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Health literacy should be developed from early ages, but students, including preservice teachers, hold misconceptions about micro-organisms. The objective of this study was to analyse the knowledge that a sample of 102 Early Childhood Preservice Teachers (PST) had about micro-organisms and about cystitis. The PSTs performed a series of activities that included an inquiry-based laboratory activity. Their knowledge about micro-organisms was assessed by pre- and post-questionnaires, and about cystitis, by analysing the responses to an open-ended pretest, the inquiry reports and the performance of the PSTs when changing nappies on dolls. Results show a better understanding about the micro-organisms at the end of the study. In the case of cystitis, in the pretest PSTs did not identify bacteria as agents, but they did after the inquiry activity, and they also mentioned the proliferation of bacteria. Nevertheless, only 32% of PSTs changed nappies coherently with the knowledge.

This study investigates college students' current food safety knowledge and food-handling perceptions and utilized an online survey which designed based on previous studies as method. The questionnaire measured respondents' food safety knowledge and perception, and were divided into knowledge, attitudes and perception categories. The results show that college students significantly lacked in basic food safety knowledge as well as food handling skills and implies a high need to develop enhanced food safety resources for college students, especially on topics related to cross-contamination prevention, correct food preparation procedures, time and temperature control, and awareness of pathogens that cause foodborne illness.

Background: Due to the progressive deterioration of motor, cognitive, and psychological function, individuals with Huntington's disease (HD) rely heavily on family caregivers, including children in the home. This "young carer" role can result in responsibilities that are inappropriate for the child's age and abilities. Also referred to as parentification, this experience can result in both positive and negative outcomes for the child, spanning multiple domains of health and well-being. Objective: To explore the manifestation of parentification among young carers of a parent with HD. Method: Directed content analysis, guided by a literature-derived framework of parentification, was utilized for this qualitative study. Participants included 28 young carers (mean age of 16.6 (± 2.6)) who self-identified as engaging in caregiving activities related to HD with the majority providing care for 1-3 years (53.6%)--averaging 25.4 h of care per week. Results: Three main themes with subthemes emerged--(1) being a young carer [perceptions of caregiving, learning to be a caregiver, caregiver burden, coping], (2) living with a new normal (school and friends, feeling unheard/alone, support system, personal growth), and (3) facing HD as a young carer (stigma and isolation, parent/child relationship, end of life, genetic risk). Conclusions: Young carers in the context of HD experience many attributes and consequences of parentification generally present among young carers of ill parents. However, HD specific findings emerged from this study that can be used to inform clinicians and direct future research aimed at guiding policy and developing tailored support services.

Rheumatic diseases are known to be associated with the development of metabolic syndrome, which increases mortality rates due to cardiovascular complications. Although a variety of self-management programs for rheumatic diseases have been developed, few have concentrated on metabolic syndrome. This study aimed to develop and verify a blended (a mixture of telephone and online interventions) metabolic syndrome self-management program. The program was developed in four stages: analysis to identify program contents, website design, website development, and validity testing. A quasi-experimental nonequivalent control group, pretest-posttest design was adopted to verify the program effectiveness in 54 patients with rheumatic disease. The program was initially implemented via telephone for 4 weeks and then self-administered via a web-based platform for 20 weeks. Indices of metabolic syndrome and self-management and quality of life scores were measured as outcome variables. Data were collected three times: before intervention, after 4 weeks of telephone interventions, and after 20 weeks of online self-interventions. The devised program had a significant overall effect on metabolic syndrome indices, metabolic syndrome-related self-management behaviors, and quality of life. Detailed analysis showed the program effectively reduced body mass index, waist circumference, systolic blood pressure, and blood glucose levels and improved metabolic syndrome self-management behaviors. Based on our findings, it can be expected that the use of this program may retard or prevent the progression of metabolic syndrome by improving some metabolic syndrome indices and metabolic syndrome-related self-management behaviors, which are key components of care in rheumatic disease patients with metabolic syndrome. This web-based program appears to be beneficial in public health care settings because it is cost-effective, readily available, and may provide long-term support.

Background: Maintenance of speech outcomes following speech-language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check-In, a model for supported self-managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated. Aims: To investigate the impact of the semi-structured component of PD Check-In on the adoption of self-management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post-treatment. Methods and procedure: Following LSVT LOUD, 16 PWPD participated in individual PD Check-In semi-structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two-stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check-In followed by inductive content analysis to identify subcategories. Outcomes and results: Statements from PWPD indicated adoption of seven concepts of self-management across participants and across time. Six concepts from the theoretical framework of PD Check-In (partnerships, self-reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self-reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points. Conclusions and implications: Statements from PWPD indicated a positive impact of SLT-supported self-management of speech using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs.

The past decade has been marked by a series of global crises, presenting an opportunity to reevaluate the relationship between science and politics. The biological sciences are instrumental in understanding natural phenomena and informing policy decisions. However, scholars argue that current scientific expertise often fails to account for entire populations and long-term impacts, hindering efforts to address issues such as biodiversity loss, global warming, and pandemics. This article explores the structural challenges of integrating an evolutionary perspective, historically opposed to functional determinants of health and disease, into current biological science practices. Using data on Swiss biology professors from 1957, 1980, and 2000, we examine the structural power dynamics that have led to the division between these competing epistemologies, and how this division has influenced resource allocation and career trajectories. Our analysis suggests that this cleavage presents a significant obstacle to achieving fruitful reconciliations, and that increased academicization and internationalization may benefit functional biologists at the expense of evolutionary biologists. While evolutionary biologists have gained symbolic recognition in recent years, this has not translated into valuable expertise in the political domain.

Objective: The goal of this study was to report on the development and early usability of a new interactive mHealth app for reducing cardiovascular risk in primary care patients of low socioeconomic status attending clinics in Chile. Design: Mixed-methods design with qualitative and quantitative components. Setting: Three Chilean primary care clinics located in one urban (Santiago) and two rural areas (San Clemente and Chiguayante). Each clinic serves a population of about 24,000 people of generally low socioeconomic status with an average of 8.5 years of education. Methods: A qualitative co-design participatory framework was used to develop the "Mi Salud-APS" mHealth app. Three iterations of virtual workshops were held with healthcare providers and patient participants to develop the new app. Once developed, the usability phase identified, invited and followed up for 3 months a sample of primary care patients with moderate (N = 119) or high (N = 329) cardiovascular risk. Results: A total of 24 healthcare providers and 24 patients participated in the developmental workshops. Three emergent categories represented the core attributes for the mHealth app design: 'Friendly', 'Interactive' and 'Pertinent'. In the usability phase of the sample of 448 patients, 98% downloaded the app, and 64.6% of them logged in and used it for an average of 1.46 (0.5-10) times weekly. Conclusion: Findings suggest that patient and healthcare provider contributions to the development of the mHealth app accurately reflect the interests and experiences of both groups and together helped achieve the high usability levels observed among primary care patients enrolled in clinics in underserved communities.

