights the need to increase clinician and health system readiness for the clinical translation of advanced therapeutics for RNDs.", "Co-development and use of educational and psychosocial resources to support clinical decision-making, set therapeutic expectations and promotion of equitable, effective and safe delivery of advanced therapies are essential.", "Participant insights into the psychosocial burden and information need to enhance the delivery of care in this formative study are informing ongoing partnerships with families, including co-production and dissemination of psychoeducational resources featuring their voices hosted on the Sydney Children's Hospitals Network website SCHN Brain-Aid Resources." ]

[ "Advancement of research in education has propelled the augmentation of theoretical and practical knowledge in learning-oriented feedback.", "In recent years, the channels, modes, and orientations of feedback became manifold.", "Copious empirical evidence from the body of literature supported the strength of feedback in enhancing learning outcomes and promoting the motivation of learners.", "However, compared to the popularity in implementation and fruitfulness of findings in other educational domains, the application of state-of-the-art technology-enhanced feedback in fostering students' L2 oral abilities remain few and far between.", "To address the knowledge gap, the present study endeavored to investigate the effect of Danmaku-based and synchronous peer feedback on L2 oral performance and the acceptance thereof among students.", "Adopting a mixed-method design, the study recruited 74 (n = 74) undergraduate English majors from a Chinese university for a 16-week 2x2 experiment.", "The collected data were analyzed through statistical and thematic analysis respectively.", "The findings revealed that Danmaku-based and synchronous peer feed-back was impactful on students' performance in L2 oral production.", "Furthermore, the impacts of peer feedback on subdomains of L2 competence were statistically analyzed.", "Regarding students' perceptions, the incorporation of peer feedback was generally favored by participants who were satisfied and motivated in the learning process but lacked confidence in their assessment literacy.", "Furthermore, students expressed their agreement with the benefit of reflective learning and the subsequent enrichment in knowledge and horizon.", "The research was significant for its conceptual and practical contribution for follow-up researchers and educators in L2 education and learning-oriented feedback." ]

[ "Advances in artificial intelligence (AI) have given rise to sophisticated algorithms capable of generating human-like text.", "The goal of this study was to evaluate the ability of human reviewers to reliably differentiate personal statements (PS) written by human authors from those generated by AI software.", "Four personal statements from the archives of two surgical program directors were de-identified and used as the human samples.", "Two AI platforms were used to generate nine additional PS.", "Four surgeons from the residency selection committees of two surgical residency programs of a large multihospital system served as blinded reviewers.", "AI was also asked to evaluate each PS sample for authorship.", "Sensitivity, specificity and accuracy of the reviewers in identifying the PS author were calculated.", "Kappa statistic for correlation between the hypothesized author and the true author were calculated.", "Inter-rater reliability was calculated using the kappa statistic with Light's modification given more than two reviewers in a fully-crossed design.", "Logistic regression was performed with to model the impact of perceived creativity, writing quality, and authorship or the likelihood of offering an interview.", "Human reviewer sensitivity for identifying an AI-generated PS was 0.87 with specificity of 0.37 and overall accuracy of 0.55.", "The level of agreement by kappa statistic of the reviewer estimate of authorship and the true authorship was 0.19 (slight agreement).", "The reviewers themselves had an inter-rater reliability of 0.067 (poor), with only complete agreement (four out of four reviewers) on two PS, both authored by humans.", "The odds ratio of offering an interview (compared to a composite of \"backup\" status or no interview) to a perceived human author was 7 times that of a perceived AI author (95% confidence interval 1.5276 to 32.0758, p=0.0144).", "AI hypothesized human authorship for twelve of the PS, with the last one \"unsure.\"", "The increasing pervasiveness of AI will have far-reaching effects including on the resident application and recruitment process.", "Identifying AI-generated personal statements is exceedingly difficult.", "With the decreasing availability of objective data to assess applicants, a review and potential restructuring of the approach to resident recruitment may be warranted." ]

[ "Advances in computer technology, patient monitoring systems, and electronic health record systems have enabled rapid accumulation of patient data in electronic form (i.e.", "big data).", "Organizations such as the Anesthesia Quality Institute and Multicenter Perioperative Outcomes Group have spearheaded large-scale efforts to collect anaesthesia big data for outcomes research and quality improvement.", "Analytics--the systematic use of data combined with quantitative and qualitative analysis to make decisions--can be applied to big data for quality and performance improvements, such as predictive risk assessment, clinical decision support, and resource management.", "Visual analytics is the science of analytical reasoning facilitated by interactive visual interfaces, and it can facilitate performance of cognitive activities involving big data.", "Ongoing integration of big data and analytics within anaesthesia and health care will increase demand for anaesthesia professionals who are well versed in both the medical and the information sciences." ]

[ "Advances in deep learning and computer vision have overcome many challenges inherent in the field of autonomous intelligent vehicles.", "To improve the detection accuracy and efficiency of EdgeBoard intelligent vehicles, we proposed an optimized design of EdgeBoard based on our PP-YOLOE+ model.", "This model innovatively introduces a composite backbone network, incorporating deep residual networks, feature pyramid networks, and RepResBlock structures to enrich environmental perception capabilities through the advanced analysis of sensor data.", "The incorporation of an efficient task-aligned head (ET-head) in the PP-YOLOE+ framework marks a pivotal innovation for precise interpretation of sensor information, addressing the interplay between classification and localization tasks with high effectiveness.", "Subsequent refinement of target regions by detection head units significantly sharpens the system's ability to navigate and adapt to diverse driving scenarios.", "Our innovative hardware design, featuring a custom-designed mainboard and drive board, is specifically tailored to enhance the computational speed and data processing capabilities of intelligent vehicles.", "Furthermore, the optimization of our Pos-PID control algorithm allows the system to dynamically adjust to complex driving scenarios, significantly enhancing vehicle safety and reliability.", "Besides, our methodology leverages the latest technologies in edge computing and dynamic label assignment, enhancing intelligent vehicles' operations through seamless sensor integration.", "Our custom dataset, specifically designed for this study, includes 4777 images captured by intelligent vehicles under a variety of environmental and lighting conditions.", "The dataset features diverse scenarios and objects pertinent to autonomous driving, such as pedestrian crossings and traffic signs, ensuring a comprehensive evaluation of the model's performance.", "We conducted extensive testing of our model on this dataset to thoroughly assess sensor performance.", "Evaluated against metrics including accuracy, error rate, precision, recall, mean average precision (mAP), and F1-score, our findings reveal that the model achieves a remarkable accuracy rate of 99.113%, an mAP of 54.9%, and a real-time detection frame rate of 192 FPS, all within a compact parameter footprint of just 81 MB.", "These results demonstrate the superior capability of our PP-YOLOE+ model to integrate sensor data, achieving an optimal balance between detection accuracy and computational speed compared with existing algorithms." ]

[ "Advances in simulations, combined with technological developments in high-performance computing, have made it possible to produce a physically accurate dynamic representation of complex biological systems involving millions to billions of atoms over increasingly long simulation times.", "The analysis of these computed simulations is crucial, involving the interpretation of structural and dynamic data to gain insights into the underlying biological processes.", "However, this analysis becomes increasingly challenging due to the complexity of the generated systems with a large number of individual runs, ranging from hundreds to thousands of trajectories.", "This massive increase in raw simulation data creates additional processing and visualization challenges.", "Effective visualization techniques play a vital role in facilitating the analysis and interpretation of molecular dynamics simulations.", "In this paper, we focus mainly on the techniques and tools that can be used for visualization of molecular dynamics simulations, among which we highlight the few approaches used specifically for this purpose, discussing their advantages and limitations, and addressing the future challenges of molecular dynamics visualization." ]

[ "Advances in single-cell biotechnology have increasingly revealed interactions of cells with their surroundings, suggesting a cellular society at the microscale.", "Similarities between cells and humans across multiple hierarchical levels have quantitative inference potential for reaching insights about phenotypic interactions that lead to morphological forms across multiple scales of cellular organization, namely cells, tissues and organs.", "Here, the functional and structural comparisons between how cells and individuals fundamentally socialize to give rise to the spatial organization are investigated.", "Integrative experimental cell interaction assays and computational predictive methods shape the understanding of societal perspective in the determination of the cellular interactions that create spatially coordinated forms in biological systems.", "Emerging quantifiable models from a simpler biological microworld such as bacterial interactions and single-cell organisms are explored, providing a route to model spatio-temporal patterning of morphological structures in humans.", "This analogical reasoning framework sheds light on structural patterning principles as a result of biological interactions across the cellular scale and up." ]

