Descriptive Research Articles

Acute response to resistance exercise and later development of arm lymphedema in breast cancer survivors: An exploratory follow-up of a randomized cross-over trial

BackgroundIn breast cancer survivors at risk for lymphedema, variation in lymphatic function and arm volume has been observed related to a bout of exercise, with potential for prediction of breast cancer-related arm lymphedema (BCRaL). This novel, exploratory study examined the acute lymphatic response to resistance exercise and later development of BCRaL in women at high risk for BCRaL. MethodsOne year after participation in a cross-over trial evaluating the acute lymphatic response to upper-extremity resistance exercise (low-and heavy-load), participants were assessed for BCRaL (n ​= ​16). The response to exercise was assessed before and after (post, 24- and 72-hrs) each exercise bout as extracellular fluid (L-Dex; bioimpedance spectroscopy (BIS)), interarm volume % difference (IVD; Dual-energy x-ray absorptiometry (DXA)) and symptoms (Numeric rating scale, 0–10 (NRS)). BCRaL at follow-up was defined as presence of one objective indicator (L-Dex >10, change ≥+6.5, IVD >5%) plus one objective or subjective indicator (interarm symptom ≥1 or visual inspection). Descriptive statistics were used to compare the acute response between participants with and without BCRaL at follow-up. ResultsNo trends indicating a similar acute response to exercise was observed in participants who later developed BCRaL (n ​= ​5). There were no observable differences in acute lymphatic response between participants that developed BCRaL and those who did not, both at an individual and group level. ConclusionsFindings from this exploratory study showed no evidence to suggest that the acute response to resistance exercise can predict BCRaL development.

Exploring the Roles, Functions, and Work Experiences of Nurse Scientists in the Veterans Health Administration.

The aim of this project was to describe nurse scientists' roles, functions, and work experiences in the Veterans Health Administration (VHA). Nurse scientists play a critical role in shaping the culture of clinical inquiry and closing the gap between knowledge and practice. A cross-sectional survey was used to collect information on sociodemographics, workload, research, clinical practice, education, and time/effort. Data were examined using descriptive statistics and χ2 analyses. One hundred forty-four nurse scientists completed the survey. These nurse scientists serve dynamic and critical roles in conducting research, implementing evidence-based practice, and reforming policy. Research effort was limited due to workload and infrastructure constraints. Better research infrastructure was associated with higher research productivity and funding. This survey highlights the needs and challenges nurse scientists experience in conducting research and advancing VHA's mission. Given the national shortage of PhD-prepared nurses, long-term strategies are needed to attract, hire, and retain nurse scientists in healthcare systems.

Flexible endoscopic intubation in emergency medicine: A mixed-methods needs assessment.

This needs assessment aimed to improve understanding of flexible endoscopic intubation training and practice in emergency medicine (EM), providing insights to educators and practice leaders seeking to improve education and practices. We conducted a multicenter, mixed-methods needs assessment of emergency physicians (EPs) incorporating focus groups and a survey. Focus groups comprised community EPs, academic EPs, and resident EPs. We analyzed focus group transcripts using grounded theory, qualitatively describing EM endoscopic intubation. The qualitative analysis shaped our survey instrument, which we deployed in cross-sectional fashion. We report survey data with descriptive statistics. Focus groups with 13 EPs identified three themes: indications for use of endoscopic intubation, factors impacting a physician's decision to endoscopically intubate, and attaining and maintaining endoscopic intubation competency. Of 257 surveyed EPs (33% response rate), 79% had received endoscopic intubation training during residency, though 82% had performed this procedure 10 or fewer times in their career. Despite 97% acknowledging the necessity of competency, only 23% felt highly confident in their ability to perform endoscopic intubation. Participants (93%) reported scarce opportunities to perform the procedure and identified factors believed to facilitate competency acquisition and maintenance, including opportunities to perform endoscopic intubation in practice (98%), local champions (93%), and performing nasopharyngoscopy (87%). While most EPs acknowledged the importance of competency in endoscopic intubation, they reported scarce procedural opportunities and commonly expressed low confidence. Further research is needed on this topic, and we propose avenues to enhance education and practices related to endoscopic intubation. These include development of robust procedural curricula, support of local champions, and incorporating nasopharyngoscopy into EM practice.

Prevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study

BackgroundAlcohol use is pervasive in the Caribbean; however, the prevalence and correlates of alcohol use and drinking problems in the elderly have not been extensively studied. MethodsData were obtained from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study, a cohort study of Caribbean people from Puerto Rico, Barbados, Trinidad, and Tobago, and the U.S. Virgin Islands, collected between 2013 and 2018 (baseline study sample, ages 60+, n = 811). Descriptive statistics were used to compare the differences in drinking status (current vs. former vs. never), alcohol problems (Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) scale score ≥2 vs. <2), and binge drinking days (0 days vs. 1–2 days vs. ≥3 days) across sample characteristics. Logistic regression analyses estimated the association of these alcohol measures with sociodemographic (e.g., sex), psychological (depression), and cultural (e.g., religion) correlates. ResultsThirty-six percent were 70 + years of age, 64 % were female, and 41 % had less than a high school education. Alcohol problems (≥2 CAGE score) was 21 %. Binge drinking ≥3 days was 30.6 %. Never attending religious services (vs. attending once a week or more) was associated with almost three times higher odds of alcohol problems (adjusted Odds Ratio: OR = 2.88, 95 % CI = 1.02, 8.15) four times higher odds of increasing binge drinking days (aOR = 4.04, 95 % CI = 1.11, 14.96). College education was protective against both the outcomes. ConclusionWe provide current estimates of alcohol problems among elderly Eastern Caribbean people. Among the sociodemographic, psychological, and cultural correlates examined, religious attendance was significant. Replicate longitudinal studies using DSM-5 alcohol dependence are recommended.

Nurses' satisfaction with an educational web application to prevent transmission of multidrug-resistant organisms.

Multidrug-resistant organism infections are a serious health problem globally, and can result in patient mortality and morbidity. In this descriptive study, we produced the first web application for transmission prevention specific to the situation based on nursing experience, knowledge, and practice guidelines and to evaluate web application satisfaction among Thai nurses. The sample comprised 282 Thai registered nurses experienced in caring for patients with multidrug-resistant organisms in a tertiary hospital. A demographic form and knowledge test were completed anonymously online. Data were analyzed using descriptive statistics. The application emphasized crucial topics for which participants had low preliminary knowledge and included tutorial sessions, pictures, video clips, drills, and a post-test. The application was piloted with a random sample of 30 nurses, and an instrument tested their satisfaction with this. Results revealed that preliminary knowledge scores for preventing transmission were moderate, and participants were highly satisfied with the application. Findings suggest the application is suitable for Thai nurses and could be applied to nursing practice elsewhere. However, further testing is recommended before implementing it into nursing practice.

Sociodemographic inequality in children aged 0–19 years with and without parents diagnosed with heart disease: a Danish nationwide register-based study

ObjectivesThis study aimed to estimate the prevalence of children aged 0–19 years who have a parent with a history of heart disease and investigate their sociodemographic characteristics. Study designA national register-based study. MethodsFrom the Danish Fertility Register and the Danish National Patient Register information on children of parents with ischemic heart disease, arrhythmia, heart failure and heart valve disease in the period 1981–2018 were obtained. Statistical analyses including descriptive statistics, logistic and linear regression were used to illuminate associations between parental heart disease and sociodemographic characteristics. ResultsThe study population consisted of 142,480 children aged 0–19 years with at least one parent diagnosed with heart disease, corresponding to every 9th child in Denmark in 2018. The number increased from 4.5% in 2002 to 11.1% in 2018. In the study population most had a father with heart disease (57.8%) and 4.6% had two parents with heart disease. Parents with heart disease had significantly higher odds of being out of work (OR 1.68, 95% CI 1.64; 1.72), in a single-parent household (OR 1.09, 95% CI 1.07; 1.11), divorced or widowed (OR: 1.10, 95% CI 1.08; 1.12), having a lower educational level (OR 1.35, 95% CI 1.33; 1.37), and a lower family income (−42,410 DKR, 95% CI -50,306; −34,514, P < 0.0001) compared to those without heart disease. ConclusionChildren affected by parental heart disease comprise a substantial part of the Danish population. These have significantly different sociodemographic characteristics than children in families without parental heart disease, which might affect social heritage and parental capacity.

