Convenience Sample Research Articles

Secondary school students’ understanding of circular economy and recycling at a small rural school

Biology education plays a crucial role in bridging the gap between science and society. This is of high interest and relevance for several reasons helping students to become biologically literate and understanding basic biological concepts and principles as healthcare, environmental issues, and sustainability. The aim of this study was to investigate the understanding of the 9<sup>th</sup> grade and the 12<sup>th</sup> grade students regarding circular economy and recycling. To achieve the objectives, a study was conducted with the convenience sample, involving students from a rural school. The sample was made up of 27 students, including 17 students from the 9<sup>th</sup> grade and 10 students from the 12<sup>th</sup> grade. The prior knowledge of students was assessed by the tool of drawing on the topic of the circular economy and recycling. A two-hour training module was created and carried out, including several practical tasks followed by fulfilling the compliant worksheets. The effectiveness of the module was assessed by the questionnaire focused on the new information received during the module and the general feedback of the module was gathered from the students. The results were analyzed using qualitative content analysis and descriptive quantitative research methods. The findings revealed that the understanding of circular economy and recycling among the 9<sup>th</sup> grade and the 12<sup>th</sup> grade students was different, expressed in the categories of pre-knowledge and the secondary school students are aware of the importance and purpose of circular economy and recycling. The differences appaired in the students’ obtained knowledge and changed attitudes of the 9<sup>th</sup> grade and the 12<sup>th</sup> grade students and the improvement of attitudes and willingness to behave in a sustainable way surpassed the increase of understanding of term “circular economy”.<i> </i>

Motivational Interviewing as an Intervention to Improve Antiretroviral Treatment Initiation among People who Inject Drugs (PWID): A Pilot Study in Jakarta and Bandung, Indonesia.

Progress towards the 95-95-95 target among People Who Inject Drugs (PWID) with Human Immunodeficiency Virus (HIV) infection was considerably low. A behavioral approach, such as motivational interviewing (MI), has been recognized as an effective strategy for improving HIV treatment outcomes among PWID. This study aimed at assessing the impact of MI counselling to improve ARV initiation among HIV-positive PWID. A cohort design pilot study was performed, and participants were recruited using a convenience sampling technique. Participants were PWID with HIV who accessed healthcare facilities in two Indonesian cities. Selected participants were assigned to an intervention group and a control group. The intervention group followed MI counselling, while the control group received ART following the standard of care. The participants were assigned to each group based on their preferences. The data was collected between January 2018 and January 2019. In total, 115 PWID with HIV participated in this study in the intervention (n=30) and control (n=85) groups. All but one intervention group's participants started ART, while 68/85 in the control group did so. Receiving MI counselling significantly contributed to ART initiation. In addition, the participants were followed-up until 12 months after ARV initiation. During this period, we found that similar proportions of participants in both groups discontinued the treatment, and only a small number achieved HIV viral suppression. The positive effect of MI counselling on ART initiation provides insight into the possibility of its wider implementation. Further studies are needed to gain a deeper understanding of MI counselling and its effect on other outcomes of the HIV treatment cascade.

Doctoral graduates’ attitudes toward scholarly work and Institutional Review Board and Quality Improvement Committee education and submission processes: A pilot study

BackgroundEducators are challenged to find better ways to prepare doctoral nursing students to conduct scholarly work involving human subjects. PurposeTo better understand doctoral nursing students’ attitudes toward programmatic scholarly work and Institutional Review Board (IRB)/Quality Improvement Committee (QIC) education and submission processes. MethodsRecent Doctor of Nursing Practice (DNP) and Philosophy of Nursing (PhD) graduates were recruited using convenience sampling techniques to participate in this cross-sectional, descriptive, mixed-methods pilot study. Data were collected using two researcher-developed instruments. DiscussionNineteen doctoral nursing students participated in this study. Students most often used a quantitative approach with health care providers to complete their scholarly work requirements. Both PhD and DNP participants were overall satisfied with the IRB/QIC content in the curricula and the submission process. Four themes were identified: (a) Efficiency, (b) Collaboration, (c) Faculty Mentorship, and (d) Areas for Improvement. ConclusionFindings from this pilot study may be used to enhance IRB/QIC processes through revision of administrative processes and student education.

