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Background: Nursing students are given opportunities to develop critical thinking disposition, caring behaviors, and professional commitment through clinical training. Therefore, nurse educators should move away from traditional methods toward new ones, such as internship programs in clinical training. This study assessed the effect of nursing internship programs on senior undergraduate nursing students' critical thinking disposition, caring behaviors, and professional commitment. Methods: This quasi-experimental study was conducted using a pretest-posttest design but with no control group. The study sample included 46 senior students enrolled in nursing internship programs. A demographic questionnaire, the Critical Thinking Disposition Inventory (CTDI), the Caring Assessment Report Evaluation (Care-Q), and the Nursing Professional Commitment Scale (NPCS) were used to collect data before and five months after the nursing internship programs were implemented. Results: The study findings revealed that the senior nursing students' caring behaviors improved, but the total scores of critical thinking disposition and professional commitment did not change significantly after the nursing internship programs (p > 0.05). Conclusion: According to the results, nurse educators are recommended to adopt strategies to improve the effectiveness of internship programs on critical thinking disposition and professional commitment among senior undergraduate nursing students. [ABSTRACT FROM AUTHOR]

Introduction: The preparedness of the healthcare system to address emergency situations is contingent on the inclination of healthcare personnel. Nursing students can serve as valuable resources to supplement the workforce during major incidents and disasters. This study investigated the facilitators and barriers of nursing students' willingness to respond to disasters at the Alborz University of Medical Sciences in 2022. Methods: In this cross-sectional descriptive study, 234 nursing students were recruited using convenience sampling. A deductive-inductive questionnaire was developed and distributed through an online self-administered survey comprising demographic information and questions on barriers, facilitators, various disaster scenarios, preferred activities, and reasons for pursuing a nursing career. Results: The mean willingness scores of nursing students in response to various disasters were as follows: 3.15 for natural disasters, 2.60 for man-made disasters, 2.94 for pandemics, and 3.32 overall. Among the disaster scenarios, the earthquake response obtained the highest willingness score, while infectious disease epidemics received the lowest score. The most and least willingness to perform activities during disaster response were related to bedside care and participation in patients' personal hygiene, respectively. Key determinants of participation included the possibility of immunization and concerns for family safety. Conclusion: The findings indicated that nursing students are generally willing to assist as members of the healthcare team during disasters. However, the willingness to respond to infectious disease epidemics and man-made disasters was below the norm. Concerns about family health and the risk of disease transmission were identified as primary barriers. Addressing these concerns is crucial to enhance nursing students' participation in disaster response. [ABSTRACT FROM AUTHOR]

Background: Emergency ward nurses face a variety of occupational hazards due to the nature of their occupational and professional duties, which can negatively affect their health. Therefore, this study aimed to evaluate the effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards in Tehran, Iran, in 2023. Methods: The present quasi-experimental study was conducted with two intervention and control groups, using a pretest-posttest design. A total of 124 nurses working in the emergency wards of four hospitals (two hospitals for the intervention group and two hospitals for the control group by random assignment) were selected by multistage sampling method. The educational intervention based on the protection motivation theory was implemented for the intervention group for three weeks. The nurses of both groups completed a demographic questionnaire and the scale of emergency ward nurses' protective behaviors against occupational hazards before, immediately, and one month after the intervention. Data analysis was performed using descriptive and inferential methods. Results: The two groups were similar in terms of demographic characteristics at the baseline (p > 0.05). Protective behaviors of emergency nurses against occupational hazards and their sub-scales (physical, chemical, biological, ergonomics, and psychosocial hazards) were higher in the intervention group than in the control group immediately and one month after the educational intervention. In addition, the measurement over time also showed the positive effect of time and educational intervention on the protective behaviors of emergency nurses against occupational hazards and their sub-scales in the intervention group. Conclusion: These findings showed that the educational intervention based on the protection motivation theory can be effective and helpful in improving the protective behaviors of emergency ward nurses against occupational hazards and their sub-scales. Future studies can focus on a more specific design of this kind of intervention based on the type of occupational hazards and needs of nurses in different wards. [ABSTRACT FROM AUTHOR]

Introduction: Clinical education is a fundamental part of nursing professional education. One method of education is the implementation of the preceptorship program, in which clinical nurses are responsible for educating nursing students. The present study aimed to determine the effectiveness of the preceptorship training program for the participation of clinical nurses in the education of nursing students. Methods: This quasi-experimental study was conducted in 2023 at the teaching hospital in Tehran, Iran. The sample consisted of 66 nurses from a teaching hospital selected using the accessible method and randomly were put into two groups. The workshop addressed the educational needs of preceptors and students, their readiness for their role, and strategies to effectively support students. Prior to the study, the nurses' level of participation was assessed utilizing a valid IMSOC questionnaire that gauged their involvement in guiding nursing students. The participation rate was reassessed after one month using the same questionnaire. The data were analyzed using SPSS version 19. Findings: The two groups were homogeneous in terms of demographic characteristics. The average score for nurses' participation in the education of students before the intervention was 101.84 ± 15.42 in the test group and 107.24 ± 10.53 in the control group; these two groups were not significantly different (P = 0.10). After the intervention, the scores reached 118.90 ± 15.11 in the test group and 106.21 ± 11.96 in the control group, indicating a significant difference (P < 0.001). A comparison of the nurses' participation scores in the test group indicated a significant difference from the pretest to the posttest, with the improvement in all nurses's participation scores (P < 0.001). However, in the control group, this difference was not significant (P = 0.41). Conclusion: The preceptorship training program is effective in light of increasing the participation of clinical nurses in the education of nursing students. This program can improve various aspects, such as motivation, satisfaction, commitment, implementation, and obstacle removal. Considering the importance of clinical training for nursing students and the essential role of preceptors, it is recommended that managers and health trustees in all university hospitals implement a preceptorship training program to increase the participation of clinical nurses in the education of nursing students. [ABSTRACT FROM AUTHOR]

Background: Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods: A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results: Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions: This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices. [ABSTRACT FROM AUTHOR]

Background: Mind-body interventions focused on intentional breathing and movement have been found to mitigate the negative effects of caregiving such as such as stress, psychosocial distress, and emotional distress associated for persons living with Alzheimer's disease and related dementias. Objective: The objective was to assess the feasibility and acceptability and preliminary impacts of our 12-week mind body intervention "Gentle Yoga and Yogic Breathing" for caregivers of persons living with dementia on health outcomes including mutuality, depression and anxiety, loneliness and social support, quality of life, and physical function. Methods: We conducted a single-group cohort study in which 20 caregivers were enrolled. Data were collected at baseline and at the 12-week post-intervention endpoint. Results: The intervention was acceptable; 75% (n = 15/20) completed the study; 16 completed post-study questionnaires. Very few experienced technical issues; 31% (n = 3) most commonly reported as poor internet connectivity, 75% (n = 12/16) perceived a health benefit, 88% (n = 14/16) perceived improved day-to-day mood, and 100% (n = 16/16) would recommend the intervention to other caregivers. Although there was minimal change from baseline to 12 weeks, for health outcomes, there were very small improvements noted in anxiety and overall health. There were no reported adverse events. Conclusion: The intervention was well received and is feasible and acceptable for future studies of stress and health management interventions for caregivers of persons living with dementia. Registered with https://www.ClinicalTrials.gov (NCT03853148). [ABSTRACT FROM AUTHOR]

This scholarly project implemented the 3 Wishes Project (3WP), which aims to fulfill the final wishes of dying critically ill patients, in a 16-bed tertiary intensive care unit (ICU). The project assessed outcomes through surveys, mortality, and intervention records. The initial implementation involved 11 patients and 49 fulfilled wishes. A comparison of pre- and postintervention data showed statistically significant increases in perceptions of end-of-life care, services, and interprofessional communication. All found the 3WP valuable for patients and families, and 61% reported boosted morale. [ABSTRACT FROM AUTHOR]

