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While the literature is abundant on hand therapy assessment and treatment of nonsurgical thumb carpometacarpal (CMC) osteoarthritis (OA), clarity and uniformity are meager, making it a desirable diagnosis to establish expert consensus. This study aimed to ascertain if consensus exists for the assessment and treatment of nonsurgical management of thumb CMC OA in the hand therapy clinical setting. This was a consensus paper via the modified Delphi approach. A modified Delphi method was used to determine consensus among an expert panel, including hand therapists and hand surgeons, via two online surveys. A consensus paper steering committee (from the American Society of Hand Therapist's research division) designed the surveys and analyzed responses. Consensus was established as 75% agreement among the expert panel. Demographic information was collected from the expert panel. The expert panel included 34 hand therapists and seven hand surgeons. The survey response rates were 93.6% for the first survey and 90.2% for the second survey. Consensus recommendations were classified according to the World Health Organization categorization. These included evaluating the body structures for clinical signs/clinical testing and body functions for pain, range of motion for palmar abduction, radial abduction, opposition, and thumb metacarpal phalangeal flexion/extension, and grip and tripod pinch strength. Further consensus recommendations were for the assessment of function using a region-specific, upper extremity patient-reported outcome measure (activity and participation), environmental factors, outcome expectation, and illness perception within the patient's unique environmental and social contexts. Treatment recommendations included the use of an orthosis during painful activities, a dynamic stability program (stable C posture, release of tight adductors, and strengthening of stabilizers), patient education, joint protection techniques, adaptive equipment, and functional-based intervention. The findings describe the consensus of a group of experts and provide a clinical reference tool on the hand therapy assessment and treatment of nonsurgical thumb CMC joint OA. • A consensus paper using a modified Delphi process to determine consensus on non-surgical assessment and treatment of thumb CMC OA. • Assessment recommendations: evaluate clinical signs/testing, pain, thumb range of motion grip and tripod pinch, a region-specific PROM, environmental factors, outcome expectation, and illness perception. • Treatment: orthosis during painful activities as needed, a dynamic stability program, patient education, joint protection techniques, adaptive equipment, and functional based intervention. • Findings provide a clinical reference tool on hand therapy assessment and treatment of non-surgical CMC joint OA. [ABSTRACT FROM AUTHOR]

Racial and ethnic disparities have been clearly documented in schizophrenia studies, but it is unclear how much research attention they receive among US-based studies published in high-impact journals. The current paper updates Lewine and Caudle's (1999) and Chakraborty and Steinhauer's (2010) works, which quantified how frequently schizophrenia studies included information on race and ethnicity in their analyses. We examined all US-based papers on schizophrenia-spectrum, first-episode psychosis, and clinical high-risk groups, published between 2014 to 2016 in four major psychiatric journals: American Journal of Psychiatry, Journal of the American Medical Association – Psychiatry, Schizophrenia Bulletin, and Schizophrenia Research. Of 474 US-based studies, 62% (n = 295) reported analyses by race or ethnicity as compared to 20% in Lewine and Caudle's (1999) study. The majority of papers (59%) reported sample descriptions, a 42% increase from Lewine and Caudle's (1999) study. Additionally, 47% matched or compared the racial/ethnic composition of primary study groups and 12% adjusted for race (e.g., as a covariate). However, only 9% directly analyzed racial and/or ethnic identity in relation to the primary topic of the paper. While schizophrenia studies report analyses by race and ethnicity more frequently than 20 years ago, there remains a strong need for systematic, nuanced research on this topic. The authors offer recommendations for how to conceptualize and report upon race and ethnicity in schizophrenia research. [ABSTRACT FROM AUTHOR]

Background: The most impactful research on pediatric type 1 diabetes (T1D) remains unknown. Objective: We aimed to evaluate the characteristics and impact of the 100 most-cited articles on pediatric T1D. Materials and Methods: Using a predefined bibliometric strategy, the Scopus database was searched for high-cited papers (HCPs) published from 2001 to 2020. Articles were evaluated for data on the publication year, countries, authors, journals, topics, and types. Social network analysis was performed to visualize the interaction among countries, organizations, and authors using VOSviewer software. Results: The top 100 HCPs received 390 to 4634 citations, averaging 773.5 citations per paper (CPP). The funded HCPs (n = 50) had a higher impact (CPP 791.5). The majority of HCPs (n = 83) were collaborative. Classifying by research type, 65 studies were clinical (n = 65), risk factors (n = 27), epidemiology (n = 26), pathophysiology (n = 16), treatment outcome (n = 13), genetics (n = 12), complications (n = 3), quality of life (n = 2), and prognosis (n = 1). The number of authors involved was 1,101, affiliated with 545 organizations in 27 countries; the USA (n = 64) and the UK (n = 24) were the most productive countries, whereas Australia and the UK were the most impactful. D.M. Nathan and J.M. Lawrence were the most prolific authors, while P. Raskin and J.M. Lachin were the most impactful. Conclusions: High-income countries such as the USA, UK, and Australia contribute significantly to high-impact pediatric T1D research. Funding and collaboration improve the impact of citations in publications. Less researched areas such as treatment outcomes, genetics, complications, quality of life, and prognosis should be the focus of future research on pediatric T1D. [ABSTRACT FROM AUTHOR]

System barriers to effective healthcare engagement and navigation contribute to healthcare disparities among Latino children with immigrant parents in the US. We evaluated a nine-minute educational video supporting healthcare navigation and engagement skills of Spanish-speaking Latino parents of infants. Participants viewed the video at their child's 2-month well-visit, completed a pre-and post-video knowledge evaluation, and answered open-ended questions on video style. A paired t test was used to examine differences in knowledge and open-ended responses were coded using an iterative, consensus-based process. Of the 79 participants, 63.3% had an education level below high school diploma/GED and 84.8% were at risk for limited health literacy. There was a significant gain in healthcare navigation and engagement knowledge after watching the video (p < 0.001). Parents expressed that the video was interesting and provided useful information. Parents valued the knowledge gained and preferred videos over written materials for receiving culturally and linguistically tailored health education. [ABSTRACT FROM AUTHOR]

PURPOSE Consent processes are critical for clinical care and research and may benefit from incorporating digital strategies. We compared an electronic informed consent (eIC) option to paper consent across four outcomes: (1) technology burden, (2) protocol comprehension, (3) participant agency (ability to self-advocate), and (4) completion of required document fields. METHODS We assessed participant experience with eIC processes compared with traditional paper-based consenting using surveys and compared completeness of required fields, over 3 years (2019-2021). Participants who consented to a clinical trial at a large academic cancer center via paper or eIC were invited to either pre-COVID-19 pandemic survey 1 (technology burden) or intrapandemic survey 2 (comprehension and agency). Consent document completeness was assessed via electronic health records. RESULTS On survey 1, 83% of participants (n = 777) indicated eIC was easy or very easy to use; discomfort with technology overall was not correlated with discomfort using eIC. For survey 2, eIC (n = 262) and paper consenters (n = 193) had similar comprehension scores. All participants responded favorably to at least five of six agency statements; however, eIC generated a higher proportion of positive free-text comments (P < .05), with themes such as thoroughness of the discussion and consenter professionalism. eIC use yielded no completeness errors across 235 consents versus 6.4% for paper (P < .001). CONCLUSION Our findings suggest that eIC when compared with paper (1) did not increase technology burden, (2) supported comparable comprehension, (3) upheld key elements of participant agency, and (4) increased completion of mandatory consent fields. The results support a broader call for organizations to offer eIC for clinical research discussions to enhance the overall participant experience and increase the completeness of the consent process. [ABSTRACT FROM AUTHOR]

