Lower Mean Scores Research Articles

Audio-Visual Distraction- A Non-Pharmacological Approach to Alleviate Pain in Pediatric Vaccine Administration: An Observational Study

Introduction: The routine vaccine injections are one of the most common and painful procedures during childhood specifically in infancy. In order to improve the effectivity of pain reduction during routine vaccination OPD this study was done to analyse the effectiveness of audio-visual gadgets as a distraction tool for pain reduction in infants during the vaccination procedure. Methods: A comparative observational study conducted at a tertiary healthcare center vaccination out patient department. Children aged 1 month to 2 years receiving the vaccine were included in the study. The study group was exposed to audio-visual clip while the control group received the vaccine as per routine vaccination protocol. The Face, Legs, Activity, Cry, Controllability Scale score was used to assess the behavioural reactions to pain which assesses five behavioural areas. The study protocol was approved by the Institute Ethics Committee (Reference number: BJGMC/IEC/1122238-238).Results: The Face, Legs, Activity, Cry, Controllability Scale score were studied among two groups, it was observed that the pain score and every component of the score had a statistically significant lower mean score in audio-visual group as compared to the control group. Mean pain score in the audio-visual group was 6.31±0.79 as compared to 9.57±0.65 in the control group with the p value of 0.001.Conclusions: A lower pain score in response to vaccination with an audio-visual distraction indicates that it can be regularly used to reduce pain during the vaccination procedure and can be used during different painful procedures.

Unveiling the nexus: Financial inclusion, financial literacy, and financial performance as catalyst for women-owned enterprises in India

ABSTRACT The imperative role of financial inclusion (FI) indispensably ensures the sustainability of women’s entrepreneurial endeavors in the evolving financial landscape. Scholarly narration provides evidence that women entrepreneurs fail to access financing due to their lower demand for funds, supply-side discrimination, and perceived structural barriers. Financial literacy (FL) is vital for FI. The study gauges the level of FI among Indian women entrepreneurs and its effect on firm performance (FP) with the moderating effect of FL. Data were collected from 216 women entrepreneurs through a structured questionnaire on the LinkedIn platform to assess the level of FL in the financial technologies era. The study revealed that traditional financial inclusion and digital financial inclusion significantly impact the FP of women’s enterprises. Further, there is evidence that a relatively lower mean score, FL, does not moderate the relationship between FI and FP. It urges policy reformers, financial institutions, entrepreneurial educators, and government bodies to promulgate policies and training programs on antecedents that enable long-term women’s entrepreneurial financial inclusiveness.

Level of perception on fertigation technology among Indigenous people in Perak, Malaysia

Fertigation technology has proven to be a successful method for enhancing crop yields by applying nutrients. It is cost-effective, easy to install, and simple to operate, which is why many farmers in Malaysia have adopted it. However, indigenous people have hesitated to use it due to negative perceptions. This study aims to determine the level of perception of indigenous people in Perak towards fertigation technology. The study uses a quantitative approach based on the Theory of Planned Behavior (TPB), with attitude, subjective norm, and perceived behavioural control as independent variables and perception towards fertigation technology as the dependent variable. A purposive sampling technique was used to select 150 respondents, and descriptive analysis was employed for data analysis. The findings demonstrate that the mean score for indigenous people's perception of fertigation technology was moderate (M = 2.7667, SD = 0.87774) including their attitude (M = 2.5875, SD = .94309). While subjective norm (M = 2.3343, SD = 0.90242), and perceived behavioural control (M =2.3933, SD = .86919) have a low mean score. These empirical findings provide valuable insights for policy-makers to help indigenous people adapt to modern technology and boost their economic growth, especially into actionable strategies that facilitate the adaptation of indigenous people to modern agricultural practices while respecting their cultural identity and promoting sustainable development.

