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Purpose: To establish a consensus on the complexity of 16 fundamental movement skills (FMS). Initially, complexity was defined as how difficult it would be to teach FMS to children and for the children to learn them. Method: The study was conducted using a modified Delphi method and a mobile application called Move Improve® to showcase video demonstrations of 16 FMS. Six experts discussed and rated the complexity of each FMS using a 5-point Likert scale until a 75% consensus was obtained during three rounds. Result: Dribble was rated as the most complex (average five) and run as the least (average one). The highest percentage of consensus at 100% was obtained for dribble, overhead throw, run, and skip during Round 3. Conclusion: Eye–hand or eye–foot coordination, laterality, and the environment were deemed as the most influential factors when rating the complexity of FMS. [ABSTRACT FROM AUTHOR]

This study aimed to determine the level of acceptability and marketability of GUOKCA (Guyabano, Okra, Camote Tops) ice cream of selected students and faculty of Francisco P. Felix Memorial National High School during the School Year 2023-2024. experimental method of research was used, utilizing survey questionnaire as the data gathering instrument. This study also used the 9 - point Hedonic rating scale for the acceptability and 5-point Likert scale for the marketability of the GUOKCA Ice Cream. There were thirty (30) Teenagers, thirty (30) Young Adults, and thirty (30) Adult respondents which included students and faculty members evaluated the acceptability and marketability of this research. The data revealed that the three groups of respondents, namely teenagers, young adults, and adult respondents evaluated the appearance, aroma, taste and texture of GUOKCA Ice Cream with 45ml, 90ml, and 120ml proportions as Very Acceptable. In addition, there were no significant differences on the evaluation of the three groups of respondents on the level of acceptability of GUOKCA Ice Cream. On the other hand, the level of marketability as evaluated by respondents obtained a rating of Very High Potential utilizing the 45ml, 90ml, and 120ml proportions in terms of supply availability, production cost, and consumer demand resulting to no significant difference on their evaluations. Furthermore, the results of physicochemical analysis from the produced GUOKCA ice cream contains 7.08 for sugar, 68.7 moisture, and less than 3* for Vitamins C with a pH Level of 5.01 at 23.5°C. Comments and suggestions were given by the three groups of respondents for further improvement of the product. [ABSTRACT FROM AUTHOR]

As digital technologies and AI systems increasingly pervade banking services, understanding customers’ digital capabilities and awareness of AI ethics principles is paramount. This paper delves into these critical aspects among banking clientele. Employing a survey research approach with a cross-sectional design, an online survey via Google Forms was distributed to 500 banking customers, of whom 466 responded. The survey evaluated respondents’ digital competencies and AI ethics awareness through multiple-choice questions and Likert scale items. Utilizing IBM SPSS version 28 and Microsoft 365 analysis software, descriptive statistics and statistical analysis were conducted to discern trends and patterns. The key finding emphasizes the urgency for financial institutions to invest in digital technologies enhancing customer experiences and fostering ethical AI adoption. A significant policy implication underscores the need for policymakers and regulatory bodies to collaborate with the banking sector, developing clear guidelines for responsible AI practices, prioritizing customer privacy, data protection, and fairness in AI algorithms. This study also introduces the CORE AI framework, concentrating on responsible AI adoption, customer-centricity, and strategic optimization, promising positive outcomes for stakeholders. The original contribution of this research lies in its comprehensive exploration of the nexus between digital competencies and AI ethics awareness. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (CC) and breast cancer (BC) threaten women's well-being, influenced by health-related stigma and a lack of reliable information, which can cause late diagnosis and early death. ChatGPT is likely to become a key source of health information, although quality concerns could also influence health-seeking behaviours. Methods: This cross-sectional online survey compared ChatGPT's responses to five physicians specializing in mammography and five specializing in gynaecology. Twenty frequently asked questions about CC and BC were asked on 26th and 29th of April, 2023. A panel of seven experts assessed the accuracy, consistency, and relevance of ChatGPT's responses using a 7-point Likert scale. Responses were analyzed for readability, reliability, and efficiency. ChatGPT's responses were synthesized, and findings are presented as a radar chart. Results: ChatGPT had an accuracy score of 7.0 (range: 6.6-7.0) for CC and BC questions, surpassing the highest-scoring physicians (P < 0.05). ChatGPT took an average of 13.6 s (range: 7.6-24.0) to answer each of the 20 questions presented. Readability was comparable to that of experts and physicians involved, but ChatGPT generated more extended responses compared to physicians. The consistency of repeated answers was 5.2 (range: 3.4-6.7). With different contexts combined, the overall ChatGPT relevance score was 6.5 (range: 4.8-7.0). Radar plot analysis indicated comparably good accuracy, efficiency, and to a certain extent, relevance. However, there were apparent inconsistencies, and the reliability and readability be considered inadequate. Conclusions: ChatGPT shows promise as an initial source of information for CC and BC. ChatGPT is also highly functional and appears to be superior to physicians, and aligns with expert consensus, although there is room for improvement in readability, reliability, and consistency. Future efforts should focus on developing advanced ChatGPT models explicitly designed to improve medical practice and for those with concerns about symptoms. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to validate the main therapies used in the treatment of heart failure through a clinical consensus conducted by cardiology experts in Colombia. Methods: The Delphi technique was employed, which involves a series of consultation rounds with experts to reach a consensus. Cardiologists with experience in HF treatment were selected, and they were sent electronic questionnaires to assess the relevance of various therapeutic interventions. Consensus was defined when at least 70% of the experts agreed on the relevance of an intervention. Results: Fourteen cardiology experts participated in the study. In the first round, nine therapeutic interventions were evaluated, but insufficient agreement was reached to form a consensus. A second round was conducted, where feedback was provided to the experts, and they were asked to rate the relevance of the interventions using a Likert scale. Consensus was achieved for eight of the evaluated therapeutic interventions. The focus of the third round was on the interventions that had not reached consensus in the previous rounds. Conclusions: This study provides clinical consensus on therapeutic interventions for HF in Colombia. Nine therapeutic interventions were identified as relevant by the experts. These findings can help improve HF treatment and optimize clinical outcomes in Colombia. It is important to note that this study was conducted with local experts, and the results may not be generalizable to other populations. [ABSTRACT FROM AUTHOR]

Introduction As female active duty populations increase in all military environments, it is critical that women's health be addressed in a comprehensive manner. The study's results will be utilized to assist Navy health care leaders in addressing female force readiness policies, treatment gaps, and training specific to women's mental health. Materials and Methods In total, 212 active duty participants were recruited from the Navy's mental health specialties. The survey was hosted on the U.S. Government's MAX.gov survey website and received Institutional Review Board and Survey Review Board approval per Navy and Defense Health Agency requirements. Participants recorded their experiences with various patient presentations using Likert scale assessments, indicated their comfort in prescribing medication to patients with 11 distinct presenting concerns, and responded to six questions regarding their training and clinical experience in the field of women's mental health. Results Differences were noted for provider gender, treatment setting, patient sex, provider rank, and years of independent practice. Female providers were more likely than males to report that their female patients presented with 15 of the 21 measured issues. Providers located at MTFs were significantly more likely than providers in operational billets to report female patients presenting with certain conditions and reported being more comfortable prescribing medication. Eighty percent of respondents authorized to prescribe medicine rated themselves as very or extremely comfortable prescribing medications to their patients for all specified conditions except two: women who are breastfeeding and women who are pregnant. Senior officers reported the most comfort prescribing medication to women who are planning to become pregnant and women who have experienced perinatal loss. Only a minority of providers (20%, female; 33%, males) reported receiving women's mental health education during their training. Of those who did receive training, it was limited to post-partum and pregnancy. Most participants (93%) agreed that women's mental health should be incorporated into training programs for military providers. Conclusions This exploratory study highlights that provider variables impact assessment and treatment of and for patients. The study highlights the interplay of gender, treatment setting, experiences, and level of comfort are associated with provider assessment of presenting concerns. The authors hope this study will help in prioritizing women's mental health practices, mental health training, and research, and in informing policy and decision-making. [ABSTRACT FROM AUTHOR]

