Health Sciences Research Articles

Faculty development for supervisors of medical student rural attachments in Zimbabwe

Reflective writing and keeping portfolios during rural hospital attachments has been shown to give medical students more confidence, better communication skills and clinical competence, thereby making them stronger adult learners. The role of supervisors as facilitators of learning during Community-based Education rural site visits is critical. The University of Zimbabwe Faculty of Medicine and Health Sciences established faculty development workshops to train supervisors to be better able to support students in becoming active learners and critical thinkers, giving them constructive feedback, and encouraging them to look for positive outcomes during their rural attachments. These educational skills were new to most supervisors, requiring a culture change from the usual didactic approaches. Educators had to learn about adult learning theories, the constructivist approach to knowledge creation, role-modelling and methods of assessment that were empowering for students. They were encouraged to form communities of practice through the faculty development process of training and assessment and to consider how to develop research and scholarship in documenting their experiences as facilitators and learning partners with their students and colleagues. These activities enhanced their professional identity formation as scholars, educators and facilitators. Their exposure to the functioning of rural hospitals, partly through narratives of the students’ reflective writing, enabled them to develop a greater appreciation of the potential of primary care and the district health services as the foundation of the Zimbabwe health system. Future benefits could include application of this training to other health professional programmes, as part of interprofessional education.

Participant observation for inquiry-based learning: a document analysis of exam papers from an internship-course for master’s students in health services research in Germany

Inquiry-based learning (IBL) is a type of problem-based learning. While IBL aims at reflecting the work of practicing researchers, only some students will pursue an academic career. We therefore designed a course that provides opportunities for IBL by applying participant observation to internship work experience inside and outside academia. Using this internship course as an example, we investigated, how master’s students in health science executed an IBL assignment regarding the application of participant observation and presentation of findings. In addition, the understanding of occupational fields provided through the IBL assignment was examined.To determine whether learning objectives were met, a document analysis of IBL assignments comprising presentation slides and field protocols was performed. Within content analysis, a category grid was used examining (a) suitability of chosen research objectives, (b) execution of field protocols, (c) sufficiency of reporting and (d) extent of reflection.49 IBL assignments from the years 2020–2022 were included. Sides of IBL observations were: (a) organizations providing health care (n = 28); (b) administrations of health care (n = 8); and (c) research institutes (n = 13). Within students’ field protocols, the level of detail of descriptions differed. 30 assignments included reflection on the methods used and research experience. In about a third of IBL assignments, indication of observation type, theoretical background and data analysis was missing.Using participant observation of internship work-experience for IBL can serve as a teaching tool for students to develop methodological skills. For future courses, we developed a checklist to strengthen reporting, reflection and use of theory. As internships are often integrated in degree programs in health sciences similar courses could be implemented in different programs, given qualified methodological guidance.

Effectiveness of Electronic Learning Courses on Neurologist Knowledge of Epilepsy Classification: A Study Based on the Kirkpatrick Model

Background: Nowadays, it is generally accepted that focusing on in-service training can lead to organizational progress and improvements in the training process. Objectives: Considering the high prevalence of epilepsy in children and the use of new technologies in education, the purpose of this study was to conduct an electronic educational course on epilepsy classification guidelines based on the guidelines of pediatric neurologists and to evaluate the effectiveness of the course using the Kirkpatrick model. Methods: This study was conducted in 2020. The study population comprised pediatric neurologists from universities of medical sciences throughout the country. Inclusion criteria included participation in the course during the semester, availability, and willingness to participate in the study. Participants entered the study according to their personal preference and provided informed consent, and those who were absent from two or more sessions related to these topics were excluded from the study. The study involved participation in the e-learning course on epilepsy classification according to the guidelines (ILAE 2017). The sample size was calculated using Cochran's formula, which resulted in 74 participants. Nineteen of them did not meet the inclusion criteria, and a total of 55 physicians were included in the study. Reaction and learning were the levels considered to evaluate the efficacy of the Kirkpatrick model. To analyze the data, paired t-test and linear regression were used at a significance level of 0.05, using SPSS version 22 statistical software. Results: The results showed that most participants were satisfied with the e-course. The mean learning and behavior level score was 27.51. The findings indicated that the e-learning of epilepsy classification guidelines according to the guidelines (ILAE 2017) improved the performance of pediatric neurologists (P-value ˂ 0.001). Conclusions: The results indicate that e-learning guidelines for the classification of epilepsy according to the guidelines (ILAE 2017) can be an effective tool in improving the clinical performance of pediatric neurologists. Applying newer methods such as the Kirkpatrick model would be an effective approach in other fields of health as well. It is recommended to use up-to-date and efficient models, such as the Kirkpatrick model, in the field of health sciences.

