Participant Satisfaction Research Articles

Turnover intention among healthcare workers in Shenzhen, China: the mediating effect of job satisfaction and work engagement.

To ensure workforce stability in China's healthcare system and maintain high-quality care, it is essential to comprehensively understand the interplay of factors contributing to turnover intention of healthcare workers. This study aims to examine the associations between potential factors and turnover intention in healthcare workers and explore the mediating effect of job satisfaction and work engagement in the association between them. In this cross-sectional study, a random sample of 1060 healthcare workers working in 98 public medical institutions were recruited to rate their turnover intention in 2018 in Shenzhen, China. Information on socio-demographic characteristics, job-related factors, turnover intention, job satisfaction, work engagement, work stress and doctor-patient relationship of participants were collected. Pearson's chi-squared tests and binary logistic regression analyses were performed to explore the association between these factor and turnover intention. Mediation analysis was used to explore the roles of potential mediators and moderators. The results showed that age (OR: 0.35, 95%CI: 0.16 to 0.72), tenure (OR: 0.98, 95%CI: 0.96 to 0.99), administrative positions (OR: 0.33, 95%CI: 0.16 to 0.63), and night shift frequency (OR: 1.84, 95%CI: 1.26 to 2.67) were significantly associated with turnover intention. We identified the mediating effect of job satisfaction and work engagement in the relationship between administrative positions and turnover intention, while the suppressing effect in the relationship between professional titles and turnover intention. Additionally, we found that monthly income plays a moderating role in the relationship between work engagement and turnover intention, and in the association between professional titles and turnover intention. Greater job satisfaction and engagement, along with reasonable remuneration, were found to be associated with lower turnover intention among healthcare workers. Employers should proactively monitor the dynamic interactions among these factors and then develop more tailored interventions in order to alleviate the ongoing loss of healthcare workers.

G.T.A.R.A. (Grip/Grasp Training with Active Range of Motion Activities Using Guitar): A Randomized Controlled Trial Using Guitar Lessons for Restoring Hand Function among Patients with Unilateral Hand Impairment

Objective. To determine the effects of guitar lessons (intervention group) in comparison to conventional occupational therapy (OT) sessions (control group) on hand function of chronic stroke patients with unilateral hand impairment. Methods. This randomized controlled trial enrolled 34 chronic stroke patients with unilateral hand impairment. Participants were grouped randomly into intervention (guitar lessons) and control (conventional occupational therapy) groups. Each group participant underwent a total of eight consecutive therapy sessions, twice weekly for an hour each session, at the designated treatment rooms in the Department of Rehabilitation Medicine of the Philippine General Hospital. Pre- and post-treatment evaluations were done to assess range of motion, grip and pinch strength, and hand functions. Satisfaction surveys were answered at the end of the 8-therapy session. Results. Improvements in hand function were assessed through measurement of range of motion (ROM), grip and pinch strength, and with the use of Beery-Buktenica Developmental Test of Visual-Motor Integration, Jebsen-Taylor Hand Function test, and Purdue Pegboard Test of Manual Dexterity. In this study, the comparison of actual change of passive range of motion (ROM) of the impaired hand from pre- to post-treatment between control and intervention groups showed no statistically significant difference. No statistically significant difference between groups were also observed for the active ROM of the impaired hand. Comparison of function of the impaired hand pre- and posttreatment between control and intervention groups showed no statistically significant difference except for an observed greater improvement with the control group in motor coordination (median [IQR] 0 [-1 to 0] vs 1 [1 to 5], p = 0.004), tip (median [IQR] 0.33 [0 to 0.75] vs 1 [0.58 to 1.5], p = 0.006), and 3-jaw (median [IQR] 0.5 [0 to 0.92] vs 1.08 [0.41 to 2], p = 0.043) pinch strength. In evaluating the satisfaction of participants in both groups, higher mean scores were observed in the control group. No statistically significant difference in most of the questions in the satisfaction survey in both groups. All participants in both groups displayed 100% compliance in attending onsite treatments. Despite not showing statistically significant difference between groups (p = 0.721), an 11.8% tendency for better compliance is found in the intervention group. Conclusion. The specific guitar lesson created and performed in this study as used by 17 participants of the intervention group have brought about improvement in hand function that is comparable with those who underwent traditional occupational therapy. This may be most helpful in areas with limited access to rehabilitation facilities and occupational therapy services. This may also be used as a continuing activity of chronic stroke patients at home to help improve hand function.