This study explores the prevalence of postdoctoral fellows in fast-moving and competitive scientific research. We use the results of a new and original large-scale survey of scientists in Japan and the United States for the analyses. Descriptive statistics show that, in both Japan and the United States: (1) the mean citation time lag was shorter by about 2 years in the highly cited papers (top 1 %) compared to other normal papers; and (2) the perceived degree of competitive threat was also higher for the projects producing the highly cited papers compared to those for normal papers. We also found that the likelihood of participation of postdoctoral fellows is significantly higher in research with shorter mean time lag and higher competitive threat (while that of students is not), controlling for author size, suggesting that postdoctoral fellows are especially prevalent in research efforts in fast-moving and competitive scientific research. [ABSTRACT FROM AUTHOR]

The study aimed to analyze the Journal of Hospital Librarianship (JHL) publications between 2001 and 2020 as indexed in Elsevier's Scopus database. The dataset was extracted on February 25, 2021 and 807 records were identified for data analysis. Various bibliometric indicators of the papers were assessed. There was an average of 1.32 citations per document. Sixty percent of the papers were single-authored, but the multi-author papers had a higher number of citations. The USA was identified as the country with the most contributions; Louisiana State University was the highest contributing institution, while Helen-Ann Brown Epstein was the most prolific author. [ABSTRACT FROM AUTHOR]

Objectives: In all health system sectors, electronic health information (EHI) is created, used, released, and reused. We examined states' efforts to address EHI uses in law to provide an understanding of the EHI legal environment. Methods: Attorney researchers used WestlawNext to search for EHI-related statutes and regulations of the US states, US territories, and the District of Columbia in effect as of January 2014. The researchers independently catalogued provisions by the EHI use described in the law. Researchers resolved discrepancies through peer review meetings and recorded the consensus codes for each law. Results: This study identified 2364 EHI-related laws representing 49 EHI uses in 54 jurisdictions. A total of 18 EHI uses were regulated by ≥10 jurisdictions. More than 750 laws addressed 2 or more EHI uses. Jurisdictions varied by the number of EHI laws in effect, with a mean of 44 laws. Texas had the most EHI laws (n = 145). Hawaii and South Carolina had the fewest (n = 14 each). Conclusions: The EHI legal landscape is complex. The large quantity and diversity of laws complicate legal analysis, likely delay implementation of public health solutions, and might be detrimental to the development of emerging health information technology. Research is needed to understand the effect of EHI-related laws. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The Healthy, Hunger-Free Kids Act of 2010 ( HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success. [ABSTRACT FROM AUTHOR]

Aim: Bibliometric analysis of the nursing literature can provide insights into the current state and dynamics of the nursing profession. This study aimed to assess global nursing‐related research activity from 2009 to 2020. Method: The corpus of nursing papers was harvested from the Web of Science Core Collection database. The bibliometric indicators and VOSviewer mapping of the retrieved papers were presented. Results: The search found 109,782 papers, and 39.0% of papers reported funded studies. Publication numbers were increasing. The USA was the most prolific country in literature production and international collaboration in nursing studies. International cooperation in nursing research was dominated by developed regions. Among the 20 most cited articles, 75% were published in first quartile journals, and review papers received a higher number of citations than original research articles. Author keyword analysis identified 'quality of life', 'mental health', 'nursing students' education' and 'adolescent' as common nursing focus topics. Conclusions: The publication trend of nursing papers was positive. However, several problems were associated with nursing research activity, including low research funding, regionally centred research activity and inactivity of developing regions in terms of international collaborations, which need to be addressed by policy makers, nursing managers and scholars. Summary statement: What is already known about this topic? Nursing research has developed rapidly worldwide over the years.Little is known about its overall development in recent years. What this paper adds? This study describes the nature of nursing research worldwide in terms of publication numbers, growth trend, geographic locus, international collaborations, the most productive authors, the most cited articles and author keywords analysis. The implications of this paper: The study is important for nursing scholars, managers and professionals to learn about the present status and dynamics of nursing research.The study provides important information for policymakers to allocate research grant that promotes the dissemination of nursing research into the broader scientific community. [ABSTRACT FROM AUTHOR]

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

Introduction Mentholated cigarettes are at least as dangerous to an individual's health as non-mentholated varieties. The addition of menthol to cigarettes reduces perceived harshness of smoke, which can facilitate initiation. Here, we examine correlates of menthol use, national trends in smoking menthol and non-menthol cigarettes, and brand preferences over time. Methods We estimated menthol cigarette use during 2004-2010 using annual data on persons ≥12 years old from the National Surveys on Drug Use and Health. We adjusted self-reported menthol status for selected brands that were either exclusively menthol or nonmenthol, based on sales data. Data were weighted to provide national estimates. Results Among cigarette smokers, menthol cigarette use was more common among 12-17 year olds (56.7%) and 18-25 year olds (45.0%) than among older persons (range 30.5% to 34.7%). In a multivariable analysis, menthol use was associated with being younger, female and of non-Caucasian race/ethnicity. Among all adolescents, the percentage who smoked non-menthol cigarettes decreased from 2004-2010, while menthol smoking rates remained constant; among all young adults, the percentage who smoked non-menthol cigarettes also declined, while menthol smoking rates increased. The use of Camel menthol and Marlboro menthol increased among adolescent and young adult smokers, particularly non-Hispanic Caucasians, during the study period. Conclusions Young people are heavy consumers of mentholated cigarettes. Progress in reducing youth smoking has likely been attenuated by the sale and marketing of mentholated cigarettes, including emerging varieties of established youth brands. This study should inform the Food and Drug Administration regarding the potential public health impact of a menthol ban. [ABSTRACT FROM AUTHOR]

Objective Scanty and controversial information is available on the impact of macroeconomic fluctuations on smoking behaviour. No study has quantified the effects of fiscal crises on smoking prevalence. This study aimed to investigate the effects of the 2007-2008 economic crisis on smoking prevalence and number of smokers in the USA. Methods Using data from the repeated Behavioural Risk Factor Surveillance System (BRFSS) surveys in pre-crisis (2005-2007) and post-crisis (2009-2010) periods on a total of 1 981 607 US adults, we separated the expected (after allowance for the demographic growth of the US population, secular smoking prevalence trends and changes in sociodemographic characteristics) from the unexpected (assumed attributable to the economic crisis) changes in the number of smokers across different employment statuses. Results Joinpoint regression analysis revealed no significant changes in smoking prevalence trends over the period 2005-2010. The crisis resulted in an increase in the number of smokers in the US by 0.6 million. This is largely due to an unexpected decrease of 1.7 million smokers among employed and an increase of 2.4 million smokers among unemployed individuals, whose smoking prevalence also remains extremely high in the post-crisis period (32.6%). Conclusions The 2008 financial crisis had a weak effect on smoking prevalence. The pro-cyclical relationship (ie, the crisis results in a lower number of smokers) found among the employed is offset by the counter-cyclical relationship (ie, the crisis results in a higher number of smokers) found among unemployed individuals. Public health interventions should specifically target those in unemployment, particularly in hard times. [ABSTRACT FROM AUTHOR]

