Effects Of Programming Research Articles

Nasal Fiber-optic Intubation Training for Nurse Anesthesia Students Incorporating Deliberate Practice and Summative Assessment

Introduction Managing difficult airways and adverse respiratory events is critical for anesthesia providers. Fiber-optic intubation (FOI) is a strategic management approach in difficult airway situations. Clinical exposure to FOI can be limited, posing challenges for skill development. Simulation-based medical education offers a safe alternative for training. This study aims to evaluate the effectiveness of a simulation-based FOI training program for student registered nurse anesthetists (SRNAs) in an educational context. Methods A repeated measure study was conducted during the Pediatric Anesthesia Simulation for Student Nurse Anesthetists course at the Peter M. Winter Institute for Simulation, Education, and Research. One hundred twenty-three SRNAs participated in the FOI simulation program. For the analysis, students were stratified into 2 groups based on their performance in the summative testing of nasal FOI time. Baseline characteristics and the students' performance during the simulation were analyzed. Results Among the participants, 58 were categorized as “above median time” (AMT) and 65 as “below median time” (BMT) for FOI testing. No significant differences were observed in baseline characteristics. The AMT group exhibited longer mean times for summative testing FOI (50 vs. 26 seconds), first FOI attempt (97 vs. 78 seconds), and subsequent sets (third: 374 vs. 325 seconds, fourth: 323 vs. 268 seconds). Both groups showed performance improvement across training sets with reduced variability. Conclusions The simulation-based FOI training program effectively enhanced SRNA skill, with performance improvement during the training period. This study underscores the importance of simulation in anesthesia education, offering a safe and structured environment for skill development in FOI.

Evaluating the Impact of an Online Mindfulness Program on Healthcare Workers in Korean Medicine Institutions: A Two-Year Retrospective Study

Background/Objectives: This retrospective study evaluated the effectiveness of a two-year online mindfulness program (five biweekly sessions) combined with a smartphone application for healthcare workers (HCWs) in Korean medicine (KM) institutions. Methods: Twenty-three participants, including KM University students, KM doctors, and nurses, completed a 9-week online mindfulness program in 2023 or 2024. The pre- and post-intervention surveys assessed subjective health status (SHS), knowledge of mind–body modalities (MBMs), hwa-byung (HB) symptoms, emotional labor (EL), burnout, and program satisfaction. Results: Participants showed significant improvements in SHS (p = 0.008) and MBM knowledge (p = 0.035). HB personality scores decreased significantly (p = 0.027), while the reduction in HB symptoms approached statistical significance (p = 0.052). The frequency of interactions among job-focused EL increased (p = 0.003). The subgroup analysis revealed significant reductions in HB personality traits (p = 0.017) and symptoms (p = 0.006) among practicing KM doctors and nurses. No significant changes were observed in burnout levels. Participants reported high satisfaction (median 8.00 [IQR 8.0–9.0]) and willingness to recommend the program (median 5.00 [IQR 4.0–5.0]). Conclusions: Analysis of the 2-year results suggests that the online mindfulness program effectively improved SHS, MBM knowledge, and HB-related symptoms among HCWs in KM institutions, particularly among practicing professionals. High satisfaction rates indicated the acceptability of the program. Future research should use larger sample sizes and randomized controlled designs to further validate these findings and explore long-term outcomes. This intervention shows promise as a tool to promote mental health in Korean healthcare settings.

Implementation and Effectiveness of a Nurse-Led Oral Hygiene Program for Schoolchildren: A Quasi-Experimental Study.