[ "Advances in single-cell level analytical techniques, especially cytometric approaches, have led to profound innovation in biomedical research, particularly in the field of clinical immunology.", "This has resulted in an expansion of high-dimensional data, posing great challenges for comprehensive and unbiased analysis.", "Conventional manual analysis is thus becoming untenable to handle these challenges.", "Furthermore, most newly developed computational methods lack flexibility and interoperability, hampering their accessibility and usability.", "Here, we adapted Seurat, an R package originally developed for single-cell RNA sequencing (scRNA-seq) analysis, for high-dimensional flow cytometric data analysis.", "Based on a 20-marker antibody panel and analyses of T-cell profiles in both adult blood and cord blood (CB), we showcased the robust capacity of Seurat in flow cytometric data analysis, which was further validated by Spectre, another high-dimensional cytometric data analysis package, and conventional manual analysis.", "Importantly, we identified a unique CD8+ T-cell population defined as CD8+CD45RA+CD27+CD161+ T cell that was predominantly present in CB.", "We characterised its IFN-γ-producing and potential cytotoxic properties using flow cytometry experiments and scRNA-seq analysis from a published dataset.", "Collectively, we identified a unique human CB CD8+CD45RA+CD27+CD161+ T-cell subset and demonstrated that Seurat, a widely used package for scRNA-seq analysis, possesses great potential to be repurposed for cytometric data analysis.", "This facilitates an unbiased and thorough interpretation of complicated high-dimensional data using a single analytical pipeline and opens a novel avenue for data-driven investigation in clinical immunology." ]

[ "Advances in technology and artificial intelligence (smart healthcare) open up a range of possibilities for precision intervention in the field of health sciences.", "The objectives of this study were to analyse the functionality of using supervised (prediction and classification) and unsupervised (clustering) machine learning techniques to analyse results related to the development of functional skills in patients at developmental ages of 0-6 years.", "We worked with a sample of 113 patients, of whom 49 were cared for in a specific centre for people with motor impairments (Group 1) and 64 were cared for in a specific early care programme for patients with different impairments (Group 2).", "The results indicated that in Group 1, chronological age predicted the development of functional skills at 85% and in Group 2 at 65%.", "The classification variable detected was functional development in the upper extremities.", "Two clusters were detected within each group that allowed us to determine the patterns of functional development in each patient with respect to functional skills.", "The use of smart healthcare resources has a promising future in the field of early care.", "However, data recording in web applications needs to be planned, and the automation of results through machine learning techniques is required." ]

[ "Advances in technology are changing surgical education.", "Simulation provides an important adjunct to operative experience.", "This pedagogy has arguably become more important in light of the COVID-19 pandemic, with resultant reduction in operative exposure for trainees.", "Virtual reality (VR) simulators may provide significant contribution to experiential learning; however, much of the investigative focus to date has, correctly, been on establishing validity evidence for these constructs.", "The aim of this work was to perform a scoping review to assess the current status of VR simulation education to determine curricular development efforts for orthopedic residents.", "With a trained medical librarian, searches of PubMed, EMBASE, and Web of Science were conducted for all articles in the last 10 years (September 2011-September 2021).", "Controlled vocabulary Medical Subject Headings (MeSH) terms and natural language developed with subject matter experts describing virtual reality or VR simulation and orthopedic training were used.", "Two trained reviewers evaluated all abstracts for inclusion.", "Exclusion criteria were all articles that did not assess VR simulation education involving orthopedic residents.", "Data were extracted from the included full-text articles including: study design, type of participants, type of VR simulation, simulated orthopedic skill, type of educational event, learner assessment including Kirkpatrick's level, assessment of quality using the Medical Education Research Study Quality Instrument (MERSQI), and level of effectiveness (LoE).", "Initial search identified 1,394 articles, of which 61 were included in the final qualitative synthesis.", "The majority (54%) were published in 2019- 2021, 49% in Europe.", "The commonest VR simulator was ArthroS (23%) and the commonest simulated skill was knee arthroscopy (33%).", "The majority of studies (70%) focused on simulator validation.", "Twenty-three studies described an educational module or curriculum, and of the 21 (34%) educational modules, 43% were one-off events.", "Most modules (18/21, 86%) assessed learners at Kirkpatrick level 2.", "With regard to methodological quality, 44% of studies had MERSQI 11.5-15 and 89% of studies had LoE of 2.", "Two studies had LoE of 3.", "Current literature pertaining to VR training for orthopedic residents is focused on establishing validity and rarely forms part of a curriculum.", "Where the focus is education, the majority are discrete educational modules and do not teach a comprehensive amalgam of orthopedic skills.", "This suggests focus is needed to embed VR simulation training within formal curricula efforts guided by the work of Kern, and assess the efficacy of these against patient outcomes." ]

[ "Adverse Childhood Experience (ACE) has detrimental impacts on neural development, especially hippocampal morphometry.", "Mindfulness-Based Interventions (MBI) has been shown to induce adaptive hippocampal changes especially at the subiculum.", "The present study aims to investigate the effects of MBI on subiculum volumes among ACE survivors, as well as the effects on episodic memory as a probe into hippocampal functionality.", "We analyzed anatomical MRI data and performance indices from an episodic memory task called the Mnemonic Similarity Task (MST) collected from a randomized controlled longitudinal study that compared an 8-week MBI (N = 20) to an active control condition of Stress Management Education (SME) (N = 19).", "FreeSurfer 6.0 was used for automated hippocampal subfield segmentation and volumetric estimation.", "Significant group differences were observed with the volumetric changes of the right whole hippocampus and right subiculum.", "Only the MBI group showed improved pattern separation capability from MST, which was associated with stress reduction and right subiculum volumetric changes.", "Modest sample size.", "MST task was performed outside of MRI.", "These findings suggest beneficial effects of MBI for hippocampal volumes and episodic memory, while highlighting the importance of the subiculum for MBI-induced neural and cognitive changes.", "The subiculum's known role in inhibitory control was interpreted as a potential mechanism for it to exhibit MBI-induced volumetric changes, which sheds light on the potential neural underpinnings of mindfulness meditation for reducing stress reactivity among ACE survivors." ]

[ "Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur before the age of 18.", "Researchers have examined the negative associations between adversity and adolescent and adult outcomes, such as education and physical health.", "However, research on ACEs, and their association with other outcomes in non-western contexts is sparse.", "The present study aims to increase our understanding of the prevalence of ACEs - and their association with educational aspirations - in low- and middle-income country contexts.", "We utilize data from the Family Migration and Early Life Outcomes (FAMELO) project, a multi-site survey project that collected data from families in historically high-migration contexts.", "ACEs and educational aspirations were measured in children aged 11 to17 years in Mexico (n = 853), Mozambique (n = 651), and Nepal (n = 1180).", "We use Poisson regressions to examine the prevalence of ACEs in multiple cultures, and then use multinomial logistic regressions to examine whether ACEs are associated with educational aspirations, as a practical application of the utility of the ACEs framework in cross-cultural contexts.", "Our results suggest that adolescents in Mozambique have a higher average number of ACEs (2.7) than adolescents in Mexico (1.4) and Nepal (1.3).", "Female adolescents reported fewer ACEs, while socioeconomic vulnerabilities (low-income and low parental education) were associated with higher exposure to ACEs, with differences by country.", "Lastly, ACEs were associated with lower educational aspirations in Mexico and Nepal.", "Our study attempted to heed the call of many scholars who have pushed for an expansion of research on ACEs in non-western, low- and middle-income country contexts." ]

[ "Adverse drug events (ADEs) are associated with poor outcomes and increased costs but may be prevented with prediction tools.", "With the National Institute of Health All of Us (AoU) database, we employed machine learning (ML) to predict selective serotonin reuptake inhibitor (SSRI)-associated bleeding.", "The AoU program, beginning in 05/2018, continues to recruit ≥ 18 years old individuals across the United States.", "Participants completed surveys and consented to contribute electronic health record (EHR) for research.", "Using the EHR, we determined participants who were exposed to SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, vortioxetine).", "Features (n = 88) were selected with clinicians' input and comprised sociodemographic, lifestyle, comorbidities, and medication use information.", "We identified bleeding events with validated EHR algorithms and applied logistic regression, decision tree, random forest, and extreme gradient boost to predict bleeding during SSRI exposure.", "We assessed model performance with area under the receiver operating characteristic curve statistic (AUC) and defined clinically significant features as resulting in > 0.01 decline in AUC after removal from the model, in three of four ML models.", "There were 10,362 participants exposed to SSRIs, with 9.6% experiencing a bleeding event during SSRI exposure.", "For each SSRI, performance across all four ML models was relatively consistent.", "AUCs from the best models ranged 0.632-0.698.", "Clinically significant features included health literacy for escitalopram, and bleeding history and socioeconomic status for all SSRIs.", "We demonstrated feasibility of predicting ADEs using ML.", "Incorporating genomic features and drug interactions with deep learning models may improve ADE prediction." ]