Sustainable Practices as an Incentive to Return to Play at in an International Event

Objective: The aim of this study is to investigate the effect that the implementation of green practices in a major sport tourism event, the Badminton World Championships in Huelva (Spain), has on the future intention of similar players to return to compete in sport events. Theoretical Framework: This theme introduces the main concepts and theories underpinning the research. Green practices, perceived value, satisfaction, trust and emotions are highlighted, providing a solid basis for understanding the context of the research. Method: The methodology adopted for this research comprised a total of 400 players who attended to compete in the event were randomly selected. A confirmatory factor analysis of the model and a multigroup analysis were carried out. Data collection was carried out by means of a self-administered questionnaire in the presence of the interviewer. Results and Discussion: The results obtained revealed that green practices are a direct predictor of confidence, emotions and perceived value, thus influencing satisfaction and intention to attend or re-attend a similar sporting event as a player. Research implications: Implementing green practices can be an effective strategy to improve participant satisfaction and confidence, which in turn can increase intentions to return to compete in future events. Organisers, federations, and sport tourism managers should consider including measures that promote environmental sustainability, such as waste reduction, efficient use of resources, and promotion of sustainable activities among participants. Originality/value: This study contributes to the literature by understanding the impact of green practices on participants' satisfaction, confidence and intention to return to sporting events. The relevance and value of this research is evidenced by how these practices can influence the behaviour of sport tourists, filling an important gap in the existing literature on sport tourism and sustainability.

AHP SO02 - A Quality improvement project to improve the Nutritional teaching within the General Surgery Department

Abstract Background Malnourished patients have greater incidences of post operative complications which can prolong hospital stay. Dietitians improve the nutritional status peri-operatively to reduce complications and accelerate recovery in hospital. Given that the doctors working in surgery are junior doctors who work on a rotational basis, means that they have little time to get to know the roles of the MDT, hence they are faced with the challenge of having little knowledge of complex nutritional needs of the surgical patient. The aim of the quality improvement project is to improve the nutritional teaching within the General surgery department to improve clinical practice. Method Using Plan-do-study-act (PDSA) Methodology, a Multi-disciplinary-team was created to identify ways to improve our nutritional knowledge. An initial survey was collated and distributed throughout the department to establish the current knowledge of nutritional challenges. From the initial survey, a need to improve the teaching of nutrition to the department was highlighted. The plan implemented itself in the form of informal teaching and educational resources to provide teaching to the department. Further questionnaires were used to assess the value of the teaching sessions. Pre/Post-teaching session surveys were used to assess the participant progress and satisfaction of the teaching session. Results The initial survey showed that on average the individuals sampled had a neutral/basic knowledge of the nutritional topics. In addition the survey addressed a need for surgical nutritional teaching to which 100% of respondents answered ‘Yes’. 100% of the respondents gave a 7/10 above or higher rating for how much they would benefit from the teaching and 100% of the cohort either requested teaching sessions alone or both a teaching session and information booklet. Following these interventions; a Pre/ Post-teaching survey was conducted to provide insight of how the department responded to the teaching, which was overall well received. Conclusion The role of nutrition is an important factor that affects surgical outcome and having clinical knowledge of nutritional needs and complications allows us to improve our clinical practice and patient care. The project identified a need for educational improvement and the project has allowed the department to establish regular quarterly nutritional teaching for rotational training and provided educational resources that have been demonstrated to be an effective intervention within the department. The project provided an overall positive engagement to improve our nutritional knowledge and will undoubtedly have a marked impact on quality of care, patient outcomes and their experience.