KERANGAKA PVB BAGI SOALAN PENYELESAIAN MASALAH MATEMATIK BERBENTUK KBAT UNTUK MURID TAHUN 4 DI SK SERI ANGGERIK

This study aims to develop a Visual Bar Representation (VBR) framework for solving High Order Thinking Skills (HOTS) mathematical problems for Year 4 pupils at SK Seri Anggerik. The study uses a Type I Design and Development approach to develop the framework. In the Needs Analysis Phase, the pupils’ HOTS levels were tested using the Year 4 Mathematics HOTS Test instrument. In the design and development phase of the framework, the Fuzzy Delphi method was chosen, involving 13 experts to obtain agreement, consensus, and validation on the developed framework constructs. To test the usability of this framework, a quasi-experimental study without a control group was conducted. The findings from the needs analysis phase showed a low mean score for the pupils’ HOTS test, with a mean value of 15.21 scores. The results of the Fuzzy Delphi study indicated that experts agreed and reached a consensus on five elements and twelve sub-elements, with each item exceeding 85%. Findings from the quasi-experimental study without a control group showed a mean value of 31.97 for the pre-test and 72.14 for the post-test. In conclusion, the use of the VBR framework in mathematics learning can enhance pupils’ achievement in solving HOTS-based problems among Year 4 pupils.

Perception of medical students at public universities in Uganda on their education environment: a cross-sectional study

BackgroundThe healthcare workforce is one of the six core components of a well-functioning and sufficient health system. The WHO highlights that improving education and training of the health workforce is critical to improving health systems. Medical education is a pillar of the healthcare workforce. The educational environment - the physical circumstances or conditions under which learning takes place - is an important factor determining medical education’s effectiveness. Its academic and clinical effects significantly determine medical students’ attitudes, knowledge, skills, progression, and behaviors. To ensure strong health systems, there is a need for improvement in medical education. Improvement must be contextual and informed by locally relevant data. This study, which assessed Ugandan medical students’ perception of their learning environment, provides crucial context-specific data highly relevant to the current state of medical education in Uganda.MethodsThis quantitative cross-sectional study was conducted among medical students across five medical schools in Uganda between December 2021 and February 2022. Participants completed an online questionnaire with a demographics section and the Dundee Ready Education Environment Measure (DREEM) tool. The data was analyzed using R in R Studio version 2021.09.0 + 351. The average score for each DREEM sub-scale and the total DREEM score were calculated, and their relationship with demographic characteristics was examined.ResultsThe average total DREEM score of the 335 participants was 112.27/200 (56.12%). We found that 69% (231/335) of the students had a positive perception. The sub-scale mean scores were as follows: Perception of Atmosphere – 25.14/48, Social Self-perception − 14.94/28, Perception of Teachers − 24.86/44, Perception of Learning − 28.8/48, and Academic Self-perceptions – 19.04/32. “There is a good support system for students who get stressed” was the item with the lowest mean score (1.41/5).ConclusionsThe study’s findings indicate that medical students’ perceptions of their learning environment are just above average. This suggests a need for improvement, particularly in the atmosphere and social support, to ensure the training of a robust health workforce. The results of this study should motivate stakeholders to initiate changes that will enhance the quality of medical education in Uganda.

Talent management in volatility, uncertainty, complexity, and ambiguity (VUCA) health environment, nurses’ psychological contract fulfillment, cordial relation and generation: moderation-mediation model

BackgroundThe VUCA in the healthcare environment requires combating volatility, uncertainty, complexity, and ambiguity through highly talented employees and implementing a talent management strategy. This encompasses a range of operations designed to find, attract, nurture, and utilize competent workers that impact how well nurses fulfill their psychological contracts. However, as the researchers had anticipated, several factors, such as cordial relationships and generation differences, may mediate or influence this correlation.MethodsFor a cross-sectional study, a non-probability convenience sampling technique was used to include n = 375 nurses from among the 600 total nurses at three private hospitals in Alexandria, Egypt. Three validated measures were used to measure the study variables and develop a mediation-moderation structural equation model.ResultsThe result of this study revealed that nurses perceived a moderate level of talent management with a mean score of (48.91 ± 18.15), a low mean score (8.89 ± 3.93) of psychological contract fulfillment, and a moderate mean score (185.11 ± 27.02) of cordial relation. Additionally, more than half of the participants were in the Gen Z. Also, this study concluded that there is a positive mediation role of cordial relation and a negative moderation role of Gen between talent management and psychological contract fulfillment.ConclusionsUsing Gen as a moderating variable and cordial relations as a mediating factor, a moderating mediating structural equation model is created and validates the important influence of talent management on nurses’ psychological fulfillment, confirming the mediating effect of cordial relations and the moderating effect of genes in this relationship. GEN negatively predicted psychological contract fulfillment, meaning baby boomers predicted more psychological contract fulfillment than Z gen. Furthermore, talent management could positively predict cordial relations and psychological contract fulfillment, and cordial relations partially mediated the relationship between talent management and psychological contract fulfillment. Nurse mangers should be aware of and implement effective and talent management strategies with respecting gen difference, and apply tailored strategies for fostering nurses’ cordial relation and psychological contract fulfillment to deal with the VUCA challenging healthcare environment.