Good oral hygiene is essential for schoolchildren's well-being. However, lack of knowledge, negative attitudes, and poor oral hygiene practices may predispose to oral-related diseases. This study aimed to examine the effectiveness of a nurse-led oral hygiene program on schoolchildren's knowledge, attitudes, and practices. A quasi-experimental design with pre-and-post-test was used. Using the convenience sampling technique, we recruited 400 schoolchildren, aged 11-12 and in grades 5-6, from two primary schools in Egypt. The study was conducted from September 2022 to May 2023. The Oral Hygiene Program served as the primary intervention. This program contains health education topics (e.g., the importance of oral hygiene, techniques for effective tooth brushing, and dietary choices that promote dental health). Three visits were conducted (Visit 1: introduction of the program purpose and objectives and pre-test scores collection, Visit 2: implementation of oral hygiene topics, and Visit 3: post-test scores collection). We used three self-report instruments (Oral Health Knowledge Questionnaire, Hiroshima University's Dental Behavioral Inventory, and Oral Health Practice Questionnaire) for pre- and post-test. Paired T test and Pearson correlation analysis were used for data analysis. After the intervention program, the oral hygiene program effectively enhanced schoolchildren's knowledge, attitudes, and practices. The post-intervention mean scores were 7.83±0.488 (knowledge), 6.63±1.7 (practices), and 9.33±1.1 (attitudes). High statistically significant differences were noted between schoolchildren's oral health knowledge, attitudes, and practices before and after implementing the program (p=0.000). There were enhancements in the level of knowledge, with improved positive attitudes and satisfactory practices among schoolchildren after the implementation of the oral hygiene program. Integrating oral hygiene programs into the general curriculum in primary schools and training school nurses, caregivers, and teachers in implementing oral hygiene programs could improve oral health knowledge, attitudes, and practices for preventing oral problems.

Collaborative and side-by-side artmaking: reducing social isolation in refugee youth group art therapy

ABSTRACT Background Research on social isolation in refugee youth is important because it affects their sense of belonging, mental health and wellbeing; integration and acculturation into a new country; education; and future employment opportunities. There is limited art therapy research in Australia in this area, leaving a compelling gap in understanding the effectiveness of collaborative and side-by-side artmaking in group art therapy to connect refugee youth with their peers. Aims This study aimed to explore whether collaborative and side-by-side artmaking in group art therapy would connect youth more effectively; alleviate their social isolation from trauma, displacement and re-settlement experiences; provide a safe environment and platform to express themselves; and improve their mental health and wellbeing. Methods The triangular mixed-methods approach used standardised scales and semi-structured interviews to gather information from youth, teachers and art therapists. Mixed-method data analysis was applied using the Reliable Change Index, line graphs, descriptive statistics, and thematic analysis. Results Refugee youths’ self-esteem and confidence seemed to increase through collaborative and side-by-side artmaking. Results highlighted the importance of social connection, self-esteem, confidence and a sense of safety for making positive connections during artmaking. Conclusions Findings indicate potential benefits of pportunities for refugee youth to connect with their peers in the school environment and of group art therapy. Implications for practice and future research Opportunities could be achieved through collaborative and side-by-side artmaking in group art therapy. A larger study, longer programme and mixed populations in the school setting are recommended for future research. Plain-language summary The research aimed to examine if there was an effect of a six-week art therapy programme on social isolation for five 14–15-year-old female refugee youth. This research is important because social isolation affects youth’s mental health and wellbeing. Through creating art individually and next to each other (side-by-side artmaking), and creating artworks together (collaborative artmaking), the programme aimed to reduce social isolation and increase connections between youth during the sessions and in the school environment. The research was conducted in an early intervention creative therapies service onsite at a Queensland English-language transition secondary school. The service is provided by accredited art therapists and uses creative methods to support culturally diverse refugee youth in resettling, learning and recovering from trauma and stress. During the research, youth participants engaged in art activities, such as drawing and painting, while listening to music. Interventions were designed to establish group bonds, build self-esteem and resilience, and empower youth in a safe and supportive environment. Art therapists and teachers observed youth during the research period, completed standardised scales before and after the programme and participated in semi-structured interviews. The youth participants also completed standardised scales and were interviewed before and after the programme. The results showed that after the six-week programme, youths’ wellbeing and connections to each other increased. Three central themes were identified: (1) social connection is important within the school environment; (2) self-esteem and confidence are related to connecting to others and social isolation; and (3) there is a sense of safety in artmaking individually and collaboratively with peers. The study found that the art therapy programme positively affected youth mental health and wellbeing. This suggests the programme effectively reduced participants’ social isolation, potentially offering positive opportunities to connect other youth at risk of social isolation.

'Virtual Mentorship is a No-Brainer': The Application of a Virtual Mentorship Programme for Prospective Plastic Surgery Trainees.

