Low Levels Of Confidence Research Articles

Treating the perimenopause in the UK armed forces: a mixed methods review exploring the confidence of general practitioners.

Access to high-quality perimenopause (PMP) care for UK Armed Forces (UKAF) personnel is crucial, given the increasing proportion of women aged 40-55. However, due to the lack of exposure of General Practitioners (GP) to the PMP in Defence Primary Health Care (DPHC), there are concerns about the confidence in PMP management, particularly in prescribing hormone replacement therapy (HRT). To assess the confidence of GPs working in DPHC in the management of the PMP. This study employed a mixed methods approach and included all GPs (Uniformed and Civilian) working in DPHC. A cross-sectional survey gathered quantitative data on demographics, views on perimenopause care, and self-rated confidence levels in managing the perimenopause among Defence GPs. Semi-structured interviews of purposefully sampled respondents was thematically analysed to explore this further. There were 164 responses from 542 Defence GPs (response rate 30.3%). The majority of respondents expressed confidence in managing the perimenopause but reported lower confidence levels in prescribing HRT for younger women and initiating testosterone. Factors influencing confidence included recent perimenopause continuing professional development (CPD), GP gender, and exposure to perimenopause cases. Semi-structured interviews provided deeper insights into GP characteristics, CPD, and awareness of the PMP. Women's health hubs providing PMP care and experiential education were strongly supported. While the study identified gaps in confidence among Defence GPs, particularly in certain aspects of perimenopause management, similar to those found in NHS GPs. CPD and case exposure were important predictors of confidence, with strong support for regional women's health hubs to optimise PMP care. Further research is warranted to explore strategies for bridging confidence gaps and improving perimenopause care delivery within the UKAF context.

The impact of cultural values on students’ communication apprehension in online classrooms: The moderating role of gender

In the post-COVID-19 era, online learning has become an integral part of higher education institutions (HEIs). However, limited evidence suggests that communication apprehension (CA) is a core issue in the lack of engagement in online classrooms. This study seeks to investigate how students’ CA dimensions (i.e., communication participation avoidance and low level of communication confidence) can be predicted by their cultural values using horizontal and vertical individualism/collectivism (HVIC) classification. Moreover, this study examines gender differences as a moderator in the relationship between CA and cultural values. This quantitative survey used an online questionnaire for data collection. A total of 498 samples of data were collected From MBA students studying at the seven most prestigious Iranian business schools. The results of data analysis using SmartPLS4 indicated that the CA levels of MBA students are affected by their cultural values in the HVIC classification (excluding vertical collectivism). Additionally, this study revealed that gender plays a moderating role in the relationships between cultural values and CA dimensions. In general, the results indicated that HEIs should foster a culture that supports individualistic values—such as privacy, independency, self-fulfillment, and individual decision-making—in order to lower CA levels among MBA students.

Developing Green Marketing Strategies: A Comprehensive Analysis of Consumer Behaviour and Business Practices

The purpose of this research is to examine the relationship between green marketing communication techniques, consumer behaviour patterns, and business organisations’ practices by employing both qualitative and quantitative methodologies. A hypothesized quantitative survey with 500 consumers and a qualitative case study of leading organisations to assess modern tendencies and approaches were carried out. The quantitative analysis shows that 70% of the consumers take environmental concern while purchasing products, but only 45% are ready to pay the premium price for green products. Moreover, there is a low level of confidence in green claims where only 30% of the consumers are confident that firms have sincere intentions about the statements they make. An analysis of Nike, Starbucks, and Toyota, Apple, and Microsoft organizations shows that they incorporate different strategies in supply chain management, carbon footprint, corporations’ responsibility, and customer relations. Some of these firms focus on the promotion of the company’s transparency, product sourcing based on an ethical approach, encouragement of the use of renewables, as well as community involvement in fulfilling sustainable objectives. Thus, the study also stresses the importance of clarity within communication channels and information reliability for the development of consumers’ trust. It defines factors like the cost and every person’s doubt or disbelief in what is green that prevents an extensive use of green products. Altogether, this research contributes useful knowledge for companies wanting to implement suitable green marketing initiatives that would be appealing to eco-aware consumers. It is clear that implementing corporate practice according to the customer expectation and practicing transparency would not only increase the brand value but also the customer loyalty and which in longer runs would also help in supporting and implementing sustainable development goals across the world.

