Introduction: The attitudes and behaviors of healthcare workers towards medical waste represent a significant concern for public health. This study aimed to determine the attitudes and behaviors of primary healthcare workers towards medical waste. Method: The population of this descriptive study consisted of 207 nurses, doctors, midwives, and EMTs working in 24 family health centers, 1 enhanced migrant health center, and 1 district health directorate in a district of Istanbul. The sample size was determined to be 172 using G Power. Data were collected between January and February 2025 using a “Descriptive Information Form” and the “Medical Waste Attitude and Behavior Scale” (MWABS). A total of 172 participants were reached, and the data were analyzed using SPSS. Ethics committee approval was obtained. Results: 77.3% of the participants were female, 48.8% had a bachelor's degree, the mean age was 38.84±9.20, 37.2% were nurses, 37.8% were physicians, and 19.8% were midwives. 90.7% had 4 years or more of professional experience, and 14% were managers. Medical waste training was given to 63.4% of the participants. In the study, statistically significant differences were found between MWABS scores according to age, gender, professional experience, and place of work (p<0.05). Conclusion: It was found that women, participants aged 30 years and older, those with more than 4 years of professional experience, and migrant health center workers had better attitudes and behaviors towards medical waste than others. It is recommended that beginner healthcare workers be given training on medical waste.

Joint developmental trajectories of fear of recurrence and coping behaviors among patients with lung cancer: A parallel process latent class growth analysis.

Reading is a perennial issue in the country, where many learners experience frustration and difficulties with reading. Remedial reading helps struggling learners enhance their comprehension skill and their reading abilities. This study aimed to identify the issues and challenges in teaching remedial reading in selected districts of Misamis Oriental School Year 2024–2025. It describes teachers' characteristics, assesses the level of issues and challenges in teaching remedial reading, and determines their significant relationships. The study employed a descriptive correlational method, a researcher-made questionnaire, and a stratified random sampling technique to identify the 200 teachers handling remedial reading classes. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to describe the variable in the study. Pearson's r was used to determine the relationship between the respondents' issues and challenges in teaching remedial reading, as well as their individual characteristics. The results show that most respondents are female teachers, predominantly mid-career, with over a decade of experience, holding a bachelor's degree, and having attended training at the school or district level, with an attitude towards teaching remedial reading. Respondents demonstrated their understanding of the issues in teaching remedial reading, with the highest variable in effective and innovative strategies, approaches, and styles. In contrast, unfamiliarity with letters, sounds, words, and correct pronunciation was the lowest. On the other hand, the respondents' level of challenges in teaching remedial reading, having a variable in rapport with the classroom, was the highest mean. In conclusion, challenges in teaching remedial reading are addressed through practical and effective strategies, including addressing learners' unfamiliarity with letters, sounds, and pronunciation, as well as the importance of establishing a rapport in the classroom. It is recommended that teachers and school heads collaborate to enhance remedial reading through targeted practice, phonics instruction, training, and a reduced teachers’ workload.

Globally, approximately 15million infants are born each year prematurely, increasing their risk of developmental challenges. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is a family-centered model designed to optimize neurodevelopmental outcomes in preterm infants. Nurses play a crucial role in applying NIDCAP principles; however, their knowledge, attitudes, and practices (KAP) are often hindered by inadequate training, limited resources, and institutional barriers. In Saudi Arabia, evidence on NIDCAP implementation remains scarce, particularly in the Eastern Province. This descriptive cross-sectional study was conducted among NICU nurses from two tertiary hospitals in the Eastern Province. Data were collected using a validated, structured questionnaire administered to 125 nurses (response rate: 97.6%). The survey collected demographic data, knowledge, attitudes, and practices related to NIDCAP. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson's correlations were performed, with statistical significance set at p < 0.05. Most respondents were female, aged 31-40 years, with bachelor's degrees and extensive NICU experience. Nurses showed moderate knowledge (M = 7.82/11), with gaps in long-term developmental outcomes and paternal involvement. Attitudes were highly positive (M = 23.44/27), reflecting strong support for clustering care and breastfeeding, though concerns about staffing and resources persisted. Practices were frequently applied (M = 28.81/33), particularly cue-based care and environmental modifications. Knowledge and attitudes were significantly associated with marital status, while practice correlated with supportive institutional policies, including 24-hour parental visitation. NICU nurses in Saudi Arabia exhibit positive attitudes and moderate knowledge and practice levels regarding NIDCAP. However, inconsistent application remains due to limited formal training, inadequate staffing, and insufficient institutional support. Strengthening structured education, enhancing organizational policies, and fostering leadership commitment are essential to bridge the gap between awareness and practice. Implementing these strategies can optimize developmental care delivery and improve health outcomes for preterm infants. Not applicable.