Aims This study aimed to evaluate the effectiveness of a virtual mentorship programme in plastic surgery designed for medical students and foundation doctors in the United Kingdom. The programme sought to enhance understanding of common and emergency conditions, provide guidance on the application process for speciality training, and facilitate networking opportunities. Materials and methods The programme consisted of six sessions delivered via Microsoft Teams (Microsoft® Corporation, Redmond, WA) over a four-month period from May to August 2024. Participants completed online pre- and post-mentoring questionnaires. Wilcoxon signed-rank test was used to compare paired data responses. Results Ten participants completed both questionnaires; 90% were medical students, and 10% were foundation-year doctors. There was a significant increase in the understanding of common plastic surgery conditions and emergencies (p < 0.05), as well as improved knowledge of the application processes for core surgical training (p < 0.05) and higher speciality training (p < 0.05). Interest in the speciality significantly increased (p < 0.05), and participants were more likely to seek in-person mentorship (p < 0.05). The programme was well-received, with 100% rating it as 'excellent' or 'very good'. Conclusions The virtual mentorship programme effectively enhanced foundational knowledge, career preparation, and mentor-mentee relationships. Its implementation is recommended both alone and in combination with traditional face-to-face mentorship.

Identifying the active ingredients in payment for performance programmes using system dynamics modelling

Payment for performance (P4P) is not a uniform intervention, with programme effect dependent on several interconnected factors. In this study, a system dynamics model was developed to explore the pathways to improved outcomes and how changes in the design, implementation and context of a P4P programme affected maternal and child health (MCH) service delivery outcomes in Tanzania. A previously developed causal loop diagram of the programme effects was used to inform model development, with further data sources (including an impact evaluation of programme, health surveys, stakeholder feedback and relevant literature) used to build the model. A number of pathways were identified to improved services under P4P, with increased availability of drugs underpinning the content of care outcome (intermittent preventative treatment during ANC), which together with increased supervision, enhanced health worker motivation. This in turn increased perceived quality of care at the facility which improved the coverage of services outcome (facility-based deliveries), and with increased outreach, increased awareness of services also boosted demand. Minor delays in payment reduced provider purchasing power for medicines, with severe delays driving erosion of provider trust and motivation for programme participation. Allocating a larger share of funds for facility operations can enhance performance effects, particularly for those services that rely on efficient drug administration. Contextual factors including limited baseline provision of essential medications, lower community awareness of facility services and dispersed/distant populations reduced programme effect. This paper demonstrates the feasibility and the potential of such models to inform the design of effective health system interventions.

The effect of a cultural sensitivity education program on the intercultural sensitivity and compassion levels of Turkish nurses: A randomized controlled trial

AimThis study was performed to measure the effect of a cultural sensitivity education program in increasing Turkish nurses’ intercultural sensitivity and compassion levels. BackgroundIntercultural care encompasses compassion, an indispensable value of nursing care. The primary purpose of compassion is to ensure the well-being and welfare of the individual. DesignA parallel group randomized controlled trial. MethodsThe study was completed by 64 nurses, 32 in the intervention and 32 in the control groups. A Cultural Sensitivity Education Program was presented to the intervention group. Instruments were given to both groups before the intervention (pre-test), one week after the intervention (post-test) and three months later (follow-up test). Chi-square, independent sample t-test and two-way mixed-design variance analysis with Bonferroni Multiple Comparison Test were used to analyze the data. ResultsThe post-test and follow-up test mean scores of intercultural sensitivity and compassion of the intervention group after the intervention increased significantly compared with the control group. The intervention had a large effect size. ConclusionsThe study showed that the cultural sensitivity education program effectively increased the nurses’ intercultural sensitivity and compassion levels. Nurse managers could integrate education programs into the in-service education programs to improve the intercultural sensitivity and compassion levels of nurses.

Effects of Intimate Partner Violence Prevention Programming on Social Support, Coparenting, and Parenting Among Teen Parents: A Pilot Study

Understanding mechanisms and secondary outcomes of intimate partner violence (IPV) prevention programs for teen parents can help to improve relationships. This study used data from a randomized pilot trial of the Safe Dates for Teen Mothers IPV prevention program compared to the original Safe Dates program with 32 teen mothers recruited from four community-based sites. We examined effect sizes of cross-sectional associations between IPV, social support, coparenting, and parenting, and of differences between the adapted program and the original on social support, coparenting, and parenting over 6 months. Effect sizes of associations were medium on average. Effect sizes on social support, coparenting, and parenting favored the adapted program over the original program and were medium to large. IPV prevention programs adapted for teen parents have the potential to support positive dynamics in their social relationships. These preliminary estimates can inform the design of larger research and intervention studies.