Introduction There is anecdotal evidence that health messages interpreted from waterpipe tobacco smoking (WTS) research are inconsistent, such as comparing the health effects of one WTS session with that of 100 cigarettes. This study aimed to identify key health themes about WTS discussed by online news media, and how numerical cigarette–waterpipe equivalence (CWE) was being interpreted. Methods We identified 1065 online news articles published between March 2011 and September 2012 using the ‘Google Alerts' service. We screened for health themes, assessed statements mentioning CWE and reported differences between countries. We used logistic regression to identify factors associated with articles incorrectly reporting a CWE equal to or greater than 100 cigarettes, in the absence of any comparative parameter (‘CWE ≥100 cigarettes'). Results Commonly mentioned health themes were the presence of tobacco (67%) and being as bad as cigarettes (49%), and we report on differences between countries. While 10.8% of all news articles contained at least one positive health theme, 22.9% contained a statement about a CWE. Most of these (18.6% total) were incorrectly a CWE ≥100 cigarettes, a quarter of which were made by healthcare professionals/organisations. Compared with the Middle East, articles from the USA and the UK were the most significant predictors to contain a CWE ≥100 cigarettes statement. Conclusions Those wishing to write or publish information related to WTS may wish to avoid comparing WTS to cigarettes using numerical values as this is a major source of confusion. Future research is needed to address the impact of the media on the attitudes, initiation and cessation rates of waterpipe smokers. [ABSTRACT FROM AUTHOR]

Purpose The news media plays an important role in agenda setting and framing of stories about tobacco control. The purpose of this study was to examine newspaper, newswire and television coverage of tobacco issues in the USA over a 7-year period. Methods Analyses of 2004-2010 news media surveillance system data from the US Centers for Disease Control and Prevention's Office on Smoking and Health, based on content analysis and quantitative methods. Information on extent of news coverage, and types of tobacco-related themes, were examined from articles in 10 newspapers and 2 major newswires, as well as transcripts from 6 national television networks. Results The overall extent of newspaper, newswire and television stories about tobacco, and level of coverage by specific media outlets, varied over time, especially for newspapers. Nevertheless, there was an average of 3 newspaper stories, 4 newswire stories, and 1 television tobacco-related story each day. Television stories were more likely to contain cessation/addiction or health effects/statistics themes and less likely to contain secondhand smoke or policy/regulation themes than newspaper/newswire stories. There was more variation in the choice of tobacco theme among individual newspapers/newswires than television media outlets. Conclusions News coverage of tobacco in the USA was relatively constant from 2004 to 2010. Audiences were more likely to be exposed to different tobacco themes in newspapers/newswires than on television. Tracking information about tobacco news stories can be used by advocates, programs and others for planning and evaluation, and by researchers for hypothesis generation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Those with any psychiatric diagnosis have substantially greater rates of smoking and are less likely to quit smoking than those with no diagnosis. Using nationally representative data, we sought to provide estimates of smoking and longitudinal cessation rates by specific psychiatric diagnoses and mental health service use. DESIGN AND PARTICIPANTS: Data were analysed from a two-wave cohort survey of a US nationally representative sample (non-institutionalised adults): the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002, n=43 093; 2004-2005, n=34 653). MAIN OUTCOME MEASURES: We examined smoking rates (lifetime, past year and past year heavy) and cross-sectional quit rates among those with any lifetime or past year psychiatric diagnosis (DSM-IV). Importantly, we examined longitudinal quit rates and conducted analyses by gender and age categories. RESULTS: Those with any current psychiatric diagnosis had 3.23 (95% CI 3.11 to 3.35) times greater odds of currently smoking than those with no diagnosis, and were 25% less likely to have quit by follow-up (95% CI 20% to 30%). Prevalence varied by specific diagnoses (32.4% to 66.7%) as did cessation rates (10.3% to 17.9%). Comorbid disorders were associated with higher proportions of heavy smoking. Treatment use was associated with greater prevalence of smoking and lower likelihood of cessation. CONCLUSIONS: Those with psychiatric diagnoses remained much more likely to smoke and less likely to quit, with rates varying by specific diagnosis. Our findings highlight the need to improve our ability to address smoking and psychiatric comorbidity both within and outside of healthcare settings. Such advancements will be vital to reducing mental illness-related disparities in smoking and continuing to decrease tobacco use globally. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe relationships between tobacco-related environments and disparities in smoking by sexual orientation. METHODS: We examined three aspects of state-level tobacco environments, which were derived from the ImpacTeen State Level Tobacco Control Policy and Prevalence Database: (1) tobacco price and tax data and tobacco control funding; (2) tobacco control policies and (3) tobacco prevalence and norms data. This information was linked to individual-level data on sexual orientation, tobacco use and nicotine dependence in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34 653; 577 LGB respondents), a cross-sectional, nationally representative survey of adults in the USA. RESULTS: Lesbian, gay and bisexual (LGB) adults in states with more restrictive tobacco environments were less likely to have ever smoked (AOR=0.78, 95% CI 0.62 to 1.00) and to currently smoke (AOR=0.77, 95% CI 0.60 to 0.99) than LGB adults in more permissive tobacco environments. Further, sexual orientation disparities in past and current smoking, as well as in current nicotine dependence, were lower in states with the most restrictive tobacco environments. Results were robust to adjustment for confounders at the individual and state levels. CONCLUSIONS: Restrictive state-level tobacco environments are correlates of smoking behaviours among LGB adults in the USA; such environments could potentially reduce social inequalities in smoking based on sexual orientation. [ABSTRACT FROM AUTHOR]

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

Objective: We sought to understand the relative impact of fielding mode on response rate among public health alumni. Methods: As part of the 2021 Career Trends Survey of alumni from the University of Minnesota School of Public Health, we designed a fielding mode experiment to ascertain whether a paper survey, a postcard with a custom survey link ("postcard push-to-web"), a mobile telephone call or text (mobile), or an email invitation would garner the highest response rates. Invitations were randomly assigned from available contact information. Results: Of 8531 alumni invited, 1671 alumni (19.6%) completed the survey. Among the initial fielding modes, the paper survey had the highest response rate (28%), followed by mobile (19%), email (10%), and postcard push-to-web (10%). More robust recent engagement with alumni relations, paper survey invitation or mode switch, and recent graduation were all significantly associated with a higher likelihood of response. Conclusions: Paper and mobile invitations had the highest response rates to our survey among public health alumni. Findings from this fielding mode experiment are relevant to schools and programs of public health seeking to capture similar information among their alumni, especially given current trends in investment in the public health workforce. [ABSTRACT FROM AUTHOR]

The emphasis on research evaluation has brought scrutiny to the role of self‐citations in the scholarly communication process. While author self‐citations have been studied at length, little is known on national‐level self‐references (SRs). This paper analyses the citation context of national SRs, using the full‐text of 184,859 papers published in PLOS journals. It investigates the differences between national SRs and nonself‐references (NSRs) in terms of their in‐text mention, presence in enumerations, and location features. For all countries, national SRs exhibit a higher level of engagement than NSRs. NSRs are more often found in enumerative citances than SRs, which suggests that researchers pay more attention to domestic than foreign studies. There are more mentions of national research in the methods section, which provides evidence that methodologies developed in a nation are more likely to be used by other researchers from the same nation. Publications from the United States are cited at a higher rate in each of the sections, indicating that the country still maintains a dominant position in science. On the whole, this paper contributes to a better understanding of the role of national SRs in the scholarly communication system, and how it varies across countries and over time. [ABSTRACT FROM AUTHOR]