Men who have sex with men (MSM) with perianal condyloma face compounded health care challenges within structural inequities. Current research poorly characterizes their medical experiences, including barriers to care, psychosocial stressors, and policy-driven exclusion. Human papillomavirus (HPV)-related perianal condyloma in MSM is associated with high recurrence, diagnostic delays, and limited preventive access, underscoring the need to address systemic disparities. To explore health care experiences of MSM with perianal condyloma, identify multilevel care barriers, and characterize structural oppression affecting clinical outcomes. This qualitative study used semistructured interviews and qualitative analysis. Twenty MSM with confirmed perianal condyloma acuminatum were purposively sampled via clinician referrals. Inclusion criteria included age of 18 years or older and the capacity to provide informed consent. The study was conducted at a tertiary hospital (First Affiliated Hospital of China Medical University, Northeast China). Data were collected from January 1 to March 31, 2025, and analyzed from March 31 to June 30, 2025. Thematic analysis and grounded theory were used to identify barriers across 4 levels (individual, clinical, societal, and policy) and reflect how multiple barriers contribute to structural oppression. Twenty MSM (mean [SD] age, 23.95 [4.36] years) participated in the study. Of the 20 MSM, 10 (50%) were students, 17 (85%) had a bachelor's degree or higher, 13 (65%) identified as gay, and 9 (45%) engaged in exclusive anal-receptive intercourse. The mean (SD) monthly income was ¥4725 (¥2573). Regarding health care visits, 8 (40%) visited for active disease, 5 (25%) used private health care, and 1 (5%) had HIV coinfection. Participants faced synergistic barriers: (1) gaps in HPV knowledge, reliance on unverified online information, and risky sexual behaviors (individual level); (2) fragmented care pathways, privacy violations, and postoperative trauma (clinical level); (3) stigma-driven identity concealment, social isolation, and relationship strain (societal level); and (4) exclusion from HPV vaccination, lack of male-adapted screening tools, and inadequate sexual health education (policy level). Together, these barriers reflect how clinical neglect and structural oppression emerge and how their intersection perpetuates health care disparities among MSM with perianal condyloma. In this qualitative study of MSM with perianal condyloma, the findings suggest that privacy-protected care, standardized protocols, inclusive prevention strategies, and practitioner cultural competency training are required. These findings also emphasize the urgent need for equity-focused sexual health policies to address the needs of marginalized populations.

Improving the quality of health workers working in primary services, especially community health centers, is very important by keeping up with developments and improving health services, becoming professional services. The Community Health Center consists of several service sections, namely general BP, dental services, nutritional counseling, environmental health, laboratory, KIA services, MTBS, etc. so that all these personnel provide services to all customers or patients who need them so they really need support in services from various fields, furthermore the integrated ANC service which is a government program to reduce MMR and AKB really needs support from various fields so that the integrated ANC can be maximized. purpose To find out the leadership's support in improving the quality of health workers, services at general BP and maternal and child health (MCH), especially the implementation of Integrated ANC, as well as the factors that hinder improving the quality of general BP services and integrated ANC services.Method; The research is qualitative with interviews with the head of the health center, the health center midwife and the Kia midwife of the Health Service, totaling 26 respondents. The interviews were conducted with in-depth questions, so the respondents were the object of the research and the research was the subject of the research.Result; The characteristics of respondents or informants regarding age 41-50 years are 76.92%, all education is bachelor's degree 100%, the majority of occupations are general practitioners 84.67%, the longest length of service is 10 years. Meanwhile, for leadership support in improving the quality of health workers, services at general BP and maternal and child health (KIA), especially the implementation of Integrated ANC. The majority of community health center leaders support this, but there are still some leaders who are less supportive of the quality of KIA personnel. Factors that hinder improving the quality of general BP services and integrated ANC services, in general, services at general BP are very supportive but for integrated ANC services there are many obstacles because there is still a lack of support from nutritionists, environmental health experts because their staff is limited, while for general practitioners and dentists, patients do not want to because they have to queue.Conclusion; Improving the quality of KIA and BP health workers, some health centers are very supportive, but there are a few health center leaders who are less supportive, while there are no inhibiting factors in general BP services, but in integrated ANC services there are many obstacles because nutrition and health workers are very limited, while for general practitioners and dentists, pregnant women do not want to queue so they do not get services.