Background: Based on previous evidence person‐centred care (PCC) as a quality indicator is important in long‐term care (LTC) settings for older people. Effective ways to increase nurses' person‐centred care competence are missing. Aim: To evaluate the effectiveness of a continuing education (CE) intervention named 'Person First—Please' (PFP) for improving nurses' PPC competence and its connection to PPC climate. Methods: Quasi‐experimental cluster design with intervention and control groups was carried out in LTC settings for older people. The intervention group (n = 77) received a 10‐week CE intervention, with control group (n = 123) working as usual. The primary outcome was professional nurses' PCC competence. Secondary outcome was the PCC climate as perceived by nurses and, residents with their next of kin. Measurements were conducted pre−/post‐intervention and after 6 weeks using the validated, Person‐centred Care Competence scale and the Person‐centred Care Climate questionnaire, staff and patient versions. Data was analysed with descriptive and inferential statistics. Results: PCC competence was significantly increased in the intervention group and remained after 6 weeks of follow‐up. PCC climate increased in the intervention group in total score and also in all sub‐scales, across residents with their next of kin. The control group did not show any significant change. Comparisons of PCC competence and PCC climate in time between intervention and control groups confirmed that changes seen between groups were statistically significant in intervention group. Limitations: Measurements were self‐assessments, which may have been affected by bias, especially in context of competence assessment. Conclusion: The intervention was effective in increasing professional nurses' PCC competence and on person‐centred care climate in long‐term care settings for older people. [ABSTRACT FROM AUTHOR]

Background: High-quality patient care requires nurses with strong clinical competency. Thus, it is essential to examine the factors associated with clinical competency. Purpose: This studywas designed to (a) investigate head nurse leadership, staff nurse demographics, and clinical competency; (b) examine the impact of demographics on the clinical competency of staff nurses; (c) analyze the correlation between head nurse leadership and staff nurse clinical competency; and (d) examine the effects of demographics on clinical competency after controlling for the head nurse leadership. Methods: A cluster sampling method was used to collect data from 200 staff nurses at a national medical center in Taiwan. Questionnaires were used to gather information on head nurse leadership style and staff nurse clinical competency. Descriptive and inferential statistical analyses were conducted, including Mann--Whitney U test, Kruskal--Wallis test, Spearman's rank correlation coefficient, and multivariate analysis of covariance. Results: The average score for transformational leadership style among the head nurses was 2.89, whereas transactional leadership style scored an average of 2.49. The average scores for the components of clinical competency, listed from highest to lowest, were as follows: patient care (3.35), professionalism (3.28), communication skills (3.18), management (2.84), and knowledge (2.73). In addition, statistically significant differences were found in clinical competency based on demographic factors, including age, marital status, educational level, job title, and length of employment. Also, a statistically significant, positive correlation between the head nurse transformational leadership style and nurse clinical competency was found. The main effect of length of employment on the five competency components was statistically significant after controlling for transformational leadership. Furthermore, post hoc analysis of covariance revealed a significant effect of length of employment on patient care, knowledge, communication skills, and management. Conclusions: The findings of this study indicate transformational leadership and employment length impact the clinical competency of staff nurses, particularly in terms of patient care, communication skills, management, and knowledge. Providing education and training in leadership and management to current and prospective head nurses may be expected to enhance clinical competency in staff nurses and create a more nurturing work environment. Moreover, targeted training may help current head nurses gain insight into their leadership styles and acquire skills to promote transformational leadership. In addition, leadership development may help equip prospective head nurses with critical competencies before assuming leadership responsibilities. [ABSTRACT FROM AUTHOR]

Introduction: People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana. Methods: A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis. Results: Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes. Conclusion: The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs. Plain Language summary: People with disabilities make up 16 percent of the world population, but their sexual and reproductive health (SRH) needs are often unmet, especially in poorer countries, contributing to adverse outcomes. This study assessed factors influencing the sex lives of PwDs in two districts of Ghana. Quantitative data were collected from 402 respondents, while qualitative data were collected from 37 participants. The results showed that age, severity of disability, and household size influence sexual activity. Many respondents also reported adverse SRH issues including STIs and unintended pregnancies. Sixty-five percent reported experiencing violence or abuse, which is related to their disability type and severity. The study also found that PwDs encounter many challenges in their sexual lives, including abuse and neglect. The findings suggest the need to pay attention to the sexual health needs and the social issues that make PwDs vulnerable to various abuses. [ABSTRACT FROM AUTHOR]

Purpose: Autistic students experience lower college graduation rates than their peers, affecting future opportunities. Self-advocacy is crucial for successful adaptation in postsecondary settings and is documented as a challenge for autistic students. The purpose of the study was to examine autistic college students’ engagement in self-advocacy and specific college-related challenges as compared to their neurodivergent and neurotypical peers. Method: This study used a cross-sectional survey design to compare perceptions related to self-advocacy and college-related challenges across three groups of students: autistic students, students with a disability other than autism, and nondisabled students. Descriptive and inferential statistics were used to compare survey responses across groups. Results: Differences in the groups’ perceptions of their engagement in overall self-advocacy and specific self-advocacy strategies were evident. Autistic students rated themselves significantly lower on self-advocacy than did students with other disabilities. When compared to their nondisabled peers, the autistic students and those with other disabilities were less likely to report comfort interacting in the classroom, including less interest in group work, and more difficulty interacting with unfamiliar peers. In addition, the autistic students were more likely to report difficulty recognizing the need for academic assistance when compared to both peer groups. Autistic students also reported greater social challenges in the college setting than their nondisabled peers, and both neurodivergent groups of students reported significantly more challenges, overall, navigating the college setting than did their nondisabled peers. Conclusions: Findings highlight the need for systematic, individualized self-advocacy supports for autistic and other neurodivergent college students. In addition, findings show the need to educate peers and professors about autism and self-advocacy to foster a welcoming college environment. Finally, findings suggest the need for increased social support and opportunities for social integration within postsecondary settings. Speech-language pathologists play a critical role in implementing these next steps. [ABSTRACT FROM AUTHOR]

The article presents a mixed-method study on the stressors and bathroom behaviors linked to development of lower urinary tract symptoms (LUTS) in nurses working during the COVID-19 pandemic. Other topics include the forms of LUTS like stress urinary incontinence (SUI) and urinary urge incontinence (UUI) and the possible causes of SUI and UUI like delayed voiding, straining while voiding, and voiding prematurely.

Background: The UK National Health Service (NHS) is one of the largest employers in the world and employs around 360,000 registered nurses. Following a protracted pay dispute in December 2022 NHS nurses engaged in industrial action resulting in the largest nurse strikes in the 74-year history of the NHS. Initially it appeared these strikes were a direct consequence of pay disputes but evidence suggests that the situation was more complex. This study aimed to explore what the key factors were in driving UK NHS nurses' decision to strike. Methods: A convergent parallel mixed methods design was used. The study was conducted throughout the UK and involved participants who were nurses working for the NHS who voted in favour of strike action. Data collection involved the use of an online survey completed by 468 nurses and 13 semi-structured interviews. Descriptive and inferential statistics were used for quantitative data analysis and a process of inductive thematic analysis for the qualitative data. The quantitative and qualitative data were analysed separately and then integrated to generate mixed methods inferences. Results: The quantitative findings showed that patient safety, followed by staff shortages, pay, and unmanageable work demands were the most important factors encouraging nurses' decision to strike. The qualitative findings served to further the understanding of these factors particularly in relation to participants' perception of the NHS and the consequences of inadequate pay and staff shortages. Three overarching and overlapping themes represented the qualitative findings: Save our NHS, Money talks, and It's untenable. Integration of the findings showed a high level of concordance between the two data sets and suggest that the factors involved are interconnected and inextricably linked. Conclusions: The UK NHS is a challenging and demanding work environment in which the well-being of its patients is dependent on the well-being of those who care for them. Concerns relating to patient welfare, the nursing profession and the NHS played a large part in driving UK NHS nurses' decision to strike. In order to address these concerns a focus on recruitment and retention of nurses in the NHS is needed. [ABSTRACT FROM AUTHOR]