This intervention study aimed to assess mothers' knowledge of iron-deficiency anemia (IDA). It also measured the impact of a health education program on their level of knowledge and their infants' IDA rates in rural areas of Nablus Governorate. Using a randomized pretest--posttest control group design, the efficacy of 3 months' education program was examined against control group. Assessments were made at baseline and after 3 months of conducting the intervention. A structured interviewing questionnaire was used to assess the knowledge about IDA, and blood samples were collected from infants in both groups. Only 1.9% of mothers in the intervention group and 3.5% of mothers in the control group had good level of knowledge at baseline. After the educational intervention, a significant statistical difference was observed in the mean total knowledge score between the intervention and control groups (33.68 + 5.366 versus 26.12 + 5.243), and the intervention group was seven times more likely to have good knowledge (relative risk = 7.332). Regarding IDA rate, there was a decrease in the infants with IDA in the intervention group (relative risk = 0.671) compared to infants in the control group. The planned health education program was effective in improving mothers' knowledge and reducing the risk of IDA among their infants.

Narratives have been widely acknowledged as a powerful persuasion tool in health promotion and education. Recently, great efforts have been devoted to identifying message components and causal pathways that maximize a narrative's persuasion power. Specifically, we investigated how narrator point of view and readers' subjective relative risk moderate the effects of protagonist competence on intentions to adopt osteoporosis-prevention behaviors, and proposed identification with the protagonist, self-referencing, and fear arousal as three mediators explaining the effect. Women aged 35 to 55, still young enough to reduce osteoporosis risk, read a narrative in which the 60-year-old female character reflects on either taking actions to prevent osteoporosis (competent protagonist) or failing to do so, resulting in osteoporosis (incompetent protagonist) (N = 563). The narratives were told from either the first- or third-person point of view. We found that women who perceived themselves to be at lower risk for developing osteoporosis relative to their peers identified more with the competent protagonist. For women at higher perceived risk, the competent and incompetent protagonists elicited similar levels of identification. Identification was higher when the protagonist's story was told from the first-person perspective, but only for the incompetent protagonist narrative. Identification, self-referencing, and fear arousal played important mediating roles. Implications for theory development and practice are examined.

Background: We now have sufficient evidence demonstrating inequalities in specific avoidable causes of death for adults with intellectual disability compared to their peers without intellectual disability. Apart from COVID-19, the largest differentials that disadvantage people with intellectual disability are in relation to pneumonia, aspiration pneumonia, epilepsy, cerebrovascular disease, ischaemic heart disease, deep vein thrombosis, diabetes and sepsis. The aim of this systematic review is to report on strategies at the individual, population or policy levels aimed at preventing these conditions that are applicable to adults with intellectual disability and that have been based on or recommended by research. Methods: Systematic review of PUBMED, EMBASE, CINAHL, PsychInfo, Social Care Online, International Bibliography of the Social Sciences (IBSS), Web of Science, Scopus, Overton, the Cochrane Library and Google Scholar databases was carried out. Searches were completed on 30 June 2023. Quantitative, qualitative and mixed-methods research; systematic, scoping or evidence-based reviews; and audit and reports of mortality reviews were included. Publications included in the review were about preventing the eight potentially avoidable causes of death. Findings: Ninety-four papers were included in the review (9 in relation to pneumonia; 11 for aspiration pneumonia; 18 for sudden unexpected death in epilepsy; 7 for cerebrovascular disease; 8 for ischaemic heart disease; 4 for deep vein thrombosis; 31 for diabetes; 6 for sepsis). The eight most frequently occurring potentially avoidable causes of death in people with intellectual disability are very different medical conditions, but they shared striking similarities in how they could be prevented. The literature overwhelmingly implicated the need to make lifestyle changes to address obesity, lack of exercise and poor nutrition, and to have regular medical reviews. In addition, 'whole-population' approaches are required that look beyond the individual to the social determinants of health. Conclusions: We found little peer-reviewed evidence specifically about preventing these conditions in people with intellectual disability. However, most of the literature about preventative strategies pertaining to the general population was applicable to people with intellectual disability, albeit that some 'reasonable adjustments' would be required.

Views of obesity as a consequence of "lack of willpower" or other behavioral choices, rather than a complex array of biological and other factors, are quite common among undergraduate students. Many undergraduates in prenursing or biology programs have little exposure to the physiology and pathophysiology of obesity, including learning about leptin and other hormones involved in appetite control. I developed materials for teaching about the pathophysiology of obesity in two different pathophysiology courses: one designed as a survey of pathophysiology topics for prenursing majors, and the other designed as an in-depth exploration of the molecular and cellular basis of selected diseases for upper-division biology majors. In the molecular basis of disease course, obesity is covered as part of a unit organized around metabolic syndrome. The discussion includes molecular and cellular mechanisms that link obesity to several other diseases, including type 2 diabetes and atherosclerosis. This article briefly describes the approaches I have taken for teaching obesity to two different undergraduate student populations and lists several resources that may be useful tools for teaching about obesity.

Here we demonstrate how data from the clinical pulmonary function lab can help students learn about the principle of airway-parenchymal interdependence. We examined the relationship between airway conductance (Gaw) and lung volume (thoracic gas volume, TGV) in 48 patients: 17 healthy; 20 with emphysema, expected to have reduced airway-parenchymal interdependence; and 11 with pulmonary fibrosis, expected to have increased airway-parenchymal interdependence. Our findings support these expectations, with the slope of Gaw vs. TGV being steeper among those with pulmonary fibrosis and flatter among those with emphysema, compared to the slope of the healthy group. This type of analytic approach, using real-world patient data readily available from any pulmonary function laboratory, can be used to explore other fundamental principles of respiratory physiology.