Challenges Faced by Vocational College Graduates in Pursuing a Bachelor's Degree in Education at a Public University in Johor

On January 1st, 2023, Shenzhen became the first city to legalize living wills in China. However, less was known about the readiness of healthcare professionals (HCPs) to implement Article 78 of the Shenzhen Special Economic Zone Medical Regulations. Our team aimed to timely examine the HCPs' readiness in Shenzhen, including their knowledge, attitude and confidence as well as associated factors. A cross-sectional study was conducted among 685 doctors and nurses across 16 hospitals using convenience sampling between February and March 2023 in Shenzhen, China. A validated, self-designed electronic questionnaire consisting of 22 items was used to assess knowledge, attitude, confidence, and related factors. The scale-level content validity index (S-CVI) for these three dimensions was 94.4%, 96.7%, and 93.3%, respectively. The internal consistency reliability (Cronbach's α) for the three dimensions was 0.693, 0.944, and 0.890, respectively. Only 315 participants (46.0%) demonstrated adequate knowledge (score ≥ 9), with an average correct rate of 65.4%. Most participants had a positive attitude (644/685, 94.0%), and 596 (87.0%) scored ≥ 16 on confidence. However, many lacked confidence in validating living wills (350/685, 51.1%), mitigating legal risks (322/685, 47.0%), and adhering to ethical principles (161/685, 23.5%). HCPs who had cared for terminally ill patients were more likely to have better knowledge (OR = 1.391, 95% CI: 1.013-1.910), attitude (OR = 2.564, 95% CI: 1.316-4.997), and confidence (OR = 1.703, 95% CI: 1.086-2.670). Those with a bachelor's (OR = 3.348, 95% CI: 1.613-6.951) or master's degree (OR = 2.645, 95% CI: 1.080-6.477) showed more positive attitudes. Prior training improved confidence (OR = 3.035, 95% CI: 1.080-8.529). Most participants preferred doctors (556/685, 81.17%), family members (513/685, 74.89%), and lawyers (511/685, 74.6%) to discuss living wills, while fewer preferred nurses (321/685, 46.86%) or social workers (241/685, 35.18%). HCPs generally supported living wills but lacked legal and ethical confidence for implementation. Targeted training integrating medical, legal, ethical, and cultural components is urgently needed to promote patient autonomy and support policy implementation in Shenzhen.

Aims: The study examined the demographic profiles of teaching and non-teaching personnel and their connection to knowledge management practices, specifically knowledge generation, in one Philippine state university. Study Design: To determine the level of knowledge generation among employees regarding their demographics, a cross-sectional survey was conducted. The differences in demographics and knowledge-generation practices were determined using nonparametric statistical analysis. Place and Duration of Study: The study was conducted in June 2022 at Central Bicol State University of Agriculture (CBSUA) in the Philippines. Methodology: Through a stratified sampling technique, the study identified and selected 123 employees (71 teaching and 52 non-teaching). Demographic information, including gender, age group, level of education, and years of work experience, was collected. A validated survey questionnaire was used to analyse the knowledge management practices under knowledge generation. Mann-Whitney U test (comparing the teaching and non-teaching groups) and the Kruskal-Wallis test (comparing differences among demographic categories) were used as statistical tests. A significance level of P = 0.05, median values, and average ranks were also calculated. Results: The findings indicated that women made up the majority of both teaching and non-teaching staff. Faculty members were most frequently between the ages of 36 and 46, whereas non-teaching staff members were between the ages of 47 and 57. In terms of educational background, the majority of teaching staff members had master's degrees, while the majority of non-teaching staff members had bachelor's degrees. Teaching staff had more than 21 years of work experience, while non-teaching staff had a higher percentage of 11–20 years. No significant difference was found in knowledge generation between teaching employees (Median = 4. 00) and non- teaching employees (Median = 4. 25), as indicated by the Mann- Whitney test (P = 0. 77). The Kruskal-Wallis test approached significance regarding age (P = 0. 07), with younger employees (aged 25-35 years) demonstrating higher scores in knowledge generation. Additionally, no significant difference was observed based on education level (P = .51) or years of experience (P = .015) between the groups with 3-5 and 6-10 years of experience; both groups showed notably higher knowledge levels. Conclusion: The years of work experience significantly influence knowledge management practices in higher education institutions, especially in generating new knowledge. Middle-aged employees, with 6 to 10 years of work experience, produce more knowledge than their more senior colleagues. HEIS needs to develop specific strategies to enhance employee knowledge generation. Organizations can establish KM frameworks to improve knowledge generation, organizational effectiveness, and sustainability across a diverse workforce. The findings give HEIs practical proof to create experience-differentiated knowledge management strategies that improve institutional sustainability and efficacy. Cross-institutional comparisons and longitudinal patterns should be investigated in future studies.

Financial toxicity, the combined objective burden and subjective distress that affects patients' medical care, is not well described in patients with IBD. We aimed to characterize financial toxicity in patients with IBD. We designed and administered a de-identified survey to patients with IBD. The primary outcome, financial toxicity, was defined as a score <22 on the COST-FACIT scale, a validated measure. We constructed multivariable logistic regression models to evaluate associations adjusting for age, sex, race, type of IBD, IBD medications, household income and education level. Respondents (n=669) had a median age of 49 years, were 62% female and 92% White. 52% were currently treated with advanced IBD-therapy and 58% reported IBD in remission/minimal activity. 53% were employed full-time. 61% had an annual household income ≥$100,000. 69% had private insurance and 31% had Medicare.21% reported trouble paying medical bills in the past year; 34% of working adults missed work in the past 7 days because of IBD. 39% experienced financial toxicity. Adjusting for confounders, adults <65 years were more likely to experience toxicity than older adults (aOR: 6.78, 95%CI: 2.60-17.65). Those with education less than a Bachelor's Degree (aOR: 2.73, 95%CI: 1.70-4.37), annual household income <$60,000 (aOR: 3.71, 95%CI: 2.14-6.42) and women were more likely to experience financial toxicity (aOR: 1.90; 95%CI: 1.28-2.81). Financial toxicity was prevalent among patients with IBD, particularly among younger adults, those with lower income and education and women. Enquiring about financial toxicity should be incorporated into IBD clinical practice.

School nursing in Oman lacks a formally defined scope of practice. This quantitative study, part of a larger mixed-methods project, surveyed 249 government school nurses in Muscat, Al Dakhiliyah, and Al Batinah (March-July 2025) to compare current practice with perceived importance across the five domains of the School Nursing Practice Framework. Mean practice scores (4.66/6) were consistently lower than importance scores (4.90/6; p < .001), with the largest gap in care coordination. Lower practice scores were associated with more than 15 years of experience, bachelor's degrees from coverage of two or three schools, and higher numbers of medically complex students. Male nurses reported higher scores for leadership and standards of practice. These findings point to role strain and systemic barriers, including split-site coverage and weak interprofessional integration. Clearer role definitions, targeted training, balanced workloads, and stronger coordination systems may enable nurses to practice at full scope.

Although assignments play a crucial role in university education, there is limited knowledge about how university teachers in Nepal oversee the challenges of assigning tasks. This research paper investigates English language teachers’ perspectives on assigning tasks in Bachelor’s Degree programs at community campuses in Pokhara. This study aims to evaluate teachers’ views on assigning tasks and to explore the importance they place on implementing assignments at this level. A mixed-method approach, incorporating both qualitative and quantitative data, was employed. Data were collected using a purposive sampling strategy, with a questionnaire serving as the primary tool for gathering information. Jean Piaget and Lev Vygotsky’s concept of constructivist learning theory is employed to analyze the data of this research. Assignments encourage active knowledge construction, which enhances creativity and critical thinking among students. This theoretical framework can help analyze how assignments are perceived by teachers as tools for fostering critical thinking and deeper understanding of the subject matter. Assignments enable teachers to gauge students’ learning levels and assess their performance, fostering confidence in oral presentations or written exams. Feedback from teachers allows students to address areas for improvement, and their completed assignments reflect their understanding and areas needing further effort. However, students often fail to take assignments seriously, as pass marks are typically awarded regardless of effort despite the acknowledged role of assignments in promoting critical thinking. Overall, assignments valuable for teachers in evaluating students and for students in deepening their understanding of the subject matter

Interdisciplinary, research-based teaching format for participatory technology development in nursing: a mixed methods study Abstract: Background: Digital assistance technologies offer great potential to support and relieve the burden of care when they are tailored to the requirements of everyday care and developed in collaboration with users. Aim: The objective was to develop and pilot an interdisciplinary, research-oriented teaching format (IFL) to train students of computer science (bachelor's degree) and health and nursing sciences (master's degree) in robotics development, participatory research, and interdisciplinary collaboration. Methods: The twelve-month IFL was divided into an idea phase and a development phase with a focus on teaching participatory and interdisciplinary skills. A mixed methods design with pre-post surveys and focus group interviews was used for evaluation to assess the impact on collaboration and the conditions for success for such teaching formats. Results: The piloted IFL led to the development of a proof of concept for robotics-assisted wound documentation. While the attitude of computer science students toward interdisciplinary collaboration improved, a negative trend was observed among nursing students. Focus group interviews emphasized the importance of clear structures, curricular anchoring, and practical tasks for successful collaboration. Conclusions: Students are in favor of IFL with practical relevance to their future professional practice. Such teaching formats promote interdisciplinary collaboration as well as the personal and professional development of students.

This study addresses the persistent challenges of low classroom participation and weak writing motivation among first-year associate-degree students (Junior College to Bachelor's Degree Program) in a large University English class. Conducted as an action research project, the study implemented a one-week pedagogical intervention involving role-playing and dubbing activities. Seventy students from Chinese Language and Preschool Education majors were grouped to select, prepare, and perform dubbed versions of video clips, often translating Chinese comedic works into English. The results demonstrated a remarkable positive shift: typically, passive students actively engaged, and the classroom atmosphere transformed through collaborative creativity and performances enhanced by physical comedy. The findings are discussed through the theoretical lenses of Krashen's Affective Filter Hypothesis and collaborative learning, arguing that the activity successfully lowered learning anxiety and built communicative confidence. The study concludes that such scenario-based, student-centered tasks are an effective strategy for engaging passive learners in large classes. Furthermore, it suggests that the confidence and linguistic fluency gained from successful oral communication can serve as a crucial foundation for fostering motivation in more complex tasks like writing. This research offers practical implications for EFL teachers seeking innovative methods to enhance student engagement in similar educational contexts.

Parent-teen sexual health communication can support and empower teens in their sexual and reproductive health (SRH) decision-making. These conversations may differ in their associations with teen health outcomes across parent-teen dynamics and parents' knowledge about and comfort with the topic. To investigate parent and teen characteristics associated with the frequency of parent-teen sexual health communication, parent information adequacy, and parent communication comfort and the association between communication frequency and teens' self-efficacy to seek SRH information and services and to examine the moderating effects of parents' perceived information adequacy and communication comfort. This cross-sectional survey comprised a probability sample of 522 parent-teen (aged 15-17 years) dyads representative of the US household population from the 2022 Teen and Parent Surveys of Health. Participants were recruited from AmeriSpeak and AmeriSpeak Teen panels, administered by the National Opinion Research Center (University of Chicago) from May 12 to September 30, 2022. Statistical analysis was performed from February to May 2024. The frequency of parent-teen sexual health communication and teens' self-efficacy to seek SRH information and services. Moderators were parent information adequacy and communication comfort. All analyses were weighted. Of 522 parents, most were female (377 [61.3%]), 45 years of age or older (214 [53.5%]), White (309 [57.0%]), and had less than a bachelor's degree (325 [56.7%]). Of 522 teens, half were male (244 [50.3%]), and most were heterosexual (394 [79.8%]). Female parents (54.5% [95% CI, 48.6%-60.2%]; P = .001), parents aged 18 to 44 years (58.0% [95% CI, 51.3%-64.4%]; P < .001), and Black parents (74.3% [95% CI, 56.5%-86.6%]; P = .01) communicated about sexual health most frequently. Parents with a Bachelor's degree or higher (36.8% [95% CI, 30.0%-47.9%]; P = .03) and household incomes higher than $100 000 (31.1% [95% CI, 22.6%-41.1%]; P < .001) were significantly less likely to communicate about sexual health. Teens whose parents talked frequently had higher self-efficacy when parents were more informed (β = 0.11 [95% CI, 0.03-0.20]; P = .01) and more comfortable (β = 0.11 [95% CI, 0.01-0.20]; P = .03); however, if parents were not informed or comfortable, frequent communication was associated with lower teen self-efficacy. In a cross-sectional, nationally representative survey of 522 parent-teen dyads, frequent parent-teen sexual health communication was associated with increased teen self-efficacy for SRH information and service seeking, but this depended on how comfortable and informed their parents felt. These findings suggest that parents must possess accurate information and comfort to discuss sexual health topics.

Background: It is currently unknown whether patient engagement in adult congenital heart disease (CHD) care is influenced by social determinants of health (SDOH) such as race/ethnicity, education, and income. Adapting from the chronic care model, patient engagement, defined as the knowledge, skills, ability, and willingness to manage one’s health, can minimize lapses in care and improve CHD care outcomes. Methods: This cross-sectional study analyzes data from patients aged 18 and older with a self-reported diagnosis of CHD enrolled in a digital health research study called Empower My Congenital Heart. Patient engagement was measured using the Gothenburg Empowerment Scale (GES). We compared mean GES scores across demographic categories (race/ethnicity, education, and income), using independent samples t-tests or one-way ANOVA as appropriate. Additionally, we conducted a multivariate linear regression analysis to evaluate the impact of race/ethnicity, education, and income on GES scores, adjusting for age, gender, marital status, parental status, and employment status. Results: Of 323 adult CHD patients, the mean age was 45.6 ±15 years, 32.5% were males, 89.9% were non-Hispanic White, 29.7% had less than a Bachelor's degree, and 43.5% had less than $100,000 annual household income. The mean GES score was 61.8 ± 8, with significantly higher scores observed for non-Hispanic White identifying individuals (p=0.006) and those with a Bachelor's or higher level of education (p=0.005), while no difference across income levels (p = 0.394) (Figure 1). Linear regression analysis demonstrated that race and ethnicity remained significantly associated with GES scores (Table 1). Conclusions: Race/ethnicity and education level (in the bivariate analysis only), but not income, are the SDOH variables significantly associated with how empowered a CHD patient is in managing their health care. Future interventions that target enhancing patient engagement and self-management skills should take into consideration the influence of these demographic and social factors.