Background: Recent technological developments in medicine, including modern radiology have promoted the impact of scientific researches on social life. The scientific outputs such as article and patents are products that show the scientists' attempt to access these achievements. Objectives: In the current study, we evaluate the current situation of Iranian scientists in the field of radiology and compare it with the selected countries in terms of scientific papers. For this purpose, we used scientometric tools to quantitatively assess the scientific papers in the field of radiology. Materials and Methods: Radiology papers were evaluated in the context of medical field audit using retrospective model. We used the related databases of biomedical sciences for extraction of articles related to radiology. In the next step, the situation of radiology scientific products of the country were determined with respect to the under study regional countries. Results: Results of the current study showed a ratio of 0.19% for Iranian papers in PubMed database published in 2009. In addition, in 2009, Iranian papers constituted 0.29% of the Scopus scientific database. The proportion of Iranian papers in the understudy region was 7.6%. Conclusion: To diminish the gap between Iranian scientific radiology papers and other competitor countries in the region and achievement of document 2 025 goals, multifold effort of the society of radiology is necessary. [ABSTRACT FROM AUTHOR]

Objective: This study uses a systematic review with bibliometric analysis methods to investigate the characteristics of the most cited research papers in the field of nursing fatigue and pregnancy. Methods: In the Web of Science (WoS) database. We used the keywords "fatigue" and "pregnancy" to search for articles published from 2000 to 2020, limited to SSCI and Science Citation Index (SCI) journal-type articles. This study identifies the most cited studies in the WoS database based on PRISMA guidelines (Preferred reporting items for systematic reviews and meta-analyses). These studies form the research data, then visualized and analyzed using a retrospective bibliometric analysis and VOSviewer. Results: The studies in the dataset were analyzed in 319 different journals in 51 countries between 2000 and 2020. The study was found that the United States (US) was the country with the highest yield. The most frequent keywords were postpartum, depression, sleep, and postpartum depression. Conclusion: The research results further laid the foundation of bibliometrics for scholars and identified researchers, scientific journals, countries, and hot topics for fatigue-related pregnancy literature. Journals with high impact factors contain the most cited research and open new horizons for research in the nursing field of pregnancy-related fatigue, thus providing research inspiration for investigators in this field. [ABSTRACT FROM AUTHOR]

Background: The sudden growth in online instruction due to COVID‐19 restrictions has given renewed urgency to questions about remote learning that have remained unresolved. Web‐based assessment software provides instructors an array of options for varying testing parameters, but the pedagogical impacts of some of these variations has yet to be examined. Objectives: The current study examines whether question order affects student performance on online college math assessments. Drawing on the literature of testing and math anxiety, we hypothesized that difficult questions near the beginning of an assessment would have a destructive effect on student confidence, which would in turn have a deleterious effect on their performance. Methods: We employed an observational 'big data' methodology, analysing 23,468 final exams completed by students in 10 different courses over eight semesters at a Math Emporium in a large technical university in the eastern United States. Students were freshmen and sophomores enrolled in non‐engineering math courses. We regressed the final score on the difficulty level of the first and second questions, controlling for several other factors. Results and Conclusions: We found that several factors—day of the week, amount of time before the deadline, number of minutes spent on the exam—have more of an impact on score than question order. This pattern was consistent across sexes. Takeaways: Our findings contradict some previous studies, which have found that difficult early questions degrade student performance, and that this affect is more pronounced in females. This work enriches our understanding of how students respond to online assessment. Lay Description: What is already known about this topic: Previous studies have had mixed results about the effect of question difficulty ordering on student performance.Furthermore, few studies have examined this issue for computer assessments. What this paper adds: We employ a novel methodology with a uniquely large data set.Our findings indicate that difficulty ordering has no effect on student performance. Implications for practice: Math instructors can use the random ordering feature of computer assessment generating tools because question order does not affect performance. [ABSTRACT FROM AUTHOR]

Background: The United States is increasingly recognizing period product insecurity, insufficient access to menstrual products and limited private spaces for managing menstruation due to financial constraints, as an issue impacting the well-being and dignity of Americans. One strategy to address period product insecurity has been distributing free period products via period supply banks. The outcomes of period product distribution outside the school setting are absent from the literature. Objectives: This study, a formative evaluation of the free period product distribution efforts of the Alliance for Period Supplies, aims to identify (1) characteristics of individuals receiving products from period supply banks and their experiences of period product insecurity and (2) health and social outcomes experienced by recipients of free period products. Design: Survey data collection occurred at two points: baseline and one-year follow-up. All study participants provided verbal consent. Methods: Between Fall 2018 and Spring 2020, 1863 baseline and 80 follow-up surveys were administered. Participants received free period products for themselves and/or a household member from one of 20 participating Alliance for Period Supplies period supply banks directly or from one of their 64 partner agencies. Results: At baseline, 72.4% of participants had to choose between buying period products and another basic need. One year after accessing a period supply bank, 36.3% of participants reported this experience (p = 0.018). Participants reported at baseline, on average, 7.8 days in the past year of avoiding seeing others, canceling appointments, or skipping work or school because they did not have access to period products. At follow-up, this was reduced to 1.2 days, on average, t (68) = 2.214, p < 0.05. Conclusion: Period supply banks play an essential role in facilitating access to period products and the resulting benefits. Our study highlights the need for sustainable, well-funded policies and interventions to address period product insecurity effectively in society. Plain Language Summary: How people in the United States benefit when they get free period products from a period supply bank Why we did this study: In the United States, many individuals cannot afford to buy period supplies and the other stuff they need to live. Period supply banks want to help by giving them free period products. Researchers do not know if getting free period products is helpful for individuals. What we wanted to learn: The Alliance for Period Supplies is a membership program for period supply banks. We wanted to learn about the individuals who get free period products and whether getting them was helpful. What we did: For a year, starting in Fall 2018, we asked 1863 individuals to fill out paper surveys. A year later, we asked 80 of those same individuals to fill out a second survey. We asked participants to take the survey if they got free period products from a period supply bank for themselves or someone they live with. Individuals only participated in the study if they told us they wanted to. What we learned: Individuals who cannot afford period products must navigate difficult decisions between purchasing products or choosing other basic needs. Providing free products through a period supply bank has lessened the burden on these individuals, reducing the number who had to choose. Individuals unable to afford period products may sometimes opt out of going places they want to go for pleasure or miss important events, like work or school, because they do not have period products. Getting free period products has eased these challenges, letting individuals participate more fully in activities and engagements without worry about period products. Why is this important: Period supply banks are essential places where individuals receive free period products. The period supply banks need more individuals, including our government, to donate period supplies or money to buy them so they can help more individuals. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of Congolese refugee women seeking asylum in the USA has recently garnered substantial attention. Many women have fled the Democratic Republic of Congo due to trauma and loss. Likewise, the resettlement process, particularly acculturative stress, may exacerbate mental health issues such as depression and anxiety. By recognizing the centrality of family within Congolese culture, this study aims to investigate cultural beliefs about family among Congolese refugee women in the USA, using acculturative theory as an interpretative lens. Design/methodology/approach: The authors' study centered on understanding the resettlement experiences of 20 Congolese refugee women living within an urban area of Midwest America after their arrival in America since 2011. Through using convenient sampling methods, the authors chose these particular activists as they could provide insight into their stories concerning their journey from Congo to settling down as refugees within Northeast America. During interviews, semi-structured questioning was used to gather responses from participants which were later analyzed through implementing a thematic interpretation process. Findings: Three themes emerged encapsulating cultural beliefs about family: supporting one another; the importance of togetherness; and disciplining our children. These findings provide culturally tailored resources to support Congolese refugee women and their families upon resettlement optimally. Research limitations/implications: The authors' work provides health equity researchers with an opportunity to better understand cultural beliefs among Congolese refugee women. Findings from this study provide an increased understanding of how to provide culturally specific tools to better aid Congolese refugee women and their families upon arrival. Practical implications: The authors' research offers insights for health equity researchers seeking to understand the cultural beliefs of Congolese refugee women. The findings contribute to an enhanced understanding of how to provide culturally specific resources better to support Congolese refugee women and their families upon arrival. Originality/value: The authors verify that, to the best of the authors' knowledge, the paper was written completely independently, and neither the entire work nor any of its parts have been previously published. The authors confirm that the paper has not been submitted to peer review, nor is in the process of peer reviewing, nor has been accepted for publishing in another journal. The authors confirm that the research in their work is original. [ABSTRACT FROM AUTHOR]