This article introduces an innovative teaching and learning tool called "Edelman Gamblegrams" that aims to help medical learners better understand disorders related to water/plasma tonicity homeostasis, i.e., hyponatremia and hypernatremia. Gamblegrams, named after physician James L. Gamble, are bar diagrams displaying the relative abundance of extracellular anions and cations and are commonly used in the analysis of acid-base disorders. The Edelman equation represents the physiological variables that determine plasma sodium concentration, namely, total body sodium mass, total body potassium mass, and total body water volume. Edelman Gamblegrams inspired by traditional Gamblegrams but using the components of the Edelman equation, visually demonstrate how sodium, potassium, and water contribute to plasma sodium concentration under normal and pathological conditions. Scenarios that lead to hypotonic hyponatremia and hypernatremia in Edelman Gamblegrams are also discussed. Furthermore, examples of how these visual aids can enhance understanding of the pathogenesis of dysnatremias are also presented. Overall, the use of Edelman Gamblegrams has the potential to improve comprehension and retention of concepts related to water/plasma tonicity homeostasis.

Pharmacists are increasingly becoming the healthcare professional who interacts most regularly with patients who have diseases or disorders for which exercise is an effective and recommended treatment. With the relative scarcity of clinical exercise physiologists in the United States, pharmacists are expected to provide lifestyle advice to their patients, especially in community (i.e. retail) pharmacy settings, but student pharmacists typically receive no formal or informal training in exercise physiology and prescription. To address this deficit, an elective course was developed to provide student pharmacists with the knowledge and skill set that will enable them to apply evidence-based physical activity guidelines in the pharmacy. The course utilized the Exercise is Medicine resources for chronic diseases and disorders that are routinely encountered in community pharmacies, in addition to analysis of interactions between exercise and medications commonly prescribed for these conditions. After completion of the course, students reported being significantly more comfortable discussing physical activity with their patients compared to the start of the course (P < 0.001). Similarly, at the end of the course, 99% of students reported that they felt confident in their ability to apply evidence-based recommendations of common diseases and disorders to their patients. Postcourse student evaluations clearly demonstrated that student pharmacists viewed the course positively and as essential in their professional training. These data highlight the feasibility and efficacy of improving self-perceptions for the provision of physical activity recommendations via an elective course in physical activity prescription in a Doctor of Pharmacy program.

Diabetes mellitus and obesity are major public health issues that significantly impact the health care system. The next generation of health care providers will need a deep understanding of the pathophysiology of these diseases if we are to prevent, treat, and eventually cure these diseases and ease the burden on patients and the health care system. Physiology core concepts are a set of core principles, or "big ideas," identified by physiology educators that are thought to promote long-term retention, create a deeper understanding, and help with formation of critical thinking skills. Here we describe our scaffolded teaching approach in an upper year undergraduate pathophysiology course to educate students about these two diseases and discuss how learning about the basis of these highly integrative diseases from the biochemical to whole body level is a meaningful tool in the physiology educator toolbox to reinforce physiology core concepts. This teaching strategy is designed to engage students in the scientific process and hone their problem-solving skills such that they are hopefully equipped to treat and eventually cure these diseases as they move forward in their careers.

Background: People with intellectual disability often present atypically for various health conditions, making it challenging to identify concerns, particularly when communication challenges are also considered. Additionally, they may face barriers to healthcare access, resulting in many conditions going unnoticed. Health screening inequities are also evident in this population, and osteoporosis, a silent condition often only diagnosed postfracture, requires screening; however, if this does not happen, it may result in unnecessary fracture. Therefore the aim of this study is to identify predictors of osteoporosis in older adults with intellectual disability and examine potential inequity in the diagnosis of the condition. Methods: The study used data from the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA). Bone quality was measured using quantitative ultrasound (QUS). Logistic regression was performed to identify significant predictors of poor bone quality, including chronic health conditions, dietary intake, medication use and activity levels. Results: Out of 575 participants who completed QUS, osteoporosis prevalence was objectively measured at 41%, with a further 33.2% measured within the osteopenic range, but less than 2 in 10 had a doctor's diagnosis of osteoporosis. Reported Dual-Energy X-ray Absorptiometry screening uptake was low at 18.2%. Three major predictor variables of osteoporosis and osteopenia were found significant: difficulty walking 100 yards, taking antiepileptic drugs medicines and taking proton pump inhibitors. The model achieved an overall classification accuracy of 70.8% for osteopenia and 72.5% for identifying osteoporosis. Conclusion: The study highlights the different risk factors in people with intellectual disability, the potential for missed diagnoses and the likelihood there is inadequate screening. There is an urgent need for robust risk assessment and reasonable adjustments to ensure equitable screening and targeted preventive strategies. Clinicians must consider specific concerns for this population to avoid missed diagnoses and reduce the adverse effects of osteoporosis/osteopenia, such as an increased risk of fragility fractures.

Background: Type 2 diabetes mellitus, cardiovascular disease and chronic obstructive pulmonary disease contribute significantly to societal and individual impact globally. High-quality management of these long-term health conditions is important to prevent deterioration of health, although potentially more complex for patients with intellectual disabilities in residential care. Disease management in this context particularly benefits from complete and accurate recording of disease management. Without complete records, long-term health conditions are more difficult to track due to the level of uncertainty regarding which clinical examinations have and have not been performed. This study therefore aims to examine the recording routines of quality indicators for disease monitoring for chronically ill patients with intellectual disabilities in Dutch residential care. Methods: This retrospective study utilised medical record data from a large Dutch long-term care provider. We assessed the occurrence of cardiovascular disease (ICPC-2 codes K74, K75, K76, K89 and K90), type 2 diabetes mellitus (T90, T90.02) and/or COPD (R91, R95). For adults with intellectual disabilities and long-term condition, we analysed data entries in an 18-month period (between July 2020 and December 2021). Observed consultation rates were calculated and presented in median with interquartile range and contrasted against the baseline number of consultations in primary care. Information on recorded quality indicators was presented in frequencies and percentages. Findings: Of the three long-term conditions investigated, the most common was type 2 diabetes mellitus (8.6%; n = 287), followed by cardiovascular disease (5.8%; n = 195) and COPD (3.0%; n = 101). Of those who received management for their long-term condition from their contracted GP, patients with type 2 diabetes mellitus, cardiovascular disease, or COPD had fewer consultations in 2021 than the Dutch baseline. Discussion of lifestyle was often not recorded. Disease monitoring quality indicators were recorded more often but at a lower frequency than expected. Conclusions: Because of the infrequent recording of quality indicators, recording of management of long-term conditions for patients with intellectual disabilities in long-term care appears suboptimal. Although this may not directly harm individual patients, it may jeopardise the quality of management of long-term conditions, as suboptimal recording limits opportunities for evaluation and improvement. Within a broader trend towards data-driven work methods in healthcare, recording of quality indicators requires attention from practice, research and policy.

