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Interventions involving simulated interactions aimed at mimicking real situations must be engaging to maximize their effectiveness. This study aimed to assess how a sample of middle school girls displayed behavioral and cognitive indicators of engagement when interacting with avatars representing game characters that were controlled by a human digital puppeteer. The simulation game, DRAMA-RAMA, is a component of an intervention intended to reduce at-risk girls' sexual and other risky behaviors. We used verbal/nonverbal behaviors and surveys to assess the game players' cognitive and behavioral involvement (N = 131). Participants perceived the game scenarios and interactions as realistic and the characters as similar to people in real life. Participants' behavior indicated their involvement and interest in interacting with the game characters. Finally, participants tended to be appropriate but not effective when attempting to advise/support the characters. These findings have implications for assessing successful operationalization of communication designs in interactive virtual learning environments. [ABSTRACT FROM AUTHOR]

Background & purpose: Previous research has noted that Hispanic pre-adolescents may be at an increased probability for engagement in risk-taking behaviors. The purpose of this study was to explore parent-child communication among Hispanic parents and 4th-6th grade children related to substance use, puberty, sex, and social media use. Methods: A qualitative descriptive design was used to examine Hispanic parents'/caregivers' communication with their children about substance use behaviors, pubertal developments, engagement in sexual risk behaviors, and social media use. The study included two components: four focus groups consisting of 23 children; five focus groups and one interview consisting of 24 adults. All were conducted until data saturation was reached. Parents and pre-adolescents were interviewed separately. Interviews with parents and pre-adolescents were audio-recorded, transcribed verbatim, and analyzed using content analysis techniques. Results & conclusion: The themes that emerged from the interviews were about children's feelings, parents' feelings, communication messages that children received from their parents, and information parents provided to their children during parent-child communication. The results indicate discrepancies between information that parents provided and information that the pre-adolescents reported. The results have implications for healthcare providers in that parents need to be better educated on communicating effectively with their pre-adolescents about risk-taking behaviors. Healthcare providers may help facilitate parent-child communication with Hispanic families. More research is needed to develop intervention programs for Hispanic parents to learn how to effectively communicate with their pre-adolescent children in a developmentally appropriate manner. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the characteristics of hypozincemia in long COVID patients. Methods: This study was a single-center retrospective observational study for outpatients who visited the long COVID clinic established in a university hospital during the period from 15 February 2021 to 28 February 2022. Characteristics of patients with a serum zinc concentration lower than 70 μg/dL (10.7 μmol/L) were compared with characteristics of patients with normozincemia. Results: In a total of 194 patients with long COVID after excluding 32 patients, hypozincemia was detected in 43 patients (22.2%) including 16 male patients (37.2%) and 27 female patients (62.8%). Among various parameters including the background characteristics of the patients and medical histories, the patients with hypozincemia were significantly older than the patients with normozincemia (median age: 50 vs. 39 years). A significant negative correlation was found between serum zinc concentrations and age in male patients (R = −0.39; p < 0.01) but not in female patients. In addition, there was no significant correlation between serum zinc levels and inflammatory markers. General fatigue was the most frequent symptom in both male patients with hypozincemia (9 out of 16: 56.3%) and female patients with hypozincemia (8 out of 27: 29.6%). Patients with severe hypozincemia (serum zinc level lower than 60 μg/dL) had major complaints of dysosmia and dysgeusia, which were more frequent complaints than general fatigue. Conclusions: The most frequent symptom in long COVID patients with hypozincemia was general fatigue. Serum zinc levels should be measured in long COVID patients with general fatigue, particularly in male patients. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to examine public health nursing (PHN) students' experiences delivering peer‐to‐peer health education to college students during a health fair. Design: A qualitative, descriptive research design was used. Sample: Senior‐level nursing students (n = 13) completing the clinical portion of a PHN course. Measurements: A semi‐structured focus group guide consisting of 10 questions and follow‐up probes was used to elicit PHN student experiences. Focus groups were recorded, transcribed, and analyzed using a thematic analysis technique. Results: Five main themes were identified: (1) benefits of health fairs in general, (2) benefits of nursing‐student‐led health fairs, (3) negatives of nursing‐student‐let health fairs, (4) importance of interaction, and (5) suggestions for maximizing the potential of nursing student‐led health fairs. Conclusions: Although challenges exist, PHN students experienced several benefits from the provision of peer‐to‐peer health education. College campuses represent a unique clinical site that allows nursing students to utilize their insider status to better assess, understand, and provide tailored health education to the college community. This clinical site has shown to provide positive experiences for nursing students and is critical in developing essential nursing skills and building confidence for future clinical rotations. [ABSTRACT FROM AUTHOR]