Talking About Incarceration History: Engaging Patients and Healthcare Providers in Communication.

Incarcerated individuals in carceral facilities demonstrate an elevated prevalence of chronic disease conditions which are likely to persist post-release. Healthcare providers may not be trained on how exposure to incarceration may influence patient health outcomes and patient-provider communication. To examine the self-perceived preparedness of healthcare providers to interview patients regarding history of incarceration and the potential related health consequences. This cross-sectional study consisted of a web-based self-administered questionnaire distributed via email to a random sample of healthcare providers in the Department of Medicine at Brigham and Women's Hospital. In total, 400 healthcare providers were invited to participate; 114 respondents completed the survey, of which 26% were medical doctors (n=30), 41% were physician assistants (n=47), and 32% were nurse practitioners (n=37). Understanding healthcare provider training in caring for formerly incarcerated patients, current treatment practices and confidence caring for patients who have experienced incarceration, and implications for clinical care. Of 114 respondents, 73% reported that they currently care for formerly incarcerated patients. However, only 8% received specialized training for the care of formerly incarcerated patients. While most respondents did not ask their patients about prior history of incarceration (81%), when asked about comfortability in doing so, 60% reported low levels of comfort. Most providers (77%) reported high agreement that incarceration impacted health, with 54% reporting that it led to significant healthcare access barriers, but 64% reported low confidence levels in addressing the needs of formerly incarcerated patients. Healthcare workers recognized incarceration as a detrimental health exposure. However, providers reported low levels of confidence in understanding and addressing the unique needs of patients who experienced incarceration. Findings support the need for further training regarding how to address the needs of formerly incarcerated patients, which would support efforts towards achieving equitable healthcare.

Is confidence in knowledge related to childbirth fear and mode of birth among Polish women?

Abstract Background In Poland, cesarean section (CS) rate is 48% what means that it is one of the highest rate among OECD countries and the highest in the European Union. WHO has considered that CS rates higher than 15% at the population level are not associated with reductions in maternal and newborn mortality rates. Fear and attitudes towards childbirth are shaped years before the first pregnancy. Yet, little is understood about how young people’s knowledge, attitudes and fears concerning the birth process shape their healthcare preferences around birth. Thus, the aim of the study was to examine whether confidence in knowledge was associated with childbirth fear prior to pregnancy and preference for CS. Methods We recruited 782 women aged 18 - 35 (mean 24.7, sd = 3.19) who had never been pregnant but wished to have at least one child in the future. The women answered questions about: (i) socio-economic situation, (ii) confidence in knowledge and educational needs related to pregnancy and childbirth; (iii) fear of childbirth prior to pregnancy; (iv) preferred mode of birth in the hypothetical pregnancy in which there are no medical indications for cesarean section. Results Almost one in four women (22.1%) preferred CS in a hypothetical low-risk pregnancy. In addition, most often young women gained knowledge on pregnancy and birth from experiences and stories of family members (62.3%). Women with moderate and high level of confidence in knowledge had respectively lower odds of high level of childbirth fear prior to pregnancy comparing to women with low level of confidence in knowledge (OR = 0.57, 95% CI: 0.39-0.83 and OR = 0.54, 95% CI: 0.33-0.88, respectively). Conclusions Increasing knowledge about pregnancy and childbirth among young women might lower childbirth fear and thus, indirectly, lower rates of CS in the future. Key messages • The results of this study may solve very important public health problem i.e. the growing rates of cesarean section. • Confidence in knowledge may be an important factor associated with the level of childbirth fear.