Designing mouthwash formulations with innovative molecular components to control initial dental erosion in vivo.

This study aimed to examine and compare the efficacy of mouthwashes containing different proteins and peptide on the prevention of enamel erosion in vivo, as well as to evaluate the participants' satisfaction with the formulations. Twelve participants were selected and underwent five cross-over mouthwash phases: Water (control); 0.1mg/mL CaneCPI-5; 0.5mg/mL MaquiCPI-3; 0.1mg/mL CsinCPI-2; and 0.037mg/mL Stn15pSpS. After prophylaxis, the participants rinsed (1min), followed by the acquired enamel pellicle (AEP) formation (2h). An erosive challenge was made (biopsy, citric acid 1%, 15s) on the buccal surface of the central maxillary incisors. The Relative Surface Reflection Intensity (%SRI) was assessed and analyzed by ANOVA/Tukey's tests. The calcium release in acid was measured by the Arsenazo method and verified by Kruskal-Wallis/Dunn's tests. The Spearman's correlation was used between analyses. A questionnaire evaluated the satisfaction of participants. For both analyses, the results showed that mouthwashes containing the proteins or peptide were significantly more effective in preventing enamel erosion compared to deionized water, with no significant differences among the active ingredients (p < 0.05). Also, there was a significant negative correlation between %SRI and calcium released (r=-0.5754). The questionnaire revealed that the volunteers were satisfied with the taste of the products. In addition, the experimental procedures were well tolerable, and no side effects were reported. All mouthwashes containing proteins or peptide were acceptable and effective in protecting enamel against initial dental erosion in vivo. This study highlights the potential of these pioneer organic components for the development of mouthwashes designed for people with risk of erosive tooth wear.

Application and effectiveness of adaptive AI in elderly healthcare.

In addressing elderly healthcare issues, cognitive impairment can cause significant disruptions in daily life and may potentially develop into dementia. Thus, finding ways to delay the progression of cognitive impairment is a critical issue. This study aims to develop an adaptive artificial intelligence (AI) mechanism that creates enjoyable and beneficial content to help delay cognitive impairment in the elderly. Utilising virtual reality (VR) and a fishing game, the design enhances reaction time and attention through interactive fishing activities. The AI personalises content based on individual performance to improve cognitive function. Experimental results showed that adaptive AI increased participant satisfaction from 86.84 to 91.05 points and future willingness from 75.26 to 85.68 points. The number of fish caught rose from 98 to 120, with the average per participant increasing from 2.64 to 2.85. This is undoubtedly the trend of the future. VR allows the elderly to have a more impactful and memorable first experience, while AI dynamically adjusts the game's difficulty based on the elderly's performance, addressing the issue of reduced willingness to continue due to inappropriate game difficulty. The VR game developed in this study is designed to be relaxing and incorporates mechanisms to promote the elderly's health. It is not restricted by location or time and, more importantly, meets the health promotion needs of the elderly.

Efficacy and safety of Latilactobacillus curvatus LB-P9 on hair health: a randomized, double-blind, placebo-controlled clinical trial