Introduction: Hispanic adolescents are at high risk of engaging in sexual risk-taking behaviors. Parent–child communication protects against such behaviors. Among Hispanic families, it is critical to explore how cultural characteristics influence mothers–daughter communication about sex. The purpose of this qualitative study was to understand how cultural values influence mothers' communication about sex with their early adolescent Hispanic daughters. Methodology: Twenty-one Hispanic mothers of seventh-grade daughters participated in this focus group study. Directed content analysis was used to analyze the data. Results: Four Hispanic cultural values (familismo, machismo, marianismo, and respeto) and how each value influences mother–daughter communication about sex were identified. While mothers want to protect their daughters, there are multiple cultural norms that made it challenging for them to have critical conversations. Discussion: The study informs researchers and clinicians how to facilitate parent–child conversations about sex and to equip parents to teach their children how to avoid engaging in sexual risk-taking behaviors. [ABSTRACT FROM AUTHOR]

Objective: Two percent of the Japanese population is comprised of foreign residents with further increase expected due to immigration policy revisions. The purpose of this paper is to examine the healthcare needs and difficulties experienced by foreign residents in Japan by level of their Japanese language fluency. Design: A quantitative, descriptive design was used. Sample: We surveyed foreign residents in the greater Tokyo area (N = 209). Measurements: The research team created the survey questions and the contents of the survey include foreign residents' experiences during their visits or stays at medical and public health facilities in Japan. Results: More than 90% of the participants or their families visited medical facilities in Japan regardless of Japanese language fluency; however, those with less Japanese language fluency experienced statistically significant uneasiness or inconvenience concerning communication compared to those with native Japanese language fluency (p =.000). Conclusions: Nurses in Japan may benefit from additional training related to use of interpreters as well as education about diversity and cultural humility. Through better understanding of the specific communication barriers of foreign residents, nurses will be able to better anticipate difficulties and address them. [ABSTRACT FROM AUTHOR]

Objectives: Five nationally representative U.S. federal data sources consistently showed the link between poverty and poor health outcomes. To determine the modality effective in teaching students about poverty and health, this study compared the attitudes toward poverty of students participating in the Community Action Poverty Simulation (CAPS) and the poverty table‐top simulation (Dwell™). Methods: In this quasi‐experimental study, undergraduate and graduate nursing students and physical therapy students participated in either CAPS or a table‐top simulation (TTS) depending on their semester of enrollment in the relevant course. The Undergraduate Perception of Poverty Tracking Survey (UPPTS) was administered before and after each simulation. Results: The analysis included 118 matched pairs. Using MANOVA tests, the authors found no group difference in the overall change of attitude after the simulations (p =.232). However, by the subscale analyses, TTS significantly increased students' willingness to help (p =.008, η2 = 0.058) and their empathy toward those living in poverty (p =.039, η2 = 0.039). Conclusion: TTS participants had more elements of improvement, but both modalities were found to change participants' attitudes. [ABSTRACT FROM AUTHOR]