Objective: To compare needleless mini-slings placed in a retropubic (U-shape) or trans-obturator (hammock-shape) configuration for treating stress urinary incontinence at 60th month. Methods: All surgeries, conducted by a senior surgeon, involved objective and subjective assessments preoperatively and at 6, 12, 18, and 60 months postoperatively using cough-stress tests, ICIQ-SF, PGI-I, and a Likert scale. Results: After 60 months, no significant differences were found in cure rates, mesh complications, or reinterventions between U-shaped and hammock-shaped groups. However, a significant decrease in cure rates was observed at 18 and 60 months in both groups. Notable differences in ICIQ-SF, Likert scale, and PGI-I scores were seen in the hammock-shaped group, while the U-shaped group showed differences in ICIQ-SF and PGI-I scores, but not in the Likert scale. Conclusion: Given the lack of significant differences, asserting the superiority of either retropubic (U-shape) or transobturatorly (hammock-shape) needleless mini-slings for treating stress urinary incontinence is challenging. [ABSTRACT FROM AUTHOR]

Likert scales rely on the assumption that psychological attributes are ordinal, meaning that the attribute levels a, b, and c are in transitive relations. Testing transitivity is possible through pairwise comparisons of attribute levels. Previous tests showed that people can violate transitivity, which calls into question the basic assumption of rating scales. We hypothesized that transitivity violations might be related to the large number of pairwise comparisons that respondents made. We showed that a reduced number of comparisons per respondent was associated with a small number of violations, although about a quarter of respondents still violated transitivity. We explained this by the heterogeneity of psychological attributes. We discussed intransitivity in heterogeneous systems, and the importance of studying it in psychology. [ABSTRACT FROM AUTHOR]

People often alternate between bouts of walking and running, for instance, when adults participate in recreational activities. Transitioning between activities can be challenging for prosthesis users because existing prosthetic feet are not well-suited for both tasks. Meanwhile, switching between prostheses for different tasks is often impractical. Collectively, these challenges can present barriers to physical activity participation for people with limb loss, which can negatively impact social or physical health. This work describes the development and evaluation of a passive bimodal prosthetic foot prototype with different configurations and stiffnesses for walking and running. Users rated the bimodal prosthesis higher for standing and walking compared to a running prosthesis (+2.3 for both tasks on a seven-point Likert scale). Users rated the bimodal prosthesis higher for running compared to a walking prosthesis (+1.7 and +0.5 for 2.0 and 2.5 m/s running, respectively). Changing from walking to running mode increased the device's stiffness by 23–84%, depending on the user's preference. Users could switch between bimodal prosthesis walking and running modes quickly (21.3 ± 12.0 s). Overall, the preliminary results were encouraging in terms of user satisfaction, stiffness change between modes, and mode-switching speed. These findings motivate future exploration of this bimodal prosthesis concept. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify clinical guidelines that provide recommendations on prescribing refractive error correction in children, evaluate the overall quality of these guidelines using the Appraisal of Guidelines for REsearch and Evaluation II (AGREE II) tool and subsequently gain consensus on the prescribing recommendations from high‐quality guidelines using the modified Delphi technique. Methods: A comprehensive search for prescribing guidelines was conducted using databases and professional websites. The quality appraisal of eligible guidelines was undertaken by scoring the six AGREE II domains. Subsequently, the modified Delphi technique was used by 10 experts (sub‐specialist optometrists, ophthalmologists and orthoptists) to gain consensus on the prescribing recommendation statements extracted from guidelines that had been identified as high quality. Three rounds were conducted in which agreement of these statements were scored using a 9‐point Likert scale with a free‐text option for any additional comments. Results: Five eligible guidelines were identified. The AGREE II tool demonstrated that the guidelines varied substantially in quality, with only one guideline identified as being of high quality. A total of 168 prescribing statements were reviewed in the Delphi procedure. Of these, 95 statements reached expert consensus as being appropriate prescribing recommendations. Conclusion: There is significant scope for improving current guidelines for prescribing refractive error correction in children. We used the modified Delphi technique to find points of agreement on prescribing recommendations to support professionals prescribing refractive error correction in children. We recommend that further work is needed to address gaps in the guidelines. [ABSTRACT FROM AUTHOR]

In this study, a sample (N = 55) of preservice elementary teachers were asked what it takes to be good at math and whether or not they seem themselves as 'do-ers' of math. An examination of their responses to both a Likert Scale and corresponding open-ended questions revealed five key themes: having a good attitude, being a good student, practicing, possessing particular numeric skills, and natural ability. Yet, despite their personal willingness to work hard and have a good attitude, many indicated that they do not see themselves as good at math – e.g. only 38% agreed with the statement 'I am good at math'. Thus, there is a contradiction in beliefs: These preservice elementary teachers believe that to be good at math, one must practice math. They see themselves as willing to practice math. Yet, they do not see themselves as 'do-ers of math'. Their responses express a troubling disconnect, as they see themselves trying to be good at math, but not necessarily succeeding. Analysis of these intriguing findings prove instructive for enhancing the preparation of future elementary school teachers. [ABSTRACT FROM AUTHOR]

The grid and link search methods are used to recover scattered skeletal remains. Neither have not been compared robustly and clear guidelines for the link method have not been sufficiently developed. The study aimed to compare the effectiveness and efficiency of both methods and propose guidelines for the link method. The scattering patterns of two scavengers of forensic relevance—slender mongooses (Galerella sanguinea) and black-backed jackals (Canis mesomelas)—were recreated using four pig skeletons (Sus scrofa domesticus). Two groups (n = 6 each) were assigned a different method to recover the scattered remains. The length of the search and when each bone was located for each scatter pattern was recorded for each group and scatter pattern. A Likert scale questionnaire assessed participants' perceptions of their assigned method. A paired t-test (p = 0.005) compared the efficiency of each method and the questionnaire answers. Both methods were effective, recovering 100% of all remains. The link method was more efficient for both scatter patterns, despite there being no statistical significance (jackal: p = 0.089; mongoose: p = 0.464). Participants indicated favorable views for both methods; however, the link method scored significantly more favorably (p = 0.01) for efficiency. Specific guidelines were developed for the use of the link method. The link method is suggested for the recovery of scattered remains in forensic contexts, especially when the scavenger, its behavior, and scattering pattern is known or suspected. [ABSTRACT FROM AUTHOR]

The objective of this investigation was to define criteria for environmental, economic and social sustainability practices at all stages of the institutional restaurant meal production process.The method was based on an initial 35 criteria model relying on the literature, and subdivided into three dimensions: natural resources, stages of the meal production process, as well as certification and training programs for employees. This model was sent to 36 specialists for the application of the Delphi Technique, through an online form, using the 5-point Likert scale, considering the relevance and difficulty of the execution of each of the criteria.The criteria that reached an average greater than or equal to 3.5 in relation to the level of relevance were considered accepted. After the analysis of the dimensions by the investigation participants indicated that the 35 criteria were approved and two new ones were included. The 37 criteria are arranged in order of relevance and levels of difficulty. This order is intended to help to instruct managers and nutritionists in assessing and determining priority actions in institutional restaurants, in order to achieve sustainable practices. The 37 defined criteria can help institutional restaurants determine priority actions for sustainability practices. In addition, it can be inferred that the 37 criteria defined and validated by experts can support the design of programs or policies related to FNS (Food and Nutritional Security) and to sustainability. [ABSTRACT FROM AUTHOR]

Introduction Deep vein thrombosis (DVT) poses a complex challenge and often leads to postthrombotic syndrome (PTS), a debilitating complication. The emergence of venous stents offers a potential preventive avenue against this complication. This study aimed to provide consensus recommendations on the use of venous stent for DVT. Materials and Methods From June to July 2023, 20 internal medicine, angiology and vascular surgery, and vascular and interventional radiology experts were involved in the Delphi process. Thirty-one recommendations, categorized into three thematic areas, were rigorously evaluated: indications for stent use, stent selection and placement, and monitoring and prevention of complications. Agreement was evaluated using a Likert scale, with consensus defined as agreement by two-thirds of the participants. Results Consensus was reached for 23 (74.2%) of 31 recommendations. The agreement was centered on considerations, such as stent placement in specific acute DVT scenarios, emphasizing pivotal stent characteristics. However, there were divergences in the recommended stent length to prevent migration and stent characteristics based on iliocaval bifurcation morphology. Notably, there was no consensus on whether patients with DVT caused by a major transient risk factor need more than 3 months of anticoagulation therapy or whether aspirin should be added to anticoagulant treatment after venous stenting. Conclusions These consensus recommendations offer practical insights into optimizing venous stent use to prevent PTS in DVT patients. Addressing the critical aspects of stent selection, placement, and postprocedural care, these recommendations contribute to clinical decision-making. The identified divergences underscore the importance of consensus and thus indicate the need for further investigation. [ABSTRACT FROM AUTHOR]

