Planning Training Programs Research Articles

Mitigating the Risks of Enterprise Software Upgrades: A Change Management Perspective

Enterprise software upgrades are crucial for maintaining competitive advantage, ensuring security, and enhancing operational efficiency. However, these upgrades often pose significant risks, including system disruptions, data loss, and user resistance. The problem lies in effectively managing these risks to avoid operational setbacks and ensure successful adoption. This paper explores the role of change management in mitigating these risks by offering solutions through strategic planning, stakeholder engagement, and comprehensive training programs. The research employs a mixed-methods approach, integrating quantitative survey results from 185 participants and qualitative insights from 20 in-depth interviews. Results indicate that organizations prioritizing stakeholder engagement, tailored training, and proactive communication achieve higher user satisfaction, improved system performance, and enhanced operational efficiency. These findings provide a framework for best practices in change management that minimize risks and promote successful software upgrades.

Differences between Social Entrepreneurs and Social Managers in Israel

This study examines differences in personality characteristicsand background variablesbetween social entrepreneurs and managers of a social enterprise in Israel. Questionnaires were administered to 104 social entrepreneurs and 86 social managers.Regarding personality differences, social entrepreneurs are more extroverted and open to new experiences. Differences were found in their relationships with their parents and in their background characteristics. For the first time, this study compares social entrepreneurs andsocialmanagers of a social enterpriseanddescribestheir profiles and why they areimportant.The practical contribution of this research is in identifying, understanding, and cultivating social entrepreneurs and managers of a social enterprise. This research may also help in planning training programs that fit social entrepreneurs' and managers' social enterprise needs and attributes. The study limitations and recommendations for further studies are discussed.

Facilitating digital accessibility for students with disabilities into information services at Jordanian academic libraries

PurposeThis study examines the digital accessibility of information services for students with disabilities at the University of Jordan. Despite advancements in disability rights and technology, academic libraries often lag in providing fully accessible digital services.Design/methodology/approachThe mixed-methods research involved quantitative surveys from 173 students with disabilities and a qualitative interview with the head of the information application department, in addition to a focus group interview with 10 students with disabilities. Quantitative analysis included means, standard deviations and four-way ANOVA to identify significant differences in perceptions. Qualitative insights highlighted specific issues and recurring themes, revealing significant gaps in digital accessibility.FindingsThe results revealed a weak level of digital accessibility of students with disabilities to information services in academic libraries in Jordan is very low. The findings indicate a need for improvements in library infrastructure, staff training and policy development. The study also offers insights into challenges in a developing country context and provides recommendations for enhancing library inclusivity and support structures, emphasizing the importance of aligning services with international accessibility standards.Practical implicationsThe findings will primarily be beneficial for library managers to understand their library’s deficiencies and responsibility towards the local community and the enhancement of digital inclusion. This understanding will aid in planning training programs and workshops for employees on supporting students with disabilities. Additionally, it serves as a valuable resource for collaboration between libraries and educators to organize educational sessions for academic librarians in Jordan and other developing nations.Originality/valueIt serves as a valuable resource for collaboration between libraries and educators to organize educational sessions for academic librarians in Jordan and other developing nations. This research adds value to existing literature by highlighting the context in one developing country.

Building a High-Level Isolation Unit in Rwanda and Establishing a Training Program for the Medical Management of Patients With High-Consequence Infectious Diseases.

Rwanda is a country in East Africa, a region characterized by highly mobile populations and outbreaks of high-consequence infectious diseases occurring on a regular basis. To increase the level of outbreak preparedness in the region, the Rwandan government and the German Ministry of Health signed a joint agreement to construct a new high-level isolation unit in Rwanda, the first in East Africa, and implement a training program for Rwandan healthcare workers to equip them with the necessary skills and knowledge for medical management of patients under high-level isolation conditions, including intensive care treatment. To better understand the scope and format of the planned training program, a needs assessment was performed based on findings from a standardized survey of 4 intensive care units in Rwanda as well as observations from 2 members of a German high-level isolation unit who completed clinical internships at Rwandan hospitals. In this case study, we describe the necessary steps to promote the sustainability and capabilities of the new high-level isolation unit in Kigali and ensure the successful implementation of the training program.