Introduction: Innovative and culturally sensitive strategies are needed to promote research participation among minorities and develop targeted interventions aimed at decreasing health disparities. The purpose of this article is to illustrate application of the EERC (evaluate, engage, reflect, and carefully match) guidelines in facilitating participant recruitment in a study exploring infant feeding practices of Hispanic mothers. Methodology: Retrospective application of the EERC guidelines assessed using data extracted from the researcher-study recruitment field notes. A systematic categorical process was used to determine if each of the guidelines' key concepts were incorporated in the recruitment process. Results: Successful recruitment of 62 immigrant Hispanic mothers (approximately 82% of target goal) was accomplished through implementation of most of EERC criteria (90%) in planning and recruitment phases of the study. Discussion: Application of EERC guidelines facilitates recruitment of minority populations. Enhanced participant recruitment assists in assessment of population-unique conditions and targeted interventions leading to disease prevention and improved outcomes. [ABSTRACT FROM AUTHOR]

Mothers' mental health or substance use disorders impact the behaviours of their children both short‐term and long‐term. There is increased concern for mothers with mental health or substance use disorders to effectively handle parenting challenges. Children of these mothers are at risk for emotional and behavioural adjustment problems as well as poor academic performances. Parenting self‐agency refers to parents' perceptions of their confidence and ability to overcome barriers and manage issues in parenting. Examining the factors that predict parenting self‐agency aids in understanding how nurses can assist mothers and families. The purpose of this study was to explore predictors of parenting self‐agency among mothers who are impacted by mental health or substance use disorders. A secondary analysis was conducted using the baseline assessment data of a randomized trial that examined the efficacy of a nurse‐led family‐strengthening home‐health intervention. The data were obtained from 172 mothers who were receiving outpatient treatment for substance use or other mental health disorders and had children under 18. A multivariate linear regression analysis was conducted to find predictors of parenting self‐agency among participating mothers. The authors found that increased children's externalizing problems and intensity of hassle predicted lower parenting self‐agency, and family cohesion predicted higher parenting self‐agency. The authors conclude that treatments need to address family as a whole to increase mothers' parenting self‐agency, thus assisting these mothers in raising their children in the best possible environment. [ABSTRACT FROM AUTHOR]

Purpose: Implementation quality (IQ), a critical concept for translational science, measures the discrepancy between an intervention's intended design and its implementation. Quantifying the impact of IQ on intervention outcomes informs efforts to improve intervention translatability. The purpose of this article is to define and describe IQ and its dimensions (content adherence, quality of delivery, and engagement) with a focus on individualized interventions being delivered in research and practice settings. Approach: We apply IQ concepts from intervention science in two contexts: (a) an intervention currently being investigated in an efficacy trial, and (b) a practice situation involving the application of evidence‐based practice guidelines during clinic visits. IQ measurement approaches are presented using a study protocol, progress notes, interdisciplinary meeting notes, or clinical guidelines, depending upon whether the intervention is delivered during a research study or a clinical encounter. Conclusions: The investigators describe the necessary infrastructure and support for capturing IQ data and the subsequent complexities and challenges of collecting, measuring, and analyzing these data. Understanding IQ is critical to advancing translational science. Such understanding informs application of appropriate IQ measures, and promotes effective translation of evidence‐based interventions into practice. Policy changes are needed to promote IQ assessment to ensure high‐quality clinical encounters during which interventions are effectively delivered. Clinical Relevance: In both research and practice settings, the conceptualization and measurement of IQ will improve patient outcomes by advancing translational science and integrating evidence‐based interventions into nursing practice. [ABSTRACT FROM AUTHOR]

The Latino population in the United States is quickly growing, and its unintended pregnancy rate is increasing. To decrease unintended pregnancies, couples must mutually agree on family planning. Communication between partners is one key factor identified in successful family planning for couples. Therefore, the purpose of this study was to examine sexual communication and its associations with sexual relationship power, general communication, and views on family planning. The Actor-Partner Interdependence Model was used to analyze dyadic influences of the chosen variables. Forty immigrant Latino couples were recruited from prenatal care clinics. The study results were grouped according to the three types of power structures: exhibition of men's traditional machismo values, exhibition of women's increased power in their relationships, and exhibition of men's and women's own empowerment with sexual communication. There was a negative association between men's views on family planning and women's sexual communication (exhibition of machismo values); a negative association between women's sexual relationship power and their partners' sexual communication (exhibition of women's increased power); and positive associations between men's and women's general communication and sexual communication (exhibition of men's and women's own empowerment). Dyadic influences of sexual communication and associated variables need to be incorporated into interventions to facilitate family planning for couples. [ABSTRACT FROM AUTHOR]