Students with chronic health conditions experience many challenges, such as increased school absences, that may impact academic success. Additional academic problems exist for students with chronic health conditions who also have socioeconomic status (SES) factors. A systematic literature review as conducted to study the interactions between chronic health conditions, absenteeism, and factors associated with SES. Findings suggest that asthma, the most common chronic health condition in children, is the leading cause of health-related school absences. Findings also suggest that factors associated with SES, such as family income, also impact school attendance for students with chronic health conditions. Although the results are mixed for academic achievement abilities for student who have chronic health conditions, many academic challenges that students with chronic health conditions encounter can be explained by frequent school absences. Further research on school absences and SES factors affecting students with chronic illnesses is needed to help establish guidelines for appropriate school programming and positive school attendance support.

Although neurobiologic and genetic factors figure prominently in the development of attention deficit/hyperactivity disorder (ADHD), adverse physical health experiences and conditions encountered during childhood may also play a role. Poor health is known to impact the developing brain with potential lifelong implications for behavioral issues. In attempt to better understand the relationship between childhood physical health and the onset and presence of ADHD symptoms, we summarized international peer-reviewed articles documenting relationships between a select group of childhood diseases or health events (e.g., illnesses, injuries, syndromes) and subsequent ADHD outcomes among children ages 0-17 years. Drawing on a larger two-phase systematic review, 57 longitudinal or retrospective observational studies (1978-2021) of childhood allergies, asthma, eczema, head injury, infection, or sleep problems and later ADHD diagnosis or symptomatology were identified and subjected to meta-analysis. Significant associations were documented between childhood head injuries, infections, and sleep problems with both dichotomous and continuous measures of ADHD, and between allergies with dichotomous measures of ADHD. We did not observe significant associations between asthma or eczema with ADHD outcomes. Heterogeneity detected for multiple associations, primarily among continuously measured outcomes, underscores the potential value of future subgroup analyses and individual studies. Collectively, these findings shed light on the importance of physical health in understanding childhood ADHD. Possible etiologic links between physical health factors and ADHD are discussed, as are implications for prevention efforts by providers, systems, and communities.

Background: Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. Method: Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (=60 years, N = 391). Results: People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). Conclusion: There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.

Background: Knowledge of specific health-related events encountered by students studying abroad and the availability and use of pre-travel healthcare for these students is lacking. Methods: Anonymous web-based questionnaires were sent to study abroad offices, student health centers, and undergraduate students after studying abroad at eight institutions of higher education in the United States and Ireland from 2018-2021. Analyses were descriptive; relative risks and 95% confidence intervals were calculated for health-related events. Results: One study abroad office required a pre-travel consultation. All student health centers had pre-travel counseling available. Among 686 students, there were 307 infectious and 1,588 non-infectious health-related issues; 12 students (2%) were hospitalized. Duration of travel and timing of a pre-travel consultation impacted the risk of health-related events. Certain mental health conditions were associated with increased risk of alcohol and drug use. Conclusion: Future studies should address the optimal timing and best practices to optimize health for students studying abroad.

Purpose: This study examined speech changes induced by deep-brain stimulation (DBS) in speakers with Parkinson's disease (PD) using a set of auditory-perceptual and acoustic measures. Method: Speech recordings from nine speakers with PD and DBS were compared between DBS-On and DBS-Off conditions using auditory-perceptual and acoustic analyses. Auditory-perceptual ratings included voice quality, articulation precision, prosody, speech intelligibility, and listening effort obtained from 44 listeners. Acoustic measures were made for voicing proportion, second formant frequency slope, vowel dispersion, articulation rate, and range of fundamental frequency and intensity. Results: No significant changes were found between DBS-On and DBS-Off for the five perceptual ratings. Four of six acoustic measures revealed significant differences between the two conditions. While articulation rate and acoustic vowel dispersion increased, voicing proportion and intensity range decreased from the DBS-Off to DBS-On condition. However, a visual examination of the data indicated that the statistical significance was mostly driven by a small number of participants, while the majority did not show a consistent pattern of such changes. Conclusions: Our data, in general, indicate no-to-minimal changes in speech production ensued from DBS stimulation. The findings are discussed with a focus on large interspeaker variability in PD in terms of their speech characteristics and the potential effects of DBS on speech.

Art is a common approach for communicating and educating about science, yet it remains unclear the extent to which science art can benefit varied audiences in varied contexts. To examine this gap, we developed an art exhibit based on the findings of two publications in disease ecology. In study 1, we asked visitors with varying formal science, technology, engineering, and math (STEM) education backgrounds to complete a survey about their interest in science research before and after viewing the exhibit. In study 2, we recruited upper-level ecology undergraduate students to receive one of three treatments: engage with the art exhibit, read the abstracts of the papers, or do neither. Students completed a comprehension quiz immediately after their learning treatment and again 2 weeks later to evaluate retention. Following the exhibit, visitors who did not report a career or major in STEM showed a greater increase in research interest than visitors who did report a career or major in STEM. For the ecology undergraduate students, comprehension quiz scores were higher for students in the abstract group than the art exhibit group, while both groups scored higher than the control group. Retention of information did not significantly differ between the three groups. Overall, these findings suggest that science art exhibits are an effective method for increasing the accessibility of science to broader audiences and that audience identifiers (e.g., level of formal education in STEM) play an important role in audience experience of science communication and science education initiatives.