Perceiving facial attractiveness is an important behaviour across psychological science due to these judgments having real-world consequences. However, there is little consensus on the measurement of this behaviour, and practices differ widely. Research typically asks participants to provide ratings of attractiveness across a multitude of different response scales, with little consideration of the psychometric properties of these scales. Here, we make psychometric comparisons across nine different response scales. Specifically, we analysed the psychometric properties of a binary response, a 0–100 scale, a visual analogue scale, and a set of Likert scales (1–3, 1–5, 1–7, 1–8, 1–9, 1–10) as tools to measure attractiveness, calculating a range of commonly used statistics for each. While certain properties suggested researchers might choose to favour the 1–5, 1–7 and 1–8 scales, we generally found little evidence of an advantage for one scale over any other. Taken together, our investigation provides consideration of currently used techniques for measuring facial attractiveness and makes recommendations for researchers in this field. [ABSTRACT FROM AUTHOR]

Due to the lack of treatment guidelines for the management of advanced-stage marginal zone lymphoma (MZL), only one chemoimmunotherapy—cyclophosphamide, vincristine, and prednisone plus rituximab (R-CVP)—is reimbursed in the first-line setting in South Korea. The aim of this study was to develop a consensus-based recommendation for the treatment of patients with advanced-stage MZL. Twelve hematologist oncologists participated in a two-round Delphi process to identify consensus on the management of patients with advanced-stage MZL in South Korea. Physicians rated their level of agreement with each statement on a four-point Likert scale. Statements were divided into two sections: definitions used in clinical practice and clinical management of patients with advanced-stage MZL. Consensus was reached for 23 of 33 (69.7%) and 5 of 13 statements (38.5%) in rounds 1 and 2, respectively. There was strong consensus (91.7%) that advanced-stage MZL subtypes are defined according to the Lugano staging system. First-line systemic treatment should be prescribed for patients with symptomatic advanced-stage MZL. Although there was unanimous agreement that R-CVP is the standard first-line treatment for advanced-stage MZL, physicians also agreed that bendamustine with rituximab (BR) has greater efficacy than R-CVP as first-line treatment (91.7%). For the treatment of relapsed/refractory advanced-stage MZL, BR and R-CVP can be repeated in patients with short (< 24 months) and long remission periods (≥ 24 months), respectively. This study provides insights on the management of patients with advanced-stage MZL in South Korea. This may enhance clinical decision-making, thus improving patient outcomes. [ABSTRACT FROM AUTHOR]

The experience sampling method (ESM) allows for a high degree of ecological validity compared to laboratory research, at the cost of greater effort for participants. It would therefore benefit from implementations that reduce participant effort. In the present paper, we introduce a screenless wrist-worn one-button wearable as an unobtrusive measurement method that can be employed in ESM designs. We developed an open-source Android application to make this commercially available wearable easily configurable and usable. Over the course of six pilot studies, we explored the technical viability (e.g., battery life, reliability of inputs) of this wearable. We compared data quality between wearables and smartphones in a within-subjects design, exploring both the input options of using the number of button presses as a Likert scale, as well as using the angle of the device as a Physical Analogue Scale. Assessments of Extraversion made with either of these methods were highly correlated to comparable assessments made with comparable methods on a smartphone (i.e., Likert scale or a Visual Analogue Scale, respectively). Furthermore, in a preregistered ESM field experiment (N = 134, 4 weeks), we compared compliance to real-life event triggers between wearable devices and smartphones. We found higher numbers of logged events in the wearable group, indicating better adherence to the event-contingent scheduling. Overall, despite the device's minimal capabilities and resulting limitations, one-button wearables can be beneficial for use in ESM designs. [ABSTRACT FROM AUTHOR]

A testlet-based visual analogue scale (VAS) is a doubly bounded scaling approach (e.g., from 0% to 100% or from 0 to 1) composed of multiple adjectives, nouns, or sentences (statements/items) within testlets for measuring individuals' attitudes, opinions, or career interests. While testlet-based VASs have many advantages over Likert scales, such as reducing response style effects, the development of proper statistical models for analyzing testlet-based VAS data lags behind. This paper proposes a novel beta copula model and a competing logit-normal model based on the item response theory framework, assessed by Bayesian parameter estimation, model comparison, and goodness-of-fit statistics. An empirical career interest dataset based on a testlet-based VAS design was analyzed using the proposed models. Simulation studies were conducted to assess the two models' parameter recovery. The results show that the beta copula model had superior fit in the empirical data analysis, and also exhibited good parameter recovery in the simulation studies, suggesting that it is a promising statistical approach to testlet-based doubly bounded responses. [ABSTRACT FROM AUTHOR]

Organizational citizenship behavior (OCB) is crucial for individuals, groups, and organization's life. Therefore, this research focuses on investigating how transformational leadership affects lecturers' OCB through serial mediation of talent management, learning organization, and job involvement. A questionnaires in a Likert scale format were used to collect data from 230 Indonesian lecturers and analyzed by descriptive, correlational, and path analysis. The results found that transformational leadership significantly affects talent management, learning organization, job involvement, and OCB; talent management, learning organization, and job involvement significantly affect OCB; and transformational leadership significantly affects OCB, mediated by talent management, learning organization, and job involvement. This empirical discovery promotes a new model of transformational leadership that affects lecturer's OCB mediated by talent management, learning organization, and job involvement. Furthermore, it provides theoretical contributions and practical implications that require critical, in-depth, and comprehensive discussion before being considered for adaptation or adoption to improve lecturer OCB through the perspectives of transformational leadership, talent management, learning organization, and job involvement. [ABSTRACT FROM AUTHOR]

Purposes: To explore the clinical feasibility and efficacy of a deep inspiration breath-hold (BH) PET/CT using [18F]AlF-NOTA-LM3 on upper abdominal lesions in patients with neuroendocrine tumors (NETs). Methods: Twenty-three patients underwent a free-breath (FB) whole-body PET/CT, including a 10 min/bed scan for the upper abdomen with a vital signal monitoring for respiratory gating (RG) followed by a 20-second BH PET/CT covering the same axial range. For the upper abdomen bed, the following PET series was reconstructed: a 2-min FB PET; RG PET (6 bins); a 20-second and 15-second BH PET (BH_15 and BH_20). Semi-quantitative analysis was performed to compare liver SUVmean, lesion SUVmax, MTV, its percentage difference and target-to-background ratio (TBR) between both BH PET and RG PET images. Subgroup analysis considered lesion location, MTV and SUVmax. A 5-point Likert scale was used to perform visual analysis and any missed or additional lesions were identified compared with RG PET. Results: Quantitative analysis on overall lesions (n = 78) revealed higher SUVmax and TBR, and smaller MTV for both BH PET compared to FB and RG PET, with lesion location-specific variations. Neither significant difference was observed in all metrics between RG and FB PET in larger lesions, nor in MTV in lower-uptake lesions. However, both BH PET significantly enhanced these measurements. In the visual analysis, both BH PET showed noninferior performance to RG PET, and were evaluated clinically acceptable. Additional and missed lesions were observed in FB and both BH PET compared with RG PET, but didn't alter the clinical management. The BH_15 PET showed comparable performance to BH_20 PET in any comparison. Conclusion: The BH PET/CT using [18F]AlF-NOTA-LM3 is effective in detecting upper abdominal lesions, offering more accurate quantitative measurements. Using a novel PET/CT scanner, a 15-second BH PET can provide comparable and superior performance to RG PET, indicating potential feasibility in clinical routines. [ABSTRACT FROM AUTHOR]