The flipped classroom approach is an innovative teaching method to promote students' active learning. It has been used in nursing education and has showed positive results. The purpose of this article is to describe the process of developing a flipped classroom approach for an undergraduate evidence-based nursing practice course and discuss lessons learned from the process and the evaluation data. Although students may initially resist changes to the classroom environment, the flipped classroom offers a promising approach that promotes active learning and accommodates a variety of learning styles. [ABSTRACT FROM AUTHOR]

We investigated the water-depth dependence of the self-motion of a camphor disk and camphor boat. With increasing water depth, the speed of motion of the camphor disk increased, but that of the camphor boat decreased in an annular one-dimensional system. We discussed the difference in the water-depth dependence of the speed of the camphor objects in relation to Marangoni flow. We concluded that Marangoni flow, which became stronger with increasing the water depth, positively and negatively affected the speed of the disk and boat, respectively. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the relationship between the number of unintended pregnancies and current contraceptive use. This is a secondary analysis of a cross-sectional survey, the 2006–2008 National Survey of Family Growth, which included 4,052 women between the ages of 15 and 44 years. A statistically significant association was found between the nonuse of contraceptives and repeated unintended pregnancies, as well as among those who used an effective contraceptive method and repeated unintended pregnancies. Nurses are encouraged to ask questions about intendedness of pregnancies during women's visits and help women choose appropriate contraceptive methods. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the relationship between the number of unintended pregnancies and current contraceptive use. This is a secondary analysis of a cross-sectional survey, the 2006–2008 National Survey of Family Growth, which included 4,052 women between the ages of 15 and 44 years. A statistically significant association was found between the nonuse of contraceptives and repeated unintended pregnancies, as well as among those who used an effective contraceptive method and repeated unintended pregnancies. Nurses are encouraged to ask questions about intendedness of pregnancies during women's visits and help women choose appropriate contraceptive methods. [ABSTRACT FROM PUBLISHER]

Aim: This study aims to translate the Healthy Work Environment Assessment Tool (HWE-AT) into Japanese and evaluate its validity and reliability. Design and methods: The authors followed the guidelines for scale translation, adaptation, and validation in cross-cultural healthcare research. After translation and back-translation, a series of pilot studies were conducted to assess comprehensibility. Subsequently, an expert panel established the content validity. Content validity was calculated using the content validity index (CVI). Finally, we verified the construct validity and calculated the test-retest reliability. Results: The updated HWE-AT achieved sufficient comprehensibility after conducting the two pilot tests. Content validity was calculated using the scale-level CVI/average and all the items were 1.00. The content validity indices CFI and RMSEA were 0.918 and 0.082, respectively. Intraclass correlation coefficients for all dimensions ranged from 0.618 to 0.903, indicating acceptable test-retest reliability. Our findings suggest that the Japanese version of the HWE-AT has good validity and reliability. [ABSTRACT FROM AUTHOR]