Clinic-Based Characterization of Adolescents and Young Adults With Migraine: Psychological Functioning, Headache Days, and Disability.

This cross-sectional observational study retrospectively examined clinical data collected from adolescents and young adults (AYAs) seeking care in a specialty headache clinic. We characterized participants' headache characteristics and psychological functioning and examined the association between self-reported anxiety and depressive symptoms and headache frequency, severity, and disability. During their clinic visit, AYAs (M age = 18.36; range = 14-32, 79.5% female) completed an intake questionnaire and reported about their headache characteristics (i.e., frequency, severity, and duration of symptoms in months), mental health history (i.e., previous diagnosis of an anxiety or depressive disorder), and utilization of emergency department (ED) services for migraine. AYAs also completed psychometrically validated screening tools for anxiety and depressive symptoms (i.e., the GAD-7 and PHQ-9). We computed descriptive statistics and examined associations among scores on psychological measures and headache characteristics, including migraine-related disability. We also tested whether individuals with clinically elevated GAD-7 and PHQ-9 scores had higher levels of disability relative to those with fewer/subclinical levels of anxiety and depressive symptoms. Participants (N = 283) reported more than 19 headache days per month on average, with more than 90% describing their average headache intensity as moderate or severe. Nearly half of AYAs reported severe headache-related disability. Approximately one-quarter of AYAs reported a previous diagnosis anxiety or depressive disorder diagnosis, and more than one-third scored above clinical cutoffs on the PHQ-9 and GAD-7. Higher scores on both psychological screening instruments were associated with greater headache frequency. More than 10% of patients endorsed current suicidal ideation; this was not related to headache-related disability. Participants reported a high degree of ED utilization for headache; these rates were unrelated to endorsement of psychological comorbidities. In this sample of AYAs, headache characteristics were generally unrelated to scores on measures on psychological functioning. However, the observed rates of clinically elevated anxiety/depressive symptoms and suicidality in this sample of AYAs underscore the importance of screening for psychological comorbidities in neurology clinics that serve this age group, irrespective of self-reported disability. Results also emphasize the need to expand access to behavioral health services for AYAs with headache disorders and the importance of incorporating a biopsychosocial perspective to the transition of health care from pediatrics to adult neurology practice.

Current gaps in emergency medicine core content education for oncologic emergencies: A targeted needs assessment.

The core content of emergency medicine (EM) residency training includes the management of oncologic emergencies; however, documented knowledge gaps continue to exist in this subtopic. This study represents a targeted needs assessment as indicated by Step 2 of Kern's curriculum design to determine the specific training gaps to be addressed within the oncologic EM curriculum. A multi-institutional cross-sectional survey of oncologists (surgical and medical) and emergency physicians (attendings and residents) was conducted during 2023 at five institutions. The voluntary survey consisted of general and specialty-specific questions exploring gaps in oncologic emergency-specific training/education topics. Descriptive statistics reported responses as frequencies and percentages. Of the 833 surveys sent across the five sites, 302 (36.3%) were accessed by link; of these, 271 (89.7%) surveys were completed. There were no differences in the responses between early and later respondents and no differences in the characteristics of respondents between sites. A vast majority of the oncologist and EM groups (91.2% and 83.0%, respectively) reported a belief that emergency physicians would benefit from additional oncologic emergency training. Our survey identified 16 important topics for inclusion in an oncologic EM curriculum, including five topics not present on the 2022 Model of Clinical Practice of Emergency Medicine. Based on this needs assessment, an oncologic EM curriculum should include the topics listed under oncologic emergencies in the 2022 Model of the Clinical Practice of Emergency Medicine along with our respondent-identified topics of radiation therapy adverse effects, stem cell transplant complications, and the management of cancer-specific postsurgical complications, pain, and common diseases in patients with cancer.