Sleep deprivation (SD), defined as an inability to get a minimum of 7 hours of regular sleep at night is a serious health problem that impacts the performance of medical professionals. This study aims to determine the impact of sleep deprivation on perceived performance among medical officers (MOs). A cross-sectional study design involved 231 MOs from six disciplines in Hospital Tuanku Ja'afar, a tertiary center in the south of Malaysia. A self-administered questionnaire was introduced in the English language. The questionnaire involved the sociodemographic characteristics; job-related factors, and the Sleep Deprivation Impact Scale (SDIS). The SDIS is a 12-question scale, rated on a 5-point Likert scale from strongly disagree to strongly agree. A higher SDIS score reflected a higher impact of sleep deprivation. A total of 206 MOs returned the completed questionnaire yielding a response rate of 89.17%. The mean age of respondents was 31.68 (±3.49) years. Most of the respondents were female, of Malay ethnicity, and married. More than three-quarters (78.64%) reported sleep deprivation. Being less effective in communication and formulating diagnosis (3 (1.01) vs 2.5 (1.15),p = 0.005); taking longer time to do things (3.44 (1.07) vs 2.8 (1.34),p = 0.001); and feeling unsafe while driving (3.56 (1.25) vs 2.93 (1.55),p = 0.006) manifested significantly higher mean among sleep-deprived respondents. In conclusion, sleep deprivation is a prevalent problem; that adversely affects crucial functioning domains that may endanger patients and healthcare providers alike. Radical countermeasures are required to ensure satisfactory sleep duration and address areas jeopardizing MO safety. [ABSTRACT FROM AUTHOR]

It is important to consider the local people’s evaluation in increasing the effectiveness of the sustainable planning process in urban system planning. In this work, the sustainability of urban system planning in Shu city of Kazakhstan is evaluated according to the defined dimensions, which play a key role in determining the population’s living standard, and the indicators of each dimension are compared. The data are obtained mainly through the household questionnaire survey, field observations, in depth interviews, and focus group discussion. In total, 832 representative respondents were surveyed with five-point Likert scale questions in this paper. The study used 42 indicators based on six dimensions: environmental, social, cultural, economic, religious/spiritual, and institutional dimensions. The results of this analysis show that the sustainability level of urban system planning in Shu city is at a low level in all six dimensions. The results of the indicator analysis show that the people of this region are generally not satisfied with the solution of some environmental, social, and economic problems in Shu city. At the same time, residents rated the indicators of institutional stability as better, on the contrary, they rated cultural and religious/spiritual indicators relatively high. As a result, we initially asserted that the sustainability of the urban system planning in Shu city is not satisfactory considering the existing possibilities. To eliminate this shortcoming, the authorities responsible for planning the urban system should jointly develop a project policy for sustainable development with all interested parties. [ABSTRACT FROM AUTHOR]

Background: While different proposals exist for a guideline on reporting Delphi studies, none of them has yet established itself in the health and social sciences and across the range of Delphi variants. This seems critical because empirical studies demonstrate a diversity of modifications in the conduction of Delphi studies and sometimes even errors in the reporting. The aim of the present study is to close this gap and formulate a general reporting guideline. Method: In an international Delphi procedure, Delphi experts were surveyed online in three rounds to find consensus on a reporting guideline for Delphi studies in the health and social sciences. The respondents were selected via publications of Delphi studies. The preliminary reporting guideline, containing 65 items on five topics and presented for evaluation, had been developed based on a systematic review of the practice of Delphi studies and a systematic review of existing reporting guidelines for Delphi studies. Starting in the second Delphi round, the experts received feedback in the form of mean values, measures of dispersion, a summary of the open-ended responses and their own response in the previous round. The final draft of the reporting guideline contains the items on which at least 75% of the respondents agreed by assigning scale points 6 and 7 on a 7-point Likert scale. Results: 1,072 experts were invited to participate. A total of 91 experts completed the first Delphi round, 69 experts the second round, and 56 experts the third round. Of the 65 items in the first draft of the reporting guideline, consensus was ultimately reached for 38 items addressing the five topics: Title and Abstract (n = 3), Context (n = 7), Method (n = 20), Results (n = 4) and Discussion (n = 4). Items focusing on theoretical research and on dissemination were either rejected or remained subjects of dissent. Discussion: We assume a high level of acceptance and interdisciplinary suitability regarding the reporting guideline presented here and referred to as the "Delphi studies in social and health sciences–recommendations for an interdisciplinary standardized reporting" (DELPHISTAR). Use of this reporting guideline can substantially improve the ability to compare and evaluate Delphi studies. [ABSTRACT FROM AUTHOR]

Objectives Patients and Methods Results Conclusion To report the clinical outcomes of the Victo™ (Promedon, Cordoba, Argentina) adjustable artificial urinary sphincter (AUS) implantation in a cohort of patients with severe urinary incontinence (UI) after prostate surgery.This study enrolled patients with UI following prostate surgery who underwent a Victo implantation between May 2018 and December 2023. Patients were prospectively evaluated at baseline, and at 3 and 12 months after device activation, and thereafter annually. The 24‐h pad‐weight test (24hPWT) was used to assess severity of UI, while the Patient Global Impression of Improvement (PGI‐I) and patient satisfaction according to a Likert scale were used to measure patient‐reported outcomes.A total of 96 patients with a median (interquartile range [IQR]) age of 68 (65–72) years were included in the final analysis. The median (IQR) follow‐up was 3 (1–4) years. In all, 10 patients completed the 5‐year follow‐up. After the treatment, we observed a significant reduction in 24hPWT by the median of 83% (P < 0.001) at 3 months and by a median of 79% (P < 0.001) at 3 years. According to the PGI‐I, a total of 87%, 92%, 87%, 81%, 83%, and 50% (five of 10) of patients rated their condition/incontinence as ‘very much improved’, ‘much improved’ or ‘little improved’ at 3 months, 1‐, 2‐, 3‐, 4‐, and 5‐year follow‐up visits, respectively. The proportion of patients, who were ‘very satisfied’ or ‘satisfied’ with the treatment outcome was 79%, 80%, 75%, 69%, 80%, and 60% (six of 10) at 3 months, 1‐, 2‐, 3‐, 4‐, and 5‐years, respectively. There were a total of 13 (14%) device failures during the follow‐up period.In conclusion, our data suggest that Victo AUS significantly reduces the severity of UI after prostate surgery and provides a reasonably high patient‐reported satisfaction with treatment outcomes at mid‐term follow‐up. [ABSTRACT FROM AUTHOR]

This study examines baseball players' recognition framework of out, ball, and strike counts in baseball games and clarifies the differences in psychological perspectives between batters and pitchers. The participants were 396 players (294 batters and 102 pitchers) belonging to baseball clubs at eight universities. Participants answered 288 questions for all game situations by combining out, ball, and strike counts and runner position. The advantages for batters or pitchers were evaluated using a 7-point Likert scale (from very advantageous for batters to very advantageous for pitchers). Factor analysis indicated four significant factors (36 items): "Batter's advantage count," "Pitcher's advantage count," "2 out young count," and "0 out young count." In a direct comparison of these factors between batters and pitchers, batters were more aware of their advantage over pitchers in the factors "Batter's advantage count" and "0 out young count" and disadvantage in the "Pitcher's advantage count." Significant differences in recognition of these factors were observed between batters and pitchers. Batters were more susceptible to game situations than were pitchers. Our findings suggest that baseball players recognize several types of game situations, although not an infinite number. [ABSTRACT FROM AUTHOR]

Background: Sierra Leone has one of the world's highest maternal and infant mortality rates and suffers from a shortage of well-trained health professionals, including midwives. Prior to engaging in systematic interventions, it is critical to measure organizational readiness to gauge members' psychological and behavioral preparedness to implement change. We aimed to measure the organizational readiness for implementing change and compare results among midwives and administrative leaders at two schools of midwifery in Sierra Leone prior to the rollout of a midwifery preceptor program. Methods: The Organizational Readiness for Implementing Change (ORIC) survey is a validated 12-item questionnaire designed to assess two domains of organizational readiness for change: change commitment (motivation) and change efficacy (capacity). All survey items begin with the same prompt and a five-item Likert scale response, with seven questions about change commitment and five about change efficacy. Data collection occurred in two schools of midwifery in Sierra Leone during two day-long meetings with stakeholders. Statistical analysis was conducted using descriptive statistics and Wilcoxon rank-sum test to compare independent samples: School 1 versus School 2 (site), midwife versus other roles (role). Results: Participants included 42 respondents (mean age 41 years, 95% female). Surveys were distributed evenly between the two sites. Occupations included midwifery faculty (n = 8), administrators (n = 5), clinicians (n = 25), and clinical educators (n = 4). Domain 1 (change commitment) had a mean score of 4.72 (SD 0.47) while Domain 2 (change efficacy) had a mean score of 4.53 (SD 0.54) out of a total potential score of five. There were no statistically significant differences between site responses for Domain 1 (p = 0.5479) and Domain 2 (p = 0.1026) nor role responses for Domain 1 (p = 0.0627) and Domain 2 (p = 0.2520). Conclusion: Stakeholders had very high overall readiness for change across all ORIC questions for both change commitment and change efficacy. Mean scores for change commitment were slightly higher which is not surprising given the low-resourced settings stakeholders work in while training students. High mean scores across sites and roles is encouraging as this novel preceptor program is currently being rolled out. [ABSTRACT FROM AUTHOR]