Introduction: Local tissue destruction following envenomation from North American snakes, particularly those within the Crotalinae subfamily, has the potential to progress to compartment syndrome. The pathophysiology of venom-induced compartment syndrome (VICS) is a debated topic and is distinct from trauma/reperfusion-induced compartment syndrome. Heterogeneity exists in the treatment practices of VICS, particularly regarding the decision to progress to fasciotomy. Associations with functional outcomes and evolution in clinical practice since the introduction of Crotalidae polyvalent immune Fab (FabAV) have not been well defined. Our goal was to identify the potential gaps in the literature regarding this phenomenon, as well as illuminate salient themes in the clinical characteristics and treatment practices of VICS. Methods: We conducted this systematic scoping-style review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Records were included if they contained data surrounding the envenomation and hospital course of one or more patients who were envenomated by a snake species native to North America and were diagnosed with compartment syndrome from 1980-2020. Results: We included 19 papers: 10 single- or two-patient case reports encompassing 12 patients, and nine chart reviews providing summary statistics of the included patients. In case reports, the median compartment pressure when reported was 60 millimeters of mercury (interquartile range 55-68), 66% underwent fasciotomy, and functional outcomes varied. Use of antivenom appeared to be more liberal with FabAV than the earlier antivenin Crotalidae polyvalent. Rapid progression of swelling was the most commonly reported symptom. Among the included retrospective chart reviews, important data such as compartment pressures, consistent laboratory values, and snake species was inconsistently reported. Conclusions: Venom-induced compartment syndrome is relatively rare. Existing papers generally describe good outcomes even in the absence of surgical management. Significant gaps in the literature regarding antivenom dosing practices, serial compartment pressure measurements, and functional outcomes highlight the need for prospective studies and consistent standardized reporting. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding provides many short- and long-term health benefits for mothers and their infants and is a particularly relevant strategy for women who experience Gestational Diabetes Mellitus (GDM) during pregnancy. However, breastfeeding rates are generally lower amongst this group of women than the general population. This review's objective is to identify the factors that influence breastfeeding by exploring the experiences and outcomes of women in in high-income health care contexts when there is a history of GDM in the corresponding pregnancy. Methods: A comprehensive search strategy explored the electronic databases Medline, CINAHL, Web of Science and Scopus for primary studies exploring breastfeeding practices for papers published between January 2011 and June 2023. All papers were screened independently by two researchers with included papers assessed using the Crowe Critical Appraisal tool. Findings were analysed using a narrative synthesis framework. Results: From an initial search result of 1037 papers, 16 papers representing five high-income nations were included in this review for analysis – the United States of America (n = 10), Australia (n = 3), Finland (n = 1), Norway (n = 1), and Israel (n = 1). Fifteen papers used a quantitative design, and one used a qualitative design. The total number of participants represented in the papers is 963,718 of which 812,052 had GDM and 151,666 did not. Women with an immediate history of GDM were as likely to initiate breastfeeding as those without it. However, they were more likely to have the first feed delayed, be offered supplementation, experience delayed lactogenesis II and or a perception of low supply. Women were less likely to exclusively breastfeed and more likely to completely wean earlier than the general population. Maternity care practices, maternal factors, family influences, and determinants of health were contextual and acted as either a facilitator or barrier for this group. Conclusion: Breastfeeding education and support need to be tailored to recognise the individual needs and challenges of women with a history of GDM. Interventions, including the introduction of commercial milk formula (CMF) may have an even greater impact and needs to be very carefully considered. Supportive strategies should encompass the immediate and extended family who are major sources of influence. [ABSTRACT FROM AUTHOR]

Inspired by pandemic-transformed instruction, this paper examines the digital accessibility of five tech tools used in information literacy sessions, specifically for students who use assistive technologies such as screen readers. The tools are Kahoot!, Mentimeter, Padlet, Jamboard, and Poll Everywhere. First, we provide an overview of the Americans with Disabilities Act (ADA) and digital accessibility definitions, descriptions of screen reading assistive technology, and the current use of tech tools in information literacy instruction for student engagement. Second, we examine accessibility testing assessments of the five tech tools selected for this paper. Our data show that the tools had severe, significant, and minor levels of digital accessibility problems, and while there were some shared issues, most problems were unique to the individual tools. We explore the implications of tech tools' unique environments as well as the importance of best practices and shared vocabularies. We also argue that digital accessibility benefits all users. Finally, we provide recommendations for teaching librarians to collaborate with campus offices to assess and advance the use of accessible tech tools in information literacy instruction, thereby enhancing an equitable learning environment for all students. [ABSTRACT FROM AUTHOR]

Objectives: Recruitment through Facebook is gaining favor as an approach for research, including clinical trials, because of the platform's ability to reach broad and diverse populations. As older adults increase their social media use, recruitment through Facebook has become a viable option. The purposes of this paper are to report the methodological process and lessons learned from recruiting custodial grandmothers (CGMs) for a cross‐sectional study examining parenting self‐efficacy and psychological well‐being. Participants: A total of 113 people consented and accessed the survey online, with 40 (35.4%) completing surveys. The final sample comprised 68 grandmothers, with 59% recruited via Facebook. Methods: Facebook recruitment for the online survey included creating a dedicated Facebook study page, accessing existing Facebook pages for custodial grandparents, and using paid advertising. Face‐to‐face recruitment strategies also were used with paper surveys. Results: We compared the characteristics of those completing online surveys versus paper surveys. CGMs completing the survey online were significantly younger and more likely to be Caucasian than those completing the paper survey. Conclusions: Findings indicated online recruitment via Facebook is an advantageous method to reach CGMs. However, additional research is needed to determine if other online and social media platforms would be useful in recruiting this population. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological disease. There is an incidence. We aimed to evaluate the scientometrics characteristics of the scientific production on BPDCN between 2011 and 2020. METHODOLOGY: A cross-sectional and retrospective bibliometric study was performed. The search was executed in the Scopus database. Data were extracted based on a formula developed using thesaurus MeSH (Medline) and Emtree (Embase) terms. The retrieved papers received 11.2 citations per paper. Four of the ten most productive authors were from the United States. The institution with the highest impact (1064 citations) and the highest scientific output (46 papers) was the University of Texas MD Anderson Cancer Center (United States). RESULTS: The journal "Movement Disorders" rated first with 18 articles and 643 citations in terms of productivity and impact, and articles published in Q1 journals surpassed the remaining quartiles. The most cited articles had national collaboration. Conclusion the number of papers on BPDCN has been rising, yet journals with a higher quality tend to keep the similar publication rates, although they have shown a slight increase in the recent years. CONCLUSIONS: High-income countries' international collaboration is crucial for increasing publications impact; hence, greater collaborations between researchers and institutions from countries around the world are needed to expand knowledge on this subject. [ABSTRACT FROM AUTHOR]