Exploring Patient–Clinician Trust During Pregnancy Care

OBJECTIVE: To explore patient experiences and perspectives regarding trust in clinicians during pregnancy care among Latine patients, focusing on those with Spanish as their preferred language. METHODS: We conducted a qualitative focus group study to explore trust in pregnancy care clinicians. Eligible participants self-identified as Hispanic/Latine, reported Spanish or English as their preferred language, were pregnant or had given birth in the previous year, and were at least 18 years old. Participants completed a brief demographic survey. We report descriptive statistics for survey responses. A semistructured discussion guide was developed from a literature review and feedback from a patient advisory panel. We report emerging themes using a modified grounded theory approach with an analysis of focus group transcripts. We mapped themes to the five dimensions of trust according to the Building Trust Initiative—communication, caring, comfort, cost, and competency—and barriers to trust. RESULTS: We conducted eight focus groups (five in Spanish, three in English) through Zoom between July and September 2023. Cost was not discussed in any of the focus groups. Rather, there was an emerging theme around acompañamiento (accompaniment is a distinct form of companionship in which there is shared power during a shared journey), particularly in the Spanish focus groups. Barriers to building trust exist at the interpersonal and health system levels, including miscommunication, lack of continuity, and brevity of appointments. CONCLUSION: This study explores how trust is conceptualized in pregnancy care according to the perspectives of Latine patients. We found that acompañamiento is a unique and crucial dimension of trust among Spanish-speaking patients.

Organizational Culture Resilience and Subjective Happiness among Insurance Employees

Abstract: The Study of organizational culture looks at how people or groups interacts inside a company and how it affects how well the company performs in relation to its goals. It includes how different elements affect how an organization behaves, emphasizing the dynamics that shape the environment and how well it works to accomplish objectives. The ability to adjust to difficult situations in life by exhibiting mental, emotional, and behavioral flexibility is referred to as Resilience. It includes the capacity to adapt to demands from both the inside and the outside, which eventually enables one to successfully navigate trying circumstances and produce favorable results. Subjective happiness is the termed used to describe joy and fulfilment in life that is derived from self-report surveys and is impacted by both external and internal elements, including social interactions and the surrounding society and personality qualities. Businesses that offer financial safeguards against risk through a range of products such as property, casualty, health, and life insurance, are included in the Insurance industry. These organizations evaluate risks, gather premiums, and disburse claims in the case of insured occurrences. They are vital in preventing monetary losses for people, corporations, and other organizations. Understanding these factors informs how important insurance sector plays an role in the organizational world. The present study aims to determine the relationship of organizational culture on Resilience and Subjective Happiness of it employees. Sample of 164 employees who are working in the insurance sector was taken from Hyderabad, Kolkata and Bangalore. Organizational Culture Scale by Ghost and Srivastava, Brief Resilience Scale by Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., &amp; Bernard, J, Subjective Happiness Scale by Lyubomirsky, S., &amp; Lepper, H. S were used. The data were analysed using different statistical tools such Descriptive Statistics and Spearman Correlation. Findings revealed no significant relationship between organizational culture and Resilience, Organizational culture and Subjective happiness.

Investigating the Child Development of Learners with Special Educational Needs in Inclusive Education

Abstract: This study examined the development of 22 learners with special educational needs (LSENs) in inclusive education at Balamban SPED Center Elementary School in the Philippines. Surveys were used for data collection, and the analysis included descriptive statistics and comparative analysis. Most participants were 5-12-year-old females with three or four siblings. Their families had a monthly income of Php 10,000 or below. Autism was the most common particular need among successful learners, followed by hearing impairment and intellectual disability. According to parents, LSENs exhibited well-developed knowledge, attitude, skills, and behavior. Teachers, however, perceived that only knowledge and behavior were well-developed, while attitudes and skills showed moderate development. Perceptions of parents and teachers regarding child development did not differ significantly. The study concluded that inclusive education plays a crucial role in the success and development of LSENs. Successful learners demonstrated high levels of knowledge and behavior, as assessed by both parents and teachers. Teachers rated attitudes and skills as moderately developed. LSENs achieved functional literacy and adaptive behaviors necessary for daily life and prospects. Collaboration between parents and teachers was emphasized for enhancing child development and fostering holistic learners at home, school, and community. The study recommends that administrators use the findings to develop appropriate programs for LSENs, while teachers and parents utilize the results as an action plan to address educational gaps. The study can serve as a baseline for future research on the benefits of inclusive education for LSENs.