Given the implications of quality for the survival and performance of business and non-business organizations, research on its operationalization and measurement especially as it relates to services have continued to increase over the years. There is, however, a glaring dearth of research on the measurement of service quality in the non-business context, especially in the religious setting though it is a thriving segment of the market for services. Building on the Push–Pull–Mooring framework and following a multistage procedure involving both exploratory and confirmatory factor analyses (EFA and CFA), this paper described the procedure employed in developing and validating the P-P-Relqual scale for measuring the quality of services offered by Christian religious service providers in the Nigerian context. The final version of the validated scale is made up of 11 items, measured on a five-point Likert scale, which were categorized into four dimensions (Conflict, Appeal of pastor, Appeal of Church, and Opportunity for Development). Based on the result obtained, the paper concluded that adherents will perceive the religious service they receive as being of a high quality, if their providers can strategize to effectively minimize intra-church “conflict” while enhancing “Appeal of pastor,” “Appeal of Church,” and “Opportunity for Development.” [ABSTRACT FROM AUTHOR]

Background/Objectives: To define and evaluate a radiation dose optimization process for chest computed tomography (CT) imaging. Methods: Data from unenhanced and enhanced chest CT acquisitions performed between June 2018 and January 2020 in adult patients were included in the study. Images were acquired on a Siemens SOMATOM® Definition Edge CT. Dose values, including Dose.Length Product (DLP) and Volume CT Dose Index (CTDIvol), were collected. Low doses (LDs, 25th percentiles), achievable doses (ADs, 50th percentiles), and diagnostic reference levels (DRLs, 75th percentiles) were calculated before and after parameter modifications. A process was defined and applied to patient data. For unenhanced chest CT, data were differentiated according to three groups: high dose (HD), optimized dose (OD), and ultra-low dose (ULD). Dosimetric changes between protocols were expressed as mean CTDIvol % (CI95%). A Mann and Whitney statistical test was used. The diagnostic quality score (DQS) of a subset of 70 randomly selected CT examinations was evaluated by one radiologist. The DQS was scored according to a three-point Likert scale: (1) poor (definite diagnosis impossible), (2) fair (evaluation of major findings possible), and (3) excellent (exact diagnosis possible). Results: Data were collected from 1929 patients. For unenhanced chest CT protocols, only one process loop was run. A dose comparison between the chest CT protocol before the use of the process and the three groups showed a decrease of −38.3% (9.7%) and −93.4% (24.2%) for OD and ULD, respectively, and an increase of +29.4% (4.7%) for HD. For the enhanced chest CT protocol, two optimization loops were performed, and they resulted in a mean dose reduction of −50.0% (2.6%) compared to the pre-optimization protocol. For all protocols, the DQS was greater than or equal to 2. Conclusions: We proposed a radiation dose optimization process for chest CT that could significantly reduce the dose without compromising diagnosis. [ABSTRACT FROM AUTHOR]

This study aimed to create a Czech questionnaire for pediatric obstructive sleep apnea (POSA) risk screening, a first of its kind in the Czech Republic, where options for child polysomnography are limited. Compiling items from established English questionnaires and supplementing them with additional items, we designed the first version of the Czech questionnaire and tested it in a pilot study with parents of 30 children. After pilot feedback, a revised version with dichotomous and 5-item Likert scale questions was tested on 71 children's parents. All children (7–12 years old) underwent a home sleep apnea test to record their apnea–hypopnea index (AHI). The second (40-item) version showed high reliability (93%), with 17 items identified as the most significant. Findings from the final 17-item SEN CZ questionnaire correlated positively with AHI (p < 0.001), demonstrating 84% sensitivity, 86% specificity, and 93% reliability. Three factors, namely breathing problems, inattention, and hyperactivity (characterized by multiple items), were identified to form a higher-order factor of POSA risk, which was further supported by the correlations of their total scores with AHI (p < 0.001). The resulting SEN CZ questionnaire can serve as a tool for POSA risk screening in the Czech Republic without the need to involve medical professionals. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions To develop the use of Thiel soft embalmed human cadavers (TeC) in open radical cystectomy (ORC) training for the first time, to investigate the effect of cadaveric training on surgical trainees' technical skills/performance and to determine how trainees perceive the use of cadaveric workshops.A 3‐day hands‐on workshop was organised. Ten trainees performed ORC on five TeC, supervised by five experts. Feedback from trainees and mentors was evaluated on a five‐point Likert scale. All procedures were completed in a fully equipped surgical environment and complied with the principles outlined in the Declaration of Helsinki.The workshop participants evaluated the anatomical and manipulation characteristics of the TeC as similar to real‐life conditions. The colour and consistency of the urethra and ureter differed little from those in live patients. The trainees stated that the TeC were beneficial for learning the stages of ORC and urinary diversion (UD), while their self‐confidence increased. In terms of realism, all steps of radical cystectomy (RC) were rated 4 out of 5 or higher on the Likert scale by both trainees and faculty.The use of TeC for RC und UD was perceived as favourable by trainees and faculty. The TeC demonstrated a surprising ability to mimic real‐life anatomy and represent a new and effective surgical training tool. [ABSTRACT FROM AUTHOR]

Nutrition in early life plays a key role in shaping an infant's future health. There is limited understanding of the perspectives of Vietnamese mothers with children under 24 months of age regarding breastmilk expression, donation and use. In this cross‐sectional study, an online survey was administered through two parenting social media communities to assess opinions on breastmilk expression, breastmilk donation including contributions from bereaved mothers and the use of donor human milk. A 4‐point Likert scale was used to evaluate respondents' opinions, and demographic and breastfeeding information was collected. Among 375 respondents, almost 30% had received breastmilk from another woman, either through direct breastfeeding (14.7%), expressed breastmilk (12.5%) or from a human milk bank (2.7%). In this survey of 375 mothers, 84.0% indicated they would store excess breastmilk, while 75.7% and 69.6% would donate to a human milk bank or another mother, respectively. When faced with insufficient breastmilk, 88.5% of mothers would seek ways to increase supply, whereas 23.8% considered using commercial milk formula. Regarding milk expression among the 375 mothers, 78.4% preferred electric pumps, compared to 48.6% for manual pumps and 45.9% for hand expression. Additionally, 80.5% of the 375 mothers would suggest donating stored milk to bereaved peers and 85.6% would suggest mothers with mild COVID‐19 to continue breastfeeding with precautions. These findings indicate that this sample has positive views on breastfeeding, breastmilk donation and the use of donor human milk. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusion To evaluate the impact of acquisition protocols and artifact reduction filters in cone beam computed tomography on diagnosing vertical root fractures in endodontically treated teeth with and without intraradicular posts.We analyzed 480 tomographic images acquired from two J. Morita scanners (0.125‐ and 0.08‐mm voxel sizes protocols), with application of a blooming artifact reduction filter. Three evaluators assessed these images for root fractures using a 5‐point Likert scale. Diagnostic accuracy between filters and protocols was determined using generalized linear models with binomial distribution for the outcome, considering protocol, filter, and dental status. Sensitivity, specificity, positive predictive value, and negative predictive value were also estimated for the filters and protocols.The 0.08‐mm voxel size protocol demonstrated a significantly higher percentage of accurate diagnosis compared to the 0.125‐mm protocol (p = .001). No statistically significant differences (p ≥ .087) were observed for filter application, interaction between protocol and filter, or dental status. Accuracy, sensitivity, and specificity values were respectively: .93, .87, 1.00 (protocol 1); .99, .99, .99 (protocol 2); .98, .96, .99 (no filter); .95, .90, 1.00 (with filter).The new findings found for the two J Morita scanners used in our study were that images acquired using the voxel size of 0.08 mm showed an improvement in the diagnosis of root fractures and the filters in these devices have no relevance significant for the diagnosis. [ABSTRACT FROM AUTHOR]