IntroductionNumerous factors influence hair health, including genetic predisposition, hormonal changes, stress, nutritional deficiencies, medical conditions, or medications. With the rising interest in maintaining hair health, alternative approaches such as functional cosmetics and food products are gaining attention. Probiotics, health-beneficial live microorganisms, are emerging as potential candidates for improving hair health. Therefore, this study aimed to evaluate the effects and safety of oral intake of Latilactobacillus curvatus LB-P9 on hair health.MethodsThe study was a randomized, double-blind, placebo-controlled clinical trial involving participants (aged 18–60 years old) with mild to moderate hair damage. Participants were randomly assigned to the test (receiving LB-P9 supplements) or control (receiving a placebo) groups, respectively. Efficacy was assessed using measures such as hair luster, elasticity, and participant satisfaction. Safety evaluations comprised physical examinations, vital sign measurements, laboratory tests, and observation of adverse reactions.ResultsOverall, 80 participants were enrolled in the trial. Significant improvements were observed in hair luster, elasticity, and participant satisfaction in the test group compared to the control group. In the test group, the hair luster parameter increased by 1.65 ± 2.30 (LBNT) at 24 weeks (p &amp;lt; 0.001), indicating a 19% improvement over the control group. Subgroup analysis revealed significant improvement in hair luster among females with short hair. Additionally, hair tensile strength, reflecting hair elasticity and participant satisfaction are increased by 10.27 ± 16.40 (gf/mm2) at 24 weeks (p = 0.001) in the test group. The subjective indicator of participant satisfaction, which improves as survey scores decrease, significantly decreased in the test group by −17.81 ± 14.35 points (p &amp;lt; 0.001) after 24 weeks of consuming the test food than before consuming it. No significant adverse reactions were reported, and safety evaluations indicated no adverse effects linked to LB-P9 consumption.ConclusionProbiotics, including LB-P9, may serve as an alternative in the management of hair health. The findings of this study support the possible benefits of LB-P9 supplementation in enhancing hair luster and elasticity.

The Impact of Cognitive Impairment on Life Satisfaction in Older Adults: Examining the Double Mediating Roles of Neighborhood Satisfaction and Social Participation

ABSTRACT The environment plays an integral role in the lives of individuals with cognitive decline. This study analyzed data from the National Survey of Older Koreans (2020) (9,885 older Koreans). The results showed that cognitively impaired group had lower community environment satisfaction than the cognitively healthy group, which led to lower social participation and lower life satisfaction, and the double mediation effect was significant (B = −.001, p < .001). However, there was no direct effect of cognitive status on life satisfaction (B = .004, p = .759). The findings highlight the imperative for the development of neighborhood environments that foster social engagement among older adults experiencing cognitive decline.

Under the Perspective of the Integration of Industry and Education, Improving College Students’ Career Maturity: The Mediating Effect of Career Decision-Making Self-Efficacy

This study explores the impact of career activity participation satisfaction and teacher support on college students’ career maturity, verifies the mediating role of career decision-making self-efficacy therein, and finally proposes strategies for improving college students’ career maturity from the perspective of the integration of industry and education. To this end, a total of 300 college students’ questionnaire survey results were analyzed. The results show that both career activity participation satisfaction and teacher support have significant positive effects on career decision-making self-efficacy and career maturity. Among them, the direct influence of teacher support on career maturity is better than that of career activity participation satisfaction. In addition, career decision-making self-efficacy mediates the relationships between career activity participation satisfaction and career maturity, and between teacher support and career maturity, having a partial mediating effect. This indicates that in the process of improving college students’ career maturity, it is necessary to focus on increasing college students’ career practice opportunities, establishing a sound integration mechanism of industry and education, and paying attention to teachers’ career guidance and support to enhance students’ career decision-making self-efficacy, thereby ultimately promoting students’ mature career awareness.

Applied Learning in Advanced Asylum Medicine: Piloting Experiential Learning in Forensic Medical Evaluations.

Asylum medicine clinics that train clinicians to conduct forensic medical and mental health evaluations (FME) have proliferated in the United States, but there is still significant unmet need in training. We created a 12-week curriculum to develop the core skills needed to conduct effective, trauma-informed FME. Our course used a "flipped classroom" model; participants reviewed didactics in advance from a national, peer-reviewed training program, the Asylum Medicine Training Initiative, and used in-class time for case-based practice as experiential learning. Participants completed feedback surveys after each session in addition to pre-and post-course assessments. Sixteen clinicians with diverse geographic, professional, and demographic backgrounds participated in the course from January-March 2023. The three key themes that emerged from qualitative feedback were high participant satisfaction with the course model; participant desire for additional opportunities for practice; and participant desire for community-building. Post-course surveys showed that most participants felt only "somewhat comfortable" with the core skills emphasized in the course. Taken together, these findings suggest that curricula in asylum medicine should focus on experiential learning, skills practice, and building longitudinal mentorship. This curriculum is an innovative educational model that differs from the traditional didactic training that has been the mainstay in asylum medicine education. The curriculum is replicable and can be tailored to local environments or broad virtual communities.