Clinical and patient-reported outcomes after oncoplastic versus conventional breast conserving surgery-a longitudinal, multicenter cohort study.

Oncoplastic breast conserving surgery (OP-BCS) is becoming increasingly popular to avoid mastectomy or optimize cosmetic outcomes of breast conserving surgery (BCS). Few studies have compared clinical outcomes and patient-reported outcomes (PROs) of OP-BCS to conventional BCS (C-BCS). This study aims to compare clinical outcomes and short and long-term PROs after OP-BCS and C-BCS in a large prospective breast cancer cohort. Women in the prospective, multicenter UMBRELLA-breast cancer cohort who underwent OP-BCS or C-BCS were included. Clinical outcomes and PROs (measured by EORTC QLQ-C30/BR23) up to 24 months postoperatively were evaluated. Mixed-model analysis was performed to assess differences in PROs over time between groups. 1628 (84.9%) patients received C-BCS and 290 (15.1%) OP-BCS. After C-BCS and OP-BCS, free resection margins were obtained in 84.2% (n = 1370) and 86.2% (n = 250), respectively, reoperation for re-exision of margins <3 months occurred in 5.3% (n = 86) and 4.8% (n = 14), median time interval from surgery until adjuvant systemic therapy was 66 and 63 days, and 36 and 41 days until radiotherapy. Shortly postoperative, OP-BCS was associated with statistically significant lower mean scores for physical functioning (83.6 vs 87.2) and body image (82.8 vs 89.4) and more pain (19.8 vs 26.5) and breast symptoms (22.7 vs 30.3) than C-BCS. Body image scores remained significantly less favorable after OP-BSC than C-BCS up to 24 months postoperatively (87.8 vs 92.2). Oncoplastic surgery safely enables BCS, but may lead to less favorable long-term body image compared to C-BCS. These findings are important for patient education and shared decision-making.

A study of the relationship between professional autonomy and professional quality of life among operating room personnel: A cross-sectional study

BackgroundHealthcare personnel's professional autonomy and professional quality of life can influence the quality of care provided to patients. However, there is scarce and contradictory information available about the relationship between these two factors. The present study aims to investigate the relationship between professional autonomy and professional quality of life among operating room personnel. MethodsThis cross-sectional study was conducted in teaching hospitals in the south of Iran in 2023. The sample consisted of 464 operating room personnel who were selected by quota sampling. Data were collected using Dempster Professional Autonomy Scale and Stamm's Professional Quality of Life Scale. The collected data were analyzed in SPSS v. 24. Level of significance was set at 0.05. ResultsThe participants’ professional autonomy mean score was found to be average (92.6 ± 73.32). Among the subscales of professional quality of life, the participants’ highest and lowest mean scores were for compassion satisfaction (35.3 ± 3.75) and secondary traumatic stress (31.2 ± 9.94) respectively. Also, the researchers found a significant inverse correlation between professional autonomy on the one hand and the professional quality of life subscales of burnout (p = 0.017, r = -0.111) and secondary traumatic stress (p = 0.005, r = -0.131) on the other. Moreover, there was a significant correlation between the operating room personnel's employment status on the one hand and professional autonomy (p = 0.004, r = -0.133) and burnout (p = 0.034, r = -0.099) on the other. The results also showed a significant inverse correlation between the subscale of burnout on the one hand and the variables of age (p = 0.021, r = -0.107) and work experience (p = 0.027, r = -0.103) on the other. ConclusionIn view of the findings of the study, the healthcare system administrators are recommended to adopt effective policies and strategies to promote operating room personnel's professional autonomy and professional quality of life.

Survey of Bariatric Surgeon Calibration Tube Use in Sleeve Gastrectomy.