This paper presents the results of thirty-seven interviews of senior library leaders at American Association of University (AAU) institutions conducted in Spring 2023. The author replicated a 2016 study from portal , revealing an increased focus on strategic plan-based decision-making along with new priorities of open scholarship and diversity, equity, and inclusion (DEI). The COVID-19 pandemic had a drastic impact on staffing and budgets, requiring academic library leaders to balance internal operations and external collaboration. A younger, more diverse AAU library leadership population achieves success through strong advocacy to campus leadership and the inclusive leadership practices outlined in this paper. [ABSTRACT FROM AUTHOR]

Existing research suggests that prior victimizations during a person's lifetime, particularly childhood traumas and maltreatment, are risk factors for abuse and revictimization in adulthood, although longitudinal evidence is sparse. Using data from a 30-year ongoing longitudinal study of the long-term consequences of childhood maltreatment, this paper describes the extent to which childhood maltreatment predicts subsequent victimization and partner violence victimization at two time points in adulthood. Data were obtained from a prospective cohort design study in which children with court-substantiated cases of maltreatment (ages 0–11 years) and demographically matched controls were followed into adulthood and interviewed over several waves. Childhood maltreatment was assessed through juvenile and adult court records from 1967 to 1971 in a midwestern county area in the United States. Victimization experiences were assessed from 2000 to 2002 (M age = 39.5 years) and 2009 to 2010 (M age = 47.5) and included two types based on information from the lifetime trauma and victimization history instrument and questions about past year partner violence victimization. Individuals with histories of childhood maltreatment were more likely to report physical and sexual assaults and kidnapping and stalking victimization than controls through age 39.5. In contrast, the two groups did not differ at the later assessment at age 47.5, except maltreated individuals reported greater risk for sexual assault/abuse than controls. For intimate partner violence victimization at age 39.5, maltreated and control groups differed only in terms of victimization involving injury. Later in adulthood, more individuals with histories of childhood maltreatment reported partner physical violence victimization compared to controls. Although these longitudinal findings showed a general decline in victimization experiences over the two time points, these results demonstrate that childhood maltreatment increases risk for subsequent revictimization in middle adulthood, specifically for sexual assault/abuse and intimate partner physical violence victimization. These findings have implications for prevention and intervention efforts targeting maltreated children. [ABSTRACT FROM AUTHOR]

Objectives: Non-coding RNA (ncRNA) plays a role in the development of diabetes and coronary heart disease. However, there is limited research on the association between ncRNA and these conditions. This study aims to conduct a bibliometric analysis and visualization of existing research to provide a comprehensive reference for future investigation in this field. Methods: We searched the China National Knowledge Infrastructure (CNKI) and Web of Science Core Collection (WoSCC) databases for articles published from 2012 to 2024. We analyzed publication volume, country of origin, authors, and keywords using Microsoft Office Excel, CiteSpace, and VOSviewer. Results: A total of 414 papers from 56 countries/regions, involving 298 authors, were analyzed. China had the highest number of publications (177), followed by the USA (90) and Italy (28). The number of publications generally shows an increasing trend. Collaborative research efforts were prevalent, with Katare Rajesh being the most cited author on average. International Journal of Molecular Sciences emerged as the most prolific journal in this field, while the article "MicroRNA profiling unveils hyperglycaemic memory in the diabetic heart" was identified as the most frequently cited. The analysis of keywords and literature indicates that current research predominantly focuses on the expression and mechanisms of ncRNA in disease, as well as its potential as a biomarker. Conclusion: Research on ncRNA in the context of diabetes and coronary heart disease has made notable strides, although it warrants further exploration. Through bibliometric and visual analysis, we elucidate the collaborative relationships among researchers, which can facilitate the identification of potential collaborators. Additionally, we delineate the key areas and emergent trends in this field, providing valuable insights that can guide researchers in selecting future research directions. Plain Language Summary: Tables and pictures are used to show the research status of ncRNA in diabetes mellitus with coronary heart disease This research explores the connection between a type of RNA called ncRNA and two common diseases: diabetes and coronary heart disease. We used a method called bibliometrics to analyze over 400 research papers published on this topic from 2012 to 2024. What we found: • The number of studies on ncRNA and diabetes with heart disease has been increasing over the past 12 years, indicating growing interest in this area. • China and the United States have published the most research on this topic, but international collaboration could further enhance the impact of these studies. • Some scientists, like Rajesh Katare, have made significant contributions to this field with their research on miRNA as a potential biomarker for heart disease in diabetes patients. • The most common journals publishing research on this topic include the International Journal of Molecular Sciences and the Journal of the American College of Cardiology. • The main focus of current research is understanding how ncRNA is expressed and functions in these diseases, and its potential as a biomarker for early diagnosis and treatment. Why this is important: • Diabetes and coronary heart disease are major health problems worldwide, causing significant illness and death. • ncRNA has the potential to be used as a biomarker for these diseases, which could lead to earlier diagnosis and better treatment options. • Understanding the role of ncRNA in these diseases could also help develop new treatments that target the underlying causes of the diseases. What's next: • Future research should focus on understanding the role of long noncoding RNA in diabetes and heart disease, as this type of RNA is thought to be important in regulating genes related to these diseases. • Increased international collaboration could. help further advance the field and improve the impact of research findings. [ABSTRACT FROM AUTHOR]

BACKGROUND: This paper presents the process taken by a nonprofit educational organization to create authentic evaluation tools for Food Education in K‐12 schools. Development was a collaborative effort between organization staff and teachers during an Evaluation Summit. The program background, development of the Summit, and plans for post‐Summit work continuation are described. The Summit included 14 teacher participants (3‐4 per grade band in preK‐1, 2‐5, 6‐8, 9‐12). METHODS: The process of tool development was captured via direct observations and analysis of artifacts (eg, participants' brainstorming chart paper, online development documents) to identify themes in successful approaches and challenges. Additional post‐Summit activities were also captured via surveys and artifacts. Outcomes of this work are outlined, including the challenges in carrying out the creation of authentic assessments that accurately reflect the classroom teaching experience, and the value of in‐person community building in the Food Education space. RESULTS: Key findings relate to the importance of in‐person collaboration amongst teachers, centering students in evaluation, and equity and accessibility in tool development. CONCLUSIONS: Although outlining challenges and outcomes was not an a priori goal of this work, it provides important information for others working in the education nonprofit space—especially as it pertains to new approaches to classroom evaluation. [ABSTRACT FROM AUTHOR]