[ "Adverse health events within families can harm children's development, including their early literacy.", "Using data from a longitudinal Wisconsin birth cohort, we estimated the spillover effect of younger siblings' gestational ages on older siblings' kindergarten-level literacy.", "We sampled 20,014 sibling pairs born during 2007-2010 who took Phonological Awareness Literacy Screening-Kindergarten tests during 2012-2016.", "Exposures were gestational age (completed weeks), preterm birth (gestational age <37 weeks), and very preterm birth (gestational age <32 weeks).", "We used gain-score regression-a fixed effects strategy-to estimate spillover effect.", "A one-week increase in younger siblings' gestational age improved the older siblings' test score by 0.011 SD (95% confidence interval: 0.001, 0.021 SD).", "The estimated spillover effect was larger among siblings whose mothers reported having a high school diploma/equivalent only (0.024 SD; 95% CI: 0.004, 0.044 SD).", "The finding underscores the networked effects of one individual's early-life health shocks on their family members." ]

[ "Advertising is one of the most important solutions that health centers and medical services around the world use to try to encourage public opinion to create a positive attitude towards preventive measures and vaccination.", "This study has been done with the aim of text analysis of billboards and infographics related to promoting preventive behaviors and vaccination against the coronavirus pandemic and providing solutions and models for preventive information and advertising in the field of health.", "The study method in this research is a combination of qualitative and content analysis.", "Data collection was done in a targeted manner.", "The sample size includes 33 advertising billboards and infographics.", "Data collection has been done through searching the sites and websites of health networks and medical education centers in Iran, taking pictures of infographics and billboards in public places, and also receiving archive files of pictures from the public relations of health networks and medical services.", "The data was collected from February 19, 2020 to December 30, 2022 (the time frame of the pandemic and public vaccination program in Iran).", "The data was analyzed based on the three-dimensional discourse analysis theory of Fairclough.", "Then, an online survey about promoting preventive behaviors and vaccination against the coronavirus pandemic in the format of billboards and infographics was designed in SurveyMonkey and its link was provided to the audience through virtual networks and other platforms.", "The age group of people was selected from 18 to 70 years.", "Considering that the number of participants should be representative of the entire community under investigation, therefore, based on Cochran's formula, the sample size was equal to 350 people.", "Finally, users' opinions were analyzed using descriptive statistics.", "The assessment of validity involved experts in infection control and linguistics.", "The reliability of the measurement, determined through the Cronbach's alpha internal consistency coefficient, yielded a coefficient of 0.968.", "The results show that among the four linguistic components of words, syntax, coherence and text structure; \"live metaphors\", \"pronoun \"we\", \"collocation and reference\", and \"attitude markers\" have the most impact on the audience.", "The frequency percentage of the data shows that these language elements have tremendous power in attracting the audience to perform preventive behaviors.", "The results show that the language reflects the culture, opinions and needs of people in the society.", "Also, the results show that encouraging people to perform preventive behaviors should be through the integration of medical information with motivational linguistic factors in order to attract the audience more.", "It can be concluded that the use of the appropriate pattern of medical advertising discourse and correct communication strategies, will help public participation in the field of epidemic control.", "The language of effective health education and health communication during an epidemic must be related to the ways of thinking and speaking of ordinary people.", "Also, words with metaphorical and ironic meanings have a high potential to influence the health performance of people in society and increase public awareness of health communication.", "Therefore, using them to create a new value system with the aim of controlling and overcoming the consequences of the epidemic is very effective." ]

[ "Advocacy is a critical component of pediatric training and practice.", "Pediatric resident advocacy experiences include skill development and real-world projects, but little is known about how pediatric residents participate in advocacy.", "Without this knowledge, educators run the risk of underpreparing residents for the full scope of advocacy work.", "This study sought to investigate how residents participate in advocacy by characterizing their projects using an evidence-informed conceptual framework and describing the unique lessons were learned by the residents.", "The authors used principles of thematic analysis to interrogate existing documents derived from pediatric residents from 2013 to 2021 at 1 institution.", "They purposefully sampled and deidentified project proposals and written reflections.", "Using a constant comparative method, they created codes.", "Codes, connections between codes, and findings were refined by discussion.", "Residents demonstrated 4 different types of advocacy: some residents participated in directed agency or activism and others focused on shared agency or activism.", "Residents reflected on different learning experiences; residents who participated in shared forms of advocacy learned skills such as \"Partnering,\" \"Evaluating,\" and \"Planning.\"", "Residents who were involved in directed forms of advocacy shared lessons on \"Leading,\" \"Presenting,\" and \"Intervening.\"", "Advocacy work also changed over time: in later projects (2016-2021) residents took ownership of the role of \"advocate\"; social and political climate was salient in reflections.", "Pediatric residents advocate through shared activism and agency and directed activism and agency.", "Educators should recognize, support, and supplement the experiences of residents as they participate in different types of advocacy." ]

[ "Advocates and researchers have made many recommendations for forensic science improvement in the United States.", "These proposals are often motivated by wrongful convictions related to false or misleading forensic evidence.", "In many cases, the connection between the proposals and the actual experience of wrongful convictions has not been well defined.", "Further, recommendations may not have been realizable given the structure of the criminal justice system in the United States and the practical realities of forensic science laboratories.", "Finally, limited attempts have been made to assess recommendations over time to determine the progress of forensic science improvement and elucidate continuing gaps.", "Reports from the Department of Justice, the National Academy of Sciences, and the President's Council of Advisors on Science and Technology are assessed to determine the extent to which their recommendations have been implemented, whether the recommendations align with the actual experience of wrongful convictions, and how the American forensic science community has implemented forensic science improvement.", "The most successful proposals reflect a broad movement toward quality assurance, improved standards, and organizational improvement in the forensic sciences.", "Less successful proposals are associated with calls for large federal investments, difficulties in community-wide implementation, or uncertain linkage to foundations in science and practice.", "Significant progress has been made in the standardization of reporting and testimony, assessment of the foundational reliability of the disciplines, and DNA mixture interpretation.", "Significant gaps remain to improve medicolegal death investigation, governance, and the implementation of standards.", "Improved allocation and use of resources will be required to meet continuing challenges in capacity building, training, and proficiency testing, although past experience indicates that both federal and non-federal funding will be required to address these issues.", "Continued improvement is needed to address the issues associated with wrongful convictions, although forensic science leaders have demonstrated the ability to prioritize improvement initiatives." ]

[ "Africa has one of the highest burdens of cervical cancer in the world.", "The unacceptably high incidence and mortality rates could be reduced through implementing a comprehensive approach to its prevention and control that includes screening, which however, is low in most low-and-middle-income countries.", "Hence, this systematic review aims at exploring factors that prevent women from utilising cervical cancer screening services in the region.", "A mixed method systematic review was conducted.", "A search was performed on PubMed (Medline), EMBASE, CINAHL (EBSCOHOST) and Scopus databases for articles published until May 2019 without time, language or study design limits.", "Two reviewers critically appraised the included studies independently using the standard quality assessment criteria for evaluating primary research papers.", "Results of the quantitative and mixed methods studies were transformed into qualitative data and synthesised using thematic analysis.", "From a potential 2 365 studies, 24 from 11 countries met the eligibility criteria and were selected; eight qualitative, 13 quantitative, and three that used the mixed-method approach.", "The primary barriers were identified as poor access to screening services, lack of awareness and knowledge on cervical cancer and screening, and socio-cultural influences.", "Service providers perceived lack of skills, screening equipment and supplies, and staff shortages as the major barriers to the provision of screening services.", "Barriers to cervical cancer screening in Africa are multifaceted and require a holistic approach that will address them concurrently at the health system, individual, interpersonal, community and structural levels.", "Political will complimented by stakeholder involvement is required in the development and implementation of strategies that will ensure acceptability, availability, accessibility, and affordability of screening to minimise barriers in accessing the service." ]