Kinect-Based Mixed Reality Exercise Program Improves Physical Function and Quality of Life in Breast Cancer Survivors: A Randomized Clinical Trial.

Exercise is an effective non-pharmacological approach for alleviating treatment-related adverse effects and enhancing physical fitness in breast cancer survivors. A Kinect-based mixed reality device (KMR), with real-time feedback and user data collection, is an innovative exercise intervention for breast cancer survivors. This study aimed to investigate the effect of KMR exercise program on quality of life (QOL) and physical function in breast cancer survivors. Seventy-seven participants were randomly assigned to either the KMR exercise group or home stretching group with an 8-week intervention. Physical function (shoulder range of motion [ROM], body composition, aerobic capacity, and hand grip strength) was evaluated before and after the intervention period. Participants completed questionnaires such as the Disabilities of the Arm, Shoulder, and Hand (DASH), Functional Assessment of Cancer Therapy-Breast, and International Physical Activity Questionnaire (IPAQ) to assess upper extremity disabilities, QOL, and physical activity levels. Significant group-by-time interaction was found for flexion of the operated arm (154.3±12.5 to 165.8±11.2), and the non-operated arm (158.2±13.8 to 166.5±12.2), abduction of the non-operated arm (154.8±31.6 to 161.1±28.1), and adduction of the operated arm (46.5±9.1 to 52.6±7.2). Significant improvements were also observed in DASH (46.8±9.1 to 40.8±9.3) and IPAQ (1136.3±612.8 to 1287±664.1). The KMR exercise program effectively improved the physical function, alleviated edema, reduced upper extremity disability, and enhanced the QOL in breast cancer survivors. Coupled with significant group-by-time interactions for various outcomes, the results emphasize the potential benefits of incorporating the KMR exercise program to improve the QOL in breast cancer survivors.

Effects of Block-Based Visual Programming on K-12 Students’ Learning Outcomes

Computer programming is regarded as an important skill for the future. However, many K-12 students face challenges and difficulties in learning traditional text-based programming. Block-based visual programming (BVP) can reduce the difficulty of learning programming and is seen as a potential programming education tool. Nevertheless, the effects of BVP on K-12 student learning outcomes remain unclear, and there is no evidence of meta-analysis. This is the first meta-analysis that aims to examine the effects of BVP on K-12 students’ learning based on 42 effect sizes from 29 independent experimental studies (2000–2023). The result suggests that BVP has an upper-medium effect on learning ( SMD = 0.769, 95% CI = [0.554, 0.984], p &lt; .001), particularly in the cognitive outcome ( SMD = 0.698, p &lt; .001). Moreover, the BVP tool, study design, and region have moderating effects. The BVP’s effects are larger when: (1) with 61∼100 students, (2) for junior high school, (3) with the learning duration of &gt;1 month, (4) targeting math, (5) among novice students, (6) using Scratch, ScratchJr, Alice, and App Inventor, (7) employing project-based learning and project-based + game-based learning, (8) base on quasi-experimental design, (9) in Africa and Europe, (10) with latter publication years. Finally, discussions, implications, limitations, and future directions are put forward.

Effectiveness of the educational training program for Japanese chief residents: A one‐year pilot study

AbstractBackgroundMulti‐institutional faculty development programs for chief residents were lacking in Japan. This study evaluated the effectiveness of the program for enhancing the knowledge and behaviors of chief residents at the national level.MethodsSix participants completed self‐assessment questionnaires at three points: before, immediately after, and 6 months post‐program. Knowledge and behavior changes were compared using the Mann–Whitney U test.ResultsSignificant improvements in knowledge were observed and maintained at 6 months. However, behavioral changes were limited, with significant improvements only in counseling skills.ConclusionThe program effectively increased knowledge but faced challenges in translating it into sustained behavioral change.