Anti-Black bias involves negative evaluations of individuals from African-descendent groups. Researchers use explicit and implicit measures to detect this bias and evaluate intervention effectiveness. However, few behavior analysis studies have focused on identifying and addressing racial bias in children, and none have explored the effects of test-retest on implicit measures in this context. This study aimed to identify implicit and explicit anti-Black racial bias in children and examine the test-retest reliability of these measures over three time points. Thirty-four children (average age 8.60 years, 24 females) rated images of Black and White faces on a five-point Likert scale. The Modified Function Acquisition Speed Test (FAST), an implicit measure, assessed how fluently participants categorized Black and White faces with positive and negative images. Results showed no explicit racial bias in the sample. However, implicit measure results revealed an anti-Black bias, with 11 participants consistently displaying this bias across three repetitions. Regarding test-retest reliability, there were no significant performance differences on the implicit and explicit measures across the three repetitions. These findings suggest that the FAST is a sensitive tool for identifying racial bias in children, and the absence of test-retest effects supports its feasibility for repeated use. [ABSTRACT FROM AUTHOR]

Background: Gap tension is an important factor influencing the clinical outcomes of total knee arthroplasty (TKA). Traditional mechanical alignment (MA) places importance on neutral alignment and often requires additional soft tissue releases, which may be related to patient dissatisfaction. Conversely, the functional alignment requires less soft tissue release to achieve gap balance. Conventional gap tension instruments present several shortcomings in practice. The aim of this study is to introduce a new gap balancing technique with FA using the modified spacer-based gap tool and the MAKO robotic arm system. Methods: A total of 22 consecutive patients underwent primary TKA using the MAKO robotic arm system. The gap tension was assessed and adjusted with the modified spacer-based gap tool during the operation. Patient satisfaction was evaluated post-operatively with a 5-point Likert scale. Clinical outcomes including lower limb alignment, Knee Society Score (KSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were recorded before surgery, 3 months and 1 year after surgery. Results: The range of motion (ROM) was significantly increased (p < 0.001) and no patients presented flexion contracture after the surgery. KSS and WOMAC score were significantly improved at 3 months and 1 year follow-up (p < 0.001 for all). During the surgery, the adjusted tibial cut showed more varus than planned and the adjusted femoral cut presented more external rotation than planned (p < 0.05 for both). The final hip-knee-ankle angle (HKA) was also more varus than planned (p < 0.05). Conclusions: This kind of spacer-based gap balancing technique accompanied with the MAKO robotic arm system could promise controlled lower limb alignment and improved functional outcomes after TKA. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion Level of evidence Establishing the diagnosis of loosening in total or unicondylar knee arthroplasty remains a challenge with different clinical and radiological signs evaluated in study designs with high risk of bias, where few or incomplete criteria are formulated for establishing the diagnosis of implant loosening. This study aimed at evaluating the variability between different clinical and radiological criteria and establish a consensus regarding clinical and radiological criteria for the diagnosis of knee arthroplasty loosening.Highly specialized knee surgeons focusing on revision arthroplasty were invited to take part in an international panel for a Delphi consensus study. In the first round, the participants were asked to state their most important clinical and radiological criteria for implant loosening. In a second round, the panel's agreement with the collected criteria was rated on a 5‐point Likert scale (1–5). High variability was defined by receiving at least one score each indicating complete disagreement and complete agreement. Consensus was established when over 70% of participants rated a criterion as ‘fully agree’ (5) or ‘mostly agree’ (4).High variability was observed in 56% of clinical criteria and 38% of radiological criteria. A consensus was reached on one clinical (weight‐bearing pain [82%]) and four radiological criteria, that is, implant migration, progressive radiolucencies, subsidence and radiolucencies >2 mm on X‐ray or computed tomography (CT) (84%–100%).Amongst specialized knee revision surgeons, there is high variability in clinical and radiological criteria that are seen as important contributing factors to diagnosis of knee implant loosening. A consensus was reached on weight‐bearing pain as clinical criterion and on implant migration, progressive radiolucencies, subsidence and radiolucencies of more than 2 mm on X‐ray or CT as radiological criteria. The variability rates observed, along with the criteria that reached consensus, offer important insights for the standardization of diagnostic protocols.Level V. [ABSTRACT FROM AUTHOR]

AbstractWithin the context of extended displacement, this research examines the meaning of ‘place’ as perceived by long-term Palestinian refugees residing in two prominent West Bank camps, Balata and Jenin. The study delves into the complex dynamics of place within the context of protracted exile. Using a robust constructivist grounded theory approach, it enables theoretical revelations to surface from empirical evidence collected in the field. Fieldwork was performed, employing a mixed-methods strategy that incorporates a Likert scale questionnaire and in-depth interviews with three different generations of displaced individuals. Despite the crises induced by forced displacement and its influence on place identity, the research illuminates the ability to form place attachments to these temporary settlements. Notably, this attachment is unique in its dependence on memories and connections to a lost homeland rather than the physical attributes of the current living environment. The findings of the study contribute to the theoretical exploration of place attachment, place identity, and place dependence, specifically in contexts of extended displacement. Moreover, the insights derived from the research have practical implications for the management and planning strategies within such refugee settlements. [ABSTRACT FROM AUTHOR]

Background Approach Evaluation Implications Multimorbidity is a rising health care phenomenon and doctors require specific skill sets to effectively care for patients with multiple illnesses. Despite this, most medical education is taught using a single‐disease, systems‐based approach. Consequently, students can struggle to manage patients with multimorbidity. To help final year medical students manage patients with multimorbidity in clinical practice, we devised, taught, and evaluated a heuristic: collect, cluster and co‐ordinate.Students attended a 1‐hour online workshop during their family medicine clerkship. Using a flipped classroom design, students watched a podcast, followed by facilitated small‐group work.Out of 132 final‐year medical students, 102 participated in the evaluation. Students rated their confidence managing patients with multimorbidity, pre and post teaching on a Likert scale. Prior to teaching, 36% (n = 37) students rated their ability to manage a patient with multimorbidity as slightly confident. After teaching, 74.5% (76) students rated their ability to manage the same patient as fairly or completely confident. Prior to graduation students were surveyed to determine if they had applied the framework during clinical placements. Sixty‐one students responded; 32 applied the heuristic during family medicine and in other clinical rotations such as paediatrics, obstetrics, emergency medicine and anaesthesia.Specific instruction on managing consultations with patients experiencing multimorbidity during undergraduate medical education increased learner confidence caring for these patients. The heuristic was relevant and applied in disciplines outside family medicine. Students indicated that earlier teaching on this topic would have prepared them better for clinical placements. [ABSTRACT FROM AUTHOR]

Background: Assessment of undergraduate students using assessment instruments in the clinical setting is known to be complex. The aim of this study was therefore to examine whether two different assessment instruments, containing learning objectives (LO's) with similar content, results in similar assessments by the clinical supervisors and to explore clinical supervisors' experiences of assessment regarding the two different assessment instruments. Method: A mixed-methods approach was used. Four simulated care encounter scenarios were evaluated by 50 supervisors using two different assessment instruments. 28 follow-up interviews were conducted. Descriptive statistics and logistic binary regression were used for quantitative data analysis, along with qualitative thematic analysis of interview data. Result: While significant differences were observed within the assessment instruments, the differences were consistent between the two instruments, indicating that the quality of the assessment instruments were considered equivalent. Supervisors noted that the relationship between the students and supervisors could introduce subjectivity in the assessments and that working in groups of supervisors could be advantageous. In terms of formative assessments, the Likert scale was considered a useful tool for evaluating learning objectives. However, supervisors had different views on grading scales and the need for clear definitions. The supervisors concluded that a complicated assessment instrument led to limited very-day usage and did not facilitate formative feedback. Furthermore, supervisors discussed how their experiences influenced the use of the assessment instruments, which resulted in different descriptions of the experience. These differences led to a discussion of the need of supervisor teams to enhance the validity of assessments. Conclusion: The findings showed that there were no significant differences in pass/fail gradings using the two different assessment instruments. The quantitative data suggests that supervisors struggled with subjectivity, phrasing, and definitions of the LO´s and the scales used in both instruments. This resulted in arbitrary assessments that were time-consuming and resulted in limited usage in the day-to-day assessment. To mitigate the subjectivity, supervisors suggested working in teams and conducting multiple assessments over time to increase assessment validity. [ABSTRACT FROM AUTHOR]