A roadmap for improving representation in clinical trials

Clinical trials continue to struggle with recruiting diverse participants that include historically underrepresented and minoritized patients, who are typically patients in non-white racial and ethnic groups and have low income (Medicaid). Enrolling diverse participants will benefit the health sciences by providing more generalizable findings. The Cancer Financial Experience project (CAFÉ) study sought to improve financial distress by providing financial navigation for newly diagnosed cancer patients, and intentionally recruited diverse participants. All diverse participants consented at slightly higher rates than non-diverse participants (21.3 % vs. 20.1 %). Spanish-speaking patients consented at a much higher rate than non-Spanish speakers (36.4 % vs. 20.2 % respectively). Here we discuss how we increased our recruitment of diverse participants. Obtaining diverse participation is achievable and will provide more meaningful findings.

Chronopsychiatry

This editorial summarises the clinical relevance of ‘chronopsychiatry’, defined as the interface between circadian science and mental health science. Chronopsychiatry represents a move towards time-variable perspectives on neurobiology and symptoms, with a greater emphasis on chronotherapeutic interventions.

The European association for predictive, preventive and personalized medicine (EPMA) World Congress 2024: pioneering the intersection of tourism and health science

The European association for predictive, preventive and personalized medicine (EPMA) World Congress 2024: pioneering the intersection of tourism and health science

Experiences, health needs, and access to health services of university students with female circumcision: A qualitative study.

This study aimed to assess the female circumcision (FC) experiences, healthcare needs, and access to health services of foreign university students who are victims of female genital mutilation and studying in Turkey. This descriptive qualitative study was conducted in the Faculty of Health Science in a state university in Turkey from December 2021 to January 2022. Eight students who had been subjected to FC participated in this study. Data were collected by conducting in-depth, semistructured online interviews and using a pilot-tested interview guide. The data were analyzed using inductive thematic analysis. Four themes emerged: "reasons for performing FC, 'health effects of FC,' 'psychological problems linked to FC,' and 'FC survivors' access to health services.'" Students stated that they exposed to this practice because of limiting their womanhood, they experienced problems, such as pelvic pain, infection, loss of sexuality, fear of pregnancy and birth, and they had healthcare needs due to FC but face some barriers. FC negatively affects women's health and has specific healthcare needs. Studying in a different country can be turned into an opportunity to solve the health problems they experience. For this, the right approach with knowledgeable and culturally sensitive health professionals can change stereotypes towards practice.

Abstract B056: Empowering underserved communities: The impact of the Sun Bus and Texas Tech on skin cancer awareness and prevention in “Sun City”

Abstract Purpose: Ultraviolet radiation is the primary cause of skin cancer.1,2 Other risk factors include fair skin, moles, family history, and history of sunburns.1,3 Photoprotective practices and regular skin examinations can help prevent skin cancer associated with ultraviolet radiation,5-8 underlining the importance of prevention and early detection. However, dermatological health disparities, such as limited access to dermatologists and inadequate awareness of sun protection practices, present significant challenges to effective prevention and early detection efforts. Recognizing and addressing these barriers is crucial, particularly amongst minoritized groups, who carry a higher burden of skin cancer morbidity and mortality.9 The Sun Bus, affiliated with the Colorado Melanoma Foundation, travels across the United States providing free skin cancer screenings and prevention education to reduce the incidence of skin cancer.1 In collaboration with the Sun Bus, Paul L. Foster School of Medicine and Myth Busters at Texas Tech University Health Sciences Center El Paso organized a bilingual skin cancer education and screening community event in El Paso, Texas. The main objectives were to debunk skin cancer myths prevalent in underserved communities and to strengthen prevention initiatives. Methods: Participants were administered optional surveys assessing their skin cancer knowledge and prevention behaviors before and after attending the session. Demographic data was collected, and pre-event and post-event knowledge were quantified using unpaired T-tests. Results: The event was attended by over 100 people. Over 80% of the event attendees were Hispanic. Among them, approximately one-third had only graduated high school, another third had completed college, and one-quarter held advanced degrees. The ages of participants ranged from 18 to over 75. Notably, 22% of respondents were uninsured. All survey respondents reported learning something new from the event. The performance from the pre-test to the post-test improved significantly by 7.04% (p=0.017). Additionally, attendees reported better knowledge about where to apply sunscreen and the importance of wearing sun-protective clothing. Conclusion: The Sun Bus Community Initiative proved to be an effective method for participants to learn about sun protection, skin cancer prevention and screening. This initiative could serve as a model to implement in other underserved communities to improve skin cancer awareness and prevention. Citation Format: Daniel Lovasz, Brian Kan, Hannah Riva, Shravya Kichena, Fabiola Ramirez, Whitney Shaffer, Julia Guido, Mariana Arajuo-Rincon, Jessica Chacon. Empowering underserved communities: The impact of the Sun Bus and Texas Tech on skin cancer awareness and prevention in “Sun City” [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B056.