Is Dorso-Volar Kinesiotape Added to the Home Exercise Program Effective in the Treatment of Carpal Tunnel Syndrome? Randomized Controlled Electrodiagnostic Study

Abstract Objective We aimed to compare the short- and medium-term efficacy of dorso-volar kinesiotape (KT) added to home exercises (HE) with sham-KT and HE alone in the treatment of mild or moderate carpal tunnel syndrome (CTS) in terms of pain, symptom severity, function, gripping strength, and electrophysiological parameters. Materials and Methods A total of 120 patients (99 females, 21 males) were divided into three groups dorso-volar KT and HE (n=40), sham-KT and HE (n=40), and HE (n=40). Pain (The visual analog scale [VAS]), symptom severity (Boston symptom severity scale [SSS]), functional status (Boston functional status scale [FSS]), nerve conduction study (NCS), hand, finger muscle strength were evaluated pretreatment, at the end of treatment (4th week), and in the third month posttreatment. Results There were statistically significant improvements in VAS (p&lt;0.001), Boston SSS (except HE group) (p&lt;0.001), and Boston FSS (p&lt;0.001) in all groups posttreatment compared to pretreatment, and more in the dorso-volar KT group than pretreatment and the posivite improvement continued at a decreasing rate in the third month posttreatment. At the end of treatment the dorso-volar KT group showed statistically significant improvement in Boston SSS (p&lt;0.001, p&lt;0.001) and Boston FSS (p&lt;0.001, p&lt;0.001) compared to the sham-KT and HE groups. Conclusions The combination of dorso-volar KT and HE program makes a more effective and durable contribution to the improvement of CTS symptom severity, pain and functional status, as well as handgrip strength and NCS parameters compared with sham-KT and HE program.

Effect of serious games over conventional therapy in the rehabilitation of people with multiple sclerosis – a systematic review and meta-analysis

Purpose This meta-analysis aimed to quantify the effect of serious games over conventional therapy on upper-limb activity, balance, gait, fatigue, and cognitive functions in people with multiple sclerosis. Materials and methods Search strategies were developed for PubMed, Embase, Cochrane Library, and Scopus. Studies were selected if participants were adults with multiple sclerosis; the intervention consisted of a virtual reality serious game-based program; the control group received conventional therapy; outcomes included upper limb activity, balance, gait, fatigue, or cognitive functions; and used a randomized controlled trial design. Data were synthesized using a standardized mean difference with a random-effects model. Results From 2532 studies, seventeen trials were selected (n = 740). Overall, serious games programs effect on upper limb activity, gait, verbal memory, verbal fluency and attention seemed neutral. Balance functions appeared to be improved by semi-immersive virtual reality serious games (SMD = 0.48;95%CI = 0.12–0.84;p = 0.01;I2=0%), fatigue by treadmill serious games (SMD = 0.80;95%CI = 0.40–1.20;p < 0.001) and visuo-spatial memory by semi-immersive virtual reality general cognitive serious games (SMD = 0.35;95%CI = 0.04–0.65;p = 0.03;I2=0%). Conclusion This review suggests, with a very-low-to-low certainty of evidence, that while some specific serious games may improve balance, fatigue and visuo-spatial memory, their overall effect on upper limb activity, gait, and other cognitive functions appears neutral.

The application effect of a pulmonary rehabilitation program based on empowerment theory for patients with COPD combined with heart failure.

Chronic obstructive pulmonary disease (COPD) and heart failure are often coexisting conditions that can severely impact patients' cardiopulmonary function and quality of life. Pulmonary rehabilitation programs, particularly those based on empowerment theory, may improve clinical outcomes by enhancing self-efficacy and promoting patient engagement. A total of 70 patients with COPD and heart failure admitted to our hospital's respiratory department from January 1, 2023, to April 31, 2024, were randomly assigned to either a control group (n = 35) or an observation group (n = 35). The control group received routine care, while the observation group underwent an empowerment-based pulmonary rehabilitation program in addition to routine care for 4 weeks. Lung function (forced vital capacity, forced expiratory volume in 1 second, maximum voluntary ventilation), arterial blood gas levels (partial pressure of carbon dioxide, partial pressure of oxygen, and arterial oxygen saturation), cardiac function (left ventricular ejection fraction and serum brain natriuretic peptide), cardiopulmonary function (heart rate, respiratory rate, and 6-minute walk test), self-efficacy, and rehabilitation compliance were measured before and after the intervention. There were no significant differences between the groups before the intervention (P > 0.05). After the intervention, the observation group exhibited significant improvements in lung function, arterial blood gas levels, cardiac and cardiopulmonary function, and self-efficacy scores compared with the control group (P < 0.05). Rehabilitation compliance was also significantly higher in the observation group (P < 0.05). An empowerment-based pulmonary rehabilitation program effectively improves rehabilitation compliance, lung and heart function, and self-efficacy in COPD patients with heart failure, suggesting it has strong potential for clinical application.