Background: Mindfulness practices enhance executive function skills and academic achievement, spurring interest in integrating mindfulness interventions into education. Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and boost game‐based learning, yet this approach remains unexplored. Objectives: We investigated the learning benefits of integrating mindfulness exercises in a digital math learning game and examined how students' trait mindfulness might moderate the outcomes. Methods: Two classroom studies were conducted with 404 5th and 6th grade students from six public schools in the U.S. (nStudy 1 = 227, nStudy 2 = 177). The two randomized controlled experiments assigned students to one of the three conditions: passive control (playing the digital learning game Decimal Point), story‐enriched active control, or mindfulness‐enriched condition. Trait mindfulness, learning gains, and in‐game problem‐solving (including problem‐solving duration, error count and correctness after reminder) were assessed. Study 2 included a manipulation check to better understand the effects of the mindfulness intervention. Results: Findings showed no significant differences in learning gains, problem‐solving duration or error count among the conditions. Students' trait mindfulness did not moderate these outcomes. Mindfulness reminders in the mindfulness‐enriched game led to more correct answers after errors than jokes in the story‐enriched game. Study 2 revealed that we failed to induce higher state mindfulness through the mindfulness inductions. Conclusions: Mindfulness prompts could be especially beneficial for students experiencing frustration during gameplay, warranting more exploration for digital game‐based instruction. We highlight barriers and future directions for fostering mindfulness through computer‐based instruction in classrooms. Lay Description: What is currently known about this topic?: Researchers focus on digital games as productive learning environments for math, with potential for higher learning gains compared with traditional methods. However, results are mixed, and not all games lead to improved math outcomes.Executive function (EF) skills are crucial for math learning, and mindfulness‐based interventions show promise in enhancing EF skills in school‐aged students.Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and, in turn, boost EF skills and game‐based learning, yet this approach remains unexplored What does this paper add?: This paper presents the results of two randomized control trials investigating the feasibility and benefits of incorporating mindfulness exercises into a digital math game designed for middle school students. Benefits are compared to those of a story‐enriched and regular version of the same digital math learning game.The paper also explores variations in the effects of the mindfulness‐enriched game based on students' initial trait mindfulness levels.We observe that listening to mindfulness inductions at the beginning of game sessions do not induce mindfulness, and therefore does not benefit math learning.We find that mindfulness prompts received after recurrent errors can be beneficial for students' problem solving. Implications of study findings for practitioners: Our study provides important information on how digital learning game designers should attempt to induce mindfulness in a digital game to promote learning.Digital learning game designers should consider incorporating mindfulness exercises into their games strategically. Presenting mindfulness inductions in audio format at the beginning of game sessions may not induce mindfulness or benefit math learning. Instead, designers should focus on integrating mindfulness prompts at moments when students encounter frustration within the learning game.Beyond embedding audio mindfulness exercises in the game, learning designers should also consider alternative technological and game features to induce mindfulness within a learning game. [ABSTRACT FROM AUTHOR]

Aim: To identify attitudes towards HIV/STI screening guidelines and explore the acceptability of assessing sexual positioning practices among Black sexual minority men (SMM). Background: Risks for HIV/STIs vary by sexual positioning practices. However, clinicians and Black SMM do not always discuss sexuality with each other. Therefore, HIV/STI screening and testing remain suboptimal. Design: Qualitative study using focus groups. Methods: Data were obtained from 12 focus groups and one in‐depth interview conducted in Baltimore, MD among HIV‐negative Black SMM between October 2019 and May 2020 (N = 39). Groups were stratified into three age categories: 18–24, 25–34 and 35+. Participants were given the "5 P's" from the CDC's 2015 Sexual History Screening Guidelines and asked to discuss attitudes towards existing questions regarding sexual positioning practices. Themes were identified using an electronic pile sorting approach. Results: Most identified as homosexual/gay/same gender‐loving (68%), were employed (69%) and single (66%). Additionally, 34% had ever been diagnosed with an STI, of whom 38% had a history of repeated STI acquisition in their lifetime. Participants across age groups said clinicians should use the words "top" and "bottom" to demonstrate cultural familiarity and build trust. Some said that screening for sexual positioning was unnecessary and intrusive; others said that questions should be justified. Younger men wanted clinicians to ask questions in ways that make them feel cared for. Discussion: Guidelines should include language for clinicians to use culturally specific language and better ways to prepare Black SMM patients for screening. Impact to Nursing Practice: Some Black SMM will not discuss sexual positioning practices without clinicians' demonstration of cultural understanding and respect. Screening should incorporate culturally responsive language, justification and convey care. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ). No Patient or Public Contribution: There was no patient or public involvement in the design or drafting of this discursive paper. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices–such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future. [ABSTRACT FROM AUTHOR]

Purpose Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. Methods We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Findings Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. Conclusions Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. [ABSTRACT FROM AUTHOR]

Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]

Background: Early identification and treatment of chronic disease is associated with better clinical outcomes, lower costs, and reduced hospitalisation. Primary care is ideally placed to identify patients at risk of, or in the early stages of, chronic disease and to implement prevention and early intervention measures. This paper evaluates the implementation of a technological intervention called Future Health Today that integrates with general practice EMRs to (1) identify patients at-risk of, or with undiagnosed or untreated, chronic kidney disease (CKD), and (2) provide guideline concordant recommendations for patient care. The evaluation aimed to identify the barriers and facilitators to successful implementation. Methods: Future Health Today was implemented in 12 general practices in Victoria, Australia. Fifty-two interviews with 30 practice staff were undertaken between July 2020 and April 2021. Practice characteristics were collected directly from practices via survey. Data were analysed using inductive and deductive qualitative analysis strategies, using Clinical Performance - Feedback Intervention Theory (CP-FIT) for theoretical guidance. Results: Future Health Today was acceptable, user friendly and useful to general practice staff, and supported clinical performance improvement in the identification and management of chronic kidney disease. CP-FIT variables supporting use of FHT included the simplicity of design and delivery of actionable feedback via FHT, good fit within existing workflow, strong engagement with practices and positive attitudes toward FHT. Context variables provided the main barriers to use and were largely situated in the external context of practices (including pressures arising from the COVID-19 pandemic) and technical glitches impacting installation and early use. Participants primarily utilised the point of care prompt rather than the patient management dashboard due to its continued presence, and immediacy and relevance of the recommendations on the prompt, suggesting mechanisms of compatibility, complexity, actionability and credibility influenced use. Most practices continued using FHT after the evaluation phase was complete. Conclusions: This study demonstrates that FHT is a useful and acceptable software platform that provides direct support to general practice in identifying and managing patients with CKD. Further research is underway to explore the effectiveness of FHT, and to expand the conditions on the platform. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is a significant cause of female cancer-related deaths in the US. Checking how severe the cancer is helps in planning treatment. Modern AI methods are good at grading cancer, but they are not used much in hospitals yet. We developed and utilized ensemble deep learning algorithms for addressing the tasks of classifying (1) breast cancer subtype and (2) breast cancer invasiveness from whole slide image (WSI) histopathology slides. The ensemble models used were based on convolutional neural networks (CNNs) known for extracting distinctive features crucial for accurate classification. In this paper, we provide a comprehensive analysis of these models and the used methodology for breast cancer diagnosis tasks. Cancer diagnosis and classification are pivotal for effective patient management and treatment planning. In this study, a comprehensive approach is presented utilizing ensemble deep learning techniques to analyze breast cancer histopathology images. Our datasets were based on two widely employed datasets from different centers for two different tasks: BACH and BreakHis. Within the BACH dataset, a proposed ensemble strategy was employed, incorporating VGG16 and ResNet50 architectures to achieve precise classification of breast cancer histopathology images. Introducing a novel image patching technique to preprocess a high-resolution image facilitated a focused analysis of localized regions of interest. The annotated BACH dataset encompassed 400 WSIs across four distinct classes: Normal, Benign, In Situ Carcinoma, and Invasive Carcinoma. In addition, the proposed ensemble was used on the BreakHis dataset, utilizing VGG16, ResNet34, and ResNet50 models to classify microscopic images into eight distinct categories (four benign and four malignant). For both datasets, a five-fold cross-validation approach was employed for rigorous training and testing. Preliminary experimental results indicated a patch classification accuracy of 95.31% (for the BACH dataset) and WSI image classification accuracy of 98.43% (BreakHis). This research significantly contributes to ongoing endeavors in harnessing artificial intelligence to advance breast cancer diagnosis, potentially fostering improved patient outcomes and alleviating healthcare burdens. [ABSTRACT FROM AUTHOR]