Background. Electronic-prescribing (e-prescribing) is the most recent technological advancement in the medication use process. Its adoption and consequent realization of its potential benefits, however, mainly depend on the healthcare professionals' perception, willingness to accept, and engagement with the technology. Objectives. This study is aimed at assessing the perception of healthcare professionals towards e-prescribing at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, from June 1 to August 30, 2021. Method. A cross-sectional study was conducted using a simple random sampling technique. A self-administered questionnaire was used for data collection. Data were entered into and analyzed by using the Statistical Package for the Social Sciences (SPSS® (IBM Corporation)) version 24. Both descriptive and inferential statistics like the Kruskal-Wallis and Mann–Whitney tests were used for data analysis. A statistical significance was declared at a p value < 0.05. Result. From 401 participants, the majority of study participants had a neutral perception of e-prescribing. More than two-thirds (68.8%) of them had a neutral perception towards the perceived usefulness of e-prescribing with a median (interquartile range (IQR)) perceived usefulness of 43.0 (7.0) (maximum score = 60). The perceived ease of use of e-prescribing was also neutral in the case of more than three-fourths (79.8%) of participants with a median (IQR) perceived ease of use of 49.0 (6) (maximum score = 75). Similarly, more than half (56.6%) of the participants had a neutral perception towards the perceived fitness of e-prescribing with a median (IQR) perceived fitness of 15.0 (2.5) (maximum score = 15). The perception of the participants showed a significant difference based on their qualifications and work and computer use experience. Participants who heard about e-prescribing and e-prescribing software had a significantly higher mean rank score of perceived usefulness, perceived ease of use, and perceived fitness of e-prescribing. Participants who previously used e-prescribing had also a significantly higher mean rank score of perceived usefulness. Conclusion and Recommendation. The majority of healthcare professionals had a neutral perception of e-prescribing. The perception of healthcare professionals differs based on their qualifications, work and computer use experience, and their exposure to e-prescribing. The hospital should take all expectations and concerns of all HCPs into consideration and provide experience-sharing opportunities for all healthcare professionals who may potentially be involved in e-prescribing. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study introduced Zentangle®, which involves drawing simple, repetitive lines and shapes to create patterns, as a tool to promote wellness for oncology nurses in a clinical practice setting. OBJECTIVES: The purpose of this study was to determine whether Zentangle used as a meditative activity in an acute time frame decreased stress, fatigue, and burnout while increasing professional quality of life and well-being in oncology nurses. METHODS: Twenty-six oncology nurses participated in a two-hour Zentangle class and received materials to complete art over four weeks. The Perceived Stress Scale, the Warwick--Edinburgh Mental Wellbeing Scale, the Patient-Reported Outcomes Measurement Information System--29, and the Professional Quality of Life measure were administered at selected periods. Twenty-four participants completed the study. FINDINGS: Nurses' well-being, socialization, anxiety, fatigue, secondary traumatic stress levels, and stress levels improved significantly. Most participants noted they would continue using Zentangle after the study. Zentangle is another tool to advance nurses' wellness by encouraging self-care. [ABSTRACT FROM AUTHOR]

Background It is necessary to provide safe care for patients with acute and life-threatening conditions by nurses working in the emergency departments (EDs). These nurses need higher levels of independent performance. Therefore, the competency to provide safe care and having professional nursing autonomy in novice nurses working in the EDs are very important. Objective The purpose of this study was to determine the relationship between professional nursing autonomy and safe nursing care in newly graduated nurses working in the EDs. Methods In this analytical cross-sectional study, the study population consists of all newly graduated nurses working in EDs of hospitals in Guilan, Iran. They all were included in the study using a census sampling method. The tools for collecting information were a demographic form, the assessment of safe nursing care questionnaire, and the professional nursing autonomy scale. Descriptive and inferential statistics (independent t-test, Spearman or Pearson correlation test, and linear regression analysis) were used to analyze the collected data. Results There was a significant relationship between professional nursing autonomy and safe nursing care; for every one unit increase in professional autonomy, the chance of providing safe nursing care increases by 0.133 (P=0.009). Conclusion The significant relationship of professional nursing autonomy with safe nursing care among the EDS nurses shows that if nurses have a greater control over their performance, decision-making ability, and autonomy to act based on patient safety, they can provide better quality care to patients. Therefore, empowering nurses by providing conditions to perform based on professional autonomy, can ultimately lead to better results for the patients and cause overall safety in the EDs. [ABSTRACT FROM AUTHOR]

Background: Detailed preoperative information is associated with superior outcomes. We aimed to describe the recovery pattern after decompression of central lumbar spinal stenosis (CLSS). Methods: 50 patients aged 51–85 years who underwent decompression without fusion due to CLSS were followed from before to after surgery (post-op day 1, 7, and 14). Back and leg pain were evaluated using the Numeric Rating Scale (NRS; 0 = no pain 0, 10 = worst pain) and quality of life using the EuroQol-5D index (0 = death, 1 = best), and EQ-5D-visual analogue scale (VAS; 0 = worst, 100 = best). Results: NRS leg pain was reduced from preoperative to first postoperative day by 5.2 (6.1, 4.3) (mean (95%CI)], and NRS back pain from postoperative day 1–7 by 0.6 (1.2, 0.03) and from day 7 to 14 by 0.7 (1.3, 0.2)]. In contrast, EQ-5D index increased from preoperative to first postoperative day by 0.09 (0.06, 0.13) and from day 1 to 7 by 0.05 (0.02,0.08), and EQ-5D VAS from preoperative to first postoperative day by 13.7 (9.1, 18.3) and from day 1 to 7 by 6.0 (2.0, 10.0). After two weeks, 51% of the patients had improved above the minimal clinically important difference (MCID) in back pain and 71% in leg pain. Conclusions: Patients scheduled for decompression due to CLSS should be informed that improvement in leg pain and quality of life in general can be expected within one day of surgery, that quality of life improves a little further in the first postoperative week, and that back pain improves in the first 2 postoperative weeks. In most patients, decompression without fusion due to CLSS seems to achieve clinically relevant improvement within 2 weeks. [ABSTRACT FROM AUTHOR]

Background: Missed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients' needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses' moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran. Methods: A cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis. Results: Most participants (52.97%) showed moderate moral sensitivity. Nurses' mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (β = 0.213, p < 0.001), age (β = 0.131, p < 0.001), working in rotating shifts (β = 0.183, p < 0.001), monthly income (β = 0.079, p = 0.004), work experience (β = 0.030, p = 0.010), and monthly work hours (β = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables. Conclusion: Our nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly. [ABSTRACT FROM AUTHOR]

Introduction: Female-headed households, due to continuous and chronic exposure to various pressures, often face psychological challenges. Resilience is a crucial variable influencing the mental health of women in such circumstances. This study aims to assess the impact of implementing the Peplau Interpersonal Theory on the resilience of female-headed household members. Materials and Methods: This is a quasi-experimental study. The target population consisted of female-headed households covered by the Welfare Office of Khorramabad. Using convenience sampling, 60 female household heads were selected from those covered by the Welfare Office, and they were randomly assigned into two groups: control and intervention. The intervention for the experimental group included face-to-face and individual training sessions based on the Peplau theory. Data were collected using demographic information questionnaires and the Connor-Davidson Resilience Scale before and one month after the intervention. The gathered data were analyzed using descriptive and inferential statistical tests with SPSS software version 22. Results: Both intervention and control groups did not have statistically significant differences in terms of demographic variables and the level of resilience before the intervention (P>0.05). Comparison of the average resilience score showed a significant increase in the participants of the intervention group compared to the control group (p<0.001). Conclusion: Based on the findings of this research, it can be concluded that education based on Peplau interpersonal theory increases the level of resilience in female-headed households. Therefore, counselors and welfare professionals, as well as other executive bodies, should pay special attention to improving the resilience of female-headed household members. [ABSTRACT FROM AUTHOR]