Background: A surgical team works in a high‐performance environment and is exposed to stress. Mindfulness practice is evidenced to reduce symptoms of stress, as well as burnout, which is high amongst health workers. The operating theatre is unique, with many job‐roles, needs and time‐critical tasks. It is plausible that group mindfulness may benefit the surgical team. This evaluates the take‐5 theatre brief, consisting of a 'check‐in' and short breathwork, when used by two surgical teams as part of the regular theatre team brief. Approach: The take‐5 theatre brief was evaluated using domains of acceptability and implementation. Data were collected at two district general hospitals in the United Kingdom using 5‐point Likert scales hosted on electronic surveys Thematic analysis was performed of participant voice notes, strategic meeting notes and transcripts of interviews between key informants. Evaluation: There were 17 participants. Ten were from site A (59%), with the remainder being from site B (41%) and covered a range of roles within the theatre team. Participants found the take‐5 theatre brief helpful (median Likert 5) and felt that it would benefit themselves (median Likert 5) as well as the team (median Likert 5) and that it fitted into the day easily (median Likert 4). There was a high demand, no financial investment was required and overall it was easy to implement; however, it became challenged in theatre lists that were late to start. Implication: The take‐5 theatre brief is an acceptable initiative for these two operating theatre teams. [ABSTRACT FROM AUTHOR]

Background: Voter initiatives in Oregon and Colorado authorize legal frameworks for supervised psilocybin services, but no measures monitor safety or outcomes. Aims: To develop core measures of best practices. Methods: A three-phase e-Delphi process recruited 36 experts with 5 or more years' experience facilitating psilocybin experiences in various contexts (e.g., ceremonial settings, indigenous practices, clinical trials), or other pertinent psilocybin expertise. Phase I, an on-line survey with qualitative, open-ended text responses, generated potential measures to assess processes, outcomes, and structure reflecting high quality psilocybin services. In Phase II, experts used seven-point Likert scales to rate the importance and feasibility of the Phase I measures. Measures were priority ranked. Qualitative interviews and analysis in Phase III refined top-rated measures. Results: Experts (n = 36; 53% female; 71% white; 56% heterosexual) reported currently providing psilocybin services (64%) for a mean of 15.2 [SD 13.1] years, experience with indigenous psychedelic practices (67%), and/or conducting clinical trials (36%). Thematic analysis of Phase I responses yielded 55 candidate process measures (e.g., preparatory hours with client, total dose of psilocybin administered, documentation of touch/sexual boundaries), outcome measures (e.g., adverse events, well-being, anxiety/depression symptoms), and structure measures (e.g., facilitator training in trauma informed care, referral capacity for medical/psychiatric issues). In Phase II and III, experts prioritized a core set of 11 process, 11 outcome, and 17 structure measures that balanced importance and feasibility. Conclusion: Service providers and policy makers should consider standardizing core measures developed in this study to monitor the safety, quality, and outcomes of community-based psilocybin services. [ABSTRACT FROM AUTHOR]

Disturbance in bodily experience (BE) is a potential adverse consequence of ventricular assist device (VAD) implantation. The concept BE encompasses all cognitive and affective processes related to the subjective experience of one's own body. A cross-sectional, multicenter study was performed, involving 365 VAD patients (85% male; time postimplant: 3-36 months). Patients completed a BE questionnaire (BE-S, 5-point Likert scale), and the disturbance in BE was analyzed based on sex, time since implantation (in the first, second, or third years postimplant), and patient acuity (elective vs emergent implantation). Subsidiary, patients' gratitude was surveyed. Disturbance in BE was not particularly pronounced (mean = 2.69, standard deviation = 1.17). Eighty-five percent of patients expressed high levels of gratitude. Disturbance in BE decreased (p = 0.04), while gratitude increased (p = 0.02) with time since implantation. Female patients showed more disturbance in BE (p = 0.01) and less gratitude (p = 0.01) compared to male patients. Among patients who underwent emergency implantation, the decrease in disturbance occurred predominantly in the third year, exceeding the level observed in elective implanted patients (p = 0.03). Disturbance in BE following VAD implantation does generally not reach excessive levels and tends to decrease over time. Our data indicate more disturbance and less gratitude in female patients. In emergently implanted patients, disturbance in BE is prolonged. Screening for disturbance in BE is recommended during follow-up, especially for these at-risk groups, to ensure early and focused psychological support. [ABSTRACT FROM AUTHOR]

To analyze the Big Three diagnostic errors (malignant neoplasms, cardiovascular diseases, and infectious diseases) through internists' self-reflection on their most memorable diagnostic errors. This secondary analysis study, based on a web-based cross-sectional survey, recruited participants from January 21 to 31, 2019. The participants were asked to recall the most memorable diagnostic error cases in which they were primarily involved. We gathered data on internists' demographics, time to error recognition, and error location. Factors causing diagnostic errors included environmental conditions, information processing, and cognitive bias. Participants scored the significance of each contributing factor on a Likert scale (0, unimportant; 10, extremely important). The Big Three comprised 54.1 % (n=372) of the 687 cases reviewed. The median physician age was 51.5 years (interquartile range, 42–58 years); 65.6 % of physicians worked in hospital settings. Delayed diagnoses were the most common among malignancies (n=64, 46 %). Diagnostic errors related to malignancy were frequent in general outpatient settings on weekdays and in the mornings and were not identified for several months following the event. Environmental factors often contributed to cardiovascular disease-related errors, which were typically identified within days in emergency departments, during night shifts, and on holidays. Information gathering and interpretation significantly impacted infectious disease diagnoses. The Big Three accounted for the majority of cases recalled by Japanese internists. The most relevant contributing factors were different for each of the three categories. Addressing these errors may require a unique approach based on the disease associations. [ABSTRACT FROM AUTHOR]

Objective: In the evolving landscape of medical research and radiology, effective communication of intricate ideas is imperative, with visualizations playing a crucial role. This study explores the transformative potential of ChatGPT4, a powerful Large Language Model (LLM), in automating the creation of schematics and figures for radiology research papers, specifically focusing on its implications for musculoskeletal studies. Materials and methods: Deploying ChatGPT4, the study aimed to assess the model's ability to generate anatomical images of six large joints—shoulder, elbow, wrist, hip, knee, and ankle. Four variations of a text prompt were utilized, to generate a coronal illustration with annotations for each joint. Evaluation parameters included anatomical correctness, correctness of annotations, aesthetic nature of illustrations, usability of figures in research papers, and cost-effectiveness. Four panellists performed the assessment using a 5-point Likert Scale. Results: Overall analysis of the 24 illustrations encompassing the six joints of interest (4 of each) revealed significant limitations in ChatGPT4's performance. The anatomical design ranged from poor to good, all of the illustrations received a below-average rating for annotation, with the majority assessed as poor. All of them ranked below average for usability in research papers. There was good agreement between raters across all domains (ICC = 0.61). Conclusion: While LLMs like ChatGPT4 present promising prospects for rapid figure generation, their current capabilities fall short of meeting the rigorous standards demanded by musculoskeletal radiology research. Future developments should focus on iterative refinement processes to enhance the realism of LLM-generated musculoskeletal schematics. [ABSTRACT FROM AUTHOR]