The study objective was to identify variations in calibration tube use during sleeve gastrectomy and understand elements of ideal calibration tube performance. A survey was distributed via email and social media to bariatric surgeons, who were asked to rate the performance of their current calibration tube and an ideal calibration tube for five technical milestones involving visualization, positioning, suction capability, and sleeve sizing. Data was analyzed using descriptive and bivariate analyses including chi-square, Mann-Whitney, and Kruskal-Wallis tests. After eliminating incorrect screening question responses, 552 of 585 responses were analyzed. Demographics included 82% practicing in the USA, 64% in community practice, performing an average of 114 (SD = 94.5) sleeves annually. Calibration tubes used were most commonly reusable (54.2%) versus disposable (27.4%), endoscope (5.3%), or other (13.2%). Ninety-six percent of calibration tube sizes were 32 to 44 French. The reusable calibration tube had the lowest mean scores in all five technical areas, while the endoscope performed the best. When comparing surgeon current to ideal calibration tube performance, the endoscope performed closest to an ideal device, with significant p-values for technical milestones (i-iv). Despite the endoscope having the highest ratings for technical performance, surgeons rated higher satisfaction using disposable calibration tubes. Significant variation exists among the size and type of calibration tubes used for sleeve gastrectomy. Calibration tubes incorporating the visualization of an endoscope with the workflow of a disposable device could bridge technical performance and satisfaction goals for surgeons.

The Effect of Virtual Laboratories on the Academic Achievement of Undergraduate Chemistry Students: Quasi-Experimental Study.

Experimentation is crucial in chemistry education as it links practical experience with theoretical concepts. However, practical chemistry courses typically rely on real laboratory experiments and often face challenges such as limited resources, equipment shortages, and logistical constraints in university settings. To address these challenges, computer-based laboratories have been introduced as a potential solution, offering electronic simulations that replicate real laboratory experiences. This study examines the effect of virtual laboratories on the academic achievement of undergraduate chemistry students and evaluates their potential as a viable alternative or complement to traditional laboratory-based instruction. A quasi-experimental design was implemented to examine the cause-and-effect relationship between instructional methods and student outcomes. The study involved 60 fourth-year BSc chemistry students from Dilla University, divided into 3 groups: a real laboratory group (n=20), which performed real laboratory experiments; a virtual group (n=20), which used virtual laboratory simulations; and a lecture group (n=20), which received lecture-based instruction. Quantitative data were collected through tests administered before and after the intervention to assess academic performance. The data analysis used descriptive and inferential statistics, such as means and SDs, 1-way ANOVA, the Tukey honestly significant difference test, and independent-sample t tests (2-tailed), with a P value of .05 set for determining statistical significance. Before the intervention, the results indicated no significant differences in academic achievement among the 3 groups (P=.99). However, after the intervention, notable differences were observed in student performance across the methods. The real laboratory group had the highest mean posttest score (mean 62.6, SD 10.7), followed by the virtual laboratory group (mean 55.5, SD 6.8) and the lecture-only group, which had the lowest mean score (mean 43.7, SD 11.5). ANOVA results confirmed significant differences between the groups (F2,57=18.429; P<.001). The Tukey post hoc test further revealed that the real laboratory group significantly outperformed the lecture-only group (mean difference 18.88; P<.001), while the virtual laboratory group also performed significantly better than the lecture-only group (mean difference 11.7; P=.001). However, no statistically significant difference was found between the real laboratory and virtual laboratory groups (mean difference 7.12; P=.07). In addition, gender did not significantly influence performance in the virtual laboratory group (P=.21), with no substantial difference in posttest scores between male and female students. These findings suggest that computer-based laboratories are a viable and effective alternative when real laboratories are unavailable, enhancing learning outcomes when compared with traditional lecture-based methods. Therefore, universities should consider integrating computer-based laboratories into their practical chemistry curricula to provide students with interactive and engaging learning experiences, especially when physical laboratories are inaccessible.

Assessment of early attention in an Italian cohort of preschooler preterm children using the Early Childhood Attention Battery.