Firearm screening and intervention beliefs and practices among U.S. Air Force (USAF) mental health providers and behavioral health technicians.

We examined beliefs and practices regarding firearm assessment and lethal means safety counseling (LMSC) among U.S. Air Force (USAF) mental health providers (MHPs) and behavioral health technicians (BHTs). Data were collected from 204 USAF MHPs (74.0%; n = 151) and BHTs (26.0%; n = 53) via an anonymous, voluntary survey. A modest proportion indicated they strongly/extremely believe that firearm ownership (42.2%) and storage practices (58.3%) are related to suicide risk. A minority indicated they "strongly"/"extremely" believe that LMSC will yield changes in storage practices (30.9%) and decreases in suicide risk (29.9%). Across patient scenarios, most indicated that "most of the time"/"always" they assess for firearm access (74.5%-99.5%) and provide LMSC (57.8%-95.6%). About half (52.5%) reported having distributed cable locks. Most (59.3%) indicated they are somewhat interested/very interested in receiving additional training on LMSC. MHPs, compared with BHTs, were significantly more likely to report believing a link between firearm ownership and storage practices and suicide risk, believing LMSC is effective at reducing suicide risk, providing LMSC to female patients and patients with current suicidal ideation, and having distributed cable locks. Findings suggest that there is not widespread agreement among USAF MHPs and BHTs that personal firearm ownership and nonsecure storage practices are associated with elevated suicide risk, and there were low levels of confidence in the effectiveness of LMSC. Yet, most USAF MHPs and BHTs reported they integrate firearm access assessment and LMSC as part of their routine clinical care, particularly for patients with identified suicide risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ethical self-efficacy among healthcare professionals caring for people with dementia: a brief pre- and post-report on the CARE intervention

BackgroundInterventions targeting healthcare professionals’ confidence in managing ethical issues in dementia care are limited despite documented positive effects of educational programs on staff knowledge and self-efficacy. However, inconsistencies in the literature regarding the impact of educational programs underscore the need for targeted interventions. The CARE intervention, specifically designed to enhance confidence in ethical decision-making, aims to address this gap. This study evaluates the effectiveness of the CARE intervention in enhancing the ethical self-efficacy of healthcare professionals caring for people with dementia, particularly those with initially low levels of self-efficacy.MethodsUsing a non-experimental pre-post evaluation design, the CARE intervention was administered to healthcare professionals (n = 86), measuring ethical self-efficacy pre-and post-intervention. We hypothesized significant differences in ethical self-efficacy mean scores pre- and post-intervention for all participants, particularly those with low pre-measurement scores, whom we expected to benefit most from the intervention. Statistical analysis included paired t-tests and Wilcoxon tests for the low pre-measurement subgroup analysis.ResultsWhile no significant change was observed in the entire sample, participants with low initial self-efficacy showed a statistically significant improvement post-intervention.ConclusionsThe CARE intervention holds promise in improving ethical self-efficacy among healthcare professionals with initial low confidence levels. Targeted interventions are essential in addressing confidence gaps in managing ethical challenges in dementia care, with implications for professional well-being and quality of care. Further research should explore long-term effects and expand sample size to enhance generalizability and sustainability of findings.