INTER-COLLABORATIVE NURSING SUPERVISION PROCESS BETWEEN HOSPITAL ORGANIZATIONAL MANAGEMENT MODELS AND ACADEMIA: A QUALITATIVE APPROACH

Introduction: Organizational management models influence supervisory activity in nursing. Collaborative practice between students and health professionals in the provision of person- and family-centred care allows them to evolve in the process of autonomy and knowledge transfer. However, this does not guarantee the acquisition of supervisory practices and inter-organisational interaction between the hospital and the academy, which are necessary for carrying out safe and qualified clinical procedures. However, this does not guarantee efficient acquisition of supervisory practices and inter-organizational interaction between hospital and academia, which are necessary to provide safe and effective clinical procedures. Objectives: The aim is to understand the possible dimensions of inter-organisational collaborative practice (academic and hospital), identifying its possible processes and results capable of guaranteeing the safety and quality of clinical procedures. Methods: This study emerges from a first mixed research intervention with N=50 nurse supervisors, non-randomized, using the snowball technique. We will, nevertheless, focus on its qualitative, exploratory, and descriptive approach, using the Focus Group technique in which seven nurse supervisors took part. By using Bardin's assumptions, we conducted the content analysis of the participants' speech. Results: The content analysis allowed us to recognise the Processes of Inter-Collaborative Supervision in Nursing as the main dimension of analysis. The results identify, on the one hand, potential threats, highlighted by the time dedicated to supervision and access to information in the hospital context and, on the other hand, opportunities for articulation, highlighted by the importance of involving the various actors in each context, both in planning training programmes and in using supervisory strategies. Conclusion: This study explores the collaborative processes of nursing supervision between academia and hospitals, highlighting common elements of care and education. It reveals the influence of both bureaucratic and anarchic models in shaping these relationships. The findings underscore the importance of inter-organizational coordination, which plays a critical role in effective health promotion practices.

Effects of planned training and music listened to before a cesarean section on surgical fear, anxiety and depression: A randomized controlled trial

PurposeThis research was conducted to determine the impact of a planned training program and music on fear, anxiety, and depression among women undergoing cesarean section.MethodsThe sample of the randomized-controlled experimental study consisted of a total of 120 pregnant women (music 40, training 40, and the control 40) scheduled for cesarean section at the Obstetrics Service. Instrumental music from the Turkish music modes (the Hejaz, Neva, and Acemaşıran modes) was played for the music group, a planned training was given for the training group (what a cesarean section is, why a cesarean section should be performed, breastfeeding, mobilization, etc.) before the cesarean section, and no additional interventions were made for the control group. The data were collected using the Personal Information Form, Surgical Fear Questionnaire, and the Hospital Anxiety and Depression Scale.ResultsAfter the planned training and listening to music applications, statistically significant differences were found between the music, training, and the control groups in terms of the short-term, long-term sub-scale scores and the overall score of the Surgical Fear Questionnaire and the anxiety sub-scale scores of the Hospital Anxiety and Depression Scale (p < 0.05).ConclusionsListening to music before the cesarean section was effective in reducing women’s short-term and general surgical fears, and the training was also effective in reducing their short-term, long-term, and general surgical fears and anxiety levels. However, the applications did not change depression levels. According to these findings, listening to music and provision of training are recommended to reduce surgical fears and anxiety levels of women before a planned cesarean section.

Sex differences in strength, functional capacity and mobility in patients with multiple sclerosis: An exploratory analysis