The pandemic brought a whole newfound collection of words into our everyday language, some of which had been terms that were infrequently used outside academic and medical settings. However, as familiar as this new pandemic vocabulary has become, there are still several terms that often get mixed in everyday conversations, media communications, and even in the medical field. Some of these terms are often mistaken, which may lead to issues in the understanding of important concepts. Science communication, as a facet of scientific literacy, intends to educate people in an easy-to-understand manner, and this communication is even more important in health care, when a literate patient's medical decisions depend frequently on this process. In this article, we explore the use and misuse of some of the most common terms utilized during the 2019 coronavirus disease (COVID-19) pandemic by nursing and medical students, i.e., future health care professionals, in the hospital environment. This single-center hospital-based cross-sectional study, performed throughout September 2022, included 30 medical and nursing students. All participants completed a self-administered 15-item anonymous questionnaire at a single time point. Nine multiple-choice questions evaluated knowledge, diagnosis, disease manifestations, and vaccines related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Six questions provided demographics and quality assessment information. The analysis of the answers indicated that for at least 75% of the population surveyed, COVID-19 literacy was better for terms related to technology and actions (3/5 questions answered correctly) than for terms related to the disease (1/4 questions answered correctly). The overall median score for questions 1 to 9 was 4.5 of 9 points in total. Based on the results, the language used in the questionnaire was considered easy to understand, with an easy to medium level of complexity, and the perceived time required to complete the questionnaire was less than 5 min. In conclusion, our results showed that efforts need to be made in continuous professional education to increase the knowledge in COVID-19 literacy in the health care environment for medical and nursing students. Larger studies are recommended to identify and to fulfill the challenges that COVID-19 brought to medical and nursing education.

To better prepare undergraduate students as informed citizens, they need skills to evaluate and interpret scientific data that are relevant to real world scenarios. Socioscientific issues are typically complicated or debatable issues that require individuals to evaluate their background knowledge and make decisions with respect to social and cultural contexts. Incorporation of socioscientific issues into a course allows students opportunities to demonstrate their argumentation skills. In this study, we investigated the relationship between students' biological content knowledge and their argumentation skills. We evaluated students' content knowledge of primary research articles on mRNA vaccine development and clinical trials. There was no correlation of content knowledge and students' argumentation skills to counter vaccine hesitancy. While most students demonstrated understanding of the primary research articles, almost half the students did not include specific biological knowledge in their arguments, indicating they had difficulty in applying their knowledge to the real world. These results suggest there is a need to provide students with additional opportunities to practice and develop their argumentation skills with respect to socioscientific issues.

Parasitic infections are declining in Japan, resulting in fewer hours of parasitology instruction in medical laboratory science and medical schools. However, there are growing concerns that the parasite identification skills of medical laboratory technologists and the diagnostic skills of physicians may be compromised as a result. Effective teaching methods are required to improve the identification of parasites in pre-graduate education. We therefore adopted a new teaching method: the blended learning method, in 2018. This method combined the e-learning and jigsaw methods, which had already been implemented separately in 2017. This study aimed to evaluate the pedagogical effectiveness of this blended learning approach compared to that of 2017 in teaching parasitology practice to students enrolled in the Department of Medical Laboratory Science. The results show that the median score for the practical test was 83.3 points for the blended learning lessons, which was not significantly different from the scores for jigsaw or e-learning lessons. However, blended learning had the lowest percentage of failures on the practical test, at 10.7%. Additionally, the microscopic image test results indicate a significant memory retention effect. From the questionnaire results, 94.7% of the students were satisfied with their practice. In conclusion, the blended learning did not significantly improve parasite identification skills, but it may reduce the number of failures, suggesting a knowledge retention effect and a high level of satisfaction with this practice.

The study aimed to assess the consequences of an academic educational program on the scholars' knowledge and attitude regarding premenstrual syndromes and, its effect on the absenteeism of scholars in Sabya University College. A quasi-experimental study of 0.97 students recruited study group; data were collected then recollected after the tutorial program session was provided. Data were interred into spss version 26, organized, tabularized, and analyzed using descriptive and inferential statistics. Mean knowledge changed from 3814 pre- to 0.9081 post intervention, good knowledge score was 20.6% changed to 72.2% post intervention, while inadequate knowledge score was 79.4 pre was changed to 27.8 post, which supports the tutorial program. Positive attitude 56.6% pre was changed to 61.9% post. In contrast, the negative attitude was changed from 47.7% to 38% post intervention. Pearson correlation test showed a direct correlation between absenteeism and knowledge score pre and post-intervention. PMS was significantly associated with several problems related to educational activities. The tutorial program resulted in a significant change of data from pre to post-intervention for the study group, also changed attitude, and there's a direct correlation between premenstrual symptoms and absenteeism, premenstrual symptoms were significant effects on educational activities.

The aim of the study was to describe the validity and reliability of the Turkish version of Juvenile Arthritis Functional Assessment Report (JAFAR) in children/adolescents with Juvenile Idiopathic Arthritis (JIA). Sixty-nine children/adolescents with JIA were included in the study. JAFAR(TR)-Child and Parent forms were applied to the patients with JIA and to their parents for test retest at one-week intervals, the patients did not receive additional treatment and his/her pharmacological treatment did not change for that week. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC), and internal consistency reliability of multi-item subscales was evaluated by calculating Cronbach's alpha coefficient. Correlations between JAFAR(TR)-Child and Parent with the Pediatric Quality of Life Inventory 3.0. Module Arthritis (PedsQL), the Childhood Health Assessment Questionnaire (CHAQ), and the Juvenile Arthritis Disease Activity Score (JADAS) were evaluated to determine construct validity. The ICC value for the test/retest reliability of JAFAR(TR)-Child was 0.963 and of JAFAR(TR)-Parent was 0.576. JAFAR(TR)-Child total score had low to moderate correlations with PedsQL Child (r=-0.34; p=0.004), CHAQ (r=0.40; p=0.001), and JADAS total score (r=0.42; p=0.000). JAFAR(TR)-Parent total score had moderate to high correlations with PedsQL Parent (r=-0.55; p=0.000), CHAQ (r=0.72; p=0.000) and JADAS total score (r=0.53; p=0.000). The Turkish version of JAFAR was found to be clinically valid and reliable in JIA.