This cross-sectional monocentric study aims to utilize the Early Childhood Attention Battery to investigate early attention patterns in young preterm children and ascertain the extent to which their attentional abilities diverge from those of term peers. Inclusion criteria encompassed gestational age < 34 weeks, with assessments conducted between 3 and 5 years 11 months. Exclusion criteria included major brain lesions, significant motor or behavioral disorders, and intellectual functioning with IQ < 70. Preterm raw scores converted to scaled scores and percentiles. Frequency analysis compared preterm scores to norms. Non-parametric tests assessed significance between scaled scores and subgroups (age, gestational age, sex, birth weight). One hundred nineteen preterm patients were enrolled in the study between November 2016 and June 2023. Comparisons with published norms showed lower mean scores across all subtests and domains for preterm children. A notable proportion of assessments (13-40%) fell below the 5th percentile, with the dual task item in sustained attention being the highest (40%). Sex did not predict differences, except for auditory sustained and visual search subtests. Gestational age did not correlate with abnormal scores, consistent with previous studies. The prevalence of assessments below the 5th percentile highlights preterm children's vulnerability to attention issues. The test's sensitivity to attention deficits in preterm populations suggests its potential in identifying at-risk children early for tailored interventions. The battery effectively detects attentional deficits in preterm children. Early detection and targeted insights support tailored educational interventions. By focusing on specific attention skills, the battery guides clinicians in choosing individualized or group activities based on areas most affected. • Attention is often impaired in preterm children but it is not systematically investigated before school age. The ECAB is a tool specifically designed for preschool children. • Using the ECAB we evidenced a different level of attention between pre-term and term-born children at preschool age.

An Assessment of Rural Midwestern Schoolteachers' Nutrition Literacy and MyPlate Knowledge: Implications for Current Practice and Policy.

Background. Rural schoolchildren outpace their urban counterparts in obesity and diet-related chronic disease rates. Educating students on nutrition basics may help reduce these health burdens in this focus population. Rural schoolteachers are ideally positioned to teach students about nutrition; however, to teach nutrition, one must first understand basic nutrition concepts. The nutrition literacy and knowledge of rural schoolteachers, as well as strategies to and barriers for integrating nutrition into rural classrooms, are understudied. Examining these topics may provide a deeper understanding of nutrition education in rural schools. Methods. Data were collected via an online survey of K-12 teachers (n = 153) from seven Midwestern rural school districts. This survey collected data on nutrition literacy, nutrition knowledge, and preferred methods for implementing nutrition education into current curricula. Descriptive statistics were reported; associations between nutrition literacy and knowledge were examined. Results. Nutrition literacy levels were borderline low (mean score 45.7 out of 64). Nutrition knowledge and literacy were associated (p < .001). Most teachers (n = 108, 70%) were/may be willing to change lessons to incorporate nutrition information, with hands-on and group activities being preferred strategies. Barriers to including nutrition information into curricula included lack of time, knowledge, and resources. Most teachers reported little support from administration for promoting nutrition in the classroom. Discussion. Implementing nutrition education into teachers' continuing education requirements may provide a means of improving teacher nutrition literacy and knowledge. Support from both state-level and local administration could benefit both nutrition knowledge acquisition by schoolteachers and implementation of nutrition education throughout the curriculum.

Quality of Life Among Kurdish Patients With Knee Osteoarthritis in Duhok Governorate.

Osteoarthritis (OA) is a chronic disease and a leading cause for pain, stiffness, functional dependence, and diminished quality of life (QoL). The assessment of the latter in OA is becoming increasingly common in both research and clinical settings. The study aimed to examine OA among Kurdish patients with unilateral or bilateral OA. A cross-sectional study was conducted at the Duhok Centre of Rheumatology and Medical Rehabilitation in the Kurdistan Region of Iraq, involving 262 patients aged 40-70 who have unilateral or bilateral OA. The study subjects had the lowest mean QoL score in the domain of role limitations due to physical health problems (14.22±34.124). The highest mean QoL score was in the social functioning domain (86.78±20.878). Females had a statistically significant lower QoL mean score across most domains, except for emotional role functioning. Older patients (over 50) had lower scores in several domains, such as physical function, physical role functioning, energy/fatigue, social functioning, and bodily pain. Longer disease duration is correlated with lower QoL scores in most domains, except emotional well-being. Obesity negatively impacted QoL in terms of physical function and pain dimensions. Finally, the severity of osteoarthritis is positively correlated with a lower QoL score in the domains of physical functioning, physical role functioning, energy/fatigue, social functioning, and the pain component. QoL is diminished in Kurdish patients with unilateral or bilateral knee OA and is influenced by age, gender, obesity, disease duration, and OA severity.