Developing a Customer Satisfaction Model for Non-Wage Recipients at BPJS Employment Office, West Kalimantan Province

This study aims to develop a customer satisfaction model for BPJS Employment participants who are non-wage recipients (BPU) in West Kalimantan Province. The research focuses on the impacts of Customer Relationship Management (CRM), service quality, government role, and customer trust on participant satisfaction. Using a quantitative methodology with Partial Least Squares Structural Equation Modeling (PLS-SEM), data from 384 respondents was analyzed. Findings indicate that CRM and service quality are significant factors in customer satisfaction, with customer trust enhancing these effects. The government’s role further moderates satisfaction, suggesting policy and regulatory support are essential for public sector service providers.

Feasibility of a Multimodal Prehabilitation Program Before Elective Knee and Hip Arthroplasty in Older Adults

ObjectivesHip osteoarthritis and knee osteoarthritis cause significant disability and pain in older adults, often leading to hip or knee replacement surgery. Prehabilitation programs have been established for these surgeries, but there are few programs for orthogeriatrics. We evaluated the feasibility of a new multimodal prehabilitation program (MPP) for older adults before hip or knee replacement due to arthrosis: the Prehabilitation for Os (PRE4OS) study. DesignWe conducted a multicenter feasibility study in the Greater Paris area. Setting and ParticipantsEligible adults were ≥75 years old awaiting hip or knee replacement with at least a 6-week delay before surgery and able to participate in the MPP follow-up. The MPP included weekly hospital sessions providing nutritional, psychological, functional, and cognitive support, along with weekly home sessions featuring physiotherapist visits. MethodsThe primary outcome was at least 80% of 1-day hospital (ODH) sessions performed by 80% of participants. Secondary outcomes included intervention achievement, quality of life, and nutritional and functional status changes. Participant's satisfaction was qualitatively assessed via structured phone interviews presurgery and at 30 days postsurgery. ResultsFrom September 2021 to September 2023, a total of 27 individuals participated in the PRE4OS study. The mean (SD) age was 83 (4.3) years, with 7 males (26%) and median baseline Activities of Daily Living score 5.5 (interquartile range 5.5–6.0). Surgeries were for insertion of hip prosthesis in 17 participants (63%) and knee prosthesis in 10 (37%). The primary outcome was achieved in 89% of participants, with comparable rates for hip and knee prostheses. In total, 60% of participants rated the MPP as “excellent” presurgery and 100% at 30 days postsurgery, expressing a willingness to recommend the protocol to a friend or family. Conclusion and ImplicationsThe MPP was feasible for individuals before hip or knee replacement and was well received. Further randomized trials are needed to assess its clinical impact.

Nature-based interventions for individuals with rare skeletal disorders: evaluation of a 5-day sailing program on health-related quality of life