Background: Exposure to the sun is vital for the body but is associated with problem ranging from pigmentation to cancer. Therefore, knowledge about protective measures is critical. This study aims to assess undergraduate students' knowledge, perception and practices towards the adverse effects of sun exposure and the usage of sun-protective measures. Methods: A cross-sectional study was conducted between 1 September 2022 and 20 September 2022 using a web-based questionnaire. Undergraduate students from medical and non-medical colleges in Iraqi universities participated in this study. Descriptive and inferential statistics and logistic regression were performed to analyse the data. Results: A total of 655 students participated in this study. The knowledge level of more than one-half of the students (53%) was inadequate. Approximately three-quarters of the study sample used sunscreens products. Skin type was the main factor in choosing the appropriate sunscreen product. Media and advice from specialists were the main factors affecting participants' usage of sunscreens. Gender (females), college (medical), year(s) of study (sixth), residence (urban), daily sun exposure (1 h--3 h) and less-than-normal vitamin D levels were found to be significantly associated with better knowledge (P-value < 0.05). Age, gender, being a student in medical colleges and not knowing vitamin D levels were found to be significant predictors of participants' knowledge. Conclusion: The low level of knowledge reported among the participants' calls for more attention from health authorities in educating the public about the harmful effects of sun exposure and the importance of adopting protective measures. [ABSTRACT FROM AUTHOR]

Collegiate baseball players with professional aspirations often participate in summer leagues; foremost among them is the Cape Cod Baseball League (CCBL). Injuries acquired during the collegiate baseball season can be carried into the CCBL season and vice versa. To assess the history of throwing arm injury and current functionality in midseason CCBL players. Cross-sectional study. Online questionnaire. A total of 123 CCBL players participated. Qualifying athletes were ≥18 years old and were rostered CCBL players with remaining collegiate eligibility. After collecting background information, we used the Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow questionnaire to assess the history of throwing arm injury and current functionality. The maximum KJOC score is 100.0; higher scores correspond with greater functionality. The mean KJOC score was 86.6 ± 14.5 (n = 92); 24.5% (23/94) of players reported a prior diagnosis of throwing arm injury other than a strain or sprain. A total of 49 (49/96, 51.0%) players had undergone rehabilitation for a throwing arm injury, and 7 (7/96, 7.3%) had experienced a medical procedure. Players with no previous treatment (n = 41, mean KJOC score = 88.9 ± 19.0) more frequently demonstrated KJOC scores of ≥90 than players with such treatment (n = 55, 80.9 ± 17.1; P <.001). The 18 players with time-loss arm injury in the last year had lower mean KJOC scores (71.3 ± 20.0) than players with no injury or time loss (90.3 ± 9.8; P <.001). Similarly, players who reported current arm trouble (n = 15) had lower KJOC scores (71.6 ± 17.5) than players with healthy arms (89.5 ± 11.9; P <.001). The average KJOC score of the CCBL players was <90, with particularly low scores in athletes with prior arm injury and treatment. [ABSTRACT FROM AUTHOR]

In Gresik, Indonesia, limited resources have led to challenges in accurately diagnosing food allergies. This study aimed to identify risk factors for food allergies among children in Gresik using a questionnaire-based approach. The study's ultimate goal was to develop a simple diagnostic tool in primary healthcare settings. Conducted at Petrokimia Gresik Hospital, this cross-sectional study enrolled children aged =6 months experiencing respiratory symptoms or atopic dermatitis for =1 week. The subjects (n = 247) underwent a two-to four-week restrictive diet for diagnostic purposes. The questionnaire demonstrated validity and reliability. Bivariate statistical analyses were performed to examine the correlations between risk factors and the incidence of food allergies (p < 0.05). A receiver operating characteristic (ROC) curve analysis was used to establish the cut-off values for the number of food allergies and atopic family members. The majority of the 247 children enrolled in this study were 6 to 12 years old. Respiratory symptoms (56.3%) were more common than atopic dermatitis (38.1%). The significant risk factors for food allergies included atopic dermatitis (p = 0.001; R = 0.203), previous history of suspected food allergies (p < 0.001; R = 0.747), and atopy in the family (p = 0.013; R = 0.157). The ROC curve analysis established the cut-off values for the number of atopic family members at 1.5 (p = 0.005; 95% CI 0.53-0.67) and the number of food allergies at 0.5 (p = 0.000; 95% CI 0.85-0.94). In conclusion, children are considered at risk of food allergies if they display persistent respiratory symptoms or atopic dermatitis, considering the history of suspected food allergies even to only one specific type of food. [ABSTRACT FROM AUTHOR]

Introduction: Asian Indians (AIs), the second largest immigrant population in the United States, are disproportionately affected by type 2 diabetes mellitus (T2DM) at a lower age and body mass index (BMI). The purpose of this study was to examine the relationship between social determinants of health (SDOH) and the diagnosis of T2DM among AIs in New Jersey (NJ). Methodology: This was a secondary data analysis of the Behavioral Risk Factor Surveillance System (BRFSS) in NJ from 2013 to 2017. Statistical analyses included descriptive and inferential statistics. Results: Among 1,132 AIs, 16% had T2DM or prediabetes (PDM) and 69.2% were overweight or obese. The risk for T2DM was significantly associated with internet use, older age, having medical check-ups, and having a personal doctor (p ≤.05). Discussion: These findings inform culturally congruent care by underscoring the importance of weight management, earlier screening, and provider involvement in diabetes prevention strategies for AIs. [ABSTRACT FROM AUTHOR]

Objective: This study involved the development, dissemination, and pre- and postassessment of a mental illness awareness webinar. The goal of the webinar is to educate the general public about serious mental illness (SMI) and reduce stigmatizing attitudes. Method: The study included 203 participants (n = 101 treatment group; n = 102 control group). Each completed a pretest and posttest measure of a mental illness stigma scale and a transphobia scale in this randomized control trial research design, along with a demographic form and participant feedback questionnaire. Results: Results revealed that stigma was significantly reduced from pretest to posttest depending on group condition. Participant feedback reflected generally positive responses to the benefits of participating in the webinar in terms of feeling more knowledgeable about SMI in particular (75.5%). Furthermore, while prior contact with people with—and prior education about—SMI alone did not appear to significantly impact stigma scores from pre- to posttest, these variables did appear to have a significant interaction in their combined impact on stigma scores. Conclusions and Implications for Practice: Findings suggest that the mental illness awareness training holds promise as an effective tool or reducing stigma among members of the general public. The electronic nature of the webinar allows for widespread and cost-effective dissemination and can also be tailored to meet the needs of specific populations such as law enforcement, first responders, and veterans to destigmatize SMI and improve treatment seeking. Impact and Implications: Results revealed that stigma was significantly reduced from pretest to posttest after participating in the stigma-reducing webinar depending on group condition and that this webinar holds promise as an effective tool or reducing stigma among members of the general public. [ABSTRACT FROM AUTHOR]

Background and Objectives Developing a vision without understanding the organizational culture is a failed attempt. The purpose of this research is to understand organizational culture for understanding expectations in order to prioritize issues and compare work groups by managers for greater productivity Materials and Methods This study was carried out in Iranian Blood Transfusion Organization between 2020 and 2022. The statistical population for this research was the employees of the central headquarters and the general administrations of blood centers, and 384 of them were included in the study using stratified random sampling. To collect the required data, a 60-question organizational culture questionnaire based on Denison's model was used. For data analysis, descriptive statistics (frequency distribution, mean, standard deviation) and inferential (independent t, analysis of variance, Tukey and Pearson's coefficient) according to demographic variables, SPSS22 and Excel 2013 software were used. Results The findings show that Iranian Blood Transfusion Organization has a medium/strong organizational culture with a score of 179.31 and the highest impact after mission with a score of 46.60. Also, the indicators of "customer orientation and development of capabilities" need to be improved. Conclusions According to the findings, most employees have understood the vision, strategic intentions and mission of the organization, but their capabilities are not well seen. According to the score of customer orientation, the skills and abilities of the employees should be developed by using retraining courses, while motivating the personnel, respecting the clients, and the provinces should take advantage of the experiences. [ABSTRACT FROM AUTHOR]