Nurses' practices of children and family-centered care for chronically ill children: A cross-sectional study

PurposeThere is limited evidence of children and family-centered care (CFCC) practice in different cultural contexts, particularly regarding the factors that predict it among nurses providing care to chronically ill children. Also, the CFCC's impact on the quality of care has not been well studied. This study aimed to test a hypothesized model in which nurses' attributes and care environments predict CFCC, thereby increasing the quality of nursing care. Design and methodsA multicenter cross-sectional study recruited a convenience sample of 405 nurses caring for chronically ill children in Saudi Arabia for an online survey between February 2023 and August 2023. Structural Equation Modeling evaluated the hypothesized model. ResultsThe hypothesized model fits the data based on the fit indices. Care environment affected CFCC (β = 0.831, p = .000), while nursing attributes only indirectly affected CFCC practices through the mediating effect of the work environment (β = 0.553, p = .000). The CFCC practices positively affect the quality of nursing care (β = 0.636, p = .000). ConclusionsNursing attributes impact the work environment, which affects the practice of CFCC and enhances the quality of care for chronically ill children. Investing in nurses' attributes and a positive work environment is crucial for nursing leaders to enhance CFCC practice and the quality of care. Practical implicationsThe findings of this study can be used to shape policies and develop interventions to improve nursing CFCC practices and promote better quality of care for chronically ill children.

Development and Validation of the Attitude Towards Surrogacy Scale in a Turkiye Sample

Bacground: Surrogacy is one of the options a lot of ethical, legal and psychological controversy. Surveying attitudes toward surrogacy plays an important role in building awareness of this phenomenon in the society. In this study authors aimed to develop and validate a scale to assess the attitudes towards surrogacy. Methods: In this study cross-sectional design was implemented. Development process of the Attitude towards Surrogacy Scale (ATSS) included items development based on literature reviews, other existing questionnaires, confrmatory factor analysis (CFA), and reliability analysis using internal consistence coefcients. A total of 272 people residing in Büyükçekmece and Beylikdüzü districts of Istanbul were included in the study. Firstly, conceptual structure and item pool were created for the draft scale created by the researchers. Then, the question pool was submitted to expert opinion. After the expert opinion, a pilot study was applied to the statements in the draft scale. After the test-retest reliability was performed, the data collection phase started. Participants who agreed to participate in the study were reached both face-to-face and online. Convenience sampling method was used to reach the participants. Results: IBM SPSS and IBM AMOS package programmes were used to analyse the data obtained within the scope of the study. In the data analysis, firstly, item analysis was performed for internal consistency reliability. After this stage, structural validity analysis was used. As a result of the analysis, a measurement tool consisting of 4 dimensions and 24 statements expressed as “positive impact, negative impact, legal impact and economic impact” was developed. It has been statistically determined that this measurement tool is valid and reliable. Conclusion: The results obtained show that the scale developed for the perception of surrogacy has validity and reliability. Therefore, the “scale developed for the perception of surrogacy” can be used to measure the perception of surrogacy of people in our country.

WHY ARE INTERNATIONAL TOURISTS SATISFIED WITH ECOTOURISM IN THE MEKONG DELTA, VIETNAM?

The satisfaction of tourists plays a crucial role in the success of a tourist destination. This study aims to demonstrate factors influencing the satisfaction of international tourists with ecotourism in the Mekong Delta, Vietnam. The study employs a convenient sampling combined with direct interviews of 256 international tourists who have experienced ecotourism services in the Mekong Delta region of Vietnam. Quantitative analysis methods used in the study include testing the reliability of the scale using Cronbach’s alpha, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and covariance-based structural equation modeling (CB-SEM). The research results have proven 06 factors influencing the satisfaction of international tourists with ecotourism in the Mekong Delta, including trust, responsiveness, assurance, empathy, tangible facilities, and local characteristics. Among these, the local characteristic factor has the most impact on the satisfaction of international tourists with ecotourism in the Mekong Delta. The research results will provide managerial implications to enhance service quality and improve the satisfaction of international tourists with ecotourism in the Mekong Delta region, Vietnam.