Abstract C012: Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students

Abstract Introduction: Medical student curriculum is lacking in standardized training of skills for conducting the skin cancer screening examination. Dermatology is not a standard clinical rotation during medical school, and many medical students do not have much exposure to the specialty of dermatology for hands-on training in skin examinations by dermatologists. We sought to create an event in conjunction with the Sun Bus that included education about dermatology and skin examination for medical students. Objectives We sought to assess how the effects on knowledge of dermatology and skin cancer prevention and screening among participating medical students changed from participating in the educational event. Methods: The Health Education and Awareness Team of Texas Tech University Health Sciences Center El Paso collaborated with The Sun Bus to organize a training event for medical students. During this event, students had the opportunity to listen to a panel about dermatology as well as the basics of skin cancer screening from working dermatologists. Students also received a brief training on skin cancer screening provided by The Sun Bus and conducted screenings alongside dermatologists during a free skin cancer screening event. Students completed voluntary pre-event and post-event surveys. Results The vast majority of students did not feel confident in their ability to screen for skin cancer prior to attending the event. This research showed improved student confidence in providing skin cancer screenings and identifying suspicious skin lesions from the intervention. Conclusion: Medical students lack standardized training in dermatology and in the dermatologic skin cancer screening examination. This student educational event represents a meaningful intervention that improved medical students’ confidence in providing skin cancer screenings and identifying suspicious skin lesions. Bibliography The Sun Bus. https://www.thesunbus.org/about-us Accessed 11 Dec 2023. Compres E, Holzem K, Ibler E, Bierman JA, Rademaker AW, Kundu RV. A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence. MedEdPORTAL. 2020;16:11049. Published 2020 Dec 29. doi:10.15766/mep_2374-8265.11049 Moore MM, Geller AC, Zhang Z, et al. Skin cancer examination teaching in US medical education. Arch Dermatol. 2006;142(4):439-444. doi:10.1001/archderm.142.4.439 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Citation Format: Elian A. Martin Lopez, Hannah Riva, Shravya Kichena Kichena, Daniel Lovasz, Brian Kan, Tannis Hogg, Jessica Chacon. Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C012

Abstract B124: Driving equity: Enhancing scientific workforce diversity through mentorship and grant writing workshops