Mapping Physical Literacy in Czech Future Physical Education Teachers – a Time Trend Study

Abstract To facilitate the dissemination of physical literacy (PL), prioritizing its integration in the education of future physical education (PE) teachers is imperative. This study focuses on assessing the PL levels of university students enrolled in PE programs who have participated in a dedicated workshop on PL to understand its significance and its attributes. Utilizing the Czech version of the PLAYself questionnaire administered in a pencil-and-paper format, data were collected from 350 participants between 2017 and 2023, excluding the year 2020 due to the COVID-19 pandemic. Analysis revealed varying levels of confidence among students regarding physical activity (PA) across different environments, with outdoor activities garnering the highest confidence (71.5%) and activities on ice demonstrating the lowest (52.9%). While most students recognize the importance of being physically active for their health and well-being (96%), there exists a conscious acknowledgement of the necessity to refine movement skills, despite innate abilities (74.7%). Interestingly, students exhibit lower confidence levels within group settings, with only 32.8% perceiving themselves as the most proficient in PA among peers. Furthermore, the perceived importance of PL surpasses that of literacy and numeracy, particularly within family, school, and peer contexts. A minority of students (13.7%) feel inadequately physically fit to engage in desired PAs. These findings underscore the significance of bolstering students’ confidence in PA participation, as it correlates positively with their future academic performance. This study emphasizes the pivotal role of education in fostering a culture of PL among future educators and their influence on shaping the PL of subsequent generations.

Internal Medicine Residents' Confidence and Preferences in Hospital Medicine Competencies: A Multi-Site Study.

Hospital medicine (HM) is an important career option for internal medicine (IM) residency graduates. Limited data exist regarding preferences and educational gaps in HM competencies among IM residents. To assess resident confidence and desire for additional instruction in HM competencies across a broad spectrum of residents. A multi-center survey-based assessment of IM resident confidence and desire for additional instruction in published HM competencies. PGY-1 through PGY-4 residents from eight US IM residency programs, including academic medical center (AMC) and community-based programs (CBPs). Resident confidence and desire for more teaching in HM competency domains including procedures, point-of-care ultrasound (POCUS), system-level competencies, clinical skills, patient-level competencies, palliative care, and care transitions. We received survey responses from 272 of 594 (46%) residents. More than half of respondents envisioned a future HM position. Results demonstrated lower than expected confidence for all HM competencies surveyed. Confidence was lowest (30-36% confident) for procedures, POCUS, and system-level competencies, and highest (65-78%) in care transitions, patient-level competencies, and palliative care. Desire for more instruction was highest in the same competency domains rated with the lowest confidence. Junior residents (PGY-1 and PGY-2) reported significantly lower confidence levels than senior residents (PGY-3 and PGY-4) across all domains except patient-level competencies. Junior residents expressed a significantly higher desire than senior residents for more teaching in all domains. There were no significant differences in confidence or desire for more instruction between trainees who envision a future HM position versus those who do not. Residents from AMCs expressed significantly higher confidence than those from CBPs in POCUS, clinical skill, patient-level, palliative care, and care transitions, while residents from CBPs reported significantly higher confidence in procedures. Our data can inform targeted inpatient competencies and educational curricula for IM residents in the USA.

Search for thermonuclear burst oscillations in the Swift/BAT data set

This study comprehensively analyzes type I X-ray bursts observed by Swift/BAT from 2005 to April 2024 to search for X-ray burst oscillations (XBOs) in neutron star low-mass X-ray binaries. XBOs, periodic signals detected within type I X-ray bursts, typically range from 11 to 620 Hz and are often observed in the soft X-ray data of these bursts. Using the high-sensitivity and precise timing capabilities of the Swift/BAT, we found 50 type I X-ray bursts from 37 neutron star low-mass X-ray binaries. We conducted a detailed timing analysis of these bursts. For sources with known burst oscillation frequencies, our findings largely corroborate previous studies. However, many sources displayed low confidence levels in the oscillation signals, with Z12 values between 10 and 20. For sources without known oscillation/spin frequencies, we utilized FFT analysis to search for signals across a broad frequency range. This approach revealed potential oscillation signals, with several bursts showing significance levels exceeding 3σ, including those from MAXI J1421–613, XTE J1701–407, XMM J174457–2850.3, Swift J1734.5–3027, IGR J17473–2721, Swift J174805.3–244637, Swift J181723.1–164300, and X 1832–330.