Individuals with rare skeletal disorders like Multiple Osteochondromas and Ollier Disease often experience physical and psychological burdens. Adventure therapy, with activities like sailing in outdoor settings, promotes personal growth and psychological well-being, potentially improving health-related quality of life (HRQoL). This study aimed to evaluate the impact of a sailing program on health-related quality of life and participant satisfaction in individuals with Multiple Osteochondromas and Ollier Disease. A quasi-experimental one-group pre-post design was employed, with HRQoL assessed using the EQ-5D® instrument and participant satisfaction measured via a feedback survey. Data were collected before and after the five-day sailing program conducted in the Mediterranean Sea in 2022 and 2023, involving participants diagnosed with Multiple Osteochondromas and Ollier Disease. Statistical analyses were performed using the Wilcoxon signed-rank test and McNemar’s test for paired data. A significance level of p < 0.05 and p < 0.10 was considered. A total of 25 participants, predominantly male (52%), with a median age of 16 years (ranking from 11 to 31), were included in the study. The sailing program had mixed impact on HRQoL. Specifically, individuals who were female (p = 0.03), aged 16 and older (p = 0.04), with higher educational attainment (p = 0.10) or stronger self-management (p = 0.09), resilience (p = 0.01) and self-engagement (p = 0.09) skills experienced enhanced HRQoL. Conversely, other participants exhibited an increase in self-care difficulties (p = 0.02) and a trend towards worsening pain/discomfort (p = 0.38). Overall satisfaction with the program was high, with 90% of participants expressing satisfaction.This is the first study which examined HRQoL in Multiple Osteochondromas and Ollier Disease patients within an outdoor adventure therapy setting. Findings suggest that adventure therapy, integrated into healthcare strategies, may offer a valuable complement to conventional treatments for rare skeletal disorders. Future research, including randomized controlled trials, are necessary to confirm these results and develop robust interventions for improving the well-being in this population.

The Influence of Environmental Factors, Perception, and Participation on Industrial Heritage Tourism Satisfaction—A Study Based on Multiple Heritages in Shanghai

With the increasing public awareness and strength of industrial heritage protection, industrial heritage plays an increasingly important role in tourism after transformation and upgrading. The influence of built environment factors and visitors’ participation on satisfaction has been fully confirmed, but the primary and secondary relationships between the two variables remain unclear. The purpose of this study is to explore the relationships between the built environment, tourist participation, and tourism satisfaction, and compare the actual loads of different routes to find the dominant variable. The data of this study came from three industrial heritage renovation projects in Shanghai with remarkable transformation results. Field investigations and questionnaire surveys were conducted on them, and a total of 362 valid samples were received. Descriptive statistical analysis and structural equation models were used to analyze the data. Two paths of “built environment–tourism satisfaction” and “tourist participation–tourism satisfaction” are compared and demonstrated. The path coefficient of the former is 0.63, while that of the latter is 0.77, and the influence of the latter is more significant than that of the former. The study creatively found the audience orientation of both sexes for different types of experience activities, confirmed the mediating effect of subjective perception, and provided the following suggestions for managers of built industrial cultural heritage. Interactive experiences and guided tours deepen visitors’ understanding of the historical and cultural value of industrial heritage. Virtual reality and augmented reality technologies can be introduced to provide an immersive visit experience and attract a wider audience to participate, effectively enhancing the attractiveness of and satisfaction with industrial heritage tourism.

Assessing the Role of the Generative Pretrained Transformer (GPT) in Alzheimer's Disease Management: Comparative Study of Neurologist- and Artificial Intelligence-Generated Responses.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder posing challenges to patients, caregivers, and society. Accessible and accurate information is crucial for effective AD management. This study aimed to evaluate the accuracy, comprehensibility, clarity, and usefulness of the Generative Pretrained Transformer's (GPT) answers concerning the management and caregiving of patients with AD. In total, 14 questions related to the prevention, treatment, and care of AD were identified and posed to GPT-3.5 and GPT-4 in Chinese and English, respectively, and 4 respondent neurologists were asked to answer them. We generated 8 sets of responses (total 112) and randomly coded them in answer sheets. Next, 5 evaluator neurologists and 5 family members of patients were asked to rate the 112 responses using separate 5-point Likert scales. We evaluated the quality of the responses using a set of 8 questions rated on a 5-point Likert scale. To gauge comprehensibility and participant satisfaction, we included 3 questions dedicated to each aspect within the same set of 8 questions. As of April 10, 2023, the 5 evaluator neurologists and 5 family members of patients with AD rated the 112 responses: GPT-3.5: n=28, 25%, responses; GPT-4: n=28, 25%, responses; respondent neurologists: 56 (50%) responses. The top 5 (4.5%) responses rated by evaluator neurologists had 4 (80%) GPT (GPT-3.5+GPT-4) responses and 1 (20%) respondent neurologist's response. For the top 5 (4.5%) responses rated by patients' family members, all but the third response were GPT responses. Based on the evaluation by neurologists, the neurologist-generated responses achieved a mean score of 3.9 (SD 0.7), while the GPT-generated responses scored significantly higher (mean 4.4, SD 0.6; P<.001). Language and model analyses revealed no significant differences in response quality between the GPT-3.5 and GPT-4 models (GPT-3.5: mean 4.3, SD 0.7; GPT-4: mean 4.4, SD 0.5; P=.51). However, English responses outperformed Chinese responses in terms of comprehensibility (Chinese responses: mean 4.1, SD 0.7; English responses: mean 4.6, SD 0.5; P=.005) and participant satisfaction (Chinese responses: mean 4.2, SD 0.8; English responses: mean 4.5, SD 0.5; P=.04). According to the evaluator neurologists' review, Chinese responses had a mean score of 4.4 (SD 0.6), whereas English responses had a mean score of 4.5 (SD 0.5; P=.002). As for the family members of patients with AD, no significant differences were observed between GPT and neurologists, GPT-3.5 and GPT-4, or Chinese and English responses. GPT can provide patient education materials on AD for patients, their families and caregivers, nurses, and neurologists. This capability can contribute to the effective health care management of patients with AD, leading to enhanced patient outcomes.