The Medical Council of India (MCI) has stressed the necessity of Early Clinical Exposure (ECE) for a better understanding of preclinical medical subjects. However, its implementation at the medical college level in the current Indian scenario is a big challenge due to the large classroom strength and smaller number of faculty in preclinical subjects. The aim of this study to introduce ECE in physiology at our medical college, we planned an ECE session on anemia and recorded the students' perceptions regarding the same. We conducted an ECE session on Anemia designed by the subject experts of the Physiology and Medical Education Unit (MEU) faculty of our institute. We conducted a cross-sectional survey among MBBS students of 2019 batch using a pre-validated questionnaire via online Google form to capture their perceptions regarding the ECE session. After exclusion, a total of 127 responses from medical students were included for data analysis. The majority of the students responded that the overall format of the ECE session was appropriate and that the session was helpful to them in the clinical application of their knowledge about Anemia. More than 75% of students opined that the ECE session made basic science learning more interesting and they felt motivated to read further on the topic. About 80% of students preferred ECE over traditional teaching. In conclusion, Students find ECE to be interesting, motivating, and helpful for the clinical application of basic science knowledge into clinical practice. Hence, ECE should be conducted more frequently and more topics should be taught by ECE at all medical colleges.

Objectives: Sleep problems are highly prevalent among college students and are linked to a multitude of detrimental consequences, among which are heightened perceived stress and symptoms of depression. The present study investigated the effect of poor sleep quality on the immune function of college students. A serial mediation model was developed to test the prediction that perceived stress and depression sequentially mediate the relationship between poor sleep quality and reduced immune function among college students. Participants: 137 undergraduates were recruited from a large Midwestern university (103[subscript Females], 34[subscript Males]; M[subscript age] = 19.47, S[subscript Dage] = ± 1.54). Methods: Cross-sectional based online survey administered in Spring 2021. Results: Analyses revealed a significant total effect of sleep quality on immune function. Perceived stress and depression symptoms serially mediated the relationship between sleep quality and immune function. Conclusions: Results underscore the importance of college students' sleep in relation to their mental health and subsequent immune function.

Objective: This study examined the impact of State and Trait anxiety and dietary intake on college students' gastrointestinal symptoms during the COVID-19 pandemic. Participants: A total of 455 students, aged 18-23, from two residential colleges in the midwestern United States participated in the study during April 2021. Methods: An online questionnaire that included the National Cancer Institute Dietary Screener, State-Trait Inventory for Cognitive and Somatic Anxiety, and an adapted version of the Gastrointestinal Symptoms Questionnaire was used. Stepwise multiple regression analyses and Spearman rho correlation coefficients were used to analyze the data. Results: High rates of State-somatic, State-cognitive, and Trait-somatic anxiety were present in our study population. These anxiety subscales and dietary intake predicted 26% and 3.8% of the GI symptoms variance, respectively. Conclusion: State-anxiety and Trait-somatic anxiety are large factors in predicting GI symptoms compared to dietary intake. College students could seek anxiety-reducing techniques to ease GI symptoms.

Background: Aspiration pneumonia (AP) is a subset of pneumonia caused by the aspiration of food and fluids to the lungs and is highly prevalent in the older population. Oropharyngeal dysphagia (OD) is one of the risk factors for AP and it is also associated with malnutrition, dehydration and poor functional outcomes. As pneumonia is the second most common infection in nursing homes (NHs) and OD represents a major concern to NH staff, good practices for the prevention of AP in older adults at risk of OD are needed. Purpose: The aim of this modified e-Delphi study is to build consensus among a panel of experts regarding a set of recommendations for NH staff on good practices to prevent AP in older adults at risk of OD living in NHs. The objective of this paper is to establish the methodology inherent to the Delphi study. Methods: An online modified Delphi study will be developed in three rounds. Criteria for the Delphi panel participants include holding a master's or doctoral degree in OD or speech and language therapy; or having 10 or more years of experience in OD; or having at least one scientific publication related to OD. A previously described modified Delphi methodology will be used to achieve consensus (75% agreement). An additional round will be performed to collect the experts' perspectives regarding the priority for application of each recommendation previously validated. Discussion: This protocol aimed to describe the methodology of a future Delphi study on the prevention of AP, seeking to fulfil the gap in the literature regarding this topic. The modified Delphi technique is a widely used method for collecting experts' opinion in health sciences, but the absence of standardised guidelines allows some heterogeneity between studies with the same aim.

This comparative study of everyday life in Norwegian and French preschools explores how 'risk' related to children's body practices is understood, practised and negotiated by teachers and how this may regulate educational practices in a short- and long-term perspective. Studying educational institutions in two different societies illuminates institutional constraints, normative principles and cultural values influencing everyday practices. Using a polyphonic ethnographic approach, the staff of five settings were invited to react to edited videos of daily life in these settings, and to critically reflect on their own and others' practices. The results show how the teachers articulated the handling of risks and challenges according to the frames and resources related to children and the adults' responsibilities. Six different risk-related themes were identified: the risk of illness, injury, restricting children's bodies and the inability to cope, and risks related to teachers and to pedagogy. These themes also elucidated the different perceptions and values of indoor and outdoor activities through the identification of these risks. Body practices in ECEC appear as socio-political tools to either support or restrict children's experiences.

Background: The National Heart, Lung, and Blood Institute (NHLBI) "Learn About Chronic Obstructive Pulmonary Disease (COPD)" YouTube playlist educates the public on diagnosing, treating, and managing COPD. Despite its potential benefits, it is unknown if users with inadequate health literacy will likely understand and apply the information described in these videos. Purpose: Assess the "Learn About COPD" playlist's readability, actionability, and understandability. Methods: Central tendency statistics were computed to describe the meta-data of 28 videos available as of April 2023. Assessments included the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV), Accessible Health IT for Limited-Literacy Populations Checklist (LLPC), and the Modified Centers for Disease Control and Prevention (CDC)-Clear Communication Index (CCI) for audiovisual materials. Results: Playlist videos received an average of over 2,000 views (Mdn = 2,220, IQR = 496-8336), with very few "likes" (Mdn = 13, IQR = 1-48 "likes"). PEMAT-understandability (Mdn = 81.81%, IQR = 80-97.72%) and LLPC (Mdn = 87.50%, IQR = 75-93.75%) scores were high (above 80%). However, the modified CDC-CCI median score was 57.14% (IQR = 42.86-75%), and the median PEMAT-actionability score was 50% (IQR = 0-66.67%). Discussion: The playlist earned passing understandability, acceptability, and usability scores but scored poorly on actionability and communication clarity. Translation to Health Education Practice: Findings could inform enhancements to NHLBI's "Learn About COPD" YouTube playlist.

The racialized history of sickle cell disease (SCD) continues to contribute to racial disparities in healthcare and education. In the context of the racialized history of SCD, we begin by outlining subtypes of SCD and explaining that SCD is associated with chronic pain, silent cerebral infarct, overt stroke, and poor overall well-being--all of which have implications for school functioning. A literature search was conducted to identify significant meta-analyses, systematic reviews, and empirical articles to inform school psychologists' evaluation, service delivery, and decision-making practices when working with students with SCD. Common negative neuropsychological and psychoeducational outcomes associated with SCD are reviewed. Finally, recommended culturally responsive practices are discussed, ahead of a conclusion that contains a call to action for school psychologists.

This qualitative study highlights how children's literature can serve as a springboard for discussing current events while making connections with a similar historical event. Undergraduate students enrolled in children's literature courses read the graphic novel "Fever Year: The Killer Flu of 1918" and discussed the parallels between the book and the COVID-19 pandemic. Findings indicate strong text-to-self and text-to-world connections between the events of the flu of 1918 highlighted in the graphic novel and those of the COVID-19 pandemic. Connections included restrictions and closures, mask mandates, vaccine development, medical theories, and theories of spread. Information dissemination and consumption was a prominent theme.

Objectives: This literature review seeks to identify based on the current literature how the burden of disease for IBD patients manifests itself as this cohort transitions simultaneously from pediatric to adult care and from secondary to post-secondary education. Methods: This paper reviews the current literature regarding postsecondary students with IBD and provides a summary of research regarding key factors in their quality of experience. The research was conducted through databases including Taylor & Francis, PubMed, as well as searches via Google Scholar. Results: Over the course of this search, thirty-three relevant studies were identified. These studies addressed the themes outlined in this paper, including academic performance, social adaptation, transition of care, as well as overall transition to a postsecondary institution. Each of these is further broken down to identify specific determinants of IBD student experience. Conclusions: Although students with IBD can demonstrate resilience and adaptive behavior, the evidence suggests there are significant limitations impacting their perceived experience. The barriers IBD students face impact their ability to experience postsecondary education as they intend to, forcing them to adjust in adaptive or maladaptive manners. This review also attempts to generate possible solutions to specific barriers identified from current research, generating directions of action for students, physicians, and academic supports.

Studies consistently show the detrimental effect of school absences on pupils' achievement. However, due to an accumulation of multiple risks, school absenteeism may be more harmful to achievement among pupils from lower socioeconomic status (SES). Using a sample of upper-secondary students from the Scottish Longitudinal Study (n = 3,135), we investigated whether the association between absences (overall, sickness, and truancy) and achievement in high-stakes exams varied by family SES dimensions (parental education, class, free school meal registration, and housing). The findings for overall absences and truancy show no statistically significant differences across SES groups. However, sickness absences were more harmful to the achievement of lower SES students than higher SES students. Differences between the most and least disadvantaged groups were found on all SES dimensions except for parental education.

The present study examined whether learning disabilities (LD) in reading and/or math (i.e., reading disability [RD], math disability [MD], and RD+MD) co-occur with other diagnoses. The data comprised a clinical sample (n = 430) with LD identified in childhood and a sample of matched controls (n = 2,140). Their medical diagnoses (according to the "International Classification of Diseases" nosology) until adulthood (20-39 years) were analyzed. The co-occurrence of LD with neurodevelopmental disorders was considered a homotypic comorbidity, and co-occurrence with disorders or diseases from the other diagnostic categories (i.e., mental and behavioral disorders, diseases of the nervous system, injuries, other medical or physical diagnoses) was considered a heterotypic comorbidity. Both homotypic and heterotypic comorbidity were more common in the LD group. Co-occurring neurodevelopmental disorders were the most prominent comorbid disorders, but mental and behavioral disorders, diseases of the nervous system, and injuries were also pronounced in the LD group. Accumulation of diagnoses across the diagnostic categories was more common in the LD group. No differences were found among the RD, MD, and RD+MD subgroups. The findings are relevant from the theoretical perspective, as well as for clinical and educational practice, as they provide understanding regarding individual distress and guiding for the planning of support.

Background: Income inequality is theorized to impact health. However, evidence among adolescents is limited. This study examined the association between income inequality and health-related school absenteeism (HRSA) in adolescents. Methods: Participants were adolescents (n = 74,501) attending secondary schools (n = 136) that participated in the 2018-2019 wave of the COMPASS study. Chronic (missing =3 days of school in the previous 4 weeks) and problematic (missing =11 days of school in the previous 4 weeks) HRSA was self-reported. Income inequality was assessed via the Gini coefficient at the census division (CD) level. Multilevel modeling was used. Results: Greater income inequality was associated with a higher likelihood of chronic and problematic HRSA (chronic: OR = 1.17, 95% CI: 1.06, 1.30; problematic: OR = 1.29, 95% CI 1.11 to 1.50). Increased predicted probabilities for Problematic HRSA were observed at greater degrees of income inequality among students who identified as either white, black, Latinx, or mixed, while protective associations were observed among students who identified as Asian or other. No associations were modified by gender. Conclusion: Income inequality demonstrated unfavorable associations with HRSA, which was modified by racial identity.

Background: States are often ranked on a range of different indicators. In this study, states were ranked for each of the leading actual causes of death. Purpose: This study ranks states on how hazardous they are to the health of the citizenry in terms of the actual causes of death as identified in the seminal article by McGinnis and Foege. and later updated by Pilar et al. Methods: We ranked states for actual cause of death using multiple data sources. We also calculated an overall state ranking across all actual causes of death using the percent weightings attributable to each actual cause from the Pilar et al. study. States were ranked based on their overall score. Results: Significant differences were noted in actual cause ranking both within and across states. A different profile was found for the top and lowest ten ranking states. Discussion: Results suggest a comprehensive approach grounded in the socio-ecological model combining health promotion/education and health policy to affect change. Translation to Health Education Practice: Health professionals may use these rankings to determine methods for improving health services, programs, and behaviors in their communities.