L2 SELF-CONFIDENCE: AN EXAMINATION OF INDONESIAN UNIVERSITY STUDENTS IN VARIOUS ENGLISH FOR SPECIFIC PURPOSES CLASSES

The study aims to investigate second/foreign language (L2) confidence of English for Specific Purposes (ESP) learners. It employed a survey method. It involved 213 ESP learners from five different departments. Using descriptive statistics on SPSS, the study found a low-moderate level of L2 self-confidence among the participants. They reported interest in engaging in speaking activities in ESP classes. Nonetheless, they reported low L2 self-confidence regarding giving opinions and leading discussions in English and a low perception of their language competence in general. This low level of confidence could be attributed to the nature of ESP classes, which necessitate learners to study discipline-related vocabulary and language expressions, as well as several general aspects of L2 learning, such as pronunciation and grammar. Implications include encouraging ESP teachers to conduct more small-group-scale activities. That is to boost learners' confidence, increase learner-talk, and provide a safe environment for less confident learners to engage in the activities. This study contributes to the understanding of Indonesian ESP learners' self-confidence, and this could inform future studies involving ESP learners in Indonesia. Future quantitative studies on L2 confidence could use more representative samples. It is also strategic to conduct a mixed-methods study involving ESP teachers to allow triangulation.

Enhancing burned area monitoring with VIIRS dataset: A case study in Sub-Saharan Africa

Since 2001, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on board the Aqua and Terra platforms has made great strides in providing information on global burned areas (BA). However, the MODIS mission is nearing its end. The Visible Infrared Imaging Radiometer Suite (VIIRS) sensors, presented as the MODIS Aqua heritage, could be an excellent alternative to ensure the temporal continuity of this information at a moderate resolution. This paper describes and evaluates the effectiveness of our developed hybrid algorithm, which utilizes VIIRS reflectance and active fire products on the Google Earth Engine platform, in producing efficient information about BA. The study investigates the algorithm's performance in sub-Saharan Africa as the region of interest in 2019, using biweekly outputs and a spatial resolution of 250 m. The algorithm encompasses several steps, including pre-processing individual scenes, creating cloud-free composites, generating binary reference data for burned and non-burned areas, conducting a supervised classification using random forest, and performing region shaping. The VIIRS-BA final product, which includes three confidence levels (low, moderate, and high) known as the uncertainty layer, is compared to four other burned area products. The validation is conducted against 27 reference sampling units from the Sentinel-2 Burned Area Reference Database dataset, allowing for a comprehensive uncertainty assessment across five various biomes. The VIIRS-BA product identified 5.1 million km2 of BA, which was significantly larger than other global coarse resolution BA products such as FireCCI51, FireCCIS310, and MCD64A1 and close to the fine resolution FireCCISFD20 with a difference of 7.3%. The differences were less significant in biomes such as “Tropical Savannas” and “Temperate Grasslands” which are characterized by persistent biomass burning. Based on a stratified random sampling, the validation results demonstrate varying levels of accuracy for the VIIRS-BA product across different confidence levels. The commission error (CE) ranges from 7.8% to 23.4%, while the omission error (OE) falls between 29.4% and 58.8%. Notably, there is a significant reduction in OE (ranging from 40.7% to 50.5%) compared to global BA products like FireCCI51, FireCCIS310, and MCD64A1. When compared to VIIRS-BA, the FireCCISFD20 regional product has a 37% better OE performance. While VIIRS-BA shows great potential in detecting fires that global products miss, the VIIRS-BA with low confidence level tends to overestimate BA in regions with high fire activity. To address this, future versions of the algorithm will integrate the updated VIIRS reflectance data alongside VIIRS active fire from the National Oceanic and Atmospheric Administration to reduce CE and improve understanding spatial patterns.

Incorporating Evidence-Based Practice Learning Activities Throughout Family Nurse Practitioner Clinical Practicum Courses.