Abstract A diverse scientific workforce fosters innovation, enhances global competitiveness, contributes to robust learning environments, improves the quality of research, advances the likelihood that historically underserved, or health disparity populations participate and benefit from health research, and enhances public trust. It isn’t merely their protected status that makes underrepresented minority scholars essential to a scientific workforce, but their culture, varying perspectives, creativity, and individual enterprise to address complex scientific problems. The Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, in collaboration with the Oklahoma Center for Mentoring Excellence, has implemented a grant- writing-focused mentorship program, D.R.I.V.E. (Developing Research Initiatives through Versatile Oncology Exploration). This program is tailored to underrepresented scholars who are predoctoral, postdoctoral fellows, or early-stage investigators. Developed in response to the growing need for underrepresented minorities in cancer research, the program aims to provide participants with both theoretical knowledge and practical experience in the grant writing process. The primary objectives of the D.R.I.V.E. program is to 1) discover and promote talented underrepresented scholars and researchers in the fields of cancer and cancer health disparities research, 2) establish an early career investigator mentorship program with a strong emphasis on grant writing, and 3) utilize Training Navigators (TNs) to oversee and monitor the advancement and productivity of recently identified prospective pipeline scholars. The program serves ten mentees by providing a workshop series of interactive sessions, including discussions and lectures led by a professional with extensive experience in securing research funding, practical exercises, and collaborative activities. Each participant will have a grant application ready for submission by the end of the program. Participants also receive support through pairing with one of five faculty mentors (grant-funded oncology researchers) while utilizing Training Navigators to oversee and monitor the advancement and productivity of the pipeline scholars. A post-program survey was sent to all D.R.I.V.E participants (n = 10) as an effort to evaluate the program’s effectiveness. Initial results indicate significant improvements in participants' confidence and skills in the grant writing process. Of those who completed the post-program survey (n = 7), everyone (100%) indicated that the DRIVE program exceeded their expectations, and everyone (100%) found the DRIVE mentors to be highly helpful in providing guidance and support. While only 71% of participants deemed the Training Navigator to be beneficial, 85% recognized clear opportunities for future collaboration. In conclusion, the D.R.I.V.E. program offers a comprehensive and engaging approach to professional development in the field of cancer research. Future iterations of the program will explore expanded content to further enhance learning outcomes. Citation Format: J'Lecia G. Jones, Natasha Mickel. Driving equity: Enhancing scientific workforce diversity through mentorship and grant writing workshops [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B124.

Health related quality of life and associated factors among patients treated for ischemic heart disease in public sector hospital Karachi, Pakistan

Objective: To determine the level of health-related quality of life among patients treated for ischemic heart disease in a public-sector tertiary care setting. Method: The analytical cross-sectional study was conducted from July to September 2021 at two tertiary care hospitals in Karachi after approval from the ethics review boards of the National Institute of Cardiovascular Diseases and the Dow University of Health Sciences, and comprised patients of either gender treated for ischemic heart disease after being diagnosed within the preceding year who were coming for follow-up in the outpatient department. Data was collected using the short version of the World Health Organisation quality of life tool. Association of socio-demographic and clinical variables with health-related quality of life was explored. Data was analysed using SPSS 21. Results: Of the 300 patients aged 25-85 years, 212(70.7%) were males and 88(29.3%) were females. The mean total quality of life score was 6.1+/-1.4, while mean general health was 52.6+/-10.5. The lowest score among quality of life subscales was for environmental 44.7+/-15.1, while the highest score was for psychological 60.1+/-10.7 domains. Quality of life was significantly associated with patients’ age, education, comorbidities, marital status, monthly income, body mass index, activities of daily living and smoking status (p<0.05). Conclusion: Ischemic heart disease patients had average health-related quality of life in all domains, but showed low quality of life in the environmental domain. Key Words: Health-related quality of life, Cardiovascular diseases, QOL, Quality of life, Ischemic heart disease, Coronary artery disease.

Abstract C147: Impact of genetic ancestry in triple-negative breast cancer subtypes