Purpose: Smith--Magenis syndrome (SMS), a rare, genetically linked complex developmental disorder caused by a deletion or mutation within chromosome 17p11.2, is associated with delays in speech-language development, otopathology, and hearing loss, yet previous studies lack comprehensive descriptions of hearing and communication profiles. Here, analyses of patient registry data expand what is known about speech, language, hearing, and otopathology in SMS. Method: International speech-language and hearing registry survey data for 82 individuals with SMS were analyzed using descriptive and inferential statistics. Hearing loss, history of otitis media and pressure equalization (PE) tubes, communication mode, expressive/receptive language, and vocal quality were analyzed for all subjects and subjects grouped by age. Statistical methods included descriptive statistics and Pearson's chi-square tests of independence to test for differences between age groups for each variable of interest. Association analyses included Pearson's correlations. Results: Hearing and otological analyses revealed that 35% of subjects had hearing loss, 66% had a history of otitis media, and 62% had received PE tubes. Speech-language analyses revealed that 60% of subjects communicated using speech, 79% began speaking words at/after 24 months of age, 92% combined words at/after 36 months, and 41% used sign language before speech. There was a significant association between the age that first words were spoken and the age that PE tubes were first placed. Communication strengths noted in more than 40% of subjects included social interest, humor, and memory for people, past events, and/or facts. Conclusions: Significant delays and impairment in speech-language were common, but the majority of those with SMS communicated using speech by age 6 years. Age was a significant factor for some aspects of hearing loss and communication. Neither hearing loss nor otitis media exacerbated language impairment. These results confirm and extend previous findings about the nature of speech, language, hearing, and otopathology in those with SMS. [ABSTRACT FROM AUTHOR]

Background: Respiratory Syncytial Virus (RSV) infection mainly affects newborns, infants and young children aged < 2 years. Since an RSV vaccine is in the European Medicines Agency's waitlist validation, nowadays the prevention only includes passive immunization with monoclonal antibodies (mAb). In the present study we aimed at investigating Italian paediatricians' knowledge, attitudes and behaviours towards RSV and its prevention. Methods: From February to May 2023, an anonymous online questionnaire, with answers based on the Likert scale, was administered to a sample of Italian paediatricians' members of the Italian Society of Paediatrics. Descriptive and inferential statistical analyses were performed using STATA 17. Results: The paediatricians who answered the questionnaire were 507, mostly women (70.6%), aged 30–45 (33.1%), employed in hospitals in 66.6% of cases. The 10.8% of respondents reported that RSV is transmitted only among children younger than 2 years of age and 80.33% of participants that school-age children are not at risk of developing severe forms of RSV disease. The 25% of participants thought that active immunization is currently available to prevent RSV infection and 35.7% that does not exist passive immunization to prevent RSV for infants and newborns aged < 2 years. The 97.5% of physicians managed bronchiolitis cases and 65.6% of participants did not prescribe the administration of mAb. Higher age, seniority and RSV knowledge score were found to be associated with having a higher mAb knowledge score (p < 0.001) and having a higher RSV knowledge was associated with a higher mAb knowledge score (p < 0.001). The logistic regression model found that the odds of a positive attitude towards mAB knowledge score increased by over 3 times (OR 3.23, 95% CI [1.41, 7.40], p = 0.006) for being female and the odds of a positive attitude towards mAB knowledge score increased by almost 10 times (OR 9.73, 95% CI [3.06, 30.89], p < 0.001) for a one-unit increase in RSV knowledge score. Conclusions: Paediatricians' limited knowledge or awareness could represent a barrier to the implementation of preventive strategies against RSV infection. Strategies to improve paediatricians' education on RSV prevention are, therefore, crucial. [ABSTRACT FROM AUTHOR]

Background: The organization's work ethics is the cornerstone to promoting positive nurses' behaviours and overcoming counterproductive ones. Purpose: The current study aims to explore the relationship between work ethics (WEs) and counterproductive work behaviours (CWB) among nurses and testify to the mediating role of workplace ostracism (WO) in this relationship. Methods: A descriptive correlational study was conducted in an Egyptian hospital. A convenient sample of staff nurses (N = 369) who agreed to participate in the study answered work ethics, counterproductive work behaviours, and workplace ostracism questionnaires, which were proven to be valid and reliable study measures. Descriptive and inferential statistics were applied, and relationships were presented using structural equation modelling. Ethical Considerations: Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants' rights to voluntary participation and withdrawal were maintained. Results: The majority of nurses (78.5%) perceived a high level of work ethics while majority of nurses reporting low levels of counterproductive work behaviours and workplace ostracism (82.25%, 75.75%), respectively. In addition to the negative correlations, the findings revealed that WEs have a significant negative influence on each of CWB (β − 0.482, p < 0.005) and WO (β − 0.044, p < 0.005). The regression analysis showed that WEs can negatively predict about 15% of the variance in each of CWB and WO. On the other hand, WO has a positive effect on CWB (β 0.035, p < 0.021) and mediates the relationship between WEs and CWB. Discussion: Ostracism negatively affects the attitudes of nurses, which in turn results in negative behavioural outcomes (i.e., deviant behaviour). Conclusion: It is imperative for the hospital and nurse managers to establish a work environment that fosters support and cultivate work ethics and ethical work climate with the aim of managing negative work behaviours, enhancing nurses' retention and satisfaction, and eventually improving the quality of patient care. [ABSTRACT FROM AUTHOR]

Background: Pregnancy and the transition to parenthood are periods in parents' lives that require tremendous adjustment. The physical and mental health of mothers during these periods is significantly associated with maternal acceptance. The present study aimed to evaluate the correlation between intimate partner violence (IPV) during pregnancy and parental acceptance by primiparous mothers in Isfahan, Iran. Methods: A cross-sectional descriptive and correlational study was conducted from September 2021 to February 2022 in Isfahan, Iran. The target population was primiparous mothers in the postpartum period referred to nine different health centers across Isfahan. The participants (n=308) completed three questionnaires, namely demographic, Tabrizi intimate partner violence screening, and parental acceptance questionnaire. Data were analyzed using descriptive and inferential statistics with SPSS software (version 22.0). P<0.05 was considered statistically significant. Results: The mean score of total IPV was 40.45±28.94. Domestic violence during pregnancy was reported by 59 (19.2%) mothers. The most common types were psychological violence (74.4%), followed by financial abuse (35.1%), sexual violence (17.2%), and physical violence (14.9%). The mean score of parental acceptance was 115.77±12.58. There was a significant inverse correlation between parental acceptance and IPV score (r=-0.15, P=0.005). The number of siblings and birth order had a significant inverse correlation with parental acceptance (r=-0.13, P=0.002; r=-0.13, P=0.002, respectively). Moreover, the age difference between the mothers and their next siblings had a significant direct correlation with parental acceptance (r=0.12, P=0.003). Conclusion: Primiparous mothers subjected to IPV during pregnancy had lower parental acceptance after delivery. [ABSTRACT FROM AUTHOR]

Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = −0.199؛ p =.001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = −0.165; 95 percent CI: −0.07–0.25, p <.001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems. [ABSTRACT FROM AUTHOR]

This pilot study aimed to investigate the acceptability and efficacy of a patient storytelling intervention (live and recorded) on empathy levels of medical students. Medical students participated in a storytelling intervention that had three components: listening to live or recorded stories from women with abnormal uterine bleeding, reflective writing, and a debriefing session. Empathy scores of students pre- and post-intervention were measured using the Jefferson Scale of Empathy-student version (JSE-S). Students also completed a feedback survey. Descriptive and inferential statistics were used to analyse quantitative data and content analysis was used for text comments. Both live and recorded storytelling interventions had positive effects on student's empathy scores post intervention. Overall, students were satisfied with the intervention and reported that it improved their understanding of life experiences of women. Suggestions were made for an in-person storytelling session and interactive discussion after listening to each story. A storytelling intervention has the potential to improve medical students' empathy and understanding of lived experience of women with health conditions. This could be valuable when student-patient interactions are limited in healthcare settings, or to enable stories of small numbers of patient volunteers to reach students. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) affects more than 35 million people in the United States, many of whom are undiagnosed. Included in this number are individuals with many types of rare kidney diseases, affecting 20,000 to 200,000 individuals nationwide. There is a major need to educate these individuals on the disease and its progression, especially since many individuals are not aware they have the disease. Descriptive correlational research was conducted in a nationwide sample of adult individuals living with rare glomerular kidney disease. Patient activation and quality of life were the concepts studied across the five CKD stages. New findings included statistically significant differences between participants' self-reported mental health quality of life and CKD Stage 1, with CKD Stages 4 and 5 in the rare kidney disease population. Nurses are essential for educating and supporting patients with rare kidney disease to preserve kidney function and slow disease progression. [ABSTRACT FROM AUTHOR]