Utilization of Artificial Intelligence in the Creation of Patient Information on Laryngology Topics.

To evaluate and compare the readability and quality of patient information generated by Chat-Generative Pre-Trained Transformer-3.5 (ChatGPT) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) using validated instruments including Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease, DISCERN, and Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). ENTHealth.org and ChatGPT-3.5 were queried for patient information on laryngology topics. ChatGPT-3.5 was queried twice for a given topic to evaluate for reliability. This generated three de-identified text documents for each topic: one from AAO-HNS and two from ChatGPT (ChatGPT Output 1, ChatGPT Output 2). Grade level and reading ease were compared between the three sources using a one-way analysis of variance and Tukey's post hoc test. Independent t-tests were used to compare DISCERN and PEMAT understandability and actionability scores between AAO-HNS and ChatGPT Output 1. Material generated from ChatGPT Output 1 and ChatGPT Output 2 were at least two reading grade levels higher than that of material from AAO-HNS (p < 0.001). Regarding reading ease, ChatGPT Output 1 and ChatGPT Output 2 documents had significantly lower mean scores compared to AAO-HNS (p < 0.001). Moreover, ChatGPT Output 1 material on vocal cord paralysis had a lower PEMAT-P understandability compared to that of AAO-HNS material (p > 0.05). Patient information on the ENTHealth.org website for select laryngology topics was, on average, of a lower grade level and higher reading ease compared to that produced by ChatGPT, but interestingly with largely no difference in the quality of information provided. NA Laryngoscope, 2024.

Association among therapeutic adherence, health literacy, and engagement in care: How to increase health-conscious management of HIV disease.

In the context of People Living with HIV (PLWH), poor health literacy (HL) seems to be linked to poorer health outcomes and reduced engagement in care. Additionally, the level of HL can affect HIV knowledge and may impact adherence to antiretroviral therapy (ART). This research explored the connection between ART adherence, HL, and engagement in care in a cohort of 250 PLWH receiving ART in Italy. A questionnaire was given to PLWH at Policlinico Gemelli in Rome to assess their health literacy and adherence to therapy. The Brief Health Literacy Screening (BHLS) and the Newest Vital Sign (NVS) were used to evaluate subjective and objective HL. Adherence levels were self-reported as poor, good, or excellent, and the assessment included the Patient Health Engagement Scale (PHE-S). Notably, the majority of the sample comprised male individuals (67.9%), with 69.2% reporting a 10-years or longer duration between their HIV diagnosis and their initiation of ART. It was found that PLWH with poor adherence had low schooling, had been living with HIV for 1-5years, were HCV co-infected, had a viremia >50copies/mL, poor health status, poor engagement in care, and poor HL (p = <0.001). They exhibited lower mean scores on the subjective HL scale and lower CD4 T-cell counts and nadir CD4 T-cell counts (p < .001). Our study demonstrated a positive correlation between higher HL levels and improved disease management, treatment adherence, and overall physical and mental well-being. Enhanced HL capabilities are paramount in bolstering health management and treatment adherence.

Dynamics trajectory of patient-reported quality of life and its associated risk factors among hepatocellular carcinoma patients receiving immune checkpoint inhibitors: a prospective cohort study.