A Comparative Study of Columellar Strut and Septal Extension Grafts for Tip Support in Rhinoplasty.

Background: Rhinoplasty is one of the most common aesthetic surgical procedures. Columellar strut and septal extension grafts are commonly used for tip support, but their long-term effectiveness and stability remain debated. This study aims to compare the long-term postoperative stability of these two techniques. Methods: A retrospective cohort study of patients underwent primary rhinoplasty using either columellar strut or septal extension grafts between March 2021 and March 2022 was conducted. Nasal tip projection and rotation stability were analyzed through photographic evaluations conducted preoperatively, as well as at 6 and 18 months postoperatively. Additionally, participant's satisfaction and the incidence of postoperative complications were assessed. Results: Both grafting techniques exhibited an initial increase in tip projection, followed by a slight regression at later stages. However, this change was not statistically significant for either group. A distinct difference emerged in tip rotation, as measured by the nasolabial angle. The columellar strut group experienced a notable increase in tip rotation initially, followed by a significant decrease, while the septal extension graft group exhibited minimal and statistically insignificant changes in tip rotation over the same period. Conclusion: Nasal tip rotation was more stable in cases with septal extension grafts compared to those with columellar strut grafts.

Sosialisasi Pemanfaatan Chatgpt Sebagai Pendukung Alat Pembelajaran Bagi Guru SMP PGRI 8 Sidoarjo

In the ever-evolving digital era, education faces unprecedented challenges and opportunities. Technology is now an integrated part of the learning process, providing various tools that can increase the effectiveness and efficiency of education. One technological innovation that has great potential to support educators is ChatGPT. This ability can be utilized by teachers for various purposes, including in making learning tools. With the help of ChatGPT, teachers can save time and energy in designing teaching materials, assignments and learning evaluations that suit students' needs (Kharis et al., 2024). The teachers at SMP PGRI 8 Sidoarjo have not made much use of technology that makes it easier for them to prepare learning tools. This can be seen from the results of initial observations which show that 71.4% of teachers have never used applications or technology that makes it easier to create learning tools. This Community Service implementation was carried out with the aim of introducing, socializing and assisting teachers in utilizing ChatGPT to develop learning tools more quickly, effectively and efficiently. The results of participant responses regarding the implementation of activities are measured by participant satisfaction, which is the average of participant satisfaction with the satisfaction indicator factors. In this activity, 84.46% of participants gave an average rating of very good to the statement items in the questionnaire, which can be interpreted as meaning that 84.46% of participants were very satisfied.