Evidence-based practice (EBP) is crucial to high-quality health care, yet nurse practitioner graduates report low levels of confidence in their EBP abilities. This may be because of limited incorporation of EBP learning opportunities outside of foundational course-work. Family nurse practitioner (FNP) program faculty incorporated EBP learning activities across the three-semester clinical year curriculum, and the activities scaffolded in complexity. Initial activities included appraisal and application of clinical practice guidelines to patient case scenarios. Later, students used the seven steps of EBP to present frequently asked patient questions and EBP clinical challenges in their clinical rotations to their peers. This innovative way to thread EBP across the clinical year allowed faculty to continue to evaluate and guide students toward EBP competency. The integration of EBP learning activities across the clinical year is a feasible strategy to further expand FNP student competency in EBP. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Exploring General Practitioners' Knowledge, Attitudes, and Practices towards E-Cigarette Use/Vaping in Children and Adolescents: A Pilot Cross-Sectional Study in Sydney.

(1) Background: The increasing use of e-cigarettes/vaping in children and adolescents has been recognised as a global health concern. We aim to explore the Knowledge, Attitude, and Practice of General Practitioners (GPs) in Sydney regarding the use of e-cigarettes in children and adolescents and identify the barriers to addressing this issue. (2) Methods: This pilot study was a cross-sectional study conducted using an electronic questionnaire with a Likert scale and free-text responses. (3) Results: Fifty-three GPs participated in the study (male = 24 and female = 29) with a mean age of 50 ± 5.5 years. There was strong agreement (mean 4.5) about respiratory adverse effects and addictive potential. However, there was less awareness of cardiac side effects and the occurrence of burns. There is a lack of conversation about e-cigarettes in GP practice and a deficit of confidence in GPs regarding managing e-cigarette use in children and adolescents. (4) Conclusions: Our pilot study has shown that GPs are somewhat knowledgeable about the potential adverse effects of the use of e-cigarettes in children and adolescents, though there is a lack of knowledge of the complete spectrum of adverse effects and more importantly, there is a paucity of a structured approach to discuss the use of e-cigarettes with children and adolescents, and there is a low level of confidence in addressing these issues. There is a need for educational interventions for GPs to increase awareness of the potential adverse effects of using e-cigarettes and build confidence in providing management to children and adolescents regarding the use of e-cigarettes.

Risk Assessment of Pulegone in Foods Based on Benchmark Dose-Response Modeling.

This study presents a new risk assessment of pulegone, a substance classified as possibly carcinogenic to humans (Group 2B) by the WHO International Agency for Research on Cancer (IARC). The analysis used data from a two-year carcinogenicity studies in rats and mice conducted by the National Toxicology Program (NTP) in 2011. Because of the absence of a no-observed adverse effect level (NOAEL) in these studies, the benchmark dose (BMD) approach was employed as an alternative risk assessment method. The lowest BMD lower confidence level (BMDL) of 4.8 mg/kg b.w./day among the eight endpoints served as the point of departure for calculating an acceptable daily intake (ADI) of 48 μg/kg b.w./day. This new ADI is significantly lower than the previously established tolerable daily intake of 0.1 mg/kg b.w./day set in 1997. The analysis also considered various genotoxicity studies, which indicate that pulegone's effects follow a nongenotoxic, thresholded mechanism. The estimated intake levels of pulegone in the European Union and USA were below the newly calculated ADI, suggesting a low health risk based on current consumption patterns.

Exploring the impact of stuttering simulation-based learning and personality traits on clinical self-efficacy and professional interest among speech-language pathology students.