We aimed to characterize quality of life (QOL) trajectories among patients with intermediate and advanced hepatocellular carcinoma patients treated with immunotherapy. Barcelona Clinic Liver Cancer (BCLC) stage B-C HCC patients receiving immunotherapy at Guangxi Medical University Cancer Hospital were included. Trajectories of QOL, assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire, were identified through iterative estimations of group-based trajectory models. Associations with trajectory group membership were analyzed using multivariable multinomial logistic regression. Three trajectory groups were identified (n=156): excellent (35.3%), poor (43.6%), and deteriorating (21.1%) QOL. The deteriorating trajectory group reported a mean QOL score of 124.79 (95% CI, 116.58-133.00), but then declined significantly at month-2 (estimated QOL score 98.67 [95% CI, 84.33-113.00]), and the lowest mean score is reached at month-6 (estimated QOL score 16.58 [95% CI, 0-46.07]). Factors associated with membership to the deteriorating group included no drinking (odds ratio [OR] vs yes [95% CI], 3.70 [1.28-11.11]), no received radiotherapy (OR vs yes [95% CI], 8.33 [1.41-50.00]), diabetes (OR vs no [95% CI], 6.83 [1.57-29.73]), and extrahepatic metastasis (OR vs no [95% CI], 3.08 [1.07-8.87]). Factors associated with membership to the poor group also included body mass index ≤24.0 kg/m2 (OR vs no [95% CI], 4.49 [1.65-12.22]). This latent-class analysis identified a high-risk cluster of patients with severe, persistent post-immunotherapy QOL deterioration. Screening relevant patient-level characteristics may inform tailored interventions to mitigate the detrimental impact of immunotherapy and preserve QOL.

Quality of clinical practice guidelines for frozen shoulder: a systematic review.

Perform a systematic critical appraisal of current clinical practice guidelines (CPGs) for frozen shoulder. Systematic review of CPGs (PROSPERO number CRD42022368775). Inclusion criteria- CPGs written in English providing guidance on the evaluation and or treatment for frozen shoulder, traumatic injury and neurologic CPGs were excluded.Relevant studies were assessed for inclusion and selected studies were identified from PubMed, EMBASE, Scopus and CINAHL databases. The search strategy was developed by a biomedical librarian, performed on October 9, 2024. Data were extracted from the selected CPGs and underwent quality assessment using the Appraisal of Guidelines for Research and Evaluation (AGREE) II. The search resulted in 38,428 studies and 2 CPGs were retained for appraisal. The mean overall AGREE II score was 75% (SD = 5.7). Lowest mean scores were found in the applicability (27% SD = 24.0) and editorial independence (48% SD = 14.1) domains. The highest domain scores were found in scope and purpose (92% SD = 7.8) and clarity and presentation (79% SD = 9.9). One CPG was rated as low quality based on a priori criteria and ultimately one higher quality CPG was recommended. Given the advances in research that have developed over the last decade pertaining to the evaluation and treatment of frozen shoulder there is a critical need for an up to date, evidence informed, high quality CPG in order to identify gaps in our knowledge that the global research community should address.

Sensory processing and child appetitive traits: findings from the ROLO longitudinal birth cohort study

BackgroundOral sensory hypersensitivity has been linked with fussy eating predominantly in non-typically developing children. We hypothesized that child ‘Oral’ (touch, smell and taste in the mouth) and ‘Social-Emotional’ (response to social expectations) sensory processing are associated with child appetitive traits in typically developing preteen children. Additionally, we explored relationships between maternal sensory profiles and their offspring’s sensory profile.MethodsThis is secondary analysis of 130 mother-child dyads from the 9–11-year-old follow-up of the ROLO longitudinal birth cohort study. The Dunn Sensory Profile (Adolescent/Adult) and the Dunn Child Sensory Profile 2 were used to assess maternal and child sensory profiles, respectively. The Children’s Eating Behaviour Questionnaire was used to assess child appetitive traits. Multiple linear regression examined associations between ‘Oral’ and ‘Social-Emotional’ segments of the child sensory profile and child appetitive traits. Associations between maternal and child sensory profiles were examined using sensory profile quadrants (Dunn’s sensory processing framework). These refer to four distinct patterns of sensory processing that indicate how an individual responds to sensory input.ResultsIn total, 130 mother-child dyads were included. In adjusted analysis child ‘Oral’ sensory processing was associated with higher mean scores in the appetitive traits ‘Desire to Drink’ (B = 0.044, 95% CI = 0.025,0.062) and ‘Food Fussiness’ (B = 0.080, 95% CI = 0.059,0.101) and with lower mean scores in ‘Enjoyment of Food’ (B=-0.038, 95% CI -0.055,-0.022). Child ‘Social-Emotional’ responses were associated with higher mean scores in ‘Desire to Drink’ and ‘Food Fussiness’. Higher scores in the maternal sensory profile quadrants of ‘Sensitivity’, ‘Avoiding’ and ‘Registration’ were positively associated with higher scores in the corresponding child sensory profile quadrants.ConclusionOur findings suggest that in typically developing children presenting with fussy eating, oral sensory hypersensitivity and higher scores in social-emotional responses to sensory processing may be an underlying determinant. The relationship observed between ‘Oral’ and ‘Social-Emotional’ sensory processing segments and ‘Desire to Drink’ requires further research to ascertain the type of drinks being consumed and how this impacts appetite. Further research is also required to explore the influence of maternal sensory profile on their offsprings response to sensory input.