Project I-PASSED: An intervention program for Students-At-Risk of Dropping Out (SARDO)

Learners in developing countries like the Philippines have denied their right to education by dropping out for various reasons. This descriptive study was conducted to find out the common reasons why advisory students in the past three (3) years dropped out of school, and why students of GAS 1108 and GAS 1109 were categorized as Students-At-Risk of Dropping Out (SARDO) during the First Semester of School Year 2023-2024; to propose an intervention program based on findings; and to determine its effectiveness based on student-recipients’ perceptions, and the number of learners categorized as SARDO who remained in school. Data were obtained from anecdotal records of dropped-out students for the past three school years, and from the three sets of researcher-made survey questionnaires which undergone thorough validation by experts in the field. These were administered to 17 identified SARDO who were officially enrolled at Muntinlupa National High School – Senior High School during the School Year 2023-2024. Descriptive statistics such as frequency, percentage, mean, and standard deviation were utilized in analyzing the data. Findings revealed that the three prevailing reasons why students dropped out of school for the past three school years, and why student-respondents were categorized as SARDO were financial problems (7, 41%), teenage pregnancy and/or parenting (6, 35%), and personal problems (2,35%); Project I-PASSED (“Incorporating Partnership and Active Synergy between School and Stakeholders for the Effective Delivery of Student Services) was proposed based on the findings; and Project I-PASSED’s initiatives were “Very Effective” in terms of addressing students’ financial problems (), personal problems (), and teenage pregnancy and/or parenting () which were all supported by the testimonies of the student-recipients. There were 14 out 17 (82.35%) identified SARDO who remained in school at present, indicating that the main objective of the project was “Mostly Achieved”. Therefore, the initiatives of the project were helpful and beneficial in addressing the complex needs of students. Supporting and sustaining this project was highly recommended. The implications of this study are to empower students by bringing them back to school, and to contribute tangible solutions that may reshape the educational practices across the country.

Assessment of determinant factors responsible for divorce among divorcees in rural areas of Ibadan, Oyo State, Nigeria

The study assessed factors responsible for divorce among divorcees in rural areas of Ibadan by specifically focusing on sexual satisfaction, ethnicity/culture, and educational disparities. Divorce is related to marriage and family, and it has been used as an instrument to expose failure through marriage. In Nigeria, the high rate of divorce is mostly associated with urbanization and industrialization. The study employed a multi-stage sampling procedure using a well-structured and closed-ended questionnaire. Three out of six rural local government areas were randomly selected, representing 50%. 354 divorcees were randomly selected out of 3,064 divorce cases heard in the last 4 years using the Taro Yamane formula. The collected data were analysed through descriptive statistics (frequency and percentage) and inferential statistics (chi square). The study revealed that more than half of the respondents admitted that sexual intercourse brings peace to their family, while 52% disagreed that ethnicity has to do with divorce. Therefore, sexual activities between the couple must be set as a priority, with respect for one another's as well as unique cultural beliefs, customs, and communication preferences.