Aim. This research study aims to examine the professional quality of life (ProQOL) among healthcare workers (HCWs) in Pakistan during the fourth wave of COVID-19. Background. Under intense pressure to fight the coronavirus disease 2019 (COVID-19) pandemic, HCWs are more likely to experience psychological problems. Numerous investigations carried out in the past at various points during the pandemic have shown that COVID-19 has had important detrimental effects on HCWs. However, there are many unknowns with regard to ProQOL for HCWs. Methods. This is a cross-sectional study conducted with Pakistani HCWs who performed their duties during the fourth wave of COVID-19. Data were collected between January 1 and March 31, 2022. A total of 258 HCWs took part in the study evaluating ProQOL. The significance level was <0.05. Results. Most respondents were males (79.1%), and 20.9% were females. The scores of secondary traumatic stress (STS), burnout (BO), and compassion satisfaction (CS) were 24.03 ± 3.79, 19.18 ± 2.92, and 35.29 ± 4.37, respectively. Compared with higher-income groups, HCWs with lower incomes were significantly (P < 0.001) more likely to experience psychological issues. Males had lower BO and STS than female HCWs (P < 0.001). Similarly, doctors had a lower STS than nurses (P < 0.05). HCWs who worked hours per day longer had a heavier STS (P < 0.001). Conclusion. This study shows low BO levels, moderate CS levels, and STS levels among HCWs. HCWs with lower salary were at a higher risk of mental distress due to the pandemic. HCWs who worked for long hours and had less income had more STS and BO. HCWs who were dissatisfied with their works had poor CS. Implications for Nursing Management. It is supposed that these results may help HCW managers to improve job satisfaction and rewards while reducing working hours and workload to improve the ProQOL of HCWs fighting COVID-19. The government should focus on the mental health of HCWs, enhancing their satisfaction and allocating sufficient resources. [ABSTRACT FROM AUTHOR]

Background: Every work environment, especially in hospital settings must be conducive, friendly, and stress-free in order to promote quality care and the well-being of healthcare workers, whose job demands are increasing by the day. Aims: The purpose of this study was to determine the perceived effect of occupational stress on work behavior among nurses at Benue State University Teaching Hospital in Makurdi. Methods: From the facility's population of nurses, a quantitative survey randomly chose 150 respondents nurses, for the purpose of gathering information and testing the hypothesis, a well- developed and validated questionnaire was employed to gather data. Using SPSS, the data were descriptively analyzed, and an inferential analysis with a significance level of 5% was performed using Pearson's Chi-square test (0.05). Results: The majority of participants (56.6%) were men with a higher level of education. This study also shows the effect of occupational stress on work behavior as poor work performance 142 (94.7%), counterproductive work behavior 139 (92.7%), increases the incidence of absenteeism 112 (74.7%), high occurrence of medication error 120 (80%), Negative effect on teamwork 98 (65.3%), increases the incidence of Substance use disorders 95 (63.3), and aggressive attitude toward patients during nursing care 137 (91.3). Furthermore, there is a significant association between occupational stress and job satisfaction (x2 = 25.49, df = 8, and p < 0.001), patient safety (x2 = 51.07, df = 8, and P = 0.002), and nurses' attitudes toward their patients (x2 = 86.67, df = 12, and P = 0.012). Conclusion: We discovered that workplace stress can affect how happy nurses are with their jobs and how they behave while providing nursing care. We recommend that hospital administrators implement a plan to create a stress-free working environment for nurses. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic. Methods: In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n = 30) and experimental (n = 30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training. Results: There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index. Conclusion: Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction. Preterm infants (PTIs) are vulnerable to morbidity, disability, and mortality. They require meticulous care for survival and development in neonatal care units (NCUs). PTI care in NCUs is a collaborative and team effort among different health professionals. However, nurses have a key role for quality care. This study aimed to assess nurses' PTI care practices across different hospitals in Nepal. Methods. A descriptive cross-sectional study was conducted in NCUs of six randomly selected public hospitals in Nepal. After obtaining ethical approval, structured observation was completed among 40 NCU nurses using a practice checklist. After observation, a self-report questionnaire was administered among 102 nurses. Both descriptive and inferential statistics were used for data analysis. Results. The observation and self-reported mean infant care practices were 73.7% and 70.7%, respectively. The overall practice median score and the interquartile range (IQR) were 4.0 (3.5–4.3) with the highest score of (4.5 [4.1–4.7]) for daily supportive care and the lowest score of (2.8 [2.1–3.5]) for pain management. The care practice was strongly associated with the nurse-infant ratio (adjusted odd ratio (aOR) = 18.52, confidence interval (CI) = 5.83–58.77, and p = < 0.001) and training status (aOR = 4.95, CI = 1.59–15.39, and p = 0.006). Conclusion. Nurses have adequate practice of thermal care, safe oxygen administration, nutritional care, and infection prevention in NCUs, whereas lacking is found regarding developmental supportive care components (sleep promotion and a supportive sensory environment), parental support, and pain management practices. Consideration of the proper nurse-infant ratio and continued professional development opportunities are essential for practice enhancement in NCUs. These findings might be useful to identify the gaps in PTI care practice in NCUs. [ABSTRACT FROM AUTHOR]

Background: The progression of the nurse prescribing role encounters numerous challenges, with physician resistance being a significant obstacle. This study aims to assess physicians' perspectives regarding the expansion of the nurse prescribing role within critical care and emergency departments. Methods: This cross-sectional study employed convenience sampling to enroll 193 physicians. Data collection instruments included a demographic information form and a researcher-developed questionnaire. Descriptive and inferential statistics were used to analyze the data using SPSS-22 software. Results: A total of 193 physicians participated in the survey, with a mean age of 41.9 ± 10.7 years. Among physicians from various age groups, genders, educational backgrounds, and clinical experiences, more than 60% acknowledged prescribing medicine as an essential component of their professional responsibilities. However, a significant majority of physicians in these categories agreed that in emergency situations, nurses should be allowed to prescribe medication to save patients' lives. It is worth noting that, unlike specialist and fellowship physicians, a majority of general practitioners (83.3%) held the view that nurse-prescribed medications do not contribute to the professional development of nursing. The nurse prescribing role encountered several predominant obstacles, namely legal consequences (78.8%), interference of duties between physicians and nurses (74.1%), and a legal vacuum (77.2%). Conclusion: The majority of physicians expressed a favorable attitude towards nurse prescribing in emergency and critical care departments. To facilitate the development of the nurse prescribing role, it is essential to ensure the acquisition of scientific qualifications and implement necessary changes in nursing curricula across bachelor's, master's, and doctoral programs. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) are often too noisy, exceeding 70–80 dBA, which can have negative effects on staff. The corresponding recommendation of the World Health Organization (average sound pressure level below 35 dBA) is often not achieved. To date there is a lack of intervention studies examining the extent to which unit-based noise management in ICUs contributes to a reduction in noise exposure for the staff. The study therefore aims to provide answers to 1) how unit-based noise management sustainably reduces the subjective noise exposure among staff, and 2) how this intervention affects other noise-related topics. Methods: We performed a monocentric prospective longitudinal study with three measurement points in a German university hospital in three ICUs. We collected data from different healthcare professionals and other professional groups between October 2021 and August 2022 using an online questionnaire. Data were analyzed using descriptive and inference statistics. Results: A total of n = 179 participants took part in the surveys. The majority of participants were nurses or pediatric nurses. Most participants worked more than 75% full-time equivalent. Staff on the three ICUs reported high levels of noise exposure. No significant changes in noise exposure over time were observed. Participants were already aware of the topic and believed that a behavior change could positively influence the noise environment. Conclusions: This study provides an initial insight into how a unit-based noise management could contribute to a reduction in the subjective noise exposure among staff in ICUs. The results of this study highlight the importance of this topic. Future studies should aim to research aspects of adherence and their facilitators or barriers, which promote the sustained implementation of noise-reducing measures by staff. Trial registration: German Clinical Trials Register (DRKS): DRKS00025835; Date of registration: 12.08.2021. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To appreciate the importance of patient safety incident reporting practices • To understand that optimal patient safety incident reporting practices require effective leadership behaviours • To be aware of the need for a positive organisational culture to improve incident reporting practices Background: Patient safety is a priority for all healthcare organisations. Enhancing patient safety incident reporting practices requires effective leadership behaviours at all levels in healthcare organisations. Aim: To explore nurses' perceptions of the influence of nurse managers' leadership behaviours and organisational culture on patient safety incident reporting practices. Method: A descriptive, cross-sectional, correlational design was adopted with a convenience sample of 325 nurses from 15 Jordanian hospitals. Results: Respondents had positive perceptions of their nurse managers' leadership behaviours and organisational culture. There was a significant positive relationship between leadership behaviours and organisational culture (r=0.423, P<0.001) and between leadership behaviours and actual incident-reporting practices (r=0.131, P<0.001). Additionally, there was a significant positive relationship between organisational culture and incident-reporting practices (r=0.250, P<0.001). Conclusion: Healthcare organisations must develop leaders who will foster a supportive and just culture that will enhance nurses' practice with regards to reporting patient safety incidents. [ABSTRACT FROM AUTHOR]