Normalization of the Constant score in the Spanish population

BackgroundNormal Constant score values for healthy shoulders can vary between regions and change over the years as life expectancy increases and physical condition improves. Spain’s population is one of the healthiest and has one of the highest life expectancies in the world, which could be reflected in its normal Constant score values. The purpose of this study is finding the normal Constant score values in the Spanish population. MethodsCross-sectional study completed between 2023-2024, including subjects older than 18 years of age without any previous or ongoing shoulder condition. Constant score was taken for both shoulders of every subject. A stratified analysis of total and subtotal scores was performed, grouping subjects by age and sex. ResultsA total of 505 subjects and 1010 shoulders were included, with a mean age of 52.3 ± 18.6 years and men/women ratio of 39.6%/60.4%. Five groups were formed according to age: 18-30 years-old (18.4%), 31-45 years-old (16.4%), 46-60 years-old (29.8%), 61-75 years-old (23.7%), and over 75 years-old (11.7%). Each of these groups were divided in two groups according to sex, making a total of 10 groups. Mean Constant score was 88.9 ± 10.9, the group of men between 18-30 years-old having the highest mean score (99.2 ± 3.0) and the group of women over 75 years-old having the lowest mean score (75.3 ± 8.8). A statistically significant inverse correlation was found between total score and age (r = -.47, p < .001). Total score was also significantly lower in the women (84.5 ± 8.2 vs 92.6 ± 8.5, p < .001). The decrease in mobility (r = -.45, p < .001) and strength (r = -.40, p < .001), and the difference in strength between the men and the women (10.6 ± 3.8 vs 6.0 ± 2.0, p < .001) were the main underlying causes of the difference in total Constant score between groups. ConclusionNormal values of the Spanish version of the Constant score in healthy shoulders of the Spanish population decrease with age and are lower in women, the main differences being found in shoulder mobility and strength. Global scores found in this population are higher than those previously published for English, American, and Swiss populations.

Factors influencing health-promoting behavior among single mothers in Northeastern Malaysia: a cross-sectional study.

Health-promoting behaviors (HPB) play a vital role in maintaining and enhancing overall well-being. Single mothers are at higher risk of cardiovascular disease (CVD) and less involvement in HPB due to psychosocial disadvantages. This study aimed to determine the HPB scores and factors influencing HPB among single mothers in Kelantan (Northeastern, Malaysia). This study employed a cross-sectional design, selecting 242 single mothers from Kelantan through proportional stratified sampling. Data were gathered through questionnaires covering sociodemographic details, the Health-Promoting Lifestyle Profile-II (HPLP-II), the Malay Version of Health Beliefs Related to Cardiovascular Disease (HBCVD-M), and Multidimensional Perceived Social Support (MPSS). The relationships between the dependent variable (HPB) and independent variables were analyzed using multivariable linear regression models. The respondents achieved an average HPB score of 118.03 (SD = 19.2), with the highest mean scores in spiritual growth (22.46 [SD = 3.70]) and interpersonal relationships (22.05 [SD = 3.67]). Physical activity had the lowest mean score at 15.09 (SD = 4.62). Significant positive associations were found between HPB and perceived severity of CVD (adjusted β = 1.60; 95% CI [0.68-2.53]; p<0.001) as well as perceived social support (adjusted β = 0.63; 95% CI [0.37-0.90]; p<0.001). Conversely, educational level (adjusted β = -10.36; 95% CI [-16.06 to -4.67]; p<0.001) and perceived benefits of reducing CVD risk (adjusted β = -1.43; 95% CI [-2.37 to -0.48]; p<0.001) were negatively associated with HPB. The findings highlight the importance of health beliefs, social support, and education in shaping HPB among single mothers. Community health initiatives targeting this population should develop strategies to strengthen individuals' health beliefs and promote a supportive environment.