This study examined the relationship between early childhood sociodemographic factors, a subset of social determinants of health, and preadolescent cardiovascular health (CVH) among a cohort of children from low-income and racially and ethnically diverse households using the American Heart Association Life's Essential 8 (except sleep). This secondary data analysis used data from the NET-Works (Now Everybody Together for Amazing and Healthful Kids) randomized controlled trial and NET-Works 2 at the U follow-up study. Children (n=268) were 2 to 4 years at enrollment and followed through preadolescence (7-11 years). Sociodemographic factors at baseline were exposures. The main outcome was the CVH score (high (≥80) versus lower (<80)), calculated using Life's Essential 8 factors measured at preadolescence. Modified Poisson regression models estimated risk ratios (RRs) and 95% CIs for the association between sociodemographic factors and CVH. In early childhood, living in households with an annual income of $35 000 to $64 999 (relative to <$15 000) (RR, 2.01 [95% CI, 1.3-3.0]), a parent with at least a bachelor's degree (RR, 2.1 [95% CI, 1.3-3.3]), enrollment in social security, disability, or unemployment (RR, 1.6 [95% CI, 1.0-2.4]), and Non-Hispanic White (RR, 2.2 [95% CI, 1.5-3.3]) were associated with high CVH in preadolescence. Among Life's Essential 8 factors, lower body mass index percentile and cholesterol, and higher physical activity levels and diet quality were most strongly associated with high CVH scores. Early-life disadvantaged sociodemographic factors were negatively associated with preadolescent CVH among children from low-income and racially and ethnically diverse households. Current public health prevention efforts to alleviate social disadvantage in early childhood are insufficient for long-term CVH. URL: https://clinicaltrials.gov; Unique identifier: NCT01606891.

Background: Cognitive impairment affects roughly one in three individuals with cardiovascular disease, and is linked to poor self-care and outcomes. Communicating cognitive screening results (e.g.,MoCA) is critical for comprehension, risk awareness, and decision-making.Yet, little is known on how to return these results effectively. Aim: This study aimed to examine how 1) tailoring label wording and 2) visualization format in communicating MoCA results affects comprehension, perceived risk, and behavioral intentions. Methods: In a two-phase online study, participants (n=366) first compared two label types across four MoCA-based cognitive levels (normal, mild, moderate, severe). Based on preferences, tailored labels were applied in the main study. Then, participants (n = 540) were randomized to one of four sets, each containing combinations of cognitive level and visualization (Figure 1): A) text-only, B) text plus gauge, C) horizontal number line, and D) vertical line graph. Outcomes included comprehension, perceived risk, and behavioral intention. We used chi-square tests in R to compare outcomes across formats. Results: Participants (N = 540) were U.S. adults (M = 37.4, SD = 11.6), with 49% men and 49% women. The sample was racially and ethnically diverse: 34.4% White, 26.1% Black, 23.8% Asian, and 19.6% Hispanic. Most (61%) had some college or a bachelor's degree. Label preferences varied by severity; original labels were preferred for normal, mild, and moderate results, while modified labels (i.e., concerns for severe cognitive difficulties) for severe results. Comprehension was highest in the gauge format (94%) and lowest in text-only (89%), with a significant difference between them (p = 0.042). Participants perceived greater risk than expected for mild impairment (mean deviation = +0.49). Normal cognition was associated with underestimated risk (–0.18). Overall, 73% of participants reported an intention to act. The proportion of participants intending to act increased with severity of the cognitive result: 96% for severe, 90% for moderate, 77% for mild, and 17% for normal. Among those intending to act, the most frequently selected actions are shown in Figure 3. Conclusions: Tailored presentation of cognitive screening results—via language and visuals—can improve comprehension, risk perception, and behavioral intentions. Among cardiac patients, personalized communication may support early recognition of cognitive issues and strengthen engagement in care.

This study investigates the level and impact of second language (English) anxiety on learning performance among bachelor's degree students in UiTM. Drawing upon the theoretical framework of the Affective Filter Hypothesis, the research problem explores how anxiety acts as a barrier to language acquisition and its effects on learners’ academic performance. A mixed-methods research design was employed, with a convenience sampling of students who completed a survey and participated in interviews. Both quantitative survey data and qualitative textual responses were collected and analysed by using descriptive statistics and thematic analysis, respectively. The findings indicate that learners experience a moderate level of language anxiety, with speaking tasks being a primary source of apprehension. Furthermore, the results revealed a complex relationship in which high anxiety negatively impacted performance, while a low to moderate level could be motivating. In conclusion, anxiety is not a simple negative construct but a causal factor that requires targeted pedagogical interventions. The study's implications suggest that future research should adopt longitudinal designs and explore cultural differences to further refine the understanding of language anxiety and its effects.

Profiles of cannabis use and expense-related factors among US young adults.