[ "Africa presents a higher diabetic foot ulcer prevalence estimate of 7.2% against global figures of 6.3%.", "Engaging family members in self-care education interventions has been shown to be effective at preventing diabetes-related foot ulcers.", "This study culturally adapted and tested the feasibility and acceptability of an evidence-based footcare family intervention in Ghana.", "The initial phase of the study involved stakeholder engagement, comprising Patient Public Involvement activities and interviews with key informant nurses and people with diabetes (N = 15).", "In the second phase, adults at risk of diabetes-related foot ulcers and nominated caregivers (N = 50 dyads) participated in an individually randomised feasibility trial of the adapted intervention (N = 25) compared to usual care (N = 25).", "The study aimed to assess feasibility outcomes and to identify efficacy signals on clinical outcomes at 12 weeks post randomisation.", "Patient reported outcomes were foot care behaviour, foot self-care efficacy, diabetes knowledge and caregiver diabetes distress.", "Adjustments were made to the evidence-based intervention to reflect the literacy, information needs and preferences of stakeholders and to develop a context appropriate diabetic foot self-care intervention.", "A feasibility trial was then conducted which met all recruitment, retention, data quality and randomisation progression criteria.", "At 12 weeks post randomisation, efficacy signals favoured the intervention group on improved footcare behaviour, foot self-care efficacy, diabetes knowledge and reduced diabetes distress.", "Future implementation issues to consider include the staff resources needed to deliver the intervention, family members availability to attend in-person sessions and consideration of remote intervention delivery.", "A contextual family-oriented foot self-care education intervention is feasible, acceptable, and may improve knowledge and self-care with the potential to decrease diabetes-related complications.", "The education intervention is a strategic approach to improving diabetes care and prevention of foot disease, especially in settings with limited diabetes care resources.", "Future research will investigate the possibility of remote delivery to better meet patient and staff needs.", "Pan African Clinical Trials Registry (PACTR) - PACTR202201708421484: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=19363 or pactr.samrc.ac.za/Search.aspx." ]

[ "African American or Black (hereafter referred to as Black) adults who use cannabis use it more frequently and are more likely to meet criteria for cannabis use disorder (CUD) than both White and Hispanic or Latin individuals.", "Black adults may be more apt to use cannabis to cope with distress, which constitutes a false safety behavior (FSB; a behavior designed to reduce psychological distress in the short term).", "Although FSB engagement can perpetuate the cycle of high rates of CUD among Black individuals, limited work has applied an FSB elimination treatment approach to Black adults with CUD, and no previous work has evaluated FSB reduction or elimination in the context of a culturally tailored and highly accessible treatment developed for Black individuals.", "This study aims to develop and pilot-test a culturally tailored adaptive intervention that integrates FSB reduction or elimination skills for cannabis reduction or cessation among Black adults with probable CUD (Culturally Tailored-Mobile Integrated Cannabis and Anxiety Reduction Treatment [CT-MICART]).", "Black adults with probable CUD (N=50) will complete a web-based screener, enrollment call, baseline assessment, 3 daily ecological momentary assessments (EMAs) for 6 weeks, and a follow-up self-report assessment and qualitative interview at 6 weeks after randomization.", "Participants will be randomized into 1 out of the 2 conditions after baseline assessment: (1) CT-MICART+EMAs for 6 weeks or (2) EMAs only for 6 weeks.", "The enrollment started in June 2023 and ended in November 2023.", "Data analysis will be completed in March 2024.", "No culturally tailored, evidence-based treatment currently caters to the specific needs of Black individuals with CUD.", "This study will lay the foundation for a new approach to CUD treatment among Black adults that is easily accessible and has the potential to overcome barriers to treatment and reduce practitioner burden in order to support Black individuals who use cannabis with probable CUD.", "ClinicalTrials.gov NCT05566730; https://clinicaltrials.gov/study/NCT05566730.", "DERR1-10.2196/52776." ]

[ "African American women suffer under the burden of cervical cancer as they are first in mortality, diagnosed at later stages, and have a survivorship rate that is lower than the national average.", "The aim of our review is to evaluate the effectiveness of cervical cancer screening and prevention interventions for African American women living in the United States and to assess their commitment to health equity.", "A literature search was conducted using PubMed, Embase, CINAHL, and Scopus using MeSH terms related to cervical cancer, human papillomavirus (HPV), screening and prevention, and African Americans.", "This resulted in 1970 articles.", "Studies were included if they promoted cervical screening or prevention, sampled African American women aged 18 and over, and evaluated interventions.", "Among the 23 articles that met inclusion criteria, there were a wide variety of intervention strategies, that is, community health workers, patient navigation, patient reminders, self-sampling collection, and HPV vaccination.", "Health education interventions, when coupled with patient navigation or community health workers, were effective in promoting screening participation (odds ratio: 2.43, 95% confidence interval: 1.47-4.02).", "There were mixed results regarding the incorporation of health equity principles.", "This review supports the importance of incorporating health equity principles and community based methods in screening and prevention interventions.", "Future research and practice should incorporate African American women's perspectives in intervention development and implementation." ]

[ "African contribution to global research output is said to be low.", "Poor funding and poor skills in grant writing have been suggested as important factors for this situation.", "Applications for research ethics clearance in a hospital were reviewed to have an overview of the planned studies and the proportion of them that attracted national and international funding.", "A review of all applications for ethical clearance received by the institutional review board of a university teaching hospital at Ile-Ife, Nigeria, from 2016 to 2020.", "They were analysed according to study nature, scope, purpose, and sponsorship using descriptive statistics presented as frequency tables and charts.", "A total of 878 applications were reviewed.", "There were 803 (91.5%) applications for local, 45 (5.1%) for national multicentre, and 30 (3.4%) for international multicentre studies.", "Applications for medical fellowship were 352 (40.0%) while 208 (23.8%) were from academic staff for non-degree research.", "There were 610 (69.5%) applications for self-sponsored studies.", "Only 18 (2.0%) and 26 (3.0%) received sponsorship from national and international donor agencies, respectively.", "Local studies formed the bulk of the submissions for ethics clearance.", "National and international donor funding of research is abysmally low in this Nigerian tertiary institution studied." ]

[ "After a long-term lockdown, particularly one in which human life is at risk, negative psychological consequences are expected.", "In this study, we aimed to explore the cause of stress and fear of coronavirus-19 (COVID-19) among Chinese college students in Wuhan during the latest strictest lockdown.", "During the COVID-19 outbreak, 1,070 college students from Wuhan, aged 18-29 years, took part in an online survey.", "We used correlations, bootstrap tests, and other statistical analysis methods to analyze the data.", "Negative coping style significantly positively predicted fear of COVID-19, and stress had a significant mediating effect on the relationship between negative coping style and fear of COVID-19.", "In addition, rumination and stress had a chain-mediating effect on the relationship between negative coping style and fear of COVID-19.", "Perceived social support moderated the three paths of this serial mediation model.", "Negative emotions, such as stress and fear of COVID-19, in college students are caused by both behavior (e.g., negative coping style) and cognition (e.g., rumination).", "Importantly, negative cognitive thinking (i.e., rumination) is often a malign consequence of a negative coping style.", "Thus, to improve students' mental health, students should be encouraged to engage in more positive behaviors and seek social support during periods of adherence to regular prevention and control measures." ]

[ "After about two years of emergency remote teaching during the pandemic, the teaching of mathematics is slowly returning to (what used to be called) normal.", "However, after the period of mostly teaching online, there is uncertainty about the extent to which we will return to the way we were teaching before.", "In this survey paper we attempt to give some background to the impact that emergency remote teaching may have had on teaching mathematics.", "We examine the possible social implications and then focus on the changing mathematics classroom, focusing on the actual mathematics curriculum, learning design and assessment, the role of collaborative activities and social media, educational videos, and the role of family and parents in future.", "There are indicators from the literature that educators may not return to the traditional way of teaching entirely, especially in secondary and higher education.", "We conclude with describing some possible new research areas that have developed through emergency remote teaching, including online education for younger learners, local learning ecosystems, the role of family and parents, instructional design, and the mathematics content of curricula." ]