This study aimed to develop and validate machine learning models to predict intensities in children and adolescents with cystic fibrosis (CF) across different accelerometry brands and placements. Thirty-five children and adolescents with CF (11.6 ± 2.8 yrs; 15 girls) and 28 healthy youth (12.2 ± 2.7 yrs; 16 girls) performed six activities whilst wearing GENEActivs (both wrists) and ActiGraphs GT9X (both wrists and waist). Three supervised learning classifiers (K-Nearest Neighbour, Random Forest and eXtreme Gradient Boosted Decision Tree) were used to identify the input signal pattern for each PA type and intensity, with a 10-fold cross-validation utilized to assess the performance of the classifiers. ActiGraph GT9X on the dominant wrist and waist and GENEActiv on the dominant wrist failed to predict vigorous intensity PA activities. All other models, for activity type and intensities, exceeded 97% accuracy, with a sensitivity and specificity of greater than 95%, irrespective of accelerometer brand, placement or health condition. [This paper was written on behalf of ActiveYouth SRC group.]

Drug repurposing refers to the process of discovering new therapeutic uses for existing medicines. Compared to traditional drug discovery, drug repurposing is attractive for its speed, cost, and reduced risk of failure. However, existing approaches for drug repurposing involve complex, computationally-intensive analytical methods that are not widely used in practice. Instead, repurposing decisions are often based on subjective judgments from limited empirical evidence. In this article, we develop a novel Bayesian network meta-analysis (NMA) framework that can predict the efficacy of an approved treatment in a new indication and thereby identify candidate treatments for repurposing. We obtain predictions using two main steps: first, we use standard NMA modeling to estimate average relative effects from a network comprised of treatments studied in both indications in addition to one treatment studied in only one indication. Then, we model the correlation between relative effects using various strategies that differ in how they model treatments across indications and within the same drug class. We evaluate the predictive performance of each model using a simulation study and find that the model minimizing root mean squared error of the posterior median for the candidate treatment depends on the amount of available data, the level of correlation between indications, and whether treatment effects differ, on average, by drug class. We conclude by discussing an illustrative example in psoriasis and psoriatic arthritis and find that the candidate treatment has a high probability of success in a future trial.

Background: The Communicative Participation Item Bank (CPIB) is a patient-reported outcome measure (PROM) designed to measure the extent of interference, or difficulty, experienced by adults with communication disorders participating in their day-to-day communication activities. To date, there is limited evidence regarding sensitivity of the CPIB for capturing change with intervention in people with Parkinson's disease (PwPD). Aims: The purpose of this study was to examine the following measurement properties of the CPIB in PwPD who received community-based, standard care, speech-language therapy focusing on motor speech concerns: Change over time between treatment and observation groups, comparison to patient-defined ideal and satisfactory targets, comparison of static short form to computerised adaptive testing (CAT), comparison of self to proxy-rated scores, and comparison to other common PROMs. Methods and Procedures: Forty-six PwPD (20 treatment/26 observation) completed data collection upon enrolment (pre-treatment) and 6 months later. In addition to the CPIB, PROMs included the Voice Handicap Index 10-item short form (VHI-10), PROMIS Global Health-Related Quality of Life, Levels of Speech Usage, self-rated speech severity, and Patient Health Questionnaire-9 (PHQ-9). Participants also engaged in qualitative interviews. Forty-four family members completed proxy CPIB ratings. Outcomes and Results: There were no significant differences between treatment and observation groups on the CPIB pre-treatment, but there were significant differences post-treatment. The differences appeared to be largely due to significant gains in the treatment group. No participants reached their ideal CPIB target, and few reached their satisfactory target. Static CPIB short form and CAT scores were not significantly different, with an average of five CAT items administered per participant. Overall group similarities between patient and proxy scores may have obscured wide variability across individual patient-proxy pairs. Associations between CPIB and VHI-10, health-related quality of life, self-reported speech severity, and depression ranged from weak to moderate. Conclusions and Implications: The CPIB appears to be sensitive to capturing change with intervention, and similar results are obtained with the static short form and CAT formats. One clinical caution is that even with gains observed in the treatment group, no participants obtained their ideal communicative participation goals, and few obtained a satisfactory level of communicative participation. Thus, while current interventions are beneficial, they may not meet the full range of clients' communication needs. While responding to the CPIB through a proxy rater may be feasible, caution is warranted due to concerns about maintaining the autonomy of PwPD.

Background: Parkinson's disease (PD) can affect social interaction and communication as well as motor and cognitive processes. Speech is affected in PD, as is the control of voluntary eye movements which are thought to play an important role in 'turn taking' in conversation. Aims: This study aimed to measure eye movements during spoken conversation in PD to assess whether differences in patterns of eye gaze are linked to disrupted turn taking and impaired communication efficiency. Methods & Procedure: Eleven participants with mild PD and 14 controls completed a two-player guessing game. During each 3 min game turn, one of the players had to guess the names of as many objects as possible based only on the other player's description. Eye movements were recorded simultaneously in both participants using mobile eye trackers along with speech onset and offset times. Outcomes & Results: When people with PD played the role of describer, the other player guessed fewer objects compared to when controls described objects. When guessing objects, people with PD performed just as well as controls. Analysis of eye fixations showed that people with PD made longer periods of fixation on the other player's face relative to controls and a lower number of such 'gaze on face' periods. Conclusions & Implications: A combination of oculomotor, cognitive and speech abnormalities may disrupt communication in PD. Better public awareness of oculomotor, speech and other deficits in the condition could improve social connectedness in people with Parkinson's.

Female children with profound intellectual disabilities (IDs) may experience symptoms of urinary tract infections (UTIs) and depend on others' care. However, their caregivers may lack general hygiene skills and experience heightened anxiety when their care is expected. This study reports outcome of a training that aims to enhance genital hygiene skills and decrease anxiety levels of mothers of girls diagnosed with profound ID. The study was conducted in a city located in Turkey in 2020. It was designed with a randomized controlled experimental approach based on a pre-test and post-test model with experimental and control groups. The sample consisted of 66 mothers of girls who were diagnosed with profound ID, did not have UTI but were at high risk of developing it. A 6-week program with 24 sessions was implemented. After the training, mothers in the experimental group changed the sanitary pad and the underwear during menstruation and gave their daughters a bath more frequently; had a higher knowledge of recognizing and preventing UTI symptoms and cleaning of the perineum area; and had significantly lower levels of anxiety. A carefully designed simulator-based training can enhance the knowledge and skills of mothers to recognize the UTI symptoms, apply their knowledge to prevent the symptoms and implement genital hygiene practices, which in turn have a positive effect on reducing their level of anxiety.