Research suggests that participating in a stuttering simulation-based learning (SBL) program could help speech-language pathology (SLP) students feel more at ease, less nervous and more capable while interacting with people who stutter. Personality traits may influence SLP students' self-efficacy beliefs as well as their level of interest in working with clients who stutter. In particular, we suggest that the combination of low neuroticism and high extraversion, previously linked with a more outgoing, emotionally stable and social personality, may enhance self-efficacy. To examine the impact of participating in a stuttering SBL program on clinical self-efficacy (CSE) in managing stuttering therapy among SLP students, as well as its influence on their interest in working with fluency disorders and their associations with personality dimensions. The study also evaluated satisfaction with the SBL experience. SLP students (n = 49) underwent a fluency disorders academic course, self-reported on CSE, and had an interest in working in the field of stuttering and NEO-Five-Factor Inventory (NEO-FFI). Post-stuttering SBL program participation, CSE and level of interest in practice of stuttering were reassessed. Satisfaction with the simulation was also gauged. Students interested in working with fluency disorders scored lower in neuroticism and higher in extraversion than their uninterested counterparts. Before the SBL activity, interest ratings were negatively correlated with neuroticism and positively correlated with extraversion. Pre-SBL neuroticism was negatively correlated with CSE. Following the SBL activity, increased CSE and interest in working with fluency disorders were evident, indicating robust and medium effects of the simulation on those indices, respectively. Post-SBL neuroticism was also negatively correlated with CSE. Overall, participants reported high satisfaction with the SBL experience. The study suggests SBL is an effective tool for enhancing motivation to work with fluency disorders. Consideration of personality traits and professional interests in designing educational interventions for SLP students, along with tailoring approaches to individual differences, may enhance learning outcomes. The study also highlights the need to differentiate between CSE and objectively assessed clinical competence and the fact that professional development is influenced by various factors. Nonetheless, the positive correlations between personality traits, CSE and satisfaction emphasize the potential of SBL programs in shaping not only clinical skills but also the attitudes and preferences of future SLPs. What is already known on this subject SLPs in the field of stuttering therapy reportedly experience low levels of comfort and professional confidence, possibly due to insufficient clinical experience. According to earlier research, taking part in SBL programs may elevate the CSE of SLP students and help them feel more confident about treating people with stuttering. What this study adds to the existing knowledge In addition to showing the beneficial effects of an SBL activity on SLP students' self-efficacy and interest in working in stuttering therapy, our research shows a significant relationship between personality traits and CSE. Specifically, the combination of high extraversion and low neuroticism was found to be associated with higher CSE and higher levels of satisfaction from the SBL. What are the potential or actual clinical implications of this work? The study shows that SBL is an effective tool for enhancing motivation to work with fluency disorders. Overall, students who exhibit high extraversion and low neuroticism show higher levels of CSE, greater motivation in stuttering treatment, and higher levels of SBL stratification. Development of future SBL activities and other educational interventions should take into consideration such personality traits, to enhance learning outcomes.

Refugee child vision screening curriculum for multidisciplinary trainees

Background: Conflicts, natural disasters, and persecution have led to growing refugee populations worldwide. Vision impairment within these populations is a significant concern. Eye conditions in refugee children appear to peak during times of resettlement. Future medical and nursing professionals need to be trained to detect treatable conditions that could lead to permanent vision loss and significant morbidity if undiagnosed. While curricula regarding refugee health exist, no curriculum exists on identifying common eye conditions in refugee children and performing pediatric eye screening. Methods: We created and delivered a virtual, single-session curriculum on pediatric refugee eye conditions and screening to medical and nursing trainees. A needs assessment survey assessing trainees’ knowledge and confidence in detecting eye conditions in children and refugees informed curriculum design. Pre- and post-test assessments evaluated participants’ knowledge and confidence before and after the module. A two-sided signed-rank test was used to compare pre- and post-test scores. Results: Twenty-seven respondents completed the needs assessment survey, which revealed low levels of confidence in performing vision screening, especially in evaluating the eye surface. Fourteen participants completed the module and pre- and post-test surveys. Mean knowledge test score improved from 52% to 75% (P<0.001). Discussion: As the global refugee population grows, this study supports the value of incorporating a refugee child eye curriculum into trainee education to empower providers to detect and address refugee eye conditions.