[ "After acquiring knowledge of the neuroscience of learning, memory, stress and emotions, teachers incorporate more cognitive engagement and student-centered practices into their lessons.", "However, the role understanding neuroscience plays in teachers own affective and motivational competencies has not yet been investigated.", "The goal of this study was to investigate how learning neuroscience effected teachers' self-efficacy, beliefs in their ability to teach effectively, self-responsibility and other components of teacher motivation.", "A pilot training-of-trainers program was designed and delivered in Liberia combining basic neuroscience with information on social, emotional, behavioral and mental health issues faced by students.", "Tier I of the professional development was a 2 weeks workshop led by a visiting neuroscientist.", "A subset of the 24 Tier I secondary science teachers formed a Leadership Team who adapted the content to the Liberian context and subsequently led additional workshops and follow-up sessions for the Tier II secondary science teachers.", "Science teachers in both tiers completed the affective-motivational scales from the internationally vetted, multiscale Innovative Teaching for Effective Learning Teacher Knowledge Survey from the OECD.", "Tier II teachers completed the survey in a pre-post-delayed post design.", "Tier I teachers completed the survey after the workshop with their attitudes at that time and separately with retrospective projections of their pre-workshop attitudes.", "Ten of the 92 Tier II teachers participated in structured interviews at follow-up.", "Statistical analysis of survey data demonstrated improved teacher self-efficacy, self-responsibility for student outcomes, and motivation to teach.", "Qualitatively, teachers expressed more confidence in their ability to motivate students, engage them through active learning, and manage the class through positive rather than negative reinforcement.", "Teachers' own self-regulation improved as they made efforts to build supporting relationships with students.", "Together, these results demonstrated that (i) teacher affective-motivational attitudes can be altered with professional development, (ii) basic neuroscience, as knowledge of how students learn, can improve teacher competency, and (iii) a training-of-trainers model can be effective in a low and middle income country for disseminating neuroscience knowledge, increasing teachers' knowledge of students' social and emotional needs, and promoting educational improvement." ]

[ "After completion of training, practicing surgeons rely on hands-on courses to expand their procedure armamentarium and improve their surgical technique.", "However, such courses vary in standardized teaching methods.", "SAGES developed the Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program as a method of longitudinal instruction utilizing standardized teaching techniques, mentorship, and webinars to cover additional techniques.", "This study examines the adoption of learned techniques and participant confidence before and after an ADOPT course focused on extended-view totally extraperitoneal (eTEP) hernia repair.", "A hands-on course focused on eTEP hernia repair was conducted with enrollment capped at 10 participants.", "Pre-course and post-course surveys at 3, 6, and 12 months determined implementation of the learned procedure, case volume, and confidence with eTEP skills.", "A 5-point Likert scale (1 = not confident at all to 5 = completely confident) assessed confidence levels.", "Survey responses were summarized using descriptive statistics.", "Of the 10 participants, 10 (100%) completed the pre-course survey, and 7 (70%) completed at least one post-course survey.", "Median age was 48.5 years (36,56) with a median of 16 years (2,23) in practice, mostly in the community setting (70%).", "After the course, 50% had performed an eTEP procedure, and 100% reported considering this technique during surgical planning.", "Participants reported higher confidence in eTEP-specific skills at three months post-course from pre-course levels.", "The highest change in confidence was seen for the following skills: accessing the retromuscular/extraperitoneal space for ventral hernia and recognizing when the linea alba has been violated, p < 0.05.", "This study shows that rapid incorporation of learned techniques can be achieved through the ADOPT format.", "Furthermore, through longitudinal mentorship and a structured hands-on course, the ADOPT course supports practicing surgeons to attain autonomy and confidence even when teaching a relatively technically challenging procedure, such as eTEP." ]

[ "After discharge from the emergency department (ED), pain management challenges parents, who have been shown to undertreat their children's pain.", "Our goal was to evaluate the effectiveness of a five-minute instructional video for parents on pain treatment in the home setting to address common misconceptions about home pediatric pain management.", "We conducted a randomized, single-blinded clinical trial of parents of children ages 1-18 years who presented with a painful condition, were evaluated, and were discharged home from a large, tertiary care pediatric ED.", "Parents were randomized to a pain management intervention video or an injury prevention control video.", "The primary outcome was the proportion of parents that gave their child pain medication at home after discharge.", "These data were recorded in a home pain diary and analyzed using the chi square test to determine significant difference.", "Parents' knowledge about components of at-home pain treatment were tested before, immediately following, and two days after intervention.", "We used McNemar's test statistic to compare incorrect pretest/correct post-test answers between intervention and control groups.", "A total of 100 parents were enrolled: 59 parents watched the pain education video, and 41 the control video.", "Overall, 75% of parents completed follow-up, providing information about home medication use.", "Significantly more parents provided pain medication to their children after watching the educational video: 96% vs 80% (difference 16%; 95% CI 7.8-31.3%).", "Significantly more parents had correct pain treatment knowledge immediately following the educational video about pain scores (P = 0.04); the positive effects of analgesics (P <0.01); and pain medication misconceptions (P = 0.02).", "Most differences in knowledge remained two days after the video intervention.", "The five-minute educational video about home pain treatment viewed by parents in the ED prior to discharge significantly increased the proportion of children receiving pain medication at home as well as parents' knowledge about at-home pain management." ]

[ "After patient care transitions occur, communication from the current physician back to the transferring physician may be an important source of clinical feedback for learning from outcomes of previous reasoning processes.", "Factors associated with this communication are not well understood.", "This study clarifies how often, and for what reasons, current physicians do or do not communicate back to transferring physicians about transitioned patients.", "In 2018, 38 physicians at two academic teaching hospitals were interviewed about communication decisions regarding 618 transitioned patients.", "Researchers recorded quantitative and qualitative data in field notes, then coded communication rationales using directed content analysis.", "Descriptive statistics and mixed effects logistic regression analyses identified communication patterns and examined associations with communication for three conditions: When current physicians 1) changed transferring physicians' clinical decisions, 2) perceived transferring physicians' clinical uncertainty, and 3) perceived transferring physicians' request for communication.", "Communication occurred regarding 17% of transitioned patients.", "Transferring physicians initiated communication in 55% of these cases.", "Communication did not occur when current physicians 1) changed transferring physicians' clinical decisions (119 patients), 2) perceived transferring physicians' uncertainty (97 patients), and 3) perceived transferring physicians' request for communication (12 patients).", "Rationales for no communication included case contextual, structural, interpersonal, and cultural factors.", "Perceived uncertainty and request for communication were positively associated with communication (p < 0.001) while a changed clinical decision was not.", "Current physicians communicate infrequently with transferring physicians after assuming patient care responsibilities.", "Structural and interpersonal barriers to communication may be amenable to change.", "Clarity about transferring physicians' uncertainty and desire for communication back may improve clinical feedback communication." ]

[ "Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so.", "Specifically, we consider how ambiguous notions of 'proficiency' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity.", "A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients' freedom at the same time as the desire (and obligation) to promote patients' self-determined recovery.", "The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue.", "This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care.", "We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners.", "Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice.", "Without this, the credibility of the profession will continue to be questioned; its future uncertain." ]

[ "Against the backdrop of poor discharge communication in hospitals, this study explores the purpose of discharge interviews from the physicians' perspective and the challenges they are confronted with.", "Discharge interviews are legally required in Germany as part of the discharge management.", "Led by the ward physician, the discharge interview should summarize relevant information about the hospital stay, medication, lifestyle interventions and follow-up treatment.", "Semi-structured interviews with n = 12 physicians were conducted at Heidelberg University Hospital between February and April 2020.", "Qualitative content analysis was carried out using MAXQDA.", "Physicians reported gaining information, providing information, and answering open-ended questions as the purpose of the discharge interview.", "Challenges in conducting discharge interviews were related to finding a common language, patient-related challenges, conditions of everyday ward life, and lack of training.", "Physicians reported receiving no explicit training on discharge interviews.", "While professional experience seems to mitigate the lack of training, some physicians expressed a prevailing sense of insecurity.", "The lack of preparation for discharge interviews in medical school makes it particularly challenging for physicians to translate their theoretical knowledge into patient-centered discharge communication.", "Medical training on discharge interviews should be expanded in terms of theoretical input on the ideal content, its purpose and potential (e.g.", "in reducing readmissions), as well as practical exercises." ]

[ "Age at peak height velocity (APHV) is an indicator of maturity timing which is applicable to both sexes, and which is influenced by environmental factors.", "The objective of this study was to assess variation in APHV associated with several indicators of socioeconomic status (SES) in a longitudinal sample of Polish adolescents.", "The sample included 739 boys born in 1983 and followed annually from 12 to 16 years, and 597 girls born in 1985 and followed annually from 9 to 13 years.", "The height records were fitted with the SITAR model to estimate APHV.", "SES was estimated using principal component analysis of indicators of familial status based on parental education, family size, living conditions and household possessions.", "Statistical analyses included analysis of variance (one-way for general SES and three-way for parental education and family size) and Tukey post-hoc tests for unequal samples.", "General SES (p <.001) and family size (p < .05) significantly influenced APHV among boys, while only maternal education (p < .05) significantly influenced APHV among girls.", "Among youth from families of higher SES, as defined by the respective indicators, APHV was attained significantly earlier, on average, than in peers from families of lower SES.", "Overall, the results showed a sex-dependent effect of SES on APHV, and highlighted the influence of favorable socioeconomic conditions for optimal growth and maturation during adolescence." ]