BackgroundPhysical exercise programs are commonly designed without consideration for sex differences. Nevertheless, disease progression exhibits sex-specific patterns, resulting in different functionality and strength performances. ObjectivesTo analyze sex differences in strength, functional capacity, and mobility, and to evaluate sex-dependent differences in leg strength in multiple sclerosis (MS) patients. MethodsA cross-sectional study was conducted with 35 participants (female: n = 19; Expanded Disability Status Scale (EDSS)= 3.0 ± 1.2, male: n = 16; EDSS= 3.3 ± 1.2). Body composition, maximal voluntary isometric contraction (MVIC), explosive strength (rate of force development, RFD), central activation ratio (CAR), functional capacity, and mobility were assessed. ResultsDifferences were observed between males and females (p = 0.001) in height, lean body mass and MVIC. No differences were observed in the other variables. Regarding the leg asymmetry, men showed higher values in the stronger leg for both MVIC (p < 0.001, d=large) and RFD, whereas women showed higher values only in RFD. Men with MS demonstrated a greater capacity to produce maximal strength than women with this disease. ConclusionsThe results found suggest that maximum strength differs between men and women in our sample of patients with multiple sclerosis. Furthermore, the weaker leg, regardless of sex, exhibits poorer results in explosive strength compared to the stronger leg. However, maximum strength only shows differences in men and not in women. Therefore, these findings should serve as a basis for rehabilitation professionals when planning training programs for this population.

Designing the Future of Medical Education: The EPA Framework as a Catalyst to Inform Family Planning and Reproductive Health Fellowship Training Program in Ethiopia Medical Education: An Exploratory Sequential Mixed Method Study.

Entrustable Professional Activities (EPAs) are tasks or responsibilitieswithin a specific field that can be given to a learneronce they are competent to perform them independently. EPAs are being used in various specialty programs and serving as valuable tool to inform educational program. However, due to disparities in professional practice between different contexts, the automatic transfer of a set of core EPAs is not feasible. Hence, our study aims to develop an EPA framework to inform the Family Planning and Reproductive Health Fellowship Program in the local context of Ethiopia. We employed an exploratory mixed-method design, which involved the collection of qualitative data using the Nominal Group Technique and quantitative data through a nationwide survey in all residency training institutions across the country. Qualitative data analysis involved several steps, including compiling a list of tasks, removing duplicate tasks, reviewing EPAs using criteria and an equal rubric tool. For quantitative data analysis, descriptive statistics, validity index analysis, and intra-class correlation coefficients, were used. Seven senior panelists were able to propose a total of 57 EPAs, with 17 remaining after qualitative data analysis. The panelist evaluated the relevance of each EPA in the second phase. As a result, 17 EPAs received a content validity index of >0.83, indicating satisfactory relevance. In the national survey, experts reached a high level of final agreement regarding the relevance and representativeness of all 17 EPAs (ICC = 0.815, 95% CI [0.0.756,0.865], p.0001). The final set of 17 end-of-training EPAs is valid, acceptable and representative of the discipline, and they can be used as a framework to inform Family planning and Reproductive Health Fellowship Program in Ethiopian medical education once these core EPA statements are described in sufficient detail. This can contribute to raise the quality of training and hence the quality of patient care.

Investigation of the Relationship of Arm and Leg Volume with Anaerobic Power, Balance and Strength Characteristics in Elite Judokas

The aim of this study is to investigate the relationship between arm and leg volume, and anaerobic power, balance and strength characteristics in elite Judokas. 15 national Judokas participated in the study voluntarily from Burdur Municipality Sports Club. Frustum method to determine the arm and leg volumes of the athletes, Wingate anaerobic power test to determine their anaerobic performance, stabilometric balance platform test to determine the dynamic balance performances, and 1 RM method to determine the strength levels. “Spearman” Correlation Analysis was used to determine the relationship between the force, anaerobic power and balance results. Considering the results of the athletes, there was a significant relationship between peak power (Watt), mean power (Watt), average power (Watt / kg) and leg volume, while no relation was found in all other values. There was found no relation between the total leg volume and anaerobic power values in female Judokas, the total arm and leg volume and dynamic balance values of the male and female Judokas, the total arm and leg volumes of male Judokas with 1 RM. When the relation of total arm and leg volumes with 1 RM values in female Judokas was examined, positive significant relationship was found in calf raise repetition; no relation was found in all other values. To conclude, it can be suggested to sports scientists and coaches that they should plan training programs to enhance the strength and anaerobic power characteristics of Judokas.