The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators. Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994–2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field. Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage (n = 4879) and Annals of the Rheumatic Diseases (n = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications. Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America. [ABSTRACT FROM AUTHOR]

Kidney transplantation is a life-saving intervention for end-stage renal disease; yet, the persistent gap between organ demand and supply remains a significant challenge. This paper explores the escalating discard rates of deceased donor kidneys in the United States to assess trends, discard reasons, demographical differences, and preservation techniques. Data from the Scientific Registry of Transplant Recipients from 2010 to 2021 was analyzed using chi-squared tests for trend significance and logistic regression to estimate odds ratios for kidney discard. Over the last decade, discard rates have risen to 25% in 2021. Most discarded kidneys came from extended criteria donor (ECD) donors and elevated kidney donor profile index (KDPI) scores. Kidney biopsy status was a significant factor and predictor of discard. Discard rates varied greatly between Organ Procurement and Transplantation Network regions. Of reasons for discard, "no recipient located" reached a high of 60%. Additionally, there has been a twofold increase in hypothermic machine perfusion (HMP) since 2010, with transportation difficulties being the main reason for the discard of perfused kidneys. Our findings suggest a need to recalibrate organ utilization strategies, optimize the use of lower-quality kidneys through advanced preservation methods, and address the evolving landscape of organ allocation policies to reduce kidney discard rates. [ABSTRACT FROM AUTHOR]

Objective: Antineutrophil cytoplasmic antibody-associated vasculitides (AAV) can affect the upper and lower respiratory tract. Evaluation of voice quality was aimed at patients with AAV in this paper. Materials and Methods: In this study, AAV-diagnosed patients and their age-gender-compatible healthy counterparts were enrolled. Participants with histories of airway surgery, smoking, laryngopharyngeal reflux symptoms, allergy, active nose, throat, and larynx infection were excluded. After the otolaryngologic examination, Voice Handicap Index-10 (VHI) scores, maximum phonation times (MPT), auditory-perceptual analysis of voice (GRBAS score), and acoustic analysis were performed. The MPT, VHI, GRBAS, F0, jitter, shimmer, and harmonic-to-noise ratio (HNR) values of both groups were compared statistically. Parameters were evaluated using the PRAAT software. Results: There were 30 subjects in each group (16 women and 14 men). The mean ages were 51.1 and 51.5 years in the patient and control groups. Significant differences were found between the two groups regarding median VHI scores, MPT, and GRBAS scores (p<0.05). While median VHI and GRBAS scores were higher in the vasculitis group, median MPT was shorter. Conclusion: Voice quality may disturb patients with AAV, especially in terms of VHI, MPT, and GRBAS scores. [ABSTRACT FROM AUTHOR]

Aims: To elicit experiences of patients, family caregivers, and healthcare professionals in intermediate care units (IMCUs) in an academic medical centre in Baltimore, MD related to the challenges and intricacies of multimorbidity management to inform development of a multimorbidity symptom management toolkit. Design: Experience‐based co‐design. Methods: Between July and October 2021, patients aged 55 years and older with multimorbidity admitted to IMCUs at an academic medical centre in Baltimore, Maryland, USA were recruited and interviewed in person. Interdisciplinary healthcare professionals working in the IMCU were interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting the quality of life, symptom burden and trajectory over time, and strategies that have and have not worked for managing symptoms. An inductive thematic analysis approach was used for analysis. Results: Twenty‐three interviews were conducted: 9 patients, 2 family caregivers, and 12 healthcare professionals. Patients' mean age was 67.5 (±6.5) years, over half (n = 5) were Black or Hispanic, and the average number of comorbidities was 3.67. Five major themes that affect symptom management emerged: (1) the patient–provider relationship; (2) open and honest communication; (3) accessibility of resources during hospitalization and at discharge; (4) caregiver support, training, and education; and (5) care coordination and follow‐up care. Conclusion: Patients, caregivers, and healthcare professionals often have similar goals but different priorities for multimorbidity management. It is imperative to identify shared priorities and target holistic interventions that consider patient and caregiver experiences to improve outcomes. Implications for the Profession and/or Patient Care and Impact: This paper addresses the paucity of research related to the shared experience of disease trajectory and symptom management for people living with multimorbidity. We found that patients, caregivers, and healthcare professionals often have similar goals but different care and communication priorities. Understanding differing priorities will help better design interventions to support symptom management so people with multimorbidity can have the best possible quality of life. Reporting Method: We have adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines in our reporting. Patient or Public Contribution: This study has been designed and implemented with patient and public involvement throughout the process, including community advisory board engagement in the project proposal phase and interview guide development, and member checking in the data collection and analysis phases. The method we chose, experience‐based co‐design, emphasizes the importance of engaging members of a community to act as experts in their own life challenges. In the coming phases of the study, the public will be involved in developing and testing a new intervention, informed by these qualitative interviews and co‐design events, to support symptom management for people with multimorbidity. [ABSTRACT FROM AUTHOR]

Background: Cough is one of the most common presenting problems for patients in primary care and is largely managed in primary care clinical settings. Family physicians' familiarity with chronic cough guidelines and the extent to which these guidelines translate into everyday practice have not been well described. The objective of this study was to characterize current diagnosis, treatment, and referral practices among family physicians and to identify potentially impactful strategies to optimize chronic cough management in primary care. Methods: We conducted a cross-sectional survey of 5,000 family physicians to explore diagnosis, treatment, and referral practices related to chronic cough management in adults in primary care. Respondents completed the survey via paper or online. The outcome measures were self-reported numeric ratings and responses related to the survey elements. Results: 588 surveys were completed (11.8% response rate). About half (49.6%) of respondents defined chronic cough in a manner consistent with the American College of Chest Physicians (ACCP) chronic cough guidelines, with the rest differing in opinion primarily regarding duration of symptom presentation. Respondents reported trying to rule out most common causes of chronic cough themselves before referring (mean 3.41 on a 4-point scale where 4 is "describes me completely") and indicated a desire for more resources to help them manage and treat chronic cough. Years in practice and rural/urban setting influenced diagnosis and referral practices. Conclusions: Family physicians see chronic cough as a complicated condition that can be and is often diagnosed and treated entirely in a primary care setting. They also value the ability to refer in complex cases. Our results support that family physicians provide evidence-based management of chronic cough. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]