[ "Age-friendly environments intend to promote active ageing by facilitating social, mental, and physical participation.", "This could potentially delay the onset of chronic complex conditions, enabling people to live longer independently at home, and prevent loneliness.", "This study investigates a community-based living environment in Norway called Helgetun and aims to explore how it can facilitate active ageing.", "We chose an ethnographic approach consisting of observation, informal conversations, and in-depth semi-structured interviews with 15 residents (11 female, 4 male, ages 62-84).", "We analysed the data using reflexive thematic analysis.", "We developed three themes on facilitating active ageing in this living environment: maintaining self-identity, experiencing growth and development, and feeling a sense of belonging.", "These themes were related to physical activity levels, social engagement, and overall satisfaction with the living environment.", "Maintaining self-identity concerned getting a new role in life as well as access to meaningful activities.", "Experiencing growth and development involved being exposed to new activities, learning new skills, and experiencing mastery.", "Lastly, feeling a sense of belonging meant feeling safe and part of a group, as well as receiving social support and help.", "This feeling of social connectedness and safety was reflected in their experience with the COVID-19 pandemic, in which most felt relatively unaffected, suggesting that this way of living could increase reliance among this age group.", "Having a flexible structure, adapting to the core needs and individual resources of the residents, can facilitate active ageing in community-based living environments.", "Our findings contribute to the growing evidence that these environments increase social and physical engagement, whilst reducing social isolation and loneliness.", "These findings may be particularly relevant in a Norwegian context-where older adults are less dependent on family for care-and are meant as grounding points for policymakers to reflect upon designing future senior living." ]

[ "Ageism has been recognized as a global problem leading to poorer health, isolation, and workplace discrimination toward people based on their age.", "Consequently, there are several tools that measure levels and types of ageism with a focus on the quantification of degrees and types of ageism.", "While such quantification is valuable, this paper describes the development of an inventory, created over four stages, designed to foster introspective and collaborative thinking about age-directed values.", "In Stage 1, 34 items were identified through a comprehensive literature review.", "In Stage 2, the items were evaluated and revised via a focus group discussion.", "In Stage 3, the revised ASI was administered to a representative U.S. sample (N = 513).", "Based on factor and conceptual analysis, a revised version was tested on a second sample (N = 507) (Stage 4) and again revised.", "The final ASI consists of 35 age-related statements: 22 psychometrically linked to one of four domains, six related to identity, and seven that, although not aligned with statistical results, are conceptually important.", "Rather than provide an ageism score, the ASI is a tool for introspection and reflection about individual values and judgements about age which can lead to customized strategies to address potential age biases." ]

[ "Aggregate statistics of maternal health care services have improved in Ethiopia.", "Nevertheless, the country has one of the lowest Universal Health Coverage (UHC) service coverage indices, with slight improvement between 2000 and 2019.", "There are disparity studies that focus on a single dimension of inequality.", "However, studies that combine multiple dimensions of inequality simultaneously may have important policy implications for closing inequalities.", "In this study, we investigated education inequalities in the receipt of maternal health care services in rural and urban areas separately, and we examined whether these inequalities decreased, increased, or remained unchanged.", "The data for the study came from the 2011 and 2016 Ethiopia Demographic and Health Surveys.", "Using women's education as a dimension of inequality, we separately analyzed inequalities in maternal health care services in urban and rural settings.", "Inequalities were measured through the Erreygers concentration index, second differences, and Relative Index of Inequality (RII).", "Whether inequalities changed over time was analyzed by relative and absolute measures.", "An Oaxaca-type decomposition approach was applied to explain changes in absolute disparities over time.", "There were glaring educational disparities in maternal health care services in urban and rural areas, where the services were more concentrated among women with better schooling.", "The disparities were more severe in urban than in rural areas.", "In urban areas, skilled birth service was the most unequal in both periods.", "Disparities in rural places were roughly similar for all services except that in 2011, postnatal care was the least unequal, and in 2016, skilled birth was the most unequal services.", "Trend analyses revealed that disparities significantly dropped in urban by absolute and relative measures.", "Conversely, in rural regions, the disparities grew by the concentration index measure for most services.", "The RII and second differences presented conflicting results regarding whether the gaps were increasing, shrinking, or remaining the same.", "Substantial disparities in maternal health care services remained and even increased, as in rural areas.", "Different and targeted strategies are needed for urban and rural places to close the observed educational inequalities in these areas." ]

[ "Aggregated species occurrence and abundance data from disparate sources are increasingly accessible to ecologists for the analysis of temporal trends in biodiversity.", "However, sampling biases relevant to any given research question are often poorly explored and infrequently reported; this can undermine statistical inference.", "In other disciplines, it is common for researchers to complete 'risk-of-bias' assessments to expose and document the potential for biases to undermine conclusions.", "The huge growth in available data, and recent controversies surrounding their use to infer temporal trends, indicate that similar assessments are urgently needed in ecology.We introduce ROBITT, a structured tool for assessing the 'Risk-Of-Bias In studies of Temporal Trends in ecology'.", "ROBITT has a similar format to its counterparts in other disciplines: it comprises signalling questions designed to elicit information on the potential for bias in key study domains.", "In answering these, users will define study inferential goal(s) and relevant statistical target populations.", "This information is used to assess potential sampling biases across domains relevant to the research question (e.g.", "geography, taxonomy, environment), and how these vary through time.", "If assessments indicate biases, then users must clearly describe them and/or explain what mitigating action will be taken.Everything that users need to complete a ROBITT assessment is provided: the tool, a guidance document and a worked example.", "Following other disciplines, the tool and guidance document were developed through a consensus-forming process across experts working in relevant areas of ecology and evidence synthesis.We propose that researchers should be strongly encouraged to include a ROBITT assessment when publishing studies of biodiversity trends, especially when using aggregated data.", "This will help researchers to structure their thinking, clearly acknowledge potential sampling issues, highlight where expert consultation is required and provide an opportunity to describe data checks that might go unreported.", "ROBITT will also enable reviewers, editors and readers to establish how well research conclusions are supported given a dataset combined with some analytical approach.", "In turn, it should strengthen evidence-based policy and practice, reduce differing interpretations of data and provide a clearer picture of the uncertainties associated with our understanding of reality." ]

[ "Aging is a ubiquitous human trait that predisposes older persons to chronic diseases.", "Compared with systemic non-communicable diseases, a significant gap exists in literature on the burden of non-communicable dermatoses (NCDs) amongst older adults particularly in low and middle-income countries.", "The aim of this study was to document the epidemiology and clinical pattern of non-communicable skin diseases among older adults at a tertiary healthcare facility in Southwestern Nigeria.", "We conducted a retrospective review of medical records of ambulant adults aged ≥60 years referred for dermatological care at a teaching hospital in ile-ife, South-Western Nigeria between February 2017 and February 2022.", "The frequency and pattern of NCDs were recorded for descriptive statistical analysis using SPSS 20 statistics software.", "The level of statistical significance was set at 0.05.", "A total 553 medical records were reviewed with a female: male ratio of 1.3:1 The mean age of the study population was 68.85 ±7.87.", "Six out of every 10 patients (60.6%) had at least one chronic NCD.", "The incidence of chronic NCDs declined with increasing age.", "Chronic eczemas (22.4%), pigmentary dermatoses (9.4%) and skin tumors (8.7%) were the most frequent chronic non-communicable dermatoses recorded.", "Older males had a significantly higher incidence of chronic eczemas while chronic urticarias and skin tumors demonstrated significant female preponderance.", "There is a high burden of chronic NCDs with significant gender disparities among older adults with skin problems in Nigeria.", "Pre-emptive planning and resource allocation towards specialist geriatric-dermatology services are needed to address skin-health needs of the growing geriatric population." ]

[ "Agranulocytosis is a life-threatening side-effect of clozapine, the only approved drug for treatment-resistant schizophrenia.", "The long-term profile of this complication has not yet been well established.", "Here we aim to describe the risk of clozapine-induced agranulocytosis over the long term.", "We used the entire population of Finland to identify people diagnosed with schizophrenia or schizoaffective disorder between 1972 and 2014 and developed a Kaplan-Meier model of time to diagnosis of agranulocytosis during clozapine versus non-clozapine treatment over a 22-year observation period (1996 to 2017).", "Next, we developed a nested case-control model for agranulocytosis matching by sex, age, time since diagnosis, and being in the incident cohort on a 1 to 5 ratio.", "Various durations of use for clozapine and non-clozapine antipsychotic treatment were compared to the modal antipsychotic use duration, deriving adjusted odds ratios (aORs) in a multivariable regression model.", "Recurrence and lethality rates for clozapine-induced agranulocytosis were described.", "These data reflect on all individuals with lived experience of schizophrenia in Finland during the study time, although individuals with lived experience were not included in the design of the study.", "We identified 61 769 people with schizophrenia or schizoaffective disorder (14 037 individuals treated with clozapine and 47 732 individuals treated with non-clozapine antipsychotics), with a mean age of 46·67 years (IQR 34·44-57·61), of whom 30 721 (49·7%) were female and 31 048 (50·3%) were male (data on ethnicity not available).", "Among those, 398 individuals were diagnosed with agranulocytosis (231 individuals treated with clozapine and 167 individuals treated with non-clozapine antipsychotics), representing a cumulative incidence of agranulocytosis for 1·37% (95% CI 0·58-3·16) on clozapine and 0·13% (0·04-0·23) on non-clozapine antipsychotics.", "In the case (n=398) versus control (n=1987) model, the risk of clozapine-induced agranulocytosis decreased steeply over time from an aOR of 36·01 (95% CI 16·79-77·22) for less than 6 months on clozapine to 4·38 (1·86-10·34) for clozapine use of 54 months or more.", "Only one of 3559 individuals starting clozapine died because of clozapine-induced agranulocytosis.", "The risk of clozapine-induced agranulocytosis decreases steeply over time but might be persistently greater than that of non-clozapine antipsychotics.", "This long-term risk excess seems small in absolute terms compared with the known magnitude of the advantages of clozapine in relevant outcomes, including life expectancy.", "Given the widespread underuse of clozapine, relaxing the long-term neutrophil monitoring could favour the advantages of long-term clozapine use, including greater life expectancy, without incurring the intolerable risk of clozapine-induced agranulocytosis.", "Northwell Health and Sigrid Jusèlius Foundation." ]

[ "Agreement probability p(a) is a homogeneity measure of lists of properties produced by participants in a Property Listing Task (PLT) for a concept.", "Agreement probability's mathematical properties allow a rich analysis of property-based descriptions.", "To illustrate, we use p(a) to delve into the differences between concrete and abstract concepts in sighted and blind populations.", "Results show that concrete concepts are more homogeneous within sighted and blind groups than abstract ones (i.e., exhibit a higher p(a) than abstract ones) and that concrete concepts in the blind group are less homogeneous than in the sighted sample.", "This supports the idea that listed properties for concrete concepts should be more similar across subjects due to the influence of visual/perceptual information on the learning process.", "In contrast, abstract concepts are learned based mainly on social and linguistic information, which exhibit more variability among people, thus, making the listed properties more dissimilar across subjects.", "Relative to abstract concepts, the difference in p(a) between sighted and blind is not statistically significant.", "Though this is a null result, and should be considered with care, it is expected because abstract concepts should be learned by paying attention to the same social and linguistic input in both, blind and sighted, and thus, there is no reason to expect that the respective lists of properties should differ.", "Finally, we used p(a) to classify concrete and abstract concepts with a good level of certainty.", "All these analyses suggest that p(a) can be fruitfully used to study data obtained in a PLT." ]

[ "Agriculture contributes a third of Rwanda's GDP and is the main source of income for rural households, with 80% of the total population involved in crop and/or livestock production.", "The Government of Rwanda established the Muvumba rice project in 2011 amidst a policy shift towards rice as a national staple crop.", "However, the indiscriminate use of pesticides by local, low-income rice growers has raised concerns about potential human, animal and ecosystem health impacts as pesticide distribution and application are not strictly regulated.", "Although pesticide use can directly influence farmer health and ecosystems, little is known about small-scale farmers' pesticide application practices and knowledge.", "We aimed to assess local application practices and understanding of pesticides to identify gaps in farmers' knowledge on safe pesticide use and deviations from established standards and recommended practices.", "We conducted a cross-sectional study consisting of observations of pesticide practices and interviews with 206 small-scale rice growers in Nyagatare District, Rwanda, in March 2017.", "Descriptive statistical analyses (sample means, standard deviation and range) were performed, and we evaluated the association between farmers' personal protective equipment (PPE) use and their education level and literacy status.", "Over 95% of observed farmers did not comply with minimum standards for safe pesticide use, and 80% of respondents reported that they stored pesticides in their homes without personal protection measures.", "Education and literacy level were not significantly associated with PPE use.", "Additionally, 90% of respondents had experienced adverse health effects after using pesticides including intense headache, dizziness, stomach cramps, skin pain and itching, and respiratory distress.", "All respondents also reported animals in and around the rice scheme (cattle, birds, and fish) behaving abnormally or with signs consistent with pesticide exposure in the six months preceding the study, which may be linked to pesticide-contaminated water.", "Our study demonstrates potential for high exposure to pesticides for farmers, their families, and animals sharing rice-growing or downstream environments and points to the need for training on safe and effective pesticide use." ]

[ "Agriculture is associated with various physical and mental health risks.", "There has been growing concern about the psychological hazards associated with farming including high stress levels, depression, anxiety, and increasing rates of suicide.", "To bolster resilience and overall survival within the farmers, it is imperative to gain a comprehensive understanding of the protective factors that contribute to mental and psychological well-being.", "The study followed an explorative research design and used purposive sampling to select samples from Chikkaballapur District in Karnataka.", "Nine farmers were interviewed based on inclusion and exclusion criteria.", "The interview schedule was prepared based on the literature review.", "Experts in the field did content and face validation.", "The transcribed data were coded using the free version of QDA Miner.", "The thematic analysis approach was used for data analysis.", "Three broader themes and 15 sub-themes emerged: (1) Personal protective factors: feeling of autonomy, purpose in life, passion for work, problem-solving skills, positive mindset and building resilience, learning new skills, and spiritual and religious beliefs; (2) social protective factors: friends and peer group, belongingness, family, and social engagements; and (3) environmental protective factors: lifestyle and being physically active, rural environment, government/institutional support, and recognition in the society.", "The study successfully emerged three overarching protective factors that farmers perceived as significant for their mental health and well-being, entitled personal, social, and environmental.", "The study findings provide valuable insights for social work practitioners, guiding them in developing interventions and strategies to support the mental health and well-being of the farming population." ]

[ "AI chatbots are being increasingly used in healthcare settings.", "There is growing interest in using AI to assist in patient education.", "Currently, extensive healthcare information is found online but is often too complex to understand.", "Our objective is to determine if physicians can recommend the free version of ChatGPT version 3.5 (OpenAI, San Francisco, CA, USA) for patients to simplify text from the American Academy of Ophthalmology (AAO) in English and Spanish.", "This version of ChatGPT was assessed in this study due to its increased accessibility across various patient populations.", "Fifteen articles were chosen from AAO in both languages and simplified with ChatGPT 10 times each.", "The readability of original and simplified articles was assessed with the Flesch Reading Ease and Gunning Fog Index for English and Fernández Huerta, Gutiérrez, Szigriszt-Pazo, INFLESZ, and Legibilidad-µ for Spanish.", "Grade levels to assess readability were calculated with Flesch Kincaid Grade Level and Crawford Nivel-de-Grado.", "Mean, standard deviation, and two-tailed t-tests were performed to assess differences before and after simplification.", "Average grade levels before and after simplification were as follows: English 8.43±1.17 to 8.9±2.1 (p=0.41) and Spanish 5.3±0.34 to 4.1±1.1 (p=0.0001).", "Spanish articles were significantly simplified per Legibilidad-µ (p=0.003).", "No significant difference was noted for other scales.", "The readability of AAO articles in English worsened without significance but significantly improved in Spanish.", "This may result from simpler syllable structures and a lesser overall vocabulary in Spanish.", "With increased testing, physicians can recommend ChatGPT for Spanish-speaking patients to improve health literacy." ]