The relationship between parental health literacy levels and anthropometric measurements of children in Turkey

ObjectiveThe aim of this study was to identify the relationship between parental health literacy levels and anthropometric measurements of children in Turkey.MethodsThe research was of cross-sectional/correlational design and carried out with 378 consenting parents registered at a Family Health Center. A Sociodemographic Data Form and the Health Literacy Scale for Turkey-32 was used to collect the study data. Data collection was completed at face-to-face interviews held in the consultation department of the family health center. The data were analyzed with the chi-square test and Ordinal Logistic Regression Analysis.ResultsIt was determined that parental health literacy levels were associated with level of education, income status and the state of the parents’ employment (p < .05). A relationship was also found between adequate levels of parental health literacy and the health status, weight and height standard deviation scores by age of the parents’ children (p < .05).ConclusionThis study found that adequate levels of parental health literacy were significantly lower than the European average. The study found that adequate parental health literacy had a positive effect on children’s anthropometric measurements. Health institutions and health professionals should plan training programs to improve the health literacy of parents when they apply to health institutions.

Pengaruh Latihan Daya Tahan Kekuatan Otot Lengan Terhadap Banyaknya Pukulan Uppercut Atlet Wushu Sanda Club Unpatti

Based on the results of hypothesis, it is known that there is an influence of arm muscle strength endurance training on the number of uppercut at Unpatti Wushu Club Athletes. This training process for 6 weeks with a training frequency of 3 times a week, so that the total training process for 15 athletes were 18 times. From the length of the process, it is known that the planned training program can improve the results of Uppercut hitting ability as proven statistically, namely t-count = -8.282 and compared with the t-table value on dk/df N-1 (15-1 = 14) of 2.145. Thus it can be understood t-count &gt; t-table. This shows that there is a very significant influence of arm muscle endurance training on the number of uppercuts in Unpatti Wushu Club Athletes. These results can be achieved through planning an objective and systematic training program based on the abilities of Unpatti wushu club athletes.

Effects of problem-solving skills development training on resilience, perceived stress, and self-efficacy in nursing students: A randomised controlled trial

AimThis study aimed to investigate the effects of problem-solving skills development training for nursing students on their levels of resilience, perceived stress, and self-efficacy. BackgroundAlthough there are many studies on the problem-solving skills of nursing students, few have been based on the social problem-solving model. Most are cross-sectional and descriptive studies. Surprisingly, the number of studies that examine the effects of training for problem solving in nursing students is also quite limited. DesignThis was a single-blind, randomised controlled trial. MethodsThe study was conducted at the department of nursing of a state university in Western Turkey. Seventy-two second-year nursing students initially participated in the study. The mean age of the participants was 19.97 ± 1.39 years. Of the participants, 72.2% were women, and 70.8% did not consider themselves academically successful. Participants were randomly assigned to the experimental or control group. The experimental group received problem-solving skills development training based on the Social Problem-Solving Model once a week in a total of seven weeks (eight sessions), in which two sessions were in the last week. Duration of each session took at least 55 min and 150 min at max. Data were collected using a self-administered questionnaire that included a personal information form, Resilience Scale for Nurses, Social Problem Solving-Inventory-Short Form, Perceived Stress Scale, and General Self-Efficacy Scale. Measurements were performed at three different times: at the beginning of the study (T0), immediately after the training provided to the experimental group (T1), and one month follow-up measurement after the intervention (T2). Repeated-measures analysis of variance and covariance were performed to analyse data. ResultsThe mean post-training and 1-month follow-up scores for problem-solving, resilience, and self-efficacy of the students in the experimental group (the mean of T1 and T2 scores) were significantly higher, and the mean post-training and 1-month follow-up perceived stress scores of the students in the experimental group was significantly lower than those of the control group. ConclusionsThis study concluded that problem-solving skills training based on a social problem-solving model provided to nursing students increased their social problem solving, resilience, and self-efficacy levels and reduced their perceived stress. Therefore, further studies that plan intervention and training programs aimed at improving the social problem-solving levels of nursing students and include social problem-solving courses in university curricula are recommended.

ANALISIS PERSEPSI DAN PENGETAHUAN AKUNTANSI PENGGUNA SAK ETAP TERHADAP SAK ENTITAS PRIVAT (EP) PADA PENYUSUNAN LAPORAN KEUANGAN (STUDI EMPIRