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The present paper explores how aging bodies of middle-aged women can enable and constrain participation in physical activity. The study is inspired by the process sociology of Norbert Elias and builds on qualitative empirical material from passive observations (N = 57), focus groups (N = 51), and individual follow-up interviews (N = 21) with middle-aged Danish women who participated in a 3-month research project with exercise intervention. The qualitative study found that awareness of bodily aging enabled the taking up of exercise in the intervention. Additionally, taking up regular exercise in midlife can be understood as a highly rationalized leisure-time activity in relation to societal moral norms of self-responsibility for own physiological health. Furthermore, the qualitative material indicates that participation enabled a self-realization among the middle-aged women, as strong and capable bodies counter to the biomedical view of decline in the aging body. [ABSTRACT FROM AUTHOR]

Organizational leaders are essential in implementing, interpreting, and even proactively initiating changes for human resource (HR) functions to enhance workplace productivity and well‐being. However, recent studies have cautioned that providing positive and supportive leadership usually drains these organizational leaders. Although the literature has shed light on how leaders can use self‐care strategies to recharge, researchers and HR professionals know relatively little about (1) what specific self‐care actions leaders can take and (2) how external crises such as COVID‐19 constrain leaders' self‐care actions. To identify specific leaders' self‐care behaviors, which we refer to as oxygen masks, we interviewed 41 healthcare managers in Australia during the COVID‐19 pandemic in 2020. We presented a behavioral typology summarizing distinct oxygen masks that leaders used at different points in time. These oxygen masks include improving physical well‐being, improving emotional/spiritual/social well‐being, fulfilling managerial roles, and seeking collegial and organizational support. Moreover, we concluded that the COVID‐19 restrictions made some of these oxygen masks less accessible, negatively impacting leaders' well‐being. Our research conclusions have implications for theory and future studies on extending the literature associated with leadership development, leaders' resilience, and leaders' well‐being. The results also provide HR professionals with practical suggestions about assisting line managers in improving their self‐care and sustaining their leadership effectiveness. [ABSTRACT FROM AUTHOR]

Objectives: This scoping review assessed systematic reviews on noninvasive temporomandibular disorder therapies to identify evidence gaps and formulate clinical recommendations. Method and materials: The scoping review was conducted according to the PRISMA scoping review guidelines and Joanna Briggs Institute updated scoping review methodology using a two-step process involving four reviewers. Four key databases (Embase, PubMed, Scopus, and Google Scholar) were thoroughly searched from January 2017 to December 2022. The selected systematic reviews were classified, charted, critically appraised, and synthesized. Results: Of the initial 522 listings, 61 systematic reviews were eligible for inclusion, with the majority bearing very low- to low-quality evidence, and metaanalysis not being conducted in about a third of them. Moderate- to high-quality evidence was available for patient selfmanagement, botulinum toxin, manual, laser, and splint therapy. Conclusions: Further high-quality investigations with consistent patient selection, diagnostic criteria, treatment/assessment protocols, and outcome measures are needed to confirm the effectiveness of the various interventions fortemporo-mandibular disorder pain/dysfunction. [ABSTRACT FROM AUTHOR]

Contrast-enhanced ultrasonography (CEUS) has revolutionized diagnostic imaging by significantly improving the accuracy and capabilities of ultrasound technology. By utilizing contrast agents, CEUS offers enhanced visualization of blood flow, superior detection of vascular diseases, and delineation of pathological from healthy tissues. Real-time imaging capabilities afforded by CEUS have been shown to be instrumental in guiding interventions and assessing treatment efficacy, thereby contributing to personalized patient care and improved clinical outcomes. This document provides a comprehensive review of the current benefits, limitations, and future directions of contrast-enhanced ultrasonography. It acknowledges the potential for allergic reactions, the necessity for specialized training, high costs, and the occurrence of image artifacts as drawbacks, while also anticipating advancements in targeted agents and imaging techniques. Moreover, the document emphasizes the need for ongoing research to evaluate the long-term safety and efficacy of contrast agents and their impact across various medical disciplines. Despite the challenges, the integration of CEUS into clinical practice holds enormous potential to further refine diagnostic processes and enhance patient management. [ABSTRACT FROM AUTHOR]

Background: Effective self-care practices are crucial for maintaining health and well-being, as inadequate self-care can lead to increased health risks and decreased overall quality of life. To address these issues, one promising approach involves leveraging progressive web app (PWA) platforms to educate and empower individuals with necessary self-care services. This study aims to design, implement, and evaluate a national self-care PWA platform, aiming to enhance accessibility and effectiveness in promoting health and self-care practices. The platform designed to improve self-care processes can be utilized by mothers, children, adolescents, youth, adults, and patients with emotional and mental disorders. Methods: This study was conducted in three phases. In the first phase, during 35 meetings with 19 health care providers including physicians and another group of professionals, the most common illnesses and conditions that require self-care were identified. Platform capabilities were then assessed based on stakeholder opinions. Subsequently, during 15 meetings 19 health care providers identified a comprehensive list of conditions benefiting from dedicated decision aids to enhance individuals' self-care processes. In the second phase, a progressive web app platform was designed based on these common illnesses and conditions and capabilities and subsequently evaluated. To usability evaluation the platform, 26 evaluators utilized the system for two weeks. The QUIS 5.5 questionnaire was employed for evaluation, and the results were analyzed using SPSS 23. In the final phase, the system was implemented at the Smart University of Medical Sciences (SMUMS), affiliated with the Ministry of Health and Medical Education in Iran. Results: Based on the most common illnesses and conditions (n = 87) and identified capabilities, the national self-care platform was designed with eight sections catering to 'Maternal and child health services,' 'Mothers,' 'Infants,' 'Teenagers,' 'Adults,' 'Elderly,' 'Health of All Age Groups,' 'Patients with Mental and Emotional Health Disorders,' and 'General Information' for user education. Furthermore, the platform features 54 decision aids (DA), teleconsultation services, and a self-care magazine (Access link: https://khodmoragheb.ir/). These features were integrated to provide comprehensive support and resources for self-care. A mean exceeding 7 was attained across all evaluated dimensions, indicating that evaluators generally agreed the platform performed well. Conclusion: The designed national self-care platform offers a promising solution for managing healthcare challenges. This innovative approach addresses the specific needs of individuals and extends its reach to Persian-speaking patients worldwide, fostering a global impact. By embracing self-care practices on an international scale, this platform contributes to a more inclusive and accessible healthcare landscape for individuals in Iran, Afghanistan, Tajikistan, and beyond. [ABSTRACT FROM AUTHOR]

Aim: Identify the skills and knowledge future nurse and midwife leaders might require in the next 6 years. Design/methodology/approach: An online questionnaire elicited health professionals' perspectives on the future requirements for nurse and midwife leaders. Qualitative data were generated in response on health care and the likely leadership skills for the future. Data were extracted and analysed using qualitative content analysis. Findings: Four generic categories were abstracted from the core category 'Nursing and Midwifery Leadership'. These were values/traits; creating positive healthcare cultures; digital capability/competence; and systems thinking. Limitations/implications. This first stage evaluation has gained a wide variety of perspectives regarding the perceived skills and knowledge future nurse and midwife leaders might need. This is important to enable those who deliver leadership development programmes to plan appropriately, ensuring their programmes are designed and adjusted in response to the needs of a shifting health and care landscape. However, over 50% of respondents were White, so the data may not be representative of the diversity of registered nurses and midwives. The findings may not have direct relevance to the global context due to geographical limitations. [ABSTRACT FROM AUTHOR]

Background: As South Africa's population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions. Methods: The study used cross-sectional data from ten rounds of South Africa General Household Survey (2012–2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing. Results: Between 2012 and 2021, the percentage of participants reporting "A lot of difficulty" increased by 79.75%, "Some difficulty" increased by 112.11%, while "Unable to do" decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65–69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70–74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties. Conclusion: There was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties. [ABSTRACT FROM AUTHOR]

Background: People with communication problems experience challenges in participation. Optimizing communicative participation for this population is an important outcome of speech and language therapy. Participation experiences are best assessed from the patient's perspective, using a patient‐reported outcome measure (PROM). The Communicative Participation Item Bank (CPIB) has been developed to identify perceived problems in communicative participation. However, previous research has shown that the item bank does not cover all domains and concepts of communicative participation, contains general communication items, and is not suitable for all people with communication problems. Aims: To develop a comprehensive PROM aimed at measuring communicative participation for all adults with communication problems and test its content validity. Methods & Procedures: An initial pool of 242 items was based on three sources: relevant content from an earlier literature review and concept elicitation study, and the translation of the items of the CPIB. This item pool was pilot‐tested for comprehensibility and comprehensiveness using cognitive debriefing interviews in adults with different communication problems (speech, language, voice, hearing and cognitive communication disorders). This resulted in a second version of the item bank. The content validity of this version was tested in a group of professionals. The last (third) version of 133 items was tested for content validity in a second, new group of adults with various communication problems. Outcomes & Results: The initial pool of 242 items was developed and pilot‐tested in 27 adults with different communication problems. After modifications, 161 items remained, which were tested in a content validity study with 25 people with different communication problems and five professionals (in the field of speech and language therapy and speech and language research). The professionals considered 91.9% of the item bank relevant and comprehensible, and comprehensive by adding two items. The item bank was then considered relevant, comprehensible and comprehensive by the group of adults with communication problems. A total of 133 items remained in the item bank, related to the International Classification of Functioning, Disability and Health (ICF) Activities and Participation domains 'mobility', 'self‐care', 'domestic life', 'interpersonal interactions and relationships', 'major life areas' and 'community, social and civic life'. Conclusions & Implications: MyCommunication—Adults is an item bank for measuring communicative participation in adults with communication difficulties. The next step is to test the psychometric properties of the item bank, in order to establish a final item bank. The refined description of the construct of communicative participation can already be used for participation‐focused goal‐setting between individuals with communication problems and speech and language therapists. WHAT THIS PAPER ADDS: What is already known on the subject: The CPIB was developed to measure communicative participation in community‐dwelling adults with communication problems. The item bank does not cover all domains and concepts of communicative participation, contains general communication items and not all questions seem to be relevant for specific target groups (e.g., hearing population). What this paper adds to the existing knowledge: This study presents a refined description of the construct of communicative participation and the development of a new comprehensive PROM aimed at measuring this construct for all adults with communication difficulties. The development of the PROM is based on a previously conducted literature review and concept elicitation study. This study describes the development process of this new PROM, called MyCommunication‐Adults, and the assessment of its content validity. What are the potential or actual clinical implications of this work?: The refined description of the construct of communicative participation can be used for participation‐focused goal‐setting between individuals with communication problems and speech and language therapists. [ABSTRACT FROM AUTHOR]

Objective: The present study examines sociopolitical stress, coping, and well-being among college students. Participants: Young adult college students (N = 588; ages 18–29; 72% cisgender women) from 10 universities in the USA participated in this study. Methods: Participants completed a 45-minute online survey with closed-ended and open-ended questions, administered via Qualtrics. Results: Election-related sociopolitical stress was high with notable differences across students' demographic backgrounds (e.g., Hispanic/Latinx students, women, and sexual minority students reported high sociopolitical stress). Among those who reported being stressed by the election (N = 448), closed-ended and open-ended data reveal coping strategies including self-care, drugs and alcohol, and further civic action/political participation. Higher sociopolitical stress predicted more depression and many coping strategies were related with flourishing. Conclusions: Young adult college students are experiencing election-related sociopolitical stress and are coping in different ways. More work is needed to understand what coping strategies support well-being. Implications for colleges are discussed. [ABSTRACT FROM AUTHOR]

In this article, we explore the intricacies of veteran care and show how care practices come to incorporate veterans' 'self‐performances' to raise political attention and funding for future rehabilitation activities. By bringing into dialogue theories of care and theories of performance and representation, we illustrate how a seemingly classic form of care—veteran rehabilitation—takes the form of representative performance. Drawing on ethnographic fieldwork and interviews with the Danish Invictus Games team, we demonstrate how politics, research and TV documentaries are integrated into veteran care practices. Through this integration, mentally wounded veterans, while performing 'themselves' for shifting audiences with shifting agendas, come to assume the roles of both caregivers and care receivers. Crucially, we highlight that wounded veterans, while undertaking their personal rehabilitation journey, are curated into and (un)willingly positioned as representatives of others. By showing how caring for wounded veterans goes hand in hand with caring for fictive, future wounded veterans and for political, research and media agendas, this article offers new ways of thinking of and with care. [ABSTRACT FROM AUTHOR]

Under the conditions of neo‐liberal individual responsibilisation, self‐tracking has become the predominant model of health management. More recently, though, intuition‐based approaches to exercise and eating are also gaining traction. These two approaches are often located in opposition. While self‐tracking uses datafication and calculability to structure health decisions, intuitive approaches encourage abandonment of rules and restrictions around exercise and food in favour of corporeal self‐awareness and attunement to sensation. Although navigating these competing approaches is a common experience for all populations, the tensions between them are felt particularly acutely by people with complex health histories, such as eating disorders (EDs). In this article, we draw on mixed‐methods longitudinal data, analysed using phenomenological analysis, to propose a novel framework ‐ 'intuitive tracking'—which moves beyond understandings of self‐tracking as the antithesis of intuitive engagement with exercise and health. Drawing on longitudinal interviews and photo elicitation with 19 women who are in recovery from EDs and using weightlifting as a tool to support their recovery, we demonstrate how attentiveness to bodily and emotional cues is successfully combined with an emphasis on monitoring health behaviours to support wellbeing. We conclude that theoretical understandings of self‐tracking can and should make space for intuition‐led decision‐making. [ABSTRACT FROM AUTHOR]

Rural Australian youth exhibit high rates of mental ill-health, exacerbated by reduced access to mental health services. While the need for innovative solutions is well-established rural youth themselves are frequently excluded from the dialogue, creating a significant gap in evidence and the development of relevant service provision that reflects young people's lived experiences. Drawing on the concepts of individualism and healthism and research highlighting the continuing importance of relationships and trust in the lives of young people in a digital society, we aim to better understand how rural youth understand mental health and navigate mental health services and information. Using a qualitative methodology, we held 2 small focus groups with a total of 8 young people in rural Tasmania to identify aspects of rural mental healthcare that require improvement and to contribute to developing new and innovative solutions. Findings indicate that rural Tasmanian youth face numerous structural, social, and cultural barriers to positive mental health. Rural self-reliance and generational differences in attitudes towards mental health can negatively affect youths' help-seeking behaviours. Findings from this study suggest a need to combine technology-and community-based approaches creating a multi-generational approach to combat mental ill-health among rural youth. [ABSTRACT FROM AUTHOR]

Women Veterans constitute a distinctive cohort whose exposure to military service can contribute to development of bladder conditions, such as urinary incontinence (UI), as they age. Behavioral therapies are recommended as first-line treatment for incontinence, yet many VA Medical Centers do not have staff trained to administer them. The purpose of this research study was to conduct a qualitative program evaluation of MyHealtheBladder, a mobile telehealth version of an evidence-based eight‐week behavioral treatment program designed for women Veterans with incontinence. MyHealtheBladder uses mobile telehealth technology to teach pelvic floor muscle exercises, bladder control strategies, fluid management, risk factor reduction, and self‐monitoring. Eighteen women Veterans who completed a pilot study of MyHealtheBladder participated in semi-structured telephone interviews exploring their experience with the program. A directed content analysis was conducted of the transcribed interview data. Participants described ease of accessing MyHealtheBladder using smart phones and other mobile devices, emphasizing the flexibility of using the program at home, work, or while traveling. Most participants described program content as understandable, relevant, and easy to follow. They discussed how the program increased knowledge of UI, promoted consistency in practicing behavioral therapy, strengthened pelvic floor muscles, reduced urine leakage, and improved psychosocial wellbeing. Suggestions for improvement included more interaction with staff, more individualized tailoring of content to UI type, incorporating in-person clinic visits, and including supplementary material. Participants uniformly endorsed the program and recommended it for other women Veterans, as well as for those in active duty to prevent or treat UI earlier in the life course. [ABSTRACT FROM AUTHOR]

Context: The ballet institution is known for its aesthetic and performative standards. In professional dancers' everyday lives, self-improvement and body awareness entwine with striving for artistic excellence. In this context, 'health' has primarily been explored in relation to eating disorders, pain, and injuries. Aim: This paper explores dancers' health practices, namely how they are shaped by the ballet institution and how they relate to broader health discourses. Methodology: A reflexive thematic analysis was conducted upon interviews with nine dancers (each interviewed twice) using a theoretical framework based on the concepts of greedy institutions and biopedagogies. Analyses: Two themes were developed: What it takes to be an 'insider' of the ballet institution and Learning to develop an acute embodied self-awareness. Dancers described ballet as a 'lifestyle' rather than a 'job'; practices of self-care defined by continuous self and body work were framed as necessary to meet the demands of this lifestyle. Participants 'played with' institutional and societal norms, often resisting docile bodies promoted within the ballet institution. Conclusion: Dancers' constructions of health and the art of ballet as not fitting neatly into 'good' nor 'bad' make room to consider the tensions between adopting and resisting dominant health discourses in this institution. [ABSTRACT FROM AUTHOR]

Objective: The increased demand on healthcare professionals (HCPs) during the Coronavirus Disease (Covid-19) pandemic reduces opportunities for HCPs to deliver compassionate care to patients and to maintain self-care. This study explored how HCPs understand and experience compassionate working practices during the Covid-19 pandemic to better support HCPs' wellbeing and to sustain quality of care. Design: All nineteen participants worked as an HCP during the Covid-19 pandemic, resided in the United Kingdom (UK) and took part in individual semi-structured interviews. Main outcome measures: Using a thematic analysis approach, we developed three themes: (a) The art of compassionate care: Feeling and action, (b) The impact of Covid-19 on compassionate care and (c) Suffering during Covid-19: The importance of self-compassion and self-care. Results: Overall, the analysis illustrated the strong and negative impact that Covid-19 had on the ability to deliver compassionate care, resulting in moral injury and psychological and behavioural difficulties for HCPs, particularly in terms of self-care. Conclusions: This research demonstrates an imperative need for organisations to better support HCPs' health and wellbeing, through a self-care system that promotes self-compassionate and self-care practices. [ABSTRACT FROM AUTHOR]

Purpose: The WHO emphasises that rehabilitation services must be integrated into primary healthcare as an inherent part of universal health coverage. However, there is limited research on the integration of rehabilitation services in primary healthcare in low- and middle-income countries. The purpose of this paper is to identify and describe the literature on service guidelines, models, and protocols that support the integration of rehabilitation services in primary healthcare in the BRICS countries (Brazil, Russia, India, China, and South Africa). Methods: A scoping review guided by Arksey and O'Malley's framework was conducted. Structured database and website searches identified published and unpublished records from 2010, which were subjected to eligibility criteria. Mendeley, JBI SUMARI, and Microsoft Excel were used to extract and synthesise the data. Results: The search strategy identified 542 records. Thirty-two records met the inclusion criteria. Shared care and community-based rehabilitation were the most reported practice models, and the implementation of the models, guidelines, and protocols was mostly described in mental health services. Conclusion: This review discusses BRICS countries' rehabilitation service guidelines, models, and protocols for primary healthcare integration and implementation challenges. Rehabilitation professionals should rethink, realign, and apply existing models because of the lack of primary healthcare integration directives. IMPLICATIONS FOR REHABILITATION: The integration of rehabilitation services in low-resourced and remote settings can be improved by involving community health workers and community rehabilitation workers in transdisciplinary teams. Peer support workers and community health workers can improve rehabilitation outcomes, particularly through shared care models that emphasize peer-to-peer learning, mentoring, and coaching. Self-management interventions can have a positive impact on functional outcomes. Integrated rehabilitation services in primary healthcare can be supported through community-based rehabilitation, which emphasises community involvement and engagement. [ABSTRACT FROM AUTHOR]

Background: Surgical specialists experience significant musculoskeletal strain as a consequence of their profession, a domain within the healthcare system often recognized for the pronounced impact of such issues. The aim of this study is to calculate the risk of presenting musculoskeletal injuries in surgeons after surgical practice. Methods: Cross-sectional study carried out using an online form (12/2021–03/2022) aimed at members of the Spanish Association of Surgeons. Demographic variables on physical and professional activity were recorded, as well as musculoskeletal pain (MSP) associated with surgical activity. Univariate and multivariate analysis were conducted to identify risk factors associated with the development of MSP based on personalized surgical activity. To achieve this, a risk algorithm was computed and an online machine learning calculator was created to predict them. Physiotherapeutic recommendations were generated to address and alleviate each MSP. Results: A total of 651 surgeons (112 trainees, 539 specialists). 90.6% reported MSP related to surgical practice, 60% needed any therapeutic measure and 11.7% required a medical leave. In the long term, MSP was most common in the cervical and lumbar regions (52.4, 58.5%, respectively). Statistically significant risk factors (OR CI 95%) were for trunk pain, long interventions without breaks (3.02, 1.65–5.54). Obesity, indicated by BMI, to lumbar pain (4.36, 1.84–12.1), while an inappropriate laparoscopic screen location was associated with cervical and trunk pain (1.95, 1.28–2.98 and 2.16, 1.37–3.44, respectively). A predictive model and an online calculator were developed to assess MSP risk. Furthermore, a need for enhanced ergonomics training was identified by 89.6% of surgeons. Conclusions: The prevalence of MSP among surgeons is a prevalent but often overlooked health concern. Implementing a risk calculator could enable tailored prevention strategies, addressing modifiable factors like ergonomics. [ABSTRACT FROM AUTHOR]

Introduction: Nurses are now more likely to leave their current role in direct patient care than they were before the COVID-19 pandemic. Country culture and the organization of health care systems drive nurses' decisions to leave or stay in the profession. Methods: In a fall 2020 survey of nurse professional quality of life, a content analysis of responses to the open-ended question, " What has been challenging or rewarding during this pandemic experience?" was performed. Results were organized within Hofstede's Cultural Dimensions Theory. Results: Six hundred and fifty-six nurses across five countries responded to the question; 526 comments were analyzed. Most (53.6%) respondents were staff bedside nurses. Themes, such as Distress and Fatigue and Building and Experiencing Social Capital were found and understood to reflect cultural values and dimensions such as Uncertainty Avoidance and Power Distance. Discussion: Recommendations include strengthening culturally tailored leadership knowledge to inform and facilitate countries' nurse retention. [ABSTRACT FROM AUTHOR]

Objective: To describe the experience of implementing social robotics as an adjuvant during the hospitalization process in pediatric oncology patients. Methods: Before and after cohort study, applying an intervention with the Lego Mindstorms EV3 kit in patients between 8 and 17 years old that are hospitalized with a cancer diagnosis. We excluded patients from the intensive care unit or when their treating physician recommended so. The intervention consisted of a three-phase workshop: an open architecture story, building a car robot using the Lego Mindstorm EV3 kit, and cooperative playing activities such as races and passing obstacles. Results: Thirteen patients received the intervention with robotic lego. The median age was 15 years (IQR = 3), and 84.6% of the population (n = 11) were male. We found significant improvement in the language (topic management p =.011 and communicative intention p =.034). Other characteristics improved, but not significantly (self-care activities index, catching). No adverse events occurred during the intervention. Conclusions: The results of this pilot study suggest that implementing social robotics during hospitalization in children with cancer is a therapeutic adjuvant and safe intervention that promotes better communication, self-care, and a physical activity improvement. For future studies, the impact of this intervention could be measured in hospitalized pediatric cancer patients. [ABSTRACT FROM AUTHOR]

India is aging. The growth of India's older population has increased our concerns about their well-being. While it is critical to explore the diverse needs and aging experience of older Indians, their voices are largely missing in the aging literature. In this context, data was collected from 63 community-dwelling and OAH residing older men and women of Delhi NCR to understand their aging experience, views about old age and perceived need for government intervention in old age care and support. Reflexive thematic analysis of their aging experience and perception of old age generated five themes and six sub-themes: The aging body encompassing three sub-themes "the older we become the more diseases we have", "the ointment called positive thinking", "women's quest for self-care"; Psychological gains and social losses; Affiliation, distraction and anticipation; The aging parent and the adult child comprising three sub-themes "filial relations—quality and quantity", "children these days and their mobile phones", "our daughter shows us more love and care"; and A time for religious and spiritual devotion. Lastly, the analysis of their perceived need for government support in old age care generated five sub-themes – Political cynicism, I was a private employee but am I not a part of this country? Government or Private Hospitals: A no-win situation, Everyday life and Reforms in OAHs. The present findings highlight the multidimensional and multidirectional experience of aging and the diverse needs of older persons in the Indian context. [ABSTRACT FROM AUTHOR]

As healthcare systems grow increasingly complex, greater demands are placed on patients' abilities to find, understand, appraise, and use health information – often termed their 'health literacy'. Most health literacy research does not focus on information appraisal. When it does, there is a tendency to equate it with patients' assessment of credibility. This reproduces a healthcare-centric understanding of information appraisal where patient agency is omitted. This study explores how participants in a health information intervention practiced information appraisal. The intervention aimed to increase information uptake for people with low back pain by delivering health information to them through animations. This study draws on ethnographic participant observation of the encounters between the intervention and its participants, including 49 rapid interviews and semi-structured telephone interviews with 23 participants carried out in the spring of 2021. Inspired by a social practice approach, the study thoroughly grounds the health literacy subcategory of 'appraisal' in practice. It illustrates that participants appraised the information provided in the intervention according to several factors. These include relating the information to their personal health needs, interpreting the intended audience of the health animations, and prioritising their attention situationally between the animations and other immediate concerns. We suggest that information appraisal is a fundamental component of health literacy and should be considered key in research, policy and practice. To accommodate current healthcare ideals of patient centeredness, empowerment and informed choice, the complex and dynamic ways in which people appraise health information need be considered legitimate practices of health literacy. [ABSTRACT FROM AUTHOR]

Continuing Education (CE) aims to help health professionals fulfill their ethical responsibility of maintaining professional competence. This research compares the CE guidelines and standards of 11 health professional organizations in relation to five domains of evolving professional values: ethics, cultural diversity, social justice, interprofessionalism, and self-care. Results showed that ethics received the greatest attention across the CE standards, followed by interprofessionalism and cultural diversity. This study offers a starting point for CE accreditors to examine the extent to which their CE standards align with their profession's stipulated values, and to situate themselves within the broader context of health profession accreditors. [ABSTRACT FROM AUTHOR]

High-performance coaches (HPCs) encounter a wide range of demands and face challenges engaging in self-care and recovery activities to promote a sustainable coaching career. In this innovative mixed method study, we aimed to gain an understanding of HPCs' experiences of a brief mindful self-reflection intervention. To address this aim, 18 HPCs completed an 8-week daily intervention and reported their ratings of mood and energy via daily SMS-diaries. Self-reported measures of self-compassion, mindfulness, and well-being were collected at pre-intervention, 2 weeks post-intervention, and 6 months post-intervention. Qualitative data consisted of focus group interviews that were conducted 2 weeks after the intervention ended and a written follow-up containing three questions 6 months after the intervention. To further explore the mechanisms throughout the intervention, participants were categorized into two groups, High Mood and Energy (HME) and Low Mood and Energy (LME), and we compared these groupings with qualitative data. Using reflexive thematic analysis, we subsequently developed two overarching themes from these data that characterized group differences, (viz. HME: "Self-aware and open to attend to self-care needs and well-being" and LME: "Reflecting resistance to the intervention and low self-awareness"). Taken together, we interpret these data to suggest this mindful self-reflection intervention has the potential to enhance HPCs' self-compassion. This work provides knowledge that can help guide both coaches and organizations in their quest to promote sustainable coaching careers in the elite sport context and we offer recommendations for practitioners working with HPCs. Lay summary: In this mixed method study, we examined a mindful self-reflection intervention among HPCs with positive quantitative findings for self-reported self-compassion. Participants were also categorized based on daily ratings of energy and mood and from the qualitative data, we generated themes that provide an understanding of risk-factors and resources for sustainable HPCs. IMPLICATIONS FOR PRACTICE: This study provides support that a brief, daily, mindful self-reflection intervention may aid sustainable high-performance coaching by increasing self-compassion. The promotion of self-reflection may increase awareness of vulnerability and lower the threshold for help-seeking among HPCs, and sport organizations might promote similar interventions with the aim of supporting sustainability among individual HPCs and psychologically healthier elite sport environments. The knowledge developed here on risk factors and resources associated with sustainable high-performance coaching could be used by those responsible for coach education, particularly for coaches transitioning into elite sport. [ABSTRACT FROM AUTHOR]

Background: Self‐harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self‐harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well‐being. Methods: We conducted a mixed methods review, with qualitative meta‐synthesis focusing on links between themes and quantitative synthesis of parental well‐being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another. Results: We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self‐harm. Parents' emotions often evidenced the need to self‐care, but emotions of guilt reduced engagement in self‐care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self‐care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents. Conclusions: Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer‐support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self‐care, and parenting behaviours. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Small sample sizes are a common problem in disability research. Here, we show how Bayesian methods can be applied in small sample settings and the advantages that they provide. Method/Design: To illustrate, we provide a Bayesian analysis of employment status (employed vs. unemployed) for those with disability. Specifically, we apply empirically informed priors, based on large-sample (N = 95,593) July 2019 Current Population Survey (CPS) microdata to small subsamples (average n = 26) from July 2021 CPS microdata, defined by six specific difficulties (i.e., hearing, vision, cognitive, ambulatory, independent living, and self-care). We also conduct a sensitivity analysis, to illustrate how various priors (i.e., theory-driven, neutral, noninformative, and skeptical) impact Bayesian results (posterior distributions). Results: Bayesian findings indicate that people with at least one difficulty (especially ambulatory, independent living, and cognitive difficulties) are less likely to be employed than people with no difficulties. Conclusions/Implications: Overall, results suggest that Bayesian analyses allow us to incorporate known information (e.g., previous research and theory) as priors, allowing researchers to learn more from small sample data than when conducting a traditional frequentist analysis. Impact and Implications: We provide a Bayesian tutorial for selecting priors, computing, and interpreting results within the context of disability research. We hope to inspire future research using Bayesian analysis for small sample disability data. [ABSTRACT FROM AUTHOR]

Purpose: Children with behavioral issues in residential care settings have high rates of trauma, with a range of trauma experiences such as abuse and neglect, issues with attachment, and multiple disruptions in placements. Staff in these settings should have an understanding of trauma, its impact, and how to engage in trauma-informed practice. The purpose of this study was to examine whether a trauma-informed training, developed specifically based on the identified needs of a residential group care facility, had an impact on future staff attitudes and behaviors. Materials and methods: A 3-h training was delivered by the researchers. Three identical sessions were provided to all 48 staff, regardless of education and role, across a 3-day period. Prior to the training, staff were given a pretest survey measuring components of trauma-informed (TI) practice that indicated how often the staff members engaged in TI practice. Thirty days later, the same participants completed a posttest survey to gauge if the training had an impact on their subsequent attitudes and behavior. Results: There were improvements in many of the trauma-informed practice areas on the posttest survey. T-test analysis revealed five trauma-informed practice areas had improvements that were statistically significant from the pretest survey. Discussion: The findings present the opportunity for recommendations for trauma-informed training development and delivery, as well as providing implications for the field of social work. Conclusion: This study demonstrates the feasibility of administering a trauma-informed training program and observing relatively rapid improvements in future attitudes and behavior among staff. [ABSTRACT FROM AUTHOR]

COVID-19 outbreak produced an unprecedented crisis in care sectors. Nursing home workers, healthcare, social care, and clinical social workers (HSCW) often took the burden of managing the crisis in their facilities, risking increased stress, trauma, and burnout. As a response to this issue, increased interest in self-care in health and social work literature could be observed. Yet, the concept of self-care is problematic, as it focuses attention on the individual responsibility to care for oneself, regardless of organisational and structural factors and obstacles. The article provides a critical literature review, focused on risk factors and psychological consequences of the pandemic in health and social care and clinical social work, and on the proposed response, namely, self-care. The aim of the article is to systematise knowledge about approaches to self-care in these sectors and to critically review those approaches. Critiques of self-care are considered, including those informed by Foucauldian perspective of governmentality and responsibilization. The concept of community care is introduced as an implication and an answer to these critiques. [ABSTRACT FROM AUTHOR]

Background: Home parenteral nutrition (HPN) can improve the nutritional status of patients with gastrointestinal dysfunction. However, some patients face a series of challenges during its implementation, which significantly affect their quality of life. Aims: To explore the experience and needs of living with home parenteral nutrition in adult patients. Design: A systematic review and meta‐synthesis. Methods: A search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database and Wipu Database, to explore the real‐life experiences and needs of adult patients receiving HPN. The search covered the period up to March 2024. Qualitative research quality was evaluated using the Joanna Briggs Institute's Australian Centre for Evidence‐Based Health Care Quality Assessment Criteria for Qualitative Research. Data synthesis was performed using Thomas and Harden's method of thematic and content analysis. Results: Twelve studies, each offering qualitative data, were analysed, resulting in the identification of four themes: positive experiences of HPN; the interplay of dynamic changes across physical, mental and social levels; self‐adjustment to the new normal; and multidimensional needs of patients receiving HPN. Conclusions: Patients receiving HPN face multiple challenges physically, psychologically and socially. This paper also reveals the supportive needs of patients in adapting to a new lifestyle with HPN. This indicates that healthcare professionals should provide comprehensive, continuous and dynamic supportive medical services to facilitate patients' reintegration and return to normal social life. Patient and Public Involvement: As this study constitutes a meta‐synthesis, patient or public contribution is not applicable. Reporting Approach: Adhering to the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) reporting guidelines, this meta‐synthesis was conducted. [ABSTRACT FROM AUTHOR]

Despite having adverse physical and mental health outcomes, harsh disciplinary methods are commonly practiced all over the world. This study aims to measure the harsh disciplinary actions taken by parents and their association with child functioning in children, aged 7 to 14 years in Punjab, Pakistan. This study is based on secondary data obtained from the United Nations Children's Fund (UNICEF's) Multiple Indicator Cluster Survey, conducted in the Punjab province from 2017 to 2018. Parents/caregivers of 19,721 children were included in the analysis. Questionnaire-based interviews were conducted, and the data collection form included sociodemographic information, questions on different "Methods of Child Discipline" and the "Child functioning module." The data was analyzed using STATA 15.0. Multiple logistic regression analysis was conducted to calculate the adjusted odds ratio and 95% CI exploring the association between harsh disciplinary methods and child functioning. More than 50% of children were exposed to severe physical, psychological, and emotional disciplinary methods. Exposure to severe physical aggression was associated with increased difficulty in learning (2.60 [1.27, 5.31]), remembering (2.83 [1.47, 5.44]), controlling behavior (1.63 [1.21, 2.18]), anxiety (1.98 [1.25, 3.13]), depression (2.57 [1.57, 4.22]) and making friends (1.94 [1.01, 3.79]). Whereas moderate physical aggression and psychological aggression were associated with (1.48 [1.19, 1.84]) and 1.5 times (1.20, 1.84) increase in difficulty in controlling behavior, respectively. Nonviolent actions were associated with protective odds for self-care (0.33 [0.17, 0.65]), communication (0.51 [0.27, 0.96]), learning (0.56 [0.33, 0.95]), remembering (0.62 [0.39, 0.90]), concentration (0.50 [0.31, 0.80]), anxiety (0.60 [0.46, 0.79]) and depression (0.67 [0.49, 0.92]). Severe disciplinary methods are detrimental to the child's personal care, mental, social, emotional, and psychological well-being, whereas nonviolent actions are associated with positive child functioning. In a third-world country such as Pakistan, this topic is widely undiscovered and understudied, thus emphasizing the need for awareness and education of parents and healthcare providers. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, most, if not all, animal rescues, sanctuaries, zoos, and aquariums experienced financial distress. This stress had an impact on the welfare of animals and their human caretakers, an issue important to ecological social work. We draw on a novel dataset (n = 2,060) to assess support for policies to extend emergency funding to animal support and conservation organizations in extreme events. We find that, on average women and nonbinary individuals, those with more education, people who have pets, people who are concerned about other humans (humanistic altruism), and those who have greater concern for animals report greater support. [ABSTRACT FROM AUTHOR]

Purpose: Social workers navigate systemic stressors while managing self-care amid scant institutional support. The purpose of this systematic review is to critically examine the state of social work intervention research for self-care practices. Methods: This review includes empirical research articles focusing on self-care interventions in social work between 2011 and 2022 (N = 22). Results: All self-care interventions focused on modifying individual behaviors, attitudes, and knowledge. Discussion: Most (83%) research on self-care interventions focused on mindfulness, which tended to be associated with improvements in mindfulness, distress management, and clinical self-efficacy. The remaining interventions tended to be associated with improvements in self-care attitudes, knowledge, practices, and wellness. Conclusion: Structural factors and socioeconomic privilege have been found to be predominant predictors of whether social work students, educators, and practitioners engaged in self-care practices, yet no interventions incorporated structural or institutional variables. Multilevel interventions addressing structural, institutional, and relational determinants of burnout are needed. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the levels of Patients' spiritual well-being (SWB) and self-care agency (SCA) of patients receiving chemotherapy with a port catheter. It was a correlational and observational study. Data were collected between December 2021 and March 2022. The sample was 88 people. Of the participants; 59.1% were women, 88.6% were married, 38.6% were primary school graduates, 47.7% were unemployed, and 51.1% had income equal to their expenses. Furthermore, 38.6% patients had breast cancer diagnosis and 52.3% did not have any chronic diseases. Both scale scores were affected by different variables and there was a positive correlation between SCA and SWB. Better SWB positively affected SCA. Patient age and duration after cancer diagnosis affected SCA and SWB. Notably, SCA and SWB levels of the patients may change with age and disease progression, and patients should also be monitored in this respect. [ABSTRACT FROM AUTHOR]

Background: Ventricular assist device (VAD) implantation has become an alternative treatment for patients with end-stage heart failure. In Germany, valid and reliable instruments to assess health-related quality of life in patients with VAD are lacking. Objective: The aim of this study was to present the psychometric validation of the German version of the Quality of Life with a Ventricular Assist Device questionnaire. Methods: In a multicenter, cross-sectional study, 393 participants (mean age, 58.3 years; 85.8%male, 60.3%bridge to transplant, and 72.8%living with VAD for =2 years) completed the German Quality of Life with a Ventricular Assist Device questionnaire of physical, emotional, social, cognitive, and meaning/spiritual domains. Item and confirmatory factor analyses were conducted to test item difficulty and discrimination and the underlying structure, respectively. To examine internal consistency, Cronbach a was assessed. Convergent construct validity was tested using the Kansas City Cardiomyopathy Questionnaire and the Patient Health Questionnaire-9. Readability was examined using Flesch Reading Ease index and Vienna Factual Text Formula. Results: The Quality of Life with a Ventricular Assist Device showed reasonable itemdifficulty (Ptotal = .67) and mostly moderate to high discriminatory power (rit > 0.30). In confirmatory factor analysis, root-mean-square error of approximation (0.07) was acceptable for model fit, but no other indices. Acceptable internal consistency was found (a = 0.79), with the exception of the cognitive domain (α = 0.58). The overall questionnaire and single domains demonstrated convergent validity (r = 0.45, P < .001). The questionnaire showed adequate readability (Flesch Reading Ease, 64.11; Vienna Factual Text Formula, 6.91). Conclusion: Findings indicate a promising standardized clinical instrument to assess health-related quality of life in patients with VAD. [ABSTRACT FROM AUTHOR]

Background: Informal caregivers contribute substantially to the self-care of people with heart failure (HF) by helping with concrete and interpersonal tasks. Time perception and management are essential issues among caregivers. However, investigators have not explored this topic in caregivers of people with HF. Objectives: The aim of this study was to describe the perceptions and challenges of the timemanagement experience among caregivers who support the self-care efforts of their relatives with HF. Methods: Adult informal caregivers of patients with HF, taking care of the patient for at least 3 months and without cognitive limitations, were recruited from Spain, Italy, and the Netherlands. Data were collected using semistructured interviews. Maryring's qualitative content analysis strategy with both a deductive and an inductive approach was used for analysis. Results: We enrolled 50 participants (20 Italians, 19 Spanish, and 11 Dutch). Caregivers had a mean (SD) age of 62.8 (12.8) years and were mostly female (84%). They dedicated 31.2 (SD, 21.7) hours per week to providing caring activities for their patients. After extracting 33 codes from their qualitative interview data, we summarized them into 8 categories and identified 4 main themes: (1) time for yourself, (2) housemanagement, (3) time for the patient (dedicated to directing care), and (4) time for own socialization. Conclusion: Caregivers navigate the complexity of time management by balancing dedicated time for supporting patients with HF and their own personal time. [ABSTRACT FROM AUTHOR]

Introduction: Older adults are at high risk of adverse health outcomes in the post–emergency department (ED) discharge period. Prior work has shown that discharged older adults have variable understanding of their discharge instructions which may contribute to these outcomes. To identify discharge comprehension gaps amenable to future interventions, we utilize meta‐analysis to determine patient comprehension across five domains of discharge instructions: diagnosis, medications, self‐care, routine follow‐up, and return precautions. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, two reviewers sourced evidence from databases including Medline (PubMed), EMBASE, Web of Science, CINAHL, and Google Scholar (for gray literature). Publications or preprints appearing before April 2024 were included if they focused on geriatric ED discharge instructions and reported a proportion of patients with comprehension of at least one of five predefined discharge components. Meta‐analysis of eligible studies for each component was executed using random‐effects modeling to describe the proportion of geriatric ED cases understanding the discharge instructions; where appropriate we calculated pooled estimates, reported as percentages with 95% confidence interval (CI). Results: Of initial records returned (N = 2898), exclusions based on title or abstract assessment left 51 studies for full‐text review; of these, seven constituted the study set. Acceptable heterogeneity and absence of indication of publication bias supported pooled estimates for proportions comprehending instructions on medications (41%, 95% CI 31%–50%, I2 = 43%), self‐care (81%, 95% CI 76%–85%, I2 = 43%), and routine follow‐up (76%, 95% CI 72%–79%, I2 = 25%). Key findings included marked heterogeneity with respect to comprehending two discharge parameters: diagnosis (I2 = 73%) and return precautions (I2 = 95%). Conclusions: Older patients discharged from the ED had greater comprehension of self‐care and follow‐up instructions than about their medications. These findings suggest that medication instructions may be a priority domain for future interventions. [ABSTRACT FROM AUTHOR]

Caring for patients with hard-to-heal (chronic) wounds requires a multifaceted approach that addresses their diverse needs, which can contribute to the complexity of care. Wound care providers must have a comprehensive understanding of the patient's comorbid conditions and psychosocial issues to provide personalised and effective treatment. Key quality indicators for effective wound care involves not only selecting appropriate local wound care products, such as foam dressings, but also addressing individual patient experiences of wound-related pain, odour, itch, excessive wound drainage, and self-care needs. The purpose of this review is to inculcate the wound care practice community, research scientists and healthcare industry with a sense of accountability in order to work collaboratively in addressing these unmet care needs. [ABSTRACT FROM AUTHOR]

Objectives: This explorative cross-country qualitative study aims to describe experiences of receiving a dementia diagnosis and experiences of support following a diagnosis in Australia, Canada, the Netherlands and Poland. Method: Qualitative study using projective techniques during online focus groups, online and telephone interviews with people with dementia and caregivers. Results: Twenty-three people with dementia and 53 caregivers participated. Qualitative content analysis revealed five themes; (1) 'Coming to terms with dementia' helped people deal with complex emotions to move forward. (3) 'The social network as a source of support' and (4) 'The challenges and realities of formal support' and impacted 'Coming to terms with dementia'. (2) 'Navigating life with dementia as a caregiver' highlights caregiver burden and was impacted by (4) 'The challenges and realities of formal support'. People were (5) 'Self-caring and preparing for tomorrow' as they focused on maintaining current health whilst planning the future. Despite differences in healthcare and post-diagnostic support systems, there were more similarities across countries than differences. Conclusion: Across countries, formal support and support from friends and family are crucial for people with dementia and caregivers to come to terms with dementia and maintain carer wellbeing to ultimately live well with dementia. [ABSTRACT FROM AUTHOR]

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The clinical and economic impact of heart failure (HF) is immense and will continue to rise due to the increasing prevalence of the disease. Despite the availability of guideline-recommended medications that improve mortality, reduce hospitalizations, and enhance quality of life, there are major gaps in the implementation of such care. Quality improvement interventions have generally focused on clinicians. While certain interventions have had modest success in improving the use of heart failure medications, they remain insufficient in optimizing HF care. Here, we discuss how patient-facing interventions can add value and supplement clinician-centered interventions. We discuss how digital health can be leveraged to create patient activation tools that create a larger, sustainable impact. Small studies have suggested the promise of digital tools for patient engagement and self-care, but there are also important barriers to the adoption of such interventions that we describe. We share key principles and strategies around the design and implementation of digital health innovations to maximize patient participation and engagement. By uniquely activating patients in their own care, digital health can unlock the full potential of both existing and new quality improvement initiatives to drive forward high-quality and equitable heart failure care. [ABSTRACT FROM AUTHOR]

Introduction: Globally, hypertension is a significant public health concern and a leading cause of premature death. Since this disease is incurable, it is necessary to promote patients' self-care behaviors to control it. The goal of this research was to identify the elements that influence self-care actions in individuals with hypertension, utilizing the Protection Motivation Theory (PMT) framework. Methods: A study was carried out in Omidiyeh, located in southern Iran, using a cross-sectional design, involving 397 adults with hypertension (198 females and 199 males) who were selected from comprehensive health centers using a stratified random sampling technique. Data was gathered through a demographic data collection form and a questionnaire created by the researcher, which was based on the PMT. Data were assessed utilizing SPSS 25 and AMOS 24 software, and various statistical tests including one-way ANOVA, Pearson correlation, multiple regression, independent t-test, and structural equation modeling were conducted. Findings: The variables of intrinsic reward (r = 0.182), extrinsic reward (r = 0.288), and response cost (r = 0.126) showed a significant negative correlation with self-care behaviors. On the other hand, perceived susceptibility (r = 0.212), perceived severity (r = 0.110), self-efficacy (r = 0.555), and response efficacy (r = 0.424) demonstrated a significant positive correlation with self-care behaviors. Specifically, self-efficacy and response efficacy were the most powerful predictors of self-care behaviors, respectively. Conclusion: The results showed that several factors can forecast self-care behaviors in patients with hypertension. Researchers are recommended to incorporate PMT in educational interventions and concentrate on self-efficacy and response efficacy constructs. [ABSTRACT FROM AUTHOR]

Virtual community-based programming for people with disabilities has become a popular method for advocating for health promotion, specifically exercise, for people with disabilities (PWD). Using theoretical frameworks to better understand the perspective of PWD who participate in virtual exercise programs allows strategies of implementation following completion of virtual exercise programs. The objective of this study was to examine the effect adherence had on perceptions, experiences, and post-program exercise maintenance in participants with disabilities. Eight qualitative interviews were conducted in highly adherent participants using the Social Cognitive Theory (SCT). Interviews were recorded on Zoom, transcribed using Microsoft 365, and analyzed using NVivo software. Data were analyzed by the primary author and an independent coder to increase rigor and reduce bias. Thirty-five unique codes were generated from transcribed interviews. Member-checking was employed to increase internal validity; 100% of participants agreed with the findings. Results demonstrate an overall positive experience in the virtual exercise program, noting specific facilitators (i.e., knowledgeable instructor, program provided equipment, etc.) and barriers (i.e., limited physical space at home to exercise, other participant's attitudes, etc.) of participating. Impressionably, 100% of participants maintained exercise following their time within the virtual exercise program. [ABSTRACT FROM AUTHOR]

Educational inequalities in sports participation remain a public health issue in the Netherlands. Combining structurally based resources from Pierre Bourdieu's theory of capital with Amartya Sen's conceptualization of individual agency may offer new insights into the complex mechanisms that drive these inequalities. Specifically, we posited that the way individuals are able to exercise their agency within the structurally based economic, social, and cultural resources they have access to may help explain educational inequalities in sports participation. Data from two waves of the GLOBE study (2014, 2021) were used to test whether two sequential mediators, structurally based resources followed by individual agency, help explain the relationship between educational level and sports participation. Adults aged 25 and older residing in Eindhoven, the Netherlands self-reported highest attained educational level, structurally based resources (economic, social, and embodied cultural capital), individual agency (self-control, perceived choice, and reflexivity), and sports participation. A sequential mediation analysis using structural equation modelling was used to test the direct effect of education on sports participation, the sequential indirect effect through both mediators, and partial indirect effects through each mediator individually. Educational level was positively associated with sports participation. The hypothesized sequential mediation pathway was not supported; educational level was positively associated with structurally based resources and structurally based resources were positively associated with individual agency, but individual agency was not related to sports participation. Though not through individual agency, structurally based resources helped explain educational inequalities in sports participation. Having access to more economic, social, and cultural resources may empower individuals by increasing their agency. This increased agency was not associated with sports participation, which could be because sports participation is not universally valued as a goal. The conceptualization and operationalization of individual agency in the context of sports participation warrants more research. We found that structurally based resources helped explain a substantial portion of educational inequalities in sport, so we propose that policies alleviating more than just economic barriers to sports participation, but also social and cultural barriers, may help reduce educational inequalities in sports participation in the Netherlands. [ABSTRACT FROM AUTHOR]

Background: Animation has promise for teaching complex health content through smartphone applications. However, smartphones have had limited use in Thailand for health literacy improvement among adults with chronic diseases. This study aims to explore the perceptions of adults with diabetes and/or hypertension resulting from 2D short animated videos for literacy against chronic disease that are available via smartphones. Methods: Four animated videos were initially developed based on clinical practice guidelines and nursing experience. Physicians, an expert in health education, and an animation team developed and revised scripts and storyboards of the animated videos. Lastly, videos were validated by physicians and health educators for content breadth and depth and by media experts for motion graphics and illustration. Each video presents a different situation in diabetes, hypertension, missing appointments, and obesity, ranging from 2.18 to 4.14 min in duration. The inclusion criteria were adults 35–70 years old with diabetes or hypertension who received care from primary care units. Thematic analysis was performed on the extracted data. Results: Twenty participants with a mean age of 58.4 years (SD 6.7; ranged 41–68) were focus-group interviewed. Three animation elements were assessed, including presentation, impacts, and suggestions. Participants had positive responses regarding the presentation (suitability of images and smooth motion graphics, short length of videos, simple language, understandable content, and clear sound) and impacts (recalling information, enhancing engagement, and motivating health awareness and behavior change). Suggested improvements were for a bigger font size for subtitles and considering the use of spoken text instead of on-screen text for recommendations at the end of the animations. Conclusions: Animated videos are acceptable for delivering health information. Pilot testing animated videos for promoting literacy against chronic diseases in adults with diabetes and hypertension is needed for optimal utility. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a major cause of disability in adults and the elderly worldwide. Post-stroke rehabilitation success largely depends on consistent participation in treatment sessions and adherence to prescribed physical exercises; however, factors such as individual belief about their health status often affect motivation, slowing recovery. Addressing these influences is essential for improving health-related quality of life and optimizing recovery outcomes. Methods: This study employed a cross-sectional and correlational design with convenience sampling. The aim was to explore the relationship between recovery locus of control (RLOC) and health-related quality of life (HRQoL) among chronic stroke survivors. The Recovery Locus of Control scale and the EuroQol 5D-5L scale were utilized for assessment. Results: A total of 69 participants were included in this survey. The mean RLOC score was 34.91, with internal RLOC at 21.16 and external RLOC at 13.77 and the total EQ5D index was 0.659. Age was a significant grouping factor, with the 30–39 age group showing a significant positive relationship (r = 1.000, p = 0.002), pain and anxiety/depression (p =.045), mobility and anxiety/depression (p =.009), anxiety/depression and self-care (p =.047), IRLOC and ERLOC (p =.013). Conclusion: The study found that while respondents exhibited high RLOC scores, there was no significant relationship between RLOC scores and the EQ5D-5L index score, suggesting that other factors may play a more critical role in influencing HRQoL among chronic stroke survivors. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the impact of self-management interventions based on the COM-B model on peri-implant conditions in older adults with periodontitis. Materials and methods: The patients were randomly divided into two groups: Group 1 (control group) received only an oral health education (OHE) pamphlet. Group 2 (test group) performed a self-management intervention based on the COM-B model. Each patient was examined for the most inflammatory implant. The measurement parameters included self-efficacy, self-management ability, and clinical indicators such as probing depth (PD), bleeding on probing (BOP), modified gingival index (mGI), modified plaque index (mPI), and peri-implant mucositis severity score (PMSS). The data was collected at baseline, 4, 8, and 12 weeks. Results: 42 patients underwent testing for 3 months. After 12 weeks, the improvement of self-efficacy, self-management ability, and the reduction of BOP, mPI, and PMSS in the test group was significantly higher than in the control group. Conclusion: The study suggests that self-management interventions based on the COM-B model can enhance the self-management ability of older adults with periodontitis and reduce peri-implant inflammation. This method is more effective than distributing OHE pamphlets. Trial registration: The randomized controlled clinical trial was registered on Chinese Clinical Trial Registry (No. ChiCTR2400082660, Date: 03/04/2024). [ABSTRACT FROM AUTHOR]