Determination of long COVID requires ruling out alternative diagnoses, but there has been no report on the features of alternative diagnoses. This study was a single-center retrospective study of outpatients who visited our clinic between February 2021 and June 2023 that was carried out to determine the characteristics of alternative diagnoses in patients with post-COVID-19 symptoms. In a total of 731 patients, 50 patients (6.8%) were newly diagnosed with 52 diseases requiring medical intervention, and 16 (32%) of those 50 patients (2.2% of the total) were considered to have priority for treatment of the newly diagnosed disorders over long COVID treatment. The proportion of patients with a new diagnosis increased with advance of age, with 15.7% of the patients aged 60 years or older having a new diagnosis. Endocrine and metabolic diseases and hematological and respiratory diseases were the most common, being detected in eight patients (16%) each. Although 35 of the 52 diseases (67%) were related to their symptoms, endocrine and metabolic diseases were the least associated with specific symptoms. Other disorders that require attention were found especially in elderly patients with symptomatic long COVID. Thus, appropriate assessment and differentiation from alternative diagnoses are necessary for managing long COVID. [ABSTRACT FROM AUTHOR]

Purpose: To expose students to various public health roles and complement clinical experience using simulated encounters. Design: This exploratory study assessed students' performance of basic nursing tasks for three public health nurse roles. Methods: 15-guided questions were used to evaluate a convenience sample of 137 students' expected performance compared to their actual performance of basic nursing skills. Findings: Students' performed well in all nurse roles with some significant differences in completing a few critical tasks in the case manager and school nurse roles. Conclusion: Simulation can address gaps in nursing programs and expose student nurses to various public health roles using real-life scenarios. Clinical Evidence: Lack of clinical sites in public health limits students' experience to a myriad of nurse functions within communities. [ABSTRACT FROM AUTHOR]

Objective: Public health nursing courses typically incorporate clinical components but rarely offer simulation education as part of clinical practice. There is limited research examining the impact of simulation for public health nursing courses on final exam scores. The objective of this study was to determine the impact of simulation training on final exam scores in a public health nursing course. Design: Public health scenarios were created to provide hands‐on experience in two settings. Home and school environments were used with discussion of students' performance during debriefing. Sample: Using a convenience sample, final exam scores were compared between nursing students (n = 79) who participated in a public health nursing simulation and two similar student groups (n = 97) that did not participate in simulation. Results: Students with simulation training scored higher in both public health domains (Community Health; Clinical Prevention and Population Health). A significant difference in total mean final scores (p =.04; p =.02) was noted between groups of students with simulation training and those without. Conclusion: The difference in mean final scores suggests that simulation may be an effective educational modality in preparing students toward their state board or end of semester exams. [ABSTRACT FROM AUTHOR]

Abstract: Background: Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. Aims: The purpose of this manuscript is to describe a PHN‐student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge. Methods: Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open‐ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process. Results: We report that results from participants surveyed indicated that PHN‐student delivered health fairs improved health knowledge among community members in this sample (p = .000). Conclusion: Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community. [ABSTRACT FROM AUTHOR]

Developmental delay in very young children is trending upward. Maternal depressive symptoms are known to negatively impact child development and may also impact family management of the child's condition. Research on family management guided this second phase of a sequential mixed methods study. The purpose of this study was to explore mothers' perceptions of family management of their children's developmental delays. Mothers of very young children who received early intervention services were interviewed. A team-based content analysis approach revealed key findings: (a) views of the child that were not holistic, (b) condition management ability was informed by what the mother thought her child needed, (c) views of condition impact were related to adapting to possible child outcomes and experiences of isolation, and (d) parental/caregiver mutuality was impaired by conflict. Understanding perceptions of family management and influence of depressive symptoms in this context is essential to extend assessment and intervention. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to determine the clinical and endocrinological features of sleep disturbance in patients with long COVID. Methods: This study was a single-center retrospective observational study for patients who visited the COVID-19 aftercare outpatient clinic (CAC) established in Okayama University Hospital in Japan during the period from 15 February 2021 to 29 July 2022. The long COVID patients were divided into two groups based on the presence or absence of sleep disturbance, and the clinical and laboratory characteristics of the patients were analyzed. Results: Out of 363 patients with long COVID, after excluding 6 patients, 60 patients (16.5%) (55% males, median age of 38 years) complaining of sleep disturbance were compared with 303 patients (83.5%) (43% males, median age of 40 years) without sleep-related symptoms. Although there were no significant differences in clinical backgrounds and severities of COVID-19 between the two groups by the multivariate analysis, the percentage of long COVID patients with sleep disturbance was significantly increased among patients infected in the Omicron-dominant phase. In addition, the prevalence rate of sleep disturbance in patients when infected in the Omicron phase (24.8%) was two-times higher than that in patients infected in the Delta phase (12.8%). Of note, the percentages of patients with sleep disturbance who also complained of general fatigue, headache, concentration loss, anxiety, low-grade fever, and brain fog symptoms were higher than the percentages of patients without sleep disturbance who had the same complaints. Among the types of sleep disturbance, the percentage of patients who complained of loss of sleep induction (75%) was much higher than the percentage of patients with early-awakening sleep disturbance (6.7%), and many of the patients with mid-awakening types of insomnia had brain fog symptoms. Endocrine examinations revealed that long COVID patients with sleep disturbance had significantly higher levels of plasma adrenocorticotropin and lower levels of serum growth hormone, suggesting the presence of hypothalamic–pituitary stress. Conclusion: The prevalence of sleep disturbance has been increasing in long COVID patients infected in the Omicron phase with a certain clinical and endocrine trend. [ABSTRACT FROM AUTHOR]