This study examined uniting public organization, transparency, and accountability theories for a holistic understanding of digital government service implementation in Indonesia. This study used a survey data collection method with 424 respondents for employees in four local governments. Questionnaires were generated using a Likert scale. Structural equation modeling‐partial least squares was used to assess the validity and reliability of the data and to test hypotheses and regression models. Following the testing of hypotheses and regression analysis, this study found that variables of employee skills, leadership, regulation, infrastructure, information and communication technology, transparency, and accountability had a positive and significant effect on the variable of digital government service implementation with p‐values of 0.034, 0.025, 0.014, 0.031, 0.009, 0.005, and 0.010, respectively. In contrast, variables of budgeting and bureaucratic structure do not positively and significantly impact the variable of digital government service implementation with p‐values of 0.210 and 0.311, respectively. The influence of the independent variables on the dependent variable was strong (R‐square = 0.834). The limitations and implications of these findings are discussed in the conclusion. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic resulted in modifications to resident selection. The success of these new recruitment strategies as well as the impact on trainee attrition and competency is unknown. We previously evaluated how selection of general surgery applicants changed early in the pandemic. Here we supplement that work by reporting further modifications to the recruitment process and the perceived impact on resident attrition and competency. An anonymous cross-sectional survey sent via the Association of Program Directors in Surgery listserv in June 2022 to programs directors (PDs) at Accreditation Council for Graduate Medical Education accredited general surgery programs. Surveys contained demographic questions, 5-point Likert scale questions evaluating factors related to recruitment and match process, and postgraduate year 1 performance. 60 PDs responded to the survey. PDs continue to value the same post-COVID factors related to determining a resident's commitment to surgery but began to shift back to nonvirtual based strategies to recruit applicants in this new interview cycle. PD commentary frequently noted desire to return to in-person interviewing. 5.4% of postgraduate year 1s comprising this first class of residents who underwent virtual-only interviews and rotations did not reach Accreditation Council for Graduate Medical Education level 1 milestones, similar to prior years. The attrition rate amongst this class increased from 1.3% to 2.7%. The attrition rate for postgraduate year 1 categorical general surgery residents has increased since the onset of the pandemic. The recruitment strategies adopted early in the pandemic have not maintained their initial perceived impact. [ABSTRACT FROM AUTHOR]

Simple Summary: This article introduces an animal welfare monitoring app based on the 2020 Five Domains Model that considers how an animal's nutrition, environment, health, and behavioural interactions, influence their mental state. Adapted for smartphone use, the Mellorater app allows animal guardians (carers, keepers, and owners) to record structured observations of an animal's life-world with a free research-backed tool. The aim is to help them monitor and improve their animal's daily lived experiences, make better management decisions, and achieve a good life for their animals. Completing the checklist does not require specialist training and a user-guide with step-by-step instructions on using the app is provided. Users respond to 18 statements by noting their level of agreement with each statement, using a five-point scale from strongly disagree to strongly agree. The authors acknowledge that this form of self-reporting has some limitations but propose that these may be outweighed by the benefits of structured monitoring being repeated over time. This approach helps to identify ongoing shortfalls in an animal's life-world and trends in their observed quality of life indicators. Both of these outcomes may stimulate contact with sources of further advice, including veterinarians and other animal health and welfare professionals. When monitoring an animal's welfare, it helps to have comprehensive and day-to-day information about the animal's life. The goal is to ensure that animal guardians (carers, keepers, and owners) use such information to act in the animals' best interests. This article introduces the Mellorater, an animal welfare monitoring app based on the 2020 Five Domains Model. This framework provides a means of capturing comprehensive information about the world in which individual animals exist. The Mellorater asks animal guardians to rate their agreement with 18 statements covering any focal animal's nutrition, environment, health, and behavioural interactions using a five-point Likert scale. No specialist training is required other than following straightforward instructions on using the app, which are provided. The Mellorater is not proposed as a validated welfare auditing tool because it relies on reflective self-reporting and, thus, is vulnerable to the user's subjectivity. If users' subjectivity is stable over time, then the longitudinal data may be considered useful proxies for trends in quality of life. That said, it has the potential to be used by trained auditors if scientifically validated, species-specific indicators are applied. The Mellorater collects anonymous data and has been approved for a study to explore how the use of such scales may differ among guardians of different species and in different contexts. In this paper, we conduct the following: (1) summarise the app's purposes; (2) clarify its capabilities and limitations; and (3) invite animal welfare scholars, veterinarians, health and welfare professionals, and animal guardians to use it. [ABSTRACT FROM AUTHOR]

The Integrated Course Design (ICD), using Fink's taxonomy of significant learning, popularly known as ICD/SL, is a handy way to create a better learning environment for students. It is a learner-centered approach with the desired end-product, but at the same time, it upgrades the teaching by improving the instructors' delivery mechanism. Our goal of this study was to see whether ICD/SL affects students' class participation and academic performance in the "Introduction to Bioinformatics" course offered at the Department of Biological Science, BITS Pilani, Pilani campus, India. Three class groups were chosen for this purpose: 2019–2020 (51 students), 2020–2021 (77 students), and 2021–2022 (72 students). The control group, 2019–2020, received no ICD/SL instruction; the remaining two groups, 2020–2021 and 2021–2022, received ICD/SL instruction that included revised learning goals based on Fink's taxonomy and new teaching and evaluation activities. A Likert scale was utilized to assess students' academic feedback using the Kruskal–Wallis test to determine the P-value. The findings showed that the treatment groups had higher class participation and academic performance in the summative assessment of final grades. In the experimental groups, the class participation was 23 to 27% higher compared to the control group. The absenteeism rate on the course decreased from 14% in 2019–2020 to 9% in 2020–2021 and 4% in 2021–2022. Also, in the treatment groups, 83 to 90% of students were in the High to Excellent category, compared to 74% in the control group. The failure rate of the course decreased from nearly 18 to 10% in 2021–2022 and only 6% in 2020–2021. There were significant differences between the treatment and control groups in class participation and academic performance (P < 0.05). This study has shown that the use of ICD/SL has the potential to improve students' class participation and academic performance. [ABSTRACT FROM AUTHOR]

Background: Informed consent is a relevant backdrop for conducting clinical trials, particularly those involving children. While several factors are known to influence the willingness to consent to pediatric anesthesia studies, the influence of study design on consenting behavior is unknown. Aims: To quantify the impact of study complexity on willingness to consent to pediatric anesthesia studies. Methods: We conducted a vignette‐based interview study by presenting three hypothetical studies to 106 parents or legal guardians whose children were scheduled to undergo anesthesia. These studies differed in level of complexity and included an example of a prospective observational study, a randomized controlled trial, and a phase‐II‐pharmacological study. Primary outcome was the willingness to consent, using a 5‐point Likert scale ranging from "absolutely consent" to "absolutely decline". Secondary outcomes were the effects of child‐related (such as sex, age, previous anesthesia, research exposure) and proxy‐related factors. Results: Response probabilities for "absolute consent" were 90.9% [95% CI 85.3–96.5] for the observational study, 48.6% [95% CI 38.3–58.9] for the randomized controlled trial, and 32.7% [95% CI 23.9–41.6] for the phase‐II‐pharmacological study. Response probabilities for "absolutely decline" were 1.6% [95% CI 0.3–2.8], 14.4% [95% CI 8.3–20.5], and 24.7% [95% CI 16.6–32.7], respectively. Significant effects were found for previous research exposure (OR = 0.486 [95% CI 0.256–0.923], p =.027), older age (OR = 0.963 [95% CI 0.927–0.999], p =.045) and the gender of the parent or legal guardian, as mothers were less willing to consent (OR = 0.234 [95% CI 0.107–0.512], p <.001). Conclusions: Willingness to consent decreased with increasing level of study complexity. When conducting more complex studies, greater efforts need to be made to increase the enrollment of pediatric patients. [ABSTRACT FROM AUTHOR]

In national and international surveys, life satisfaction is often measured by a single item. However, there is a lot of debate in survey research about whether rating scales should be ordered in an ascending order (from negative to positive) or a descending order (from positive to negative). We investigate the effect of scale orientation by randomly assigning both versions in an online survey (N = 3,138). The average reported life satisfaction is 0.7 points lower when the descending version of an 11-point scale is used, as compared to the ascending scale (p < 0.001). We further test the construct validity by correlating each version of the response scales with other measures related to life satisfaction (e.g. happiness, depressive mood, and physical health). Generally speaking, the correlations of the ascending scale are significantly stronger as compared to the descending scale, indicating higher validity. Moreover, we investigate the impact of horizontal versus vertical presentations of the 11-point life satisfaction answer scale. Our results indicate that there are no statistically significant differences between horizontally and vertically presented response scales. We conclude that the order of response scales should be chosen carefully, as it affects the measurement of life satisfaction. Overall, our results suggest using an ascending life satisfaction scale. [ABSTRACT FROM AUTHOR]