[ "Aim  To investigate the relationship between health literacy (HL), self-efficacy (SE), and achievement of treatment goals in patients with type 2 diabetes mellitus (T2DM).", "Method The cross-sectional study was conducted with a random sample of patients with T2DM attending the diabetology clinic and the Home Care department of the General Hospital of Drama, Greece.", "They completed two questionnaires: the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) to measure HL and the Diabetes Management Self-Efficacy Scale (DMSES) for people with T2DM to measure SE.", "Medical history, demographic characteristics, and values related to glycemic control were also recorded.", "Linear regression analysis was used to search for the dependence of glycosylated hemoglobin (A1C) values with HL and SE and the dependence between them.", "Result About 120 patients with T2DM (response rate of 92.3%) were enrolled in the study.", "The mean age of the participants was 62.5 years [standard deviation (SD) = 10.6 years] and most of them were female (53.3%).", "A1C was found to be significantly negatively associated with diet, physical activity, and SE score.", "Also, a statistically significant positive correlation was found between HL and SE.", "HL was correlated with age, gender, education level, and A1C, with women and older people having lower HL, while conversely higher education level was significantly associated with higher HL.", "Higher A1C was significantly associated with lower HL.", "Also, SE partially mediates the relationship between HL and A1C, in a significant way.", "Conclusion The results of the study confirm the important role of HL and SE in the successful management of T2DM.", "Multi-level educational interventions for diabetic patients could improve HL and SE and promote diabetes self-management." ]

[ "Aim - to study functional organization of hemodynamic processes in brain basins of healthy children and children with mild mental retardation depending on the nature of asymmetry and gradient of cerebral blood filling are investigated.", "The research executed in the scientific laboratory of the special and inclusive education department of the Armenian State Pedagogical University after Kh.", "Abovyan and Armenian State Institute of Physical Culture and Sport.", "The study involved children aged 8 to 11 years, a total of 131.", "73 of them are healthy schoolchildren and 58 children with a low degree of mental retardation.", "Each category of subjects was divided into 2 age groups: 8-9 years and 10-11 years.", "The results of the experimental study of task performance show that interesting data have been obtained which will serve as a basis for the development of necessary means, methods, and conditions for the development of elementary practical orientation in mentally retarded elementary school children.", "The analysis of the results of the study allows us to highlight the following important points: in the control group, 88% of the examined patients showed a hyperfrontal pattern in terms of RI (rheogramm amplitude).", "In seven children, the hypermastoidal pattern was observed, and in the two children of the control group, no significant differences between the RI values in the frontal and mastoidal basins were found.", "The study involved 131 children aged 8 to 11 years old.", "73 of them were healthy with normal physical and mental development as well as 58 children with a weak degree of mental retardation.", "The study was undertaken to determine which sport and physical activity allowed children with mental retardation.", "Established that the parameter of TPWV in 8-9-year-old and 10-11-year-old schoolchildren of the control group was significantly higher than that of experimental children in the frontal, bimostoidal and hemispheric basins." ]

[ "Aim and objectives To assess oral hygiene status and salivary and microbiological parameters among 12 to 15-year-old visually impaired and normal-sighted children before and after oral health education (OHE).", "Methodology An interventional study was conducted among 25 visually impaired children (Group A) and 25 normal-sighted children (Group B) in the age range of 12 to 15 years.", "Simple random sampling was used to select the study participants.", "A questionnaire was designed to record socio-demographic data and the dietary habits of the children on pre-decided days.", "The oral hygiene practices and the Decayed Missing Filled Teeth (DMFT) index were recorded, and salivary physicochemical parameters for all the selected children were evaluated, followed by saliva collection for microbial analysis.", "After baseline assessment, the Audio-Tactile Performance technique for Group A and the animated visual performance technique for Group B children were used to impart OHE.", "Periodic assessments of salivary parameters were conducted at one-month and three-month intervals.", "Unpaired T test/Mann-Whitney U test, repeated measures analysis of variance (ANOVA)/Friedman test, followed by Bonferroni's post hoc test were carried out to determine the difference between and within groups, respectively.", "All statistical tests were performed at a significance level of 5%.", "Results Group A demonstrated a greater change in salivary pH (6.20 ± 0.41 to 6.96 ± 0.20), salivary buffering capacity (5.80 ± 0.82 to 7.20 ± 0.65), and Streptococcus mutans count (9.36 ± 0.41 to 8.7 ± 0.45 x 104 CFU/mL) when compared to Group B.", "Group B demonstrated a greater Lactobacillus acidophilus count reduction (7.96 ± 0.66 to 7.50 ± 0.64 x 104 CFU/mL) when compared to Group A.", "Conclusion The appropriate use of specialized OHE holds particular significance in the improvement of oral hygiene status and salivary parameters, along with a reduction in the bacterial count in both visually impaired children and normal-sighted children." ]

[ "Aim The aim of the study is to identify the risk factors and mortality associated with central line-associated bloodstream infection (CLABSI) and to investigate the incidence and associated etiology in trauma patients admitted to the trauma ICU (TICU) of a tertiary care teaching hospital in Northern India.", "Materials and methods The study was a prospective study conducted in the trauma ICU of a tertiary care teaching hospital in India from November 2020 to October 2022.", "Adult patients >18 years of age who were on central line for >48 hours were included in the study.", "The automated blood culture system BacT/ALERT 3D (bioMérieux, Durham, NC) was used for microbial detection from blood samples.", "We recorded patients' daily progress, and catheter-related data was collected and used as variables.", "All the data was analyzed using the Statistical Package for Social Sciences (SPSS) version 22.0 (IBM SPSS Statistics, Armonk, NY) to evaluate the risk factors associated with CLABSI.", "Result A total of 516 admissions occurred during the surveillance period, out of which 352 patients fulfilled the inclusion criteria and were enrolled in the study.", "Out of these 352 patients, a total of 74 patients developed central line-associated bloodstream infection (CLABSI).", "Thus, the incidence of CLABSI was 16.4 per 1000 central line days and 13.2 per 1000 inpatient days with a 0.8 device utilization ratio (DUR).", "The most common organisms isolated from these CLABSI cases were Acinetobacter species (23%), followed by Escherichia coli (16.5%) and Staphylococcus aureus (15.6%).", "The independent healthcare-associated risk factors for CLABSI were longer length of ICU stay and prolonged duration of central venous catheterization.", "The most common comorbidity associated with CLABSI was diabetes mellitus (20.3%), followed by hypertension (14.8%), and the mortality rate was 41.9%.", "Conclusion The healthcare-associated risk factors such as longer length of ICU stay and prolonged duration of central venous catheterization are the risk factors for developing central line-associated bloodstream infections (BSI)." ]

[ "Aim The development of lymphedema post-breast-cancer surgery has been identified as a significant burden worldwide, with nurses at the forefront of prevention and risk reduction practices.", "Prevention is of crucial importance to avoid lymphedema formation and its complications.", "This study aims to assess the knowledge gained through an educational session regarding risk reduction and prevention of breast cancer-related lymphedema (BCRL) among nursing professionals and compare the pre-test and post-test knowledge.", "Methods and material The research approach was quantitative in nature, and the design adopted was a pre-experimental, one-group pre-test post-test design.", "The study was conducted in a 400-bed multispecialty teaching hospital in Bangalore, Karnataka.", "After obtaining formal permission from the authorities, the participants were approached and informed about the purpose of the study.", "Eighty-four staff nurses working with breast cancer-related lymphedema (BCRL) patients participated in the study.", "The data for the study was collected using a validated questionnaire based on the National Lymphedema Network's (NLN) breast cancer-related lymphedema (BCRL) risk reduction and preventive guidelines.", "The questionnaire consisted of two sections.", "Section A consisted of the staff nurses' demographic data, and Section B consisted of questions on risk reduction and prevention of lymphedema.", "The pre-test was conducted, followed by a structured teaching session on risk reduction and prevention of lymphedema among 84 staff nurses working with BCRL patients.", "After the teaching session, the post-test was conducted.", "Results Descriptive and inferential statistics were used for analysis in this study.", "The t-test determined the statistical significance using the software SPSS (SPSS Inc.", "Released 2007.", "SPSS for Windows, Version 16.0.", "Chicago, SPSS Inc.).", "The result showed that the mean knowledge score was 4.286 with SD 0.97 in the pre-test, which increased to 4.452 with SD 1.511 with a significant p-value (<0.001).", "Conclusion According to the study's findings, nurses must get standardized lymphedema training in order to prevent lymphedema from developing in patients having breast cancer surgery.", "The study's outcome has implications on the focus areas for nurses in the context of the team's adoption and dissemination of breast cancer-related lymphedema preventive measures.", "Key messages of this study are - 1) BCRL is an irreversible, progressive complication with no cure if not diagnosed early.", "2) Poor knowledge of lymphedema prevention among nurses leads to frustration for BCRL patients.", "3) Risk reduction and prevention education enable the patient to reduce BCRL complications, minimize the severity of the condition, and improve the quality of life.", "4) Pre-habilitation - patient education on early diagnosis and risk reduction/prevention of BCRL reduces the cost, time, and energy for the patient and health care delivery system." ]