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Objective A major impediment to the development of novel treatment strategies for fibromyalgia (FM) is the lack of an objective marker that reflects spontaneously reported clinical pain in patients with FM. Studies of resting-state intrinsic brain connectivity in FM have demonstrated increased insular connectivity to the default mode network (DMN), a network whose activity is increased during nontask states. Moreover, increased insular connectivity to the DMN was associated with increased spontaneous pain levels. However, as these analyses were cross-sectional in nature, they provided no insight into dynamic changes in connectivity or their relationship to variations in self-reported clinical pain. The purpose of this study was to evaluate longitudinal changes in the intrinsic brain connectivity of FM patients treated with nonpharmacologic interventions known to modulate pain levels in this patient population, and to test the hypothesis that the reduction of DMN-insula connectivity following therapy would correlate with diminished pain. Methods Seventeen FM patients underwent resting-state functional magnetic resonance imaging at baseline and following 4 weeks of a nonpharmacologic intervention to diminish pain. Intrinsic DMN connectivity was evaluated using probabilistic independent components analysis. Longitudinal changes in intrinsic DMN connectivity were evaluated by paired analysis, and correlations between longitudinal changes in clinical pain and changes in intrinsic DMN connectivity were investigated by multiple linear regression analysis. Changes in clinical pain were assessed with the short form of the McGill Pain Questionnaire (SF-MPQ). Results Clinical pain as assessed using the sensory scale of the SF-MPQ was reduced following therapy ( P = 0.02). Intrinsic DMN connectivity to the insula was reduced, and this reduction correlated with reductions in pain (corrected P < 0.05). Conclusion Our findings suggest that intrinsic brain connectivity can be used as a candidate objective marker that reflects changes in spontaneous chronic pain within individual FM patients. We propose that intrinsic connectivity measures could potentially be used in either research or clinical settings as a complementary, more objective outcome measure for use in FM. [ABSTRACT FROM AUTHOR]

This study aimed to develop a smartphone‐based home workout program for shift‐work nurses to increase their levels of exercise and examine its effects on health (sleep disturbance, fatigue, musculoskeletal problems, and resilience) and nursing performance. For this quasiexperimental study with a nonequivalent control group, 54 shift‐work nurses were recruited from two general wards at a hospital in Korea and assigned to the intervention and control groups. Nurses in the intervention group were encouraged to exercise regularly using the home workout application for 18 weeks. For the first 12 weeks, text‐message counseling and environmental improvement were carried out; only environmental improvement was implemented in the remaining 12–18 weeks. The control group did not receive any intervention. After excluding dropouts, the data of the final 25 participants in the intervention group and 24 participants in the control group were analyzed. Compared with the control group, the intervention group showed statistically significant improvements in physical and psychological health. Hospital organizations could adopt a smartphone‐based home workout program to overcome obstacles to exercise, which could lead to positive health outcomes for shift‐work nurses. [ABSTRACT FROM AUTHOR]

Vaccination against COVID‐19 has been promoted as a way to protect oneself and others from infection. To ensure the comprehensive acceptance of COVID‐19 vaccines, the factors that affect COVID‐19 vaccination hesitancy should be examined. This study aimed to identify the factors that affect COVID‐19 vaccination hesitancy among Korean adults, focusing on COVID‐19 knowledge and attitudes toward vaccination. This was a cross‐sectional study conducted with 2286 Korean adults aged 20–64 years. Demographic characteristics, knowledge regarding COVID‐19, and attitudes toward vaccination were assessed. A generalized linear model with Poisson regression was used to identify factors associated with COVID‐19 vaccination hesitancy. Approximately 67% of the COVID‐19 knowledge‐related questions were correctly answered. A neutral attitude toward vaccination and relatively low vaccination hesitancy were found. COVID‐19 vaccination hesitancy was affected by individuals' attitudes toward vaccination, as well as their gender and age, but not by their knowledge. Interventions or policies considering gender and age could be helpful in reducing COVID‐19 vaccination hesitancy. Strategies to disseminate more accurate and novel information related to the COVID‐19 vaccines should be implemented. [ABSTRACT FROM AUTHOR]