Abstract Background: Triple-negative breast cancer (TNBC) is an aggressive BC subtype characterized by significant molecular and clinical heterogeneity, influenced by genetic, phenotypic, and environmental factors, as well as interactions of the tumor with its surrounding milieu. A significant racial disparity has been observed between African American (AA) and European American (EA) women regarding the incidence and clinical progression of TNBC. TNBC frequently occurs in young parous women who self-identify as AA and in women who harbor a germline BRCA1 mutation. Notably, AA women are diagnosed with TNBC at a younger age and exhibit a higher risk of developing stage IV disease. Studies examining gene expression signatures that distinguish AA and EA TNBC have reported distinct tumor-associated immunologic profiles in AA patients. We have developed a novel cell type-driven subtyping system based on a racially diverse TNBC sample set that identified three TNBC subtypes, each with distinct biology and prognosis: CC1- immune signaling/T-cell response; CC2- pro- migratory/inflammatory; CC3- fatty acid and hormone and nuclear receptor signaling. In this study, we propose to examine ancestry-inferred differences within each TNBC subtype between patients with African and European ancestry. Methods: RNA-Sequencing data for the Louisiana Tumor Registry, a TNBC cohort of 250 diverse women [EA: 123 and AA: 127], was obtained from our collaborators at Louisiana State University Health Sciences Center. Genetic admixture was performed on 227/250 patients using the method described by Pakstis, A. J. et al. Differentially expressed genes (DEGs) were identified in pairwise comparisons at p-adj ≤ 0.05. Survival was assessed using log-rank tests. Results: We investigated DEGs within each subtype between patients with >60% African (Aa, n=102) or >60% European ancestry (Ea, n=99) (identified via admixture analysis). In all three subtypes, upregulated genes, and their associated enrichment in Aa were related to immune pathways, while DEGs in Ea patients were related to epithelial cell regulation. In CC1, Aa was associated with the upregulation of immunoglobulin genes involved in immunoglobulin production and antigen recognition, while Ea was associated with the upregulation of embryonic development genes. In CC2, Aa showed enriched complement activation and immunoglobulin genes, while Ea exhibited upregulation of basal cytokeratin and growth factor EGFR. In CC3, Aa was associated with the upregulation of inflammatory genes, whereas Ea showed upregulation of cellular senescence genes. Survival analysis demonstrated favorable outcomes for Aa in CC1 and less favorable outcomes for Aa in CC2. Conclusion: Our study highlights significant ancestry-inferred differences in gene expression within TNBC subtypes, with Aa patients showing immune pathways enrichment and Ea patients exhibiting differential epithelial cell regulation. These findings underscore the importance of considering genetic ancestry in TNBC prognosis and treatment strategies. Citation Format: Zahra Mesrizadeh, Kavitha Mukund, Fokrul Hossain, Jovanny Zabaleta, Denise Danos, Luis De Valle, Xiao-Cheng Wu, Chindo Hicks, Augusto Ochoa, Lucio Miele, Victoria L. Seewaldt, Shankar Subramaniam. Impact of genetic ancestry in triple-negative breast cancer subtypes [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C147.

Intellectual Capital of Medical and Health Sciences and the Efficiency of its Formation at Scientific Institutions

The formation of intellectual capital (IC) of medical and health sciences at scientific institutions (SIs) is highly topical for all people on the world. The object of the research is formation of IC of medical and health sciences at SIs while the subject of the research is the comparative analyses of the efficiency of the involvement of academic staff and PhD students in the formation of IC of medical and health sciences at SIs of Latvia. The objective of the research is to study the involvement of academic staff and PhD students in the formation of IC of medical and health sciences at SIs in Latvia in the period from 2013 to 2018. The following tasks were determined to reach the objective: to study the formation of IC of medical and health sciences at SIs; to identify the concept of the efficiency of the involvement of academic staff and PhD students in the formation of IC of medical and health sciences; to calculate main indicators thereof, and, to carry out the comparative analysis of indicators characterising the efficiency of the involvement of academic staff and PhD students in the formation of IC of medical and health sciences at SIs in Latvia. Research me-thods used in the paper are content analysis, economic analysis, and economic experiment.

Genotypic Variations Associated with Changes in Body Mass in Response to Endurance Training

ABSTRACT This study investigates the extent to which different genotypes can explain changes in body mass following an 8-week running program, in a UK population. Participants were randomly assigned to either a training (n = 17) or control group (n = 21). Participants’ diets were not altered, only the exercise regime was manipulated to isolate effects. The exercise group completed a periodized running program consisting of 20–30 min, over an agreed route, three times per-week, whilst the control groups refrained from daily exercise. Participants were screened at the end of the study for 1,000 gene variants using a DNA test kit. Results demonstrated a significant reduction in body mass, within the exercise, compared to the control group (p = .002). This reduction in body mass varied significantly (p = .024) between individuals within the exercise group. Moreover, genetic analysis identified 17 single nucleotide polymorphisms (SNPs) associated with this variation (r2 = .74; p < .001). These findings indicate that individuals with specific alleles are better predisposed to weight-management, compared to their counterparts, following an exercise program. This study helps to bridge the gap between population health and exercise science and can inform research in the application of genetics to help develop individually tailored health interventions.