The Proximal Association Between Cyber and In-Person IPV Among College Students.

Although some evidence suggests that cyber intimate partner violence (IPV) may increase the risk of in-person IPV, some have suggested that cyber IPV may circumvent in-person IPV. To address these mixed hypotheses, the present study tested the hypothesis that cyber IPV perpetration and victimization would associate with greater odds of same and next-day psychological, physical, and sexual IPV perpetration and victimization among college students. College students (N = 236; 73.73% cisgender women) in dating relationships completed a baseline questionnaire to assess demographic characteristics and past-year cyber, psychological, physical, and sexual IPV. Following baseline assessments, participants completed 60 consecutive days of surveys on cyber, psychological, physical, and sexual IPV perpetration and victimization (71.67% compliance). Hypotheses were partially supported. Cyber IPV perpetration positively associated with odds of same-day psychological IPV perpetration (aOR = 2.46, p = .02) and next-day sexual IPV perpetration (aOR = 3.32, p < .001). Cyber IPV victimization positively associated with odds of same-day psychological IPV victimization (aOR = 5.20, p = .00). Results demonstrate that college students experience IPV both online and in-person within a single day. Cyber IPV may be a targetable antecedent to in-person sexual and psychological IPV. Future research is needed to evaluate the impact of same- and next-day polyvictimization, bidirectional cyber and in-person IPV, and the effectiveness of targeting cyber IPV prevention programming among college students.

Aerobic exercise effects on systolic blood pressure and endothelial inflammation in obese and non-obese elderly women with isolated systolic hypertension.

This study aimed to investigate the effects of a 16-week aerobic exercise program on systolic blood pressure, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1, and oxidized low-density lipoprotein of obese and nonobese elderly women with isolated systolic hypertension. Elderly women aged 70-85 years were recruited and grouped into the normal isolated systolic hypertension ( n = 12) and obese isolated systolic hypertension groups ( n = 13). The participants followed an aerobic exercise program, using a wireless heart rate monitor to maintain an appropriate heart rate reserve based on the American College of Sports Medicine exercise guidelines. The two-way repeated measures analysis of variance tested group × time interaction. Pearson's correlation and simple regression assessed the influence of each variable, which showed significant differences. An interaction effect for systolic blood pressure, intracellular cell adhesion molecule-1, and vascular cell adhesion molecule-1 ( P < 0.05) and a main time effect for oxidized low-density lipoprotein ( P < 0.05) were observed. A correlation between the rates of change in systolic blood pressure and vascular cell adhesion molecule-1 ( P < 0.05) with a 42.8% influence ( P < 0.001) and in intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 ( P < 0.05) with a 21.6% influence ( P < 0.05) was observed. These findings collectively showed that the 16-week aerobic exercise program effectively lowered blood pressure in patients with isolated systolic hypertension, particularly in the normal group compared to the obese group. Thus, regular aerobic exercise for 16 weeks or more enhances vascular health, potentially improving the healthy life expectancy of elderly women.