EXTENSION CASE STUDY: WHY PADDY FARMERS ARE NOT INCLINED TO USE A DRONE AS PART OF MECHANISATION FOR PADDY CULTIVATION

Drone technology is emerging as a pivotal component in the agricultural sector, particularly in the context of Agricultural Industrial Revolution 4.0 (IR4.0). Its application, especially in activities such as fertiliser and crop protection chemical spraying in the Kemubu Agricultural Development Authority (KADA) granary areas, can significantly enhance the farmers’ yields. Despite the positive reception of drone technology, there is a growing phenomenon of technology rejection that requires further exploration. This research aims to investigate farmers’ acceptance of drones as a mechanisation tool for paddy cultivation in the Jajahan Bachok, Kelantan granary areas within KADA authority. A structured questionnaire, based on the knowledge, attitude, practice (KAP) model, was administered to 82 farmers surrounding Jajahan Bachok through purposive sampling. Data analysis using SPSS version 26.0 involved Descriptive statistics, Spearman’s Correlation, and Reliability tests. The study reveals that paddy farmers exhibit acceptance of drone technology, albeit with a slow adoption rate. The correlations between knowledge, attitude, and practice with drone mechanisation acceptance are significant but negligible at levels of 0.253, 0.866, and 0.69, respectively. This research is vital for both agency and drone vendors to comprehend the factors influencing drone technology acceptance among paddy farmers. Understanding these factors can contribute to enhance the application and adoption rate of drone as next important mechanisation for paddy farming activities among farmers especially in the KADA granary areas. Keywords: Drone, paddy, acceptance, KAP model, KADA.

Factors Affecting Decreasing Patient Visits at Ob-Gyn Polyclinic of Outpatient Installation of “X” Hospital

In early 2020, the SARS-CoV-2 or Covid-19 outbreak resulted in decreasing number of patient visits at “X” Hospital. “X” Hospital has set a target of health services in the outpatient installation as many as 5,500 patient visits per month, but the 2020/2021 data showed a downward trend in patient visits, with the most significant decline in the Ob-Gyn polyclinic that reached 50%. Several factors could cause this decline, including the suboptimal promotion of the hospital's leading programs, a suboptimal response from the customer service officers, specialist doctors who do not only work at “X” Hospital that causes priority clashes, unclear signboards at the hospital, an uncomfortable waiting room at the outpatient polyclinic, patients who often cancel the visits, faulty online registration, and no patient satisfaction measurement in the outpatient installation. These situations will eventually cause increasing operational costs. This study aimed to determine the factors that caused decreasing patient visits at the Ob-Gyn polyclinic of “X” Hospital. This research used questionnaires distributed to patients in the Ob-Gyn polyclinic totaling 135 respondents and google forms distributed to the employees of “X” Hospital. The collected data were processed using descriptive statistics. From the study results, the three main factors that caused the decreasing patient visits are the suboptimal promotion of the hospital's leading programs, the suboptimal response of the customer service officers, and the absence of patient satisfaction measurement at the outpatient installation.

South African nursing students' stress and resilience during the global COVID-19 health crisis

The study aimed to investigate nursing students' psychological distress and their response to stress during the COVID-19 pandemic. Participants were 370 South African nursing students (female= 75%; mean age= 21.9 years, SD = 3.9 years). Students completed the following scales: Compassion Satisfaction and Fatigue, Kessler Psychological Distress, and Response to Stressful Experiences. Findings from the descriptive statistics and inferential statistical analyses indicated that students meeting the criteria for being well were likely to have higher resilience scores. Protective factors such as self-efficacy, active coping, and spirituality suggest higher resilience during COVID-19-related stressful events. Physiological factors such as self-reported medical conditions and lack of sleep were associated with poorer mental well-being. These findings provide a profile of nursing students' coping and adaptation to a community-spread pandemic. From these findings, nursing schools could manage students' well-being by providing needed resources in their current and future work health support programmes.

Workplace health culture and trust in the occupational health office: A descriptive study of meatpacking workers.

Worker trust in employer-provided occupational health services has not been explored in essential industries, such as meatpacking. The purpose of this study was to describe workplace health culture and trust in the occupational health office and highlight meatpacking workers' experiences with the occupational health office. Meatpacking workers were surveyed between February 2021 and October 2022. Descriptive statistics and nonparametric tests were used to explore trust across demographic variables, including workplace health culture. Thematic analysis was used to examine the short-answer qualitative data. Among workers who completed surveys (n = 731), health culture was rated low (M = 1.3 (0.73); possible range 0-3). Trust in the occupational health office was also rated low (M = 8.2 (5.06); possible range 0-20). Workers' descriptions of interactions with the occupational health office were mostly unfavorable (287 negative opinion units; 97 positive opinion units) and primarily focused on quality of care, communication, the supervisor as gatekeeper to health services, and the prioritization of company interests. Meatpacking worker health may be improved by building worker trust in the occupational health office. Suggested strategies include enhanced communication, protection of confidentiality, prioritization of worker well-being, and promotion of a stronger health culture in plants and throughout the industry. Supporting workers without a regular healthcare provider to establish a relationship with a primary care provider of their choice is also recommended.