INTENTION TO RETURN TO NATIONAL PARK: THE ROLE OF PERCEIVED QUALITY, PERCEIVED VALUE, AND TOURIST SATISFACTION

Understanding and predicting tourists’ intention to return to a destination is a fundamental factor for the success of a tourism destination. The objective of this study is to demonstrate the influence of perceived quality, perceived value, and satisfaction on the intention to return to the national park of tourists. The research utilizes a convenient sampling method with direct interview techniques to collect research data. The achieved sample size is 308 tourists who have visited and experienced tourism services at national parks in the Mekong Delta region, Vietnam. Applying a combination of qualitative and quantitative research methods, the study has proven that perceived quality positively influences satisfaction, enhancing the intention to return to national parks of tourists. Additionally, perceived value also has a positive impact on satisfaction, contributing to promoting the intention to return to national parks. Finally, the research has revealed a positive correlatio n between satisfaction and the intention to return to national parks of tourists.

TOURISTS’ ATTITUDE TOWARDS DESTINATION FOOD IMAGE DETERMINANTS

The aim of this research article is to analyze the various dimensions which impact the destination food image in the state of Odisha, India. The framework of the study espoused five independent variables – attitude, social media, local food experience, food culture and advertisement and the dependent variable – destination food image, which studied the associations between them. A sample of 270 respondents were obtained via convenient sampling method. The study applied descriptive statistics, factor analysis, correlation analysis and regression analysis to run the data by using SPSS 23.0 and to examine the relationships between the constructs. It was found that all the dimensions had a positive and significant impact on destination food image. Practical implications in food tourism, destination image & food image are discussed. Recognising the value of regional delicacies and their market would help the hospitality and tourism sector. The study's conclusions are thought to be helpful to marketers who see that travellers are becoming pickier and more demanding in their quest for distinctive experiences provided by travel locations.

Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents’ psychological adjustment

BackgroundThis study aimed to explore discrepancies in adolescents with chronic illness and their parents’ perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness.MethodsA cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children’s hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis.ResultsAdolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents’ psychological adjustment reported by the adolescents (r = 0.45–0.48) were higher than parents (r = 0.18–0.23). In the line of congruence, there were positive linear (a1 = 1.09–1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents’ psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents’ sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01).ConclusionThe findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.

The protective effect of physical activity on mental health of middle school students at different stages during the COVID-19 outbreak

This study aims to further understand the changes in physical activity level(PAL) and mental health among adolescents before and after the outbreak of COVID-19 and explore the protective role of physical activity (PA) on the mental health of adolescents during major disasters. A convenient sampling method was used to conduct a cross-sectional survey. The cross-sectional data from 2838 Chinese middle school students (mean age = 14.91 ± 1.71 years, 49.54% female) were used, of which 1,471 and 1,367 were in 2021 and 2022, respectively. The PAL was collected using the Physical Activity Questionnaire for Children (PAQ-CN), mental health status was collected using the Mental Health Inventory of Middle School Students (MMHI-60), sociodemographic information was collected using a self-reported questionnaire. Before and after the outbreak of COVID-19, the PAL of adolescents was 2.36 ± 0.74 and 2.50 ± 0.66, respectively, with a significant difference (p < 0.01, 95% CI: 0.09, 0.19). The mental health scores were 1.71 ± 0.60 and 1.86 ± 0.73, respectively, with a significant difference (p < 0.01, 95% CI: − 0.20, − 0.10). The detection rates of mental health problems were 27.50% and 35.50%, respectively. The rates of achieving PAL standards were 30.20% and 18.00% among adolescents, while the rates of not achieving PAL standards were 39.60% and 18.00%. PA is a protective factor for the mental health of adolescents during major disasters.

Accurate Modeling of Ejection Fraction and Stroke Volume With Mobile Phone Auscultation: Prospective Case-Control Study.

Heart failure (HF) contributes greatly to morbidity, mortality, and health care costs worldwide. Hospital readmission rates are tracked closely and determine federal reimbursement dollars. No current modality or technology allows for accurate measurement of relevant HF parameters in ambulatory, rural, or underserved settings. This limits the use of telehealth to diagnose or monitor HF in ambulatory patients. This study describes a novel HF diagnostic technology using audio recordings from a standard mobile phone. This prospective study of acoustic microphone recordings enrolled convenience samples of patients from 2 different clinical sites in 2 separate areas of the United States. Recordings were obtained at the aortic (second intercostal) site with the patient sitting upright. The team used recordings to create predictive algorithms using physics-based (not neural networks) models. The analysis matched mobile phone acoustic data to ejection fraction (EF) and stroke volume (SV) as evaluated by echocardiograms. Using the physics-based approach to determine features eliminates the need for neural networks and overfitting strategies entirely, potentially offering advantages in data efficiency, model stability, regulatory visibility, and physical insightfulness. Recordings were obtained from 113 participants. No recordings were excluded due to background noise or for any other reason. Participants had diverse racial backgrounds and body surface areas. Reliable echocardiogram data were available for EF from 113 patients and for SV from 65 patients. The mean age of the EF cohort was 66.3 (SD 13.3) years, with female patients comprising 38.3% (43/113) of the group. Using an EF cutoff of ≤40% versus >40%, the model (using 4 features) had an area under the receiver operating curve (AUROC) of 0.955, sensitivity of 0.952, specificity of 0.958, and accuracy of 0.956. The mean age of the SV cohort was 65.5 (SD 12.7) years, with female patients comprising 34% (38/65) of the group. Using a clinically relevant SV cutoff of <50 mL versus >50 mL, the model (using 3 features) had an AUROC of 0.922, sensitivity of 1.000, specificity of 0.844, and accuracy of 0.923. Acoustics frequencies associated with SV were observed to be higher than those associated with EF and, therefore, were less likely to pass through the tissue without distortion. This work describes the use of mobile phone auscultation recordings obtained with unaltered cellular microphones. The analysis reproduced the estimates of EF and SV with impressive accuracy. This technology will be further developed into a mobile app that could bring screening and monitoring of HF to several clinical settings, such as home or telehealth, rural, remote, and underserved areas across the globe. This would bring high-quality diagnostic methods to patients with HF using equipment they already own and in situations where no other diagnostic and monitoring options exist.

Chronic Procrastination Among Iranians: Prevalence Estimation, Latent Profile and Network Analyses.

Procrastination is the deliberate, unjustified postponing of an intended course of action despite its costs or unfavorable effects. The present study used a self-report online survey and collected data from a large convenience sample of the general adult population (N = 2,076; females = 55.73%; Mage = 35.1years [SD ± 12.7]) with diverse demographics. Following the ring-curve distribution, the results indicated a 15.4% prevalence rate of procrastination among the Iranian community, which was significantly higher among women and divorced individuals and lower among nomadic individuals and those with higher academic degrees. A latent profile analysis demonstrated two distinct profiles, one for procrastinators (high scores on chronic procrastination, psychological distress, neuroticism, and extraversion; and low scores on general self-efficacy, self-esteem, satisfaction with life, openness, agreeableness, and conscientiousness) and one for non-procrastinators (demonstrating a reverse pattern compared to procrastinators). Moreover, additional network analysis suggested that the examined networks were invariant across procrastination status and gender. The results indicate that procrastination differs by demographic characteristics and is associated with a unique psychological profile. However, none of the aforementioned key study variables were considered a potential vulnerability for procrastinators due to the finding that all variables were peripheral and none were central in the examined networks.Therefore, relying on the differences in mean scores on psychometric scales does not appear to be an optimal way of determining the most important variables in a therapeutic context when treating procrastination.

Analysis of factors influencing the trajectory of fatigue in maintenance haemodialysis patients: a longitudinal study.

To explore the potential categories and influencing factors of fatigue trajectory in maintenance haemodialysis patients. Between June 2023 and December 2023, a convenience sample of 306 maintenance haemodialysis patients in a tertiary hospital haemodialysis centre in Zhenjiang City was selected as the study population, and patient information was collected monthly after the baseline survey using the General Information Questionnaire, Pittsburgh Sleep Quality Scale, Piper Fatigue Revision Scale, Collaborative Social Support Scale, Patient Health Questionnaire Depression Scale, Comprehensive Economic Toxicity Rating Scale, and Fear of Disease Progression Simplified Scale, for a total of six follow-up visits. In addition, the potential category growth model was used to identify the developmental trajectory of fatigue, and univariate analysis and binary logistic regression were used to analyse its determinants. The 6month fatigue trajectory of maintenance haemodialysis patients could be divided into two categories: persistent low-fatigue group (59.8%) and fluctuating high-fatigue group (40.2%). Age, surgical history, level of social support, sleep, economic toxicity, and changes in ultrafiltration volume during dialysis were the influencing factors for repeated fatigue in maintenance haemodialysis patients (p < 0.05). The fatigue trajectory of maintenance haemodialysis patients is heterogeneous, suggesting that clinical workers should focus on the haemodialysis patients with repeated fatigue and make targeted interventions to improve their fatigue status and reduce the occurrence of adverse events in patients.

UK horse owners and veterinary practitioners' experiences of decision-making for critical cases of colic.

The survival of horses diagnosed with critical colic (requiring referral or euthanasia) relies on rapid and effective decision-making by the owner and veterinary practitioner. To explore UK horse owners' and veterinary practitioners' experiences of decision-making for critical cases of equine colic. Qualitative study using a phenomenological approach. Individual, semi-structured telephone interviews were conducted with 14 horse owners and 13 veterinary practitioners (vets) who had experienced a critical decision (referral or euthanasia) for a horse with colic. A purposive, convenience sample of participants was recruited. Sessions explored participant's experience of colic, including recognition, help-seeking behaviour, and challenges. Thematic analysis was performed on collected data. Four over-arching themes were identified; 'head', 'heart', 'practicalities' and 'impact'. Owners acknowledged responsibility for their horse's welfare but had different perspectives than vets on the importance of finance ('head'). Both vets and owners described how the horse-human relationship ('heart') often led to conflict during decision-making. The vet-client relationship was influential on decision-making for both owners and vets; involving other people in decision-making was described both positively and negatively by participants ('heart'). 'Practicalities', such as lack of preparedness, transport issues and adverse weather conditions, were identified by both owners and vets as barriers. Owners described a 'rollercoaster' of emotions after a critical decision, with profound impacts on their mental wellbeing, feelings of guilt, and long-term changes in behaviour ('impact'), and a lack of support to manage these feelings. Small sample size. This study describes stakeholder decision-making during critical cases of equine colic. Factors that commonly influenced decisions included an owner's previous knowledge and beliefs, social pressures, logistics and the relationship between the owner and vet. The study highlighted long-term impacts on the owner, including their management and decisions for subsequent horses. These factors should be considered in shared decision-making.

Modeling a Caring Approach towards Children with Fallot’s Tetralogy Repair: A Focus on the Child’s Profile

Children with Tetralogy of Fallot (TOF) continue to be on the rise in Africa. More research is needed to improve caring approach towards children with surgically corrected TOF. The consequences of surgical correction of TOF remains an important area of research interest as children with TOF repair run the high risk of increase mortality resulting from acute cardiopulmonary problems. Yet little or no research published focused on investigating which clinical or para-clinical profile of children going in for surgical correction could be the cause of morbidity or mortality amongst children with TOF repair. The aim of the study was to determine the association between the profiles of children visiting the Surgical Heart Center for consultation with Tetralogy of Fallot (TOF) on the healing process after surgical repair. It was a descriptive quantitative study in which 303 nurses were issued questionnaires. Data was collected using convenient sampling technique and analyzed using multiple corresponding analysis in SPSS software version 21.0. The results showed that the clinical symptoms, clinical history, para-clinical characteristics, and postoperative complications identified three groups of children operated on for TOF: children with unstable hemodynamics; children who usually have symptoms such as systolic thrill, oppression in chest, tachycardia, and heart murmur; and finally children with symptoms of failure to thrive and heart murmur.

Challenges to Effective English Teaching in Primary Schools in Buraydah, Saudi Arabia: Perspectives of English Teachers

Despite extensive efforts to improve the quality of English language teaching, Saudi students in the local primary schools have a poor level of proficiency in English. Hence, this study aims to examine the barriers to effective English teaching from the perspectives of teachers in the primary schools in Burydah primary schools in Saudi Arabia. 50 teachers in primary schools in Saudi Arabia were recruited through convenience sampling. The study recruited teachers from Buryadah, a city in Saudi Arabia. Self-reported questionnaires with close- and open-ended questions were used to collect rich data. Several teacher-related, student-related, classroom-related, and school-related challenges were reported. Teachers believed that the key barriers to effective English teaching in descending order were the limited ability to use technology, limited technical support to use technology, irrelevant curriculum, lack of training in immersive learning, lack of student motivation, cultural differences among students, overcrowded curriculum, malfunctioning air conditioners, limited engagement at the class, impaired communication skills, limited use of interactive teaching methods, limited teacher training, dull curriculum or unengaging content, limited students&amp;rsquo; ability to use technology, large class size, and limited flexibility in adapting the curriculum to the interests and needs of students. There is a need for cooperation among teachers, school headmasters, students, policymakers, and parents to address these barriers.

Relationship between Stigma, Psychological Flexibility, Positive and Negative Affect in Patients with Epilepsy

Background: Epilepsy is a neurological disorder that significantly impacts the daily lives of individuals, leading to psychological, social, and cognitive challenges. Despite advancements in its management, stigma remains a substantial issue for epilepsy patients. Objective: This study aimed to investigate the relationship between stigma, psychological flexibility, and positive and negative affect in patients with epilepsy. Methods: This cross-sectional study included 200 participants, with 100 epilepsy patients and 100 healthy individuals, aged 18 to 45 years, from four major cities in Punjab, Pakistan. Data were collected using convenience sampling. The instruments used were the Internalized Stigma of Mental Illness (ISMI) inventory (epilepsy version), the Cognitive Fusion Questionnaire (CFQ), the Acceptance and Action Questionnaire (AAQ-II), and the Positive and Negative Affect Schedule (PANAS). Data analysis was conducted using SPSS version 25. Descriptive statistics summarized the demographic and clinical characteristics, and independent samples t-tests were used to compare the groups. Results: Epilepsy patients had significantly higher levels of internalized stigma (ISMI total score: 84.05 ± 11.77) compared to healthy individuals (52.79 ± 13.67), t(198) = 17.33, p &lt; 0.01. They also exhibited lower psychological flexibility (AAQ-II score: 39.23 ± 8.92 vs. 26.04 ± 10.07), t(198) = 9.81, p &lt; 0.01, and higher cognitive fusion (CFQ score: 39.62 ± 9.19 vs. 27.56 ± 10.44), t(198) = 8.67, p &lt; 0.01. Positive affect was lower in epilepsy patients (12.58 ± 4.13) compared to healthy individuals (15.30 ± 4.08), t(198) = 4.68, p &lt; 0.01, while negative affect was higher (19.97 ± 4.51 vs. 14.89 ± 4.69), t(198) = -7.81, p &lt; 0.01. Conclusion: The study demonstrated significant relationships between stigma, psychological flexibility, and affect in epilepsy patients. Addressing these factors is crucial for improving the psychological well-being and quality of life for individuals with epilepsy.

Relationships among health promotion behaviors, patient engagement, and the nurse practitioner-patient partnership.

Individuals adopting health promotion behaviors benefit from improved health and reduced risk of chronic diseases. Patient engagement and a strong provider-patient partnership may play a role in health promotion. This study examined the relationships between patient engagement, the nurse practitioner-patient partnership and health promotion behaviors among adults in a primary care setting. A descriptive correlational study using convenience sampling to recruit 85 participants from a nurse practitioner primary care practice. Participants completed questionnaires measuring health promotion behaviors (Health Promoting Lifestyle Profile II), the quality of the nurse practitioner-patient partnership (Patient Reactions Assessment), and a person's capacity to engage in their health care (Person Engagement Index). Moderate to strong correlations were found among the main study variables. Multiple regression analysis found a person's capacity to engage in health care significantly predicted health promotion behaviors (R2 = 0.362, p < .001) and explained 36.2% of the variance in health promotion behaviors. Patient engagement is a significant predictor of health promotion behaviors. The interactive care model can serve as a framework for nurse practitioners to build partnerships and facilitate patient engagement. Nurse practitioners can serve as a coach, navigator, collaborator, and trusted health care partner with their patients. Nurse practitioners in primary care may need to restructure the health care encounter to allow for adequate time to communicate, listen, educate, and enlist patients in the shared decision-making process. Nurse practitioners can provide the support patients need to engage in their health care as they accept greater responsibility for their health.

“It’s probably an STI because you’re gay”: a qualitative study of diagnostic error experiences in sexual and gender minority individuals

BackgroundThere is a critical need to identify specific causes of and tailored solutions to diagnostic error in sexual and gender minority (SGM) populations.PurposeTo identify challenges to diagnosis in SGM adults,...

Association of results of the glutaraldehyde coagulation test with plasma acute phase protein concentrations and hematologic findings in hospitalized cows.

The glutaraldehyde test (GAT) allows for animal-side semi-quantitative estimation of fibrinogen and gamma-globulin concentrations in blood samples of adult cattle and therefore detection of inflammatory disease conditions. However, the test has potential limitations, especially due to the latency period until sufficiently high fibrinogen and/or gamma-globulin concentrations are reached. The aim of the present study was therefore to assess the association between results of GAT with other inflammatory markers including hematologic variables, fibrinogen, plasma haptoglobin and serum amyloid A (SAA) concentrations. For the purpose of this prospective observational study, a convenience sample of 202 cows with a broad range of inflammatory and non-inflammatory clinical conditions was included. The GAT was run on EDTA blood, fibrinogen was measured using the Clauss and the heat precipitation method, and commercially available ELISA tests were used for determination of plasma haptoglobin and SAA concentrations. Shortened GAT coagulation times were more closely correlated to serum globulin (rs = -0.72) than to plasma fibrinogen concentrations measured with the heat precipitation (rs = -0.64) and the Clauss method (rs = -0.70). Cows with a markedly (≤3 min) or moderately (4-6 min) shortened coagulation time had higher (p < 0.001) plasma haptoglobin and SAA concentrations than cows with a negative test result. Total leukocyte, monocyte and neutrophil concentrations did not differ significantly between groups. An identified cut-off for the GAT coagulation time of ≤14 min had a sensitivity and specificity of 54.4 and 100%, respectively, for the prediction of an inflammatory state based on clinical findings and/or increased plasma haptoglobin or SAA concentrations. In conclusion, this study demonstrates considerable diagnostic agreement between positive GAT results and increased plasma concentrations of haptoglobin and SAA. Despite high specificity, the test lacks sensitivity in case of acute inflammatory conditions indicating that plasma acute phase protein concentrations and hematologic findings can provide additional diagnostic information if the GAT is negative.