Residential Smoking Cessation Programs Effective, but Rare

Residential Smoking Cessation Programs Effective, but Rare

Efficacy of Health Belief Model on Collegians Health Beliefs Related to Electronic Cigarette; an Intervention Study

Background: Electronic cigarettes (e-cigarettes) are a type of electronic nicotine delivery system that heats e-liquids. The e-liquids typically contain nicotine and flavoring, and an aerosol is inhaled when the e-cigarette is vaped. College students are one of the most at-risk populations for e-cigarette use, and yet this population is virtually unstudied Paying attention to this segment of society and keeping them away from the risk of addiction and diseases resulting from electronic smoking is very important. Purpose: A study conducted to determine the efficacy of health belief model –based intervention in changing health beliefs about electronic cigarette use among collegians.Methodology: True experimental design, is conducted to determine the efficacy of the Health Beliefs Modelin changing health beliefs of collegians related to electronic cigarette use. A probability, simple random sample, of (120) undergraduate students has been selected. Data were collected by using a self-report questionnaire which consisted of two parts (a) socio-demographic characteristics (b) Scale Collegians beliefs about electronic cigarette use using concepts of Health Belief Models. Also, data were analyzed using the statistical package for social science (SPSS) for windows Version 24. Results: Collegians in the study group exhibited a significant association with the Health Belief Model post-intervention, suggesting that the intervention program effectively influenced their health beliefs regarding electronic cigarette usage. conclusion: The intervention program was highly effective in influencing collegians' health beliefs regarding electronic cigarette usage, as evidenced by significant differences. Recommendations: Conducting longitudinal studies to monitor changes in collegians' attitudes and behaviors towards electronic cigarette usage over time. This would provide valuable insights into the effectiveness of intervention programs and help identify emerging trends and challenges that need to be addressed.

Development and Effects of a Laughter Therapy Program for Middle-aged Women Hospitalized in Psychiatric Wards

Purpose: This study aimed to develop and implement a laughter therapy program for middle-aged women hospitalized in psychiatric wards and evaluate its effects on their hope, self-efficacy, and medication adherence.Methods: This study employed a non-equivalent control pre–post quasi-experimental design. Sixty middle-aged female psychiatric inpatients were enrolled in total, with 30 in the experimental group and 30 in the control group. The experimental group participated in laughter therapy sessions twice a week for a total of eight 60-minute sessions. Data were analyzed using descriptive statistics, independent t-tests, &lt;i&gt;x&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test, and repeated measures analysis of variance using SPSS/Win 20.0.Results: Following the implementation of the laughter therapy program, significant differences were observed between the experimental and control groups in hope (t=-0.21, &lt;i&gt;p&lt;/i&gt;&lt;.001) and self-efficacy (t=2.65, &lt;i&gt;p&lt;/i&gt;=.010). However, there was no significant difference found in medication adherence (t=-0.11, &lt;i&gt;p&lt;/i&gt;=.077).Conclusion: These findings indicate that the laughter therapy program effectively enhanced hope and self-efficacy among middle-aged female psychiatric inpatients. Future interventions should consider incorporating strategies to enhance medication adherence as well, as this would ultimately contribute to the development of comprehensive mental health nursing interventions for middle-aged women.

Virtual Posyandu Program during the Pandemic Maintained Children’s Growth and Development

Background: Posyandu program suspension due to COVID-19 has resulted in a decrease in monitoring children’s growth, leading to undetected problems. Understanding mothers' eating behavior plays a crucial role in preventing malnutrition, we must continue the program as a health promotion medium to enhance mothers' understanding and track children's growth and development. Objectives: This research aimed to determine the effectiveness of virtual Posyandu program in strengthening cadre health promotion services for nutritionally vulnerable children in Jember Regency agricultural area during the absence of offline Posyandu. Methods: The research was carried out September 2022-January 2023, implementing a 21-day intervention on 169 respondents from Puskesmas Arjasa and Paleran (representing two different socio-cultures). The cadres utilized the application to enhance children's nutritional health and instruct parents on its usage. The success parameter is that there were significant differences between the growth and development of children pre- and post-program. Growth variables were assessed by measuring nutritional status according to Ministry-of-Health Regulation, before and after the intervention, while development variables were assessed using a Developmental Pre-Screening questionnaire (DPSQ). Results: The virtual Posyandu program in both Puskesmas demonstrated significant differences (p&lt;0.001) in children's growth and development parameters, such as height-for-age, weight-for-height, and DPSQ, between the pre- and post-program periods. Despite the challenges posed by the pandemic, the program has effectively maintained children's growth and development. Conclusions: Balitagrow© Android-based application in virtual Posyandu program effectively maintained children’s growth and development in pandemic era and worth continuing to be developed according to user needs.