"Time is a Big Factor": Aged-Care Workforce Perspectives on Communication Partner Training for Working With Residents With Dementia.

Many individuals who reside in permanent residential aged care (RAC) have a diagnosis of dementia, with the majority experiencing a communication disorder. Existing literature has placed an emphasis on the need for staff to undertake communication partner training. This study aimed to investigate the preferences of RAC staff, and their perceived barriers and facilitators to workplace training. Through an exploratory cross-sectional online survey, a sample of RAC workers in Australia were recruited (n = 104). Descriptive statistics revealed that the majority of participants preferred training to be delivered face to face and being paid for participation. Through content analysis of open-ended questions, seven categories were identified regarding perceived barriers and facilitators for communication partner training in the workplace. These included staff shortages, time pressures, remuneration and training delivery method, and quality of the educators. Additionally, management attitudes were pertinent. These findings may inform the development and outcomes of future communication partner training in RAC.

Evaluating the precision of an online visual acuity test tool.

The aim of this study was to assess the precision of a web-based tool in measuring visual acuity (VA) in ophthalmic patients, comparing it to the traditional in-clinic evaluation using a Snellen chart, considered the gold standard. We conducted a prospective and in-clinic validation comparing the Eyecare Visual Acuity Test® to the standard Snellen chart, with patients undergoing both tests sequentially. Patients wore their standard spectacles as needed for both tests. Inclusion criteria involved individuals above 18 years with VA equal to or better than +1 logMar (20/200) in each eye. VA measurements were converted from Snellen to logMAR, and statistical analyses included Bland-Altman and descriptive statistics. The study, encompassing 322 patients and 644 eyes, compared Eyecare Visual Acuity Test® to conventional methods, revealing a statistically insignificant mean difference (0.01 logMAR, P = 0.1517). Bland-Altman analysis showed a narrow 95% limit of agreement (0.22 to -0.23 logMAR), indicating concordance, supported by a significant Pearson correlation (r = 0.61, P < 0.001) between the two assessments. The Eyecare Visual Acuity Test® demonstrates accuracy and reliability, with the potential to facilitate home monitoring, triage, and remote consultation. In future research, it is important to validate the Eyecare Visual Acuity Test® accuracy across varied age cohorts, including pediatric and geriatric populations, as well as among individuals presenting with specific comorbidities like cataract, uveitis, keratoconus, age-related macular disease, and amblyopia.

LEARNING MOTIVATION AND LEARNING ENVIRONMENT ON MATHEMATICS LEARNING ACHIEVEMENT OF FIFTH GRADE ELEMENTARY SCHOOL STUDENTS

The purposes of this research are: (1) the influence of learning motivation on mathematics learning achievement of fifth grade students of Advent 1 Tikala Manado Elementary School. (2) the influence of learning environment on mathematics learning achievement of fifth grade students of Advent 1 Tikala Manado Elementary School. (3) the influence of learning motivation and learning environment on the mathematics learning achievement of fifth grade students of Advent 1 Tikala Manado Elementary School. This type of research is causal associative research with survey research method. The population in this research were fifth grade students of Advent 1 Tikala Manado Elementary School, totaling 42 students. The sampling technique is the total sampling technique, because the population is less than 100 people so that the entire population is sampled. Methods in data collection (1) using a questionnaire. (2) using the value of the results of the midterm exam in mathematics. Data analysis techniques used are descriptive statistics, normality test, linearity test, hypothesis testing (partial test or t test and simultaneous test or F test). The research findings show that 1) There is a positive influence of Learning Motivation on Mathematics Learning Achievement, 2) There is a positive influence of Learning Environment on Mathematics Learning Achievement. 3) There is an influence of Learning Motivation and Learning Environment together on Mathematics Learning Achievement of fifth grade students of Advent 1 Tikala Manado Elementary School. KEYWORDS : Learning Motivation, Learning Environment, Mathematics Learning Outcomes