Development and validation of a training course on proton pump inhibitor deprescription for general practitioners in a rural continuing medical education program: a pilot study

BackgroundDespite being cornerstone medications for managing gastrointestinal disorders, proton pump inhibitors (PPI) have raised concerns due to inappropriate prescribing and overutilization, their potential side effects, and interactions with other medications. General practitioners (GPs) provide long-term patient follow-up and are targets to promote PPI deprescribing to reach the widest possible population. GPs practicing in rural settings encounter unique challenges as their numbers dwindle and their workload increases. Hence, targeted educational interventions are crucial to promote appropriate prescribing practices in such underserved areas.MethodsWe developed a continuing medical education (CME) program focused on PPI deprescribing for GPs in rural settings. The program comprised of an interactive training session featuring clinical cases, an open discussion, and distribution of educational materials. We assessed the program’s effectiveness using a two-level Kirkpatrick model, evaluating participant satisfaction and knowledge levels through pre- and post-course questionnaires.ResultsThirty-three GPs participated, with 61.9% working in semi-rural and 38.1% in rural areas (21 responded to the 1st questionnaire, 14 to the 2nd ). Median medical experience was 6 years, with 61.9% serving as internship supervisors. Despite 95.2% acknowledging PPI overprescription, none had previously participated in dedicated PPI CME programs. The open discussion session provided valuable insights into various topics related to PPI use and gastrointestinal health. Participants expressed high satisfaction with the program (average rating of 9.1/10) and 92.9% reported changes in practice, including increased awareness of inappropriate PPI prescriptions. Indeed, 92.9% of GPs identified inappropriate PPI use following the course. 57.1% of participants utilized the provided educational materials. The main practice changes observed included an increased reassessment rate of PPI indications (71.4% at each renewal after vs. 19% before, 28.6% non-systematically after vs. 66.8% before, 0% rarely after vs. 14.3% before; p = 0.006), the necessity for more than one consultation to deprescribe (64.3% after vs. 23.8% before; p = 0.021), systematic utilization of gradual cessation of PPI (100% vs. 61.9%; p = 0.039) and more frequent use of additional medication (92.9% vs. 57.1%; p = 0.022), primarily antiacids (92.3%).ConclusionsOur study underscores the effectiveness of targeted CME programs in promoting appropriate prescribing practices and enhancing knowledge among GPs in rural settings. Despite the challenges encountered in deprescribing PPI, the program facilitated proactive approaches in managing treatment discontinuation failures. Tailored educational interventions are essential for mitigating medication prescribing challenges and improving patient outcomes in rural primary care settings.Trial registrationsNot applicable.

Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women

BackgroundStrong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.MethodsThis process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.ResultsAverage reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders’ perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being “more than satisfied” with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.ConclusionsSHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.Clinical trials Registrationwww.clinicaltrials.gov #NCT03059472.

Voluntary Participation Mediates the Relationship Between Multi-Membership in Online Communities and Life Satisfaction Among Chinese Populations: A Gendered Perspective

Whether and how multi-membership in online communities might relate to life satisfaction within the Chinese population remain unclear. This study adopts a gendered perspective to explore the mediating role of voluntary participation in the relationship mentioned above based on a cross-sectional analysis of 2558 respondents from the 2019 Chinese Social Survey (CSS). Multivariable regressions and a mediation analysis were adopted for analyses. The findings reveal that a higher level of multi-membership in online communities is associated with greater life satisfaction for both males (B = 0.31, SE = 0.11) and females (B = 0.10, SE = 0.02). Specifically, the positive relationship is partially mediated (6.6%) by increased voluntary participation among females, where involvement in multiple types of online communities correlates with a heightened likelihood of engaging in voluntary activities (B = 0.006, Z = 3.910), which in turn contributes to higher levels of life satisfaction (B = 0.114, Z = 2.760). However, voluntary participation does not exhibit a significant mediating role in the relationship between multi-membership and life satisfaction among males. These findings provide valuable insights into the intricate ways in which online interactions can affect voluntary participation and life satisfaction, underscoring the importance of considering gender differences in these dynamics.