AbstractRelatively little is known about the unique needs and issues faced by transgender men and their self-care practices during gender transition. This study aimed to analyse self-care practices during gender transition through the life histories of a group of Costa Rican transgender men. A qualitative study with a sociohistorical design employing a thematic life history approach was conducted with fourteen participants between April and September 2022. Data were analysed using Content Analysis. Three categories were developed concerning self-care: (i) the shaping of self-care practices throughout different life stages; (ii) self-care practices related to masculinising the body; and (iii) self-care practices on the margins of a cisheteronormative society. The identified self-care practices took place with the goal of materialising men’s gender identity socially, legally and medically. While self-care plays a key role in supporting individuals throughout the transition process, it is limited in its capacity to ensure comprehensive well-being. The social prejudice and violence encountered by transgender men poses a challenge to achieving full well-being. External pressures and adversities limit the effectiveness of self-care practices, highlighting the need for broader systemic change to enhance the overall health and wellness of transgender men in Costa Rica. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusions\nKEYPOINTSTransitioning to university brings challenges and stress that could be mitigated through self-care practices and knowledge and use of mental health services. This study examined these variables in first-year students at an Australian university, exploring any differences between international and domestic students and whether demographic variables and psychological distress influence knowledge and use of mental health services and self-care practices.Participants were 821 first-year students (77.6% female, 25.2% international, Mage = 20.7, SDage = 5.54 years). Measures included the Mental Health Literacy Scale, purpose-written questions about awareness, confidence, and engagement with mental health services, self-care knowledge and use, and PsyCheck. T-tests examined differences between domestic and international students. Hierarchical regression analysis assessed relationships between demographic factors, psychological distress, and mental health-related variables.Compared with international students, domestic students had greater awareness, confidence, and engagement in mental health services, and better self-care knowledge. Demographic variables were associated with mental health outcomes, with limited model strength. Psychological distress was associated with less knowledge and confidence in accessing mental health services yet higher engagement with services, and lower self-care knowledge and use.The findings underscore the need for targeted mental health resources, particularly for international students and those experiencing higher psychological distress.What is already known about this topic:(1) Mental health issues are widespread among university students, but students often display limited knowledge of where to seek help, low engagement in help-seeking, and self-care.(2) Demographic factors such as age and gender, and barriers such as stigma and embarrassment, are associated with general mental health literacy and help-seeking behaviours among university students.(3) International students often show lower levels of awareness and engagement in seeking mental health support than domestic students.What this topic adds:(1) This topic provides up-to-date insights on the state of knowledge and use of mental health services, as well as self-care practices among first-year university students.(2) The study found that domestic students exhibited greater awareness, confidence, and engagement in mental health services, and better self-care knowledge than international students.(3) The study found that first-year students with higher levels of psychological distress had lower knowledge and confidence in accessing mental health services, more engagement with these services, and poorer self-care practices. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes is a rising health problem, especially in older adults. Health literacy and the degree of diabetes knowledge are among the factors that may influence diabetes self-care activities. The aim of this study was to assess factors affecting self-care activities among older adults living with type 2 diabetes in Alexandria, Egypt. Methods: A cross-sectional study included 400 older adults over the age of 60 with type 2 diabetes, recruited from diabetes outpatient clinics affiliated to the health insurance organization in Alexandria, Egypt. A predesigned, structured interview questionnaire was used to assess sociodemographic factors, personal habits, medical history, and drug history. The All Aspects of Health Literacy Scale (AAHLS) and the numeracy section of the Short Test of Functional Health Literacy in Adults (STOFHLA) were used to assess the level of health literacy. Diabetes Knowledge Test 2 (DKT2) was used to assess diabetes knowledge and Summary of Diabetes Self-care Activities scale was used to assess self-care activities. Multiple logistic regression analysis was used to examine the relationship between health literacy and self-care. Results: The mean age of the participants was 65.75 ± 5.15 years, and 56.2% of them were males. The mean duration of diabetes was 10.61 ± 5.28 years, 14.3% were illiterate, and 37.2% were university graduates. Positive correlations were found between health literacy, diabetes knowledge, and diabetes self-care activities (p < 0.001). Health literacy and diabetes knowledge were found to be significant predictors of diabetes self-care activities in older adults (aOR = 1.132; 95% CI:1.062–1.207, p < 0.001 and aOR = 1.313; 95% CI: 1.178–1.464, p < 0.001; respectively). Conclusions: Health literacy and diabetes knowledge were found to be predictors of good self-care activities in older adults living with diabetes. Health educators and health care professionals should focus on health education and the enhancement of diabetes knowledge to improve self-care activities and eventually glycemic control in older adults living with diabetes. [ABSTRACT FROM AUTHOR]

Objective: Diabetes is an incapacitating condition affecting millions of people in South Africa. Maintaining optimal glycaemic control is crucial in preventing diabetes complications, highlighting the importance of diabetes self-care. This study examined how Social Determinants of Health (SDoH) are associated with self-care management practices in individuals with diabetes in South Africa using the framework developed by the Healthy People 2020 initiative. Methods: This study utilised cross-sectional Project Mind baseline data collected in 2017. Self-care management was coded on a scale from '0' (never) to '7' (daily adherence). For analysis, this scale was dichotomised into two categories: low self-care (scores 0–5) and high self-care (scores 6–7). Furthermore, adherence with these daily self-care activities was categorised into three levels: no adherence, partial adherence (inconsistent or partial adherence to activities), and full adherence (consistent adherence to all self-care activities). Results: The analytical sample (n = 539) was predominantly female (76%), with a mean age of 54 years, urban residents (60%), unemployed (70%), and attained secondary education (11.3%). In determining the attainment of a higher scale of self-care, age (AOR = 1.02, CI=[0.99,1.05]) and secondary education (AOR = 1.13, CI=[1.02, 2.03]) were associated with an increase in the scale of self-care. Conversely, urban residency (AOR = 0.50, CI=[0.29,0.88]) and being obese (AOR = 0.43, CI=[0.19,1.00]) were associated with a lower scale of self-care. Although not statistically robust, food insecurity decreased while being a woman and having a stable house showed an increased association. Travelling longer distances to access healthcare was positively associated with no adherence, and urban residency has a negative association with full adherence relative to partial adherence. Conclusions: The associations between SDoH and diabetes self-care management within a South African context highlight the need for a more holistic understanding and approach to interventions. Future endeavours should examine these determinants more broadly and formulate integrative strategies to ameliorate diabetes self-care. [ABSTRACT FROM AUTHOR]