Confidence in diagnosing and managing care for cognitive impairment in primary care: a survey comparing barriers by primary care clinician type.

As cognitive impairment (CI) prevalence rises and primary care screening becomes commonplace, it is critical to understand how to support clinicians. We describe clinician-reported barriers to diagnosing and managing care for patients with CI in a health system with standardized screening. We also explore whether barriers differ by clinician type-physician or advanced-practice clinician (APC). Theory-informed surveys were administered to primary care clinicians in a large integrated health system. The survey assessed barriers, confidence in diagnosing CI and managing CI care, beliefs about the consequences of diagnosing CI, and usability of the electronic health record (EHR) to diagnose and manage CI care; it also included open-ended response items. Descriptive statistics and content analysis were used to describe perceived barriers. Differences by clinician type were compared using chi-square. Of the 408 eligible clinicians, 249 started the survey and 247 completed the primary outcomes (61% response rate). Many said they were only a little or not at all confident in diagnosing (70%) and managing care for (60%) CI, with specific gaps in confidence in distinguishing types of dementia and having CI-related conversations with patients or family/care partners. APCs reported lower confidence than physicians. Other barriers were lack of time, low usability of EHR, and lack of family/care partner availability. These did not differ by clinician type. Open-ended responses suggest clinicians would like more support for CI care. Low levels of confidence among other barriers suggest an urgent need to develop and implement effective multifaceted strategies to improve CI care.

Perspectives on managing patients with Down's syndrome among orthodontists in Saudi Arabia: A vignette and a COM-B analysis study.

This study aims to explore perspectives on managing patients with Down's syndrome among orthodontists in Saudi Arabia using a vignette study and COM-B model. This was a cross-sectional study for orthodontists working in Saudi Arabia. Participants were asked about their demographic data. Vignette (clinical scenarios) and COM-B model (C: capability, O: opportunity, M: motivation, and B: behavior) were used to assess orthodontists' perspectives regarding the management of patients with Down's syndrome. A model of Alpha (Cronbach) was used to study the properties of measurement scales. A Pearson's correlation coefficient was used to correlate variables represented by means. An independent t-test and one-way ANOVA, with least significant difference (LSD) as a post hoc test, were used to compare two group means and more than two groups, respectively. Most participants (n = 70, 85.4%) reported that they had no training/exposure to dealing with Down's syndrome patients during their orthodontic clinical training. Participants reported an average of 3.82 (SD = 1.1) when treating moderate Down's syndrome and 2.48 (SD = 1.4) when treating severe Down's syndrome with mild occlusion discrepancies. Participants also showed that their behavior and attitude are significantly related to their capability, opportunity, and motivation regarding the management of patients with Down's syndrome. The average reported agreement ranges from 2.46 (SD = 1) for the hypoplasia of the mandible to 4.38 (SD = 0.8) for the congenitally missing teeth. This study found that orthodontists in Saudi Arabia showed low confidence levels to manage Down's syndrome patients with moderate and severe challenging behavior. Despite this, the likelihood of increasing their confidence levels and attitude regarding the management of patients with Down's syndrome increased by increasing their capability, opportunity, motivation, and knowledge in this field.

Signaling confidence

We study gender differences in confidence in an experimental hiring market, focusing on how signaling confidence affects the likelihood of being hired. We document that moderate (versus low) levels of confidence enhance the probability of being hired, while excessive confidence, characterized by high performance estimates and high certainty, diminishes employment prospects. Men display greater levels of confidence than women, and this gender gap widens in forward-looking scenarios, where performance estimates are provided ex ante rather than ex post. These findings provide a cautionary reminder of the potential negative consequences of signaling excessive confidence. Hence, encouraging both men and women to signal performance predictions that are aligned with reality instead of simply advising women to be more confident may well be a safer way to foster equity in labor market outcomes.