A simpleself-propelled motor on a 4-[[(dodecyloxy)benz-4-yl]azo]benzoicacid (DBA) molecular layer was investigated from the viewpoint ofmotor control depending on the molecular structure. The nature ofthe self-motion of a camphor disk on the DBA molecular layer changeddepending on the surface pressure (π)–area (A) isotherm of DBA, which in turn changed by the photoisomerizationbetween UV and green lights. The characteristic motion of the camphordisk is discussed in relation to the π–Aisotherm of DBA, which changes depending on the photoisomerizationas the driving force of motion. [ABSTRACT FROM AUTHOR]

The first phosphinoboronic ester bearing a fused bicyclic framework was synthesised by either deprotonation and hydride abstraction or Rh-catalysed dehydrogenation of a hydrophosphineboronic ester. The phosphinoboronic ester reacted as a Lewis acid with KF/18-crown-6, pyridine and DMAP to give the corresponding adducts. Furthermore, its crystal structure shows a remarkably short P–B bond in comparison with other P–B bonded derivatives in spite of the trigonal pyramidal geometry of the phosphorus. Consistent with the phosphorus pyramidality, the π-type donor–acceptor interaction of the P–B bond is small as revealed by the DFT calculations. The P–B bond shared within the fused six-membered rings has to shorten because of the geometrical requirement and high s-character of the boron. [ABSTRACT FROM AUTHOR]

Objective A higher rate of depressive symptoms is found among mothers of children with disabilities compared to other parents. However, there is a lack of study of mothers with children <3 years of age participating in Early Intervention (EI) programs. This study aims to more fully describe the extent of mood disorders in these mothers including estimated prevalence, severity and factors associated with maternal mental health, using gold standard clinical diagnostic and symptom measures, and test models associating depressive symptoms with contextual factors and child behavior. Methods A cross-sectional study was conducted with 106 women who had at least one child enrolled in EI. Mothers were interviewed and completed reliable, valid measures to evaluate mental health, health status, family conflict, parent-child interaction, self-efficacy, social support, child behavioral problems, hardship, endangerment, and child disability. Descriptive statistics and multivariate analyses were performed. Results We found 8 % of participants met all criteria for a Major Depressive Episode (MDE) with 44 % of the sample reporting a past episode and 43 % endorsing recurrent episodes. Using the CES-D to assess depressive symptom severity approximately 34 % of mothers screened in a clinically significant range. Using linear regression to predict severity of current depressive symptoms demonstrated that current depression severity was primarily predicted by poorer maternal health status, lower self-efficacy and past MDE ( p < 0.05). Conclusions for practice A brief assessment of maternal mood, health and self-efficacy are important factors to assess when evaluating how to support mothers of children in EI. [ABSTRACT FROM AUTHOR]