Percepción de aprendizajes esperados en estudiantes de enfermería para el cuidado del paciente en situaciones críticas

Objective: to describe the expected learning outcomes perceived by fifth semester student nurses of the Health Sciences University Foundation –FUCS- Bogotá, Colombia, regarding critical care, after the implementation of a problem-based learning (PBL) didactic unit. Method: descriptive quantitative cross-sectional study in which, a Likert-type questionnaire designed Ad hoc, was applied. A sample of 43 students was obtained by convenience sampling. Results: we evaluated four dimensions: expected learning, care management, didactics and PBL. The highest score was obtained by care management, and expected learning received the lowest score. The first two dimensions, which were focused on learning and care management, obtained an average score of 4.11/5, and their relationship is very close to the achievement of competencies; on the other hand, the last two, aimed at evaluating the development of the PBL didactic unit, obtained an average score of 4/5. Conclusions: the use of the PBL methodology as a strategy in the teaching-learning process for the development of skills and competencies for care in critical situations was perceived as positive by students, thus, the institution should strengthen this type of training.

Learn@Lunch: Developing a continuing professional development programme to raise knowledge and awareness of drinking alcohol as an occupation in later life

Introduction: Occupational therapists in acute practice are increasingly likely to work routinely with people in later life who drink alcohol. Therefore, this knowledge translation study aimed to evaluate the development of a continuing professional development Learn@Lunch programme, designed to enhance awareness and understanding of occupational therapists who work in an acute hospital setting, of drinking alcohol as an occupation in later life. Method: Guided by the Promoting Action of Research Implementation in Health Sciences framework, the continuing professional development programme was developed, and a qualitative evaluation undertaken. This included pre- and post-focus groups with occupational therapists ( n = 8) in an acute setting, where the programme was delivered, pre- and post-programme delivery interviews with the research champion recruited from the site, and one interview with the Allied Health Professions Service Lead. Findings: Findings indicate the Learn@Lunch continuing professional development programme enhanced therapist knowledge and understanding of the changing patterns of drinking alcohol in later life. However, practical barriers exist impacting how participants perceived the value and delivery of the programme. Conclusion: Learn@Lunch was an effective continuing professional development programme and supported enhanced knowledge and awareness of drinking alcohol as an occupation in later life, leading to changes in local acute occupational therapy practice.

Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India

Background Better affordability of data plans and an increase in “budget” smartphones have resulted in an exponential rise in internet and smartphone users. The ease of access to sexually explicit material (SEM) coupled with adolescents’ impulsivity makes them prone to excessive SEM exposure and may affect the development of sexuality via the perceived realism of such content. This study was done to study the influence between problematic smartphone usage (PSU) and sexuality development among late adolescent boys. Methods One hundred and thirty-four adolescents aged 18-19 years, studying in a medical university, participated in this cross-sectional study. Smartphone Addiction Scale – short version (SAS-SV) to evaluate PSU and a content validated semi-structured proforma to evaluate gender identity, sexual orientation, sources of information on pubertal changes, and exposure to pornographic content was used. We expressed results as proportion and summary measures (Mean±SD), Chi-square test to find influence between PSU and adolescent sexuality development. Results We found a 45.5% prevalence of PSU. Among study participants, 88% were attracted to the opposite sex, 6% were attracted to the same-sex, and 6% were attracted to both sexes. Three per cent of participants liked wearing clothes of the opposite sex, 7.5% wanted to be members of the opposite sex, whereas 10.4% were not comfortable with their genitalia. They obtained information regarding pubertal changes from friends (85) and media (78). Many had exposure to pornographic content (90%), with the youngest being nine years old. Conclusion Nearly half of the late adolescents have PSU. Pornographic contents are accessed through Smartphones.

The Impact of Electronic Device Use on Dry Eye Disease Symptoms based on Age and Gender: A Cross-sectional Study in Health Science University Students