Introduction: The knowledge and attitudes about genetic hearing loss are essential to prevent more hearing loss incidences in societies. However, limited studies have compared the knowledge and attitude toward genetic technology between parents of normal and impaired-hearing children. Methods: A descriptive, cross-sectional study was performed involving 105 parents with one or more children having a hearing impairment and 204 control parents with children having normal hearing. Parents completed surveys designed to investigate their knowledge and attitudes about the genetic basis of hearing impairment and recent technologies. Descriptive and inferential statistics were used to measure response differences between the two groups. Results: Both groups shared the same level of knowledge, with the average knowledge scores of parents with normal-hearing children (9.53/19±2.56 points) resembling those of parents with hearing-impaired children (10.08/19±3.17 points; F(1, 307)=-2.17, p=0.14). Moreover, parents had limited information about the genetic basis of hearing loss, specifically in estimating the recurrence of congenital hearing loss (n=26 of 105, 24.76%)and misunderstanding inheritance paradigms (n=24 of 105, 22.86%). Regardless of having children with auditory issues, parents expressed positive attitudes towards genetic testing. Conclusions: These findings suggest that more genetic specialists are needed to educate families of children with hearing loss about the genetic attributes of hearing impairment and the significance of genetic technology. [ABSTRACT FROM AUTHOR]

This pilot study investigated wellness and causes and prevention of suicide in student registered nurse anesthetists (SRNAs). A cross-sectional anonymous survey study was conducted of a sample of randomly chosen SRNAs. Data were analyzed with descriptive and inferential statistics. Responses to open-ended questions were summarized and presented. Results demonstrated elevated SRNA stress levels. There was an association between suicidal ideation in SRNAs and depression, lack of perceived agency, and elevated anxiety in the classroom. SRNAs reported mental health challenges, depression, and anxiety. Sixteen percent of SRNAs felt that classmates were at risk of suicide, and two SRNAs had lost a classmate to suicide. Twenty-nine percent of SRNAs reported suicidal thoughts prior to matriculation, and 35% reported suicidal thoughts during training. Students with suicidal ideation asked for help from friends and family, but not faculty, and some did not ask for help. Students gave existing wellness initiatives low ratings, and many felt faculty did not promote wellness. Involving student group leaders and appointing a student lead wellness point person may encourage students to ask for help. Faculty should continually prioritize, check-in on, and monitor student wellness. Wellness is a never-ending, essential, and continually evolving effort. Suicide is preventable with compassionate intervention. [ABSTRACT FROM AUTHOR]

Background: Domestic violence and abuse (DVA) is a major health problem that affects individuals across the world. Nurses, midwives and healthcare providers need to be confident and competent in identifying and responding to DVA. Aims: To measure current levels of knowledge, opinions and preparedness towards DVA and how it is managed by registered nurses and midwives residing in Australia and the UK. Methods: A cross‐sectional study design was used. Data were collected using the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) measuring the perceived preparation and knowledge, actual knowledge, opinions and practice issues. Australian data were collected in 2018 and UK data were collected in 2017–2018. Descriptive and inferential statistics were used to analyse the data and differences in knowledge and attitudes of British and Australian nurses. Findings: Nurses and midwives (n = 368; 130 from Australia; 238 from the UK) responded to the survey. Minimal previous DVA training was reported by the participants. Participants had minimal knowledge about DVA, though had a positive attitude towards engaging with women experiencing DVA. Discussion: Most participants felt unprepared to ask relevant questions about DVA and had inadequate knowledge about available resources. Australian participants scored better than British participants; however, the mean difference in all aspects remained statistically insignificant. Conclusion: Australian and British nurses and midwives have a positive attitude towards women experiencing DVA; however, the knowledge and skills to support women experiencing DVA are limited. Implications for nursing policy: Nursing institutions should develop strategic policies regarding mandatory preparation and training of nurses for domestic violence assessment and management. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to investigate the relationship between nurses' job crafting, organizational identification, and work attachment. BACKGROUND: Job crafting is a proactive activity in which nurses adapt the physical, cognitive, or social aspects of their jobs to make them more meaningful. Nurses are considered fundamental healthcare stakeholders who are able to transform initiatives implemented by the healthcare organization into valuable work outcomes. Nurses' perceptions of their jobs shape the community's opinion toward an organization. METHODS: This is a descriptive correlational study. Two hundred seventy nurses were recruited from 1 governmental hospital in Egypt. Respondents completed the self-administered, printed questionnaires. Measures included job crafting, organizational identification, and work attachment questionnaires. Findings were investigated via descriptive and inferential statistics. RESULTS: Over half of the nurses reported a moderate level of job crafting, whereas none of the nurses reported a high level of organizational identification. More than half of the nurses reported low levels of work attachment. CONCLUSION: Job crafting is significantly related to nurses' organizational identification and work attachment. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality of life (QOL) among type 2 diabetes patients aged 30–64 years belonging to middle and high income group and to find out the factors associated with it. Research design and methods: A cross-sectional study was done in a tertiary care hospital in Delhi, India. Using interview-based method, the investigator collected information from 150 type 2 diabetes patients. The tool used was QOLID, i.e., Quality of Life Questionnaire for Indian Diabetes patients with scores ranging from 34 to 170. Data was analyzed using software SPSS 23.0 version, and both descriptive and inferential statistics were calculated. Results: The mean QOL score in our study was 142 ± 12.2 with a median of 145 (IQR = 135–150.7). The most affected domains of QOL were general health, treatment satisfaction, and diet satisfaction. The factors which were significantly associated with QOL were age (p = 0.002), gender (p = 0.004), duration of diabetes (p < 0.001), current treatment of patient (p < 0.01), absence of complications (p = 0.002), co-morbidities (0.006), and regular exercise (p = 0.01). Patient's current on-going treatment and regular exercise were identified as determinants of QOL. Conclusion: The quality of life of diabetes patients in our study was fairly high. It was better in younger males, those taking single oral hypoglycemic drug, who were without any complications and co-morbidities, and who did regular physical exercise. The overall infrastructure, patient friendly environment and patient management system also played a big role towards good QOL of our participants. [ABSTRACT FROM AUTHOR]

Background. The purpose of this study was to determine pediatric nurses' knowledge of autism spectrum disorders (ASD). Methods. We conducted a population-based online survey of 273 pediatric nurses in eastern Saudi Arabia using convenience sampling method. Perceived knowledge was assessed using the knowledge of childhood autism among Health Professionals Questionnaire (KCAHW) that was translated into Arabic. We used multivariate regression analysis to determine the influence of demographic factors on the perceived knowledge. Using Pearson's correlation analysis, we assessed the correlation between the outcome variables and the predictor variables. Results. ASD knowledge is generally higher among pediatric nurses with higher academic qualifications (r = 0.29, p < 0.001). They scored higher on general knowledge (M = 21.5, SD = 5.7) and lower on signs and symptoms (M = 15.2, SD = 4.3), diagnosis (M = 13.8, SD = 3.9), and management of ASD (M = 12.4, SD = 4.1). A significant correlation was found between mean KCAHW and age (r = 0.12, p = 0.029), sex (r = 0.18, p = 0.003), years of experience (r = 0.25, p < 0.001), education level (r = 0.34, p < 0.001), and hospital type (r = 0.21, p = 0.001). Predictors of knowledge and understanding were level of education (β = 0.23, p = 0.001), formal training (β = 0.16, p = 0.012), and years of experience (β = 0.19, p = 0.005). The majority could not define ASD or recognize early signs and symptoms or associated comorbidities. Lack of social and emotional reciprocity and impaired language development have been reported, as well as the perception of ASD as a neurodevelopmental disorder. Conclusion. Higher academic qualifications are associated with high general knowledge of ASD; however, nurses in this cohort performed poorly in ASD sign and symptom recognition, diagnosis, and management. [ABSTRACT FROM AUTHOR]

Older adults are a vulnerable group and face a series of problems that are preventable by changing their lifestyle, so it is necessary to understand the healthy lifestyle and its related factors in older adults. This study aimed to determine the relationship between healthy lifestyle, self-esteem, and subjective vitality in the older adults of Sirjan. This descriptive-analytical cross-sectional study included 200 older adults referred to community health centers in Sirjan in 2021. Older adults with inclusion criteria were selected by two-stage cluster sampling. Data were collected by demographic information questionnaire, the healthy lifestyle questionnaire for elderly, the Rosenberg self-esteem scale, and the subjective vitality scale. The data were analyzed using SPSS20 and descriptive and inferential statistics (Mann–Whitney U test, Kruskal–Wallis, post hoc tests, and Spearman correlation coefficient). A significance level <0.05 was considered. The study results showed that the mean scores of healthy lifestyle, self-esteem, and subjective vitality were 134.42 ± 13.78, 36.34 ± 4.62, and 21.80 ± 2.85, respectively. We observed a direct and significant relationship between healthy lifestyle, self-esteem, and subjective vitality (p < 0.001). Considering the relationship between healthy lifestyle, self-esteem, and subjective vitality in older adults, managers and planners can help older adults to promote their healthy lifestyles. [ABSTRACT FROM AUTHOR]

Caregiver coaching is a recommended practice in early intervention; however, many barriers exist that can prevent early interventionists (EIs) from implementing it. This mixed method study was designed to understand if EIs' perceived use of caregiver coaching changed after Illinois' COVID-19 pandemic stay-at-home order. Questionnaire data and interview data were analyzed together to explore changes reported by participants. Findings show that participants believed they used coaching practices and coached within routines more often following the stay-at-home order and that their changes in caregiver coaching had an impact on families (e.g., increased caregiver engagement, child progress, more meaningful intervention). Findings suggest that the stay-at-home order evoked a much-needed change in caregiver coaching. Implications include the need for research on contributors to EIs' use of caregiver coaching and how to effectively use modeling. Implications for practice suggest that EIs should explain coaching to families and individualize their approach to promote family engagement in their children's intervention. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is a common acquired depigmentory skin disorder supposed to be of autoimmune aetiology. Different immunosuppressants have been tried with varying success. Azathioprine has been less studied in vitiligo. Aims and Objectives: To study the efficacy of oral azathioprine and compare with systemic steroid in the treatment of vitiligo. Materials and Methods: It was an interventional study with multi-armed (three), parallel group, an open-label, randomized controlled trial with allocation ratio of 1:1:1. Patients of vitiligo aged between 18 and 60 years having more than 5% body surface involvement were included in the study. Patients were divided into three groups. Group A--patients received oral azathioprine 50 mg OD daily, group B--patients received combination of oral azathioprine 50 mg OD and PUVASOL and group C--patients received combination of betamethasone oral mini pulse (OMP) and PUVASOL. All the groups were treated for 1 year. Repigmentation was evaluated by vitiligo area severity index (VASI), and stabilization was evaluated by vitiligo disease activity (VIDA). Results: Group A, group B and group C showed 24.24%, 53.24% and 47.28% improvement in VASI score, respectively, at the end of 1 year. Group B and group C showed statistically significant superior repigmentation as compared to azathioprine monotherapy. Though azathioprine and betamethasone showed equivalent efficacy, azathioprine has a better safety profile. Side effects were minimal in azathioprine groups, whereas 50% patients developed various side effects in group C. Conclusion: Azathioprine is safe and effective option in the treatment of vitiligo. [ABSTRACT FROM AUTHOR]

Aims: Alternative models of cardiac rehabilitation (CR) are required to improve CR access and uptake. Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) is a comprehensive home-based rehabilitation and self-management programme, facilitated by trained health professionals, for people with heart failure (HF) and their caregivers. REACH-HF was shown to be clinically effective and cost-effective in a multi-centre randomized trial. The SCOT:REACH-HF study assessed implementation of REACH-HF in routine clinical practice in NHS Scotland. Methods and results: A mixed-method implementation study was conducted across six regional Health Boards. Of 136 people with HF and 56 caregivers recruited, 101 people with HF and 26 caregivers provided 4-month follow-up data, after participating in the 12-week programme. Compared with baseline, REACH-HF participation resulted in substantial gains in the primary outcome of health-related quality of life, as assessed by the Minnesota Living with Heart Failure Questionnaire (mean difference: −9.8, 95% CI: −13.2 to −6.4, P < 0.001). Improvements were also seen in secondary outcomes (PROM-CR+; EQ-5D-5L; Self-Care of Heart Failure Index (SCHFI) domains of maintenance and symptom perception; Caregiver Contribution to Self-Care domains of symptom perception and management). Twenty qualitative interviews were conducted with 11 REACH-HF facilitators, five supporting clinicians, and four national stakeholders. Interviewees were largely positive about REACH-HF, considering it to have 'filled a gap' where centre-based CR was not an option. Key issues to support future roll-out were also identified. Conclusion: Our findings support wider roll-out of REACH-HF as an alternative to centre-based models, to improve CR access and uptake for people with HF. Graphical Abstract [ABSTRACT FROM AUTHOR]

Objectives: Studies on immigration have shown that cultural changes can positively or negatively affect psychological, behavioral, and physical outcomes when different cultures settle into a new host community or country. The majority of research done in the United States and North America has focused on these changes for larger immigrant and minority groups such as Hispanics/Latinos and Asians. However, in the United States, there is a sub-group of immigrants that is largely understudied, resulting in misunderstood data on mental and physical health: Arab Americans. This study assesses mental health disparities between immigrant and non-immigrant populations, before and after COVID-19 restrictions, in Dearborn, MI, a city that has one of the largest concentrations of Arab immigrants in the nation. Design: Using an online survey instrument, this study assessed mental health disparities before and since COVID-19 restrictions, and stressors induced since the pandemic for immigrants and non-immigrants in Dearborn, MI. Results: Through inferential statistics and logistic regressions, results indicate that immigrants are less likely to have healthcare coverage, have lower annual incomes, lower educational attainment, and experience continuously higher mental health issues before the pandemic than non-immigrants faced during the pandemic. Conclusion: This study reinforces that the Arab-American immigrant population is a disadvantaged sub-group and faces considerable stress and mental health concerns as an acculturating population. This stress gets exacerbated when a worldwide event such as the COVID-19 pandemic strikes. Oversight of this population's health issues results in the inability to receive appropriate social services and healthcare that is vital to address this community's concerns. [ABSTRACT FROM AUTHOR]