Background Individuals with dry eye disease (DED) may experience ocular symptoms, affecting their quality of life. DED is multifactorial and is related to age, gender, and other factors. While a study may contain examination results of DED symptoms in elderly populations, where electronic device use has contributed to DED, disease occurrence in younger populations, such as university students, remains unclear. Purpose We evaluated DED frequency and risk factors for health science university students using electronic devices during online courses. Methods This study is a cross-sectional study using a previously validated DED questionnaire [Computer Vision Syndrome questionnaire (CVSQ)], which contains three parts: student demographics, electronic device information, and DED symptoms. We conducted an observational cross-sectional study of 359 health science students (aged 18 and above) at King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, between October 2022 and January 2023. We collected data on electronic device variables and DED symptoms in this cohort. Results We recruited 359 male (29.2%) and female (70.8%) health science students. Participant ages ranged from 18–20 (62.4%) to 21–27 (37.6%) years old. Participants were asked 24 questions, which gathered information on electronic device type, screen time in online classes, occupational characteristics (smoking status), and associated eye symptoms, such as pain, redness, itchiness, dryness, and heavy eyelids. Based on most responses, the Tablet was the most used and preferred device (85%), with continuous use of the device during university courses/ activities (85.8%). The correlation of the survey parameters was only significantly related to gender and study years with DED symptoms. The highest eye symptom intensity levels (always to severe) indicated burning (6.7%) and dryness (8.6%) sensations. Lastly, a significant association was identified between DED symptoms and screen time, gender, and smoking status. Conclusion DED symptoms were commonly reported in university students who used electronic devices. Our study provides valuable insights into electronic device usage duration impacted the ocular health of females and younger students, aiding in preventing dry eye disease risks and maintaining good eye health.

A methodological exploration of the P-frame approach: Implications for developing phrase lists

The widespread availability of corpora and corpus tools has led to considerable advances in our understanding of phraseology and how it can be investigated. An increasingly influential approach to investigating phraseology is the retrieval and analysis of phrase frames (p-frames), recurrent word sequences with a variable slot. Although the p-frame approach is quite well-established, pedagogically oriented research in this area is still quite new, in particular the application of phrase frames to generate useful lists of phrases. This paper aims to contribute to methodological efforts in this direction by presenting a case study to illustrate decision-making throughout the process from corpus compilation to the generation of a final pedagogical list of phrases. Using a corpus of research article (RA) introductions in Health Sciences, this study shows how key decisions including p-frame length, frequency and range thresholds were arrived at. It also discusses exclusion criteria focusing on variability and predictability of p-frame fillers, and the fine-tuning of the resulting list, focusing on semantic coherence and pedagogical usefulness. Finally, we present the results of an initial evaluation of the list by stakeholders. The main contributions of the study to p-frame research methodology lie in the clarification of threshold settings, the potential contribution of variability and predictability to decision-making and the proposal of more in-depth concordance analysis of co-text to aid in the identification of phrases.

The Use of Nudge Strategies in Improving Physicians’ Prescribing Behavior: A Systematic Review and Meta-analysis

Background Nudges have been proposed as a method of influencing prescribing decisions. Purpose The purpose of this article is to 1) investigate associations between nudges’ characteristics and effectiveness, 2) assess the quality of the literature, 3) assess cost-effectiveness, and 4) create a synthesis with policy recommendations. Methods We searched health and social science databases. We included studies that targeted prescribing decisions, included a nudge, and used prescribing behavior as the outcome. We recorded study characteristics, effect size of the primary outcomes, and information on cost-effectiveness. We performed a meta-analysis on the standardized mean difference of the studies’ primary outcomes, tested for associations between effect size and key intervention characteristics, and created a funnel plot evaluating publication bias. Synthesis We identified 21 studies containing 25 nudges. In total, 62 of 85 (73%) outcomes showed a statistically significant effect. The average effect size was −0.22 standardized mean difference. No studies included heterogeneity analyses. We found no associations between effects and selected study characteristics. Study quality varied and correlated with study design. A total of 7 of 21 (33%) studies included an evaluation of costs. These studies suggested that the interventions were cost-effective but considered only direct effects. We found evidence of publication bias. Limitations Heterogeneity and few studies limit the possibilities of statistical inference about effectiveness. Conclusions Nudges may be effective at directing prescribing decisions, but effects are small and health effects and cost-effectiveness are unclear. Future nudge studies should contain a rationale for the chosen nudge, prioritize the use of high-quality study designs, and include evaluations of heterogeneity, cost-effectiveness, and health outcomes to inform decision makers. Moreover, preregistration of the protocol is warranted to limit publication bias. Highlights Nudging as a method to improve prescribing decisions has gained popularity during the past decade. We find that nudging can improve prescribing decisions, but effect sizes are mostly small, and the size of derived health outcomes is unclear. Most studies use feedback and error-stopping nudges to target excessive opioid or antibiotic prescribing, making heterogeneity analyses across nudge types difficult. Further research on the cost-effectiveness of nudges and generalizability is needed to guide decision makers considering nudging as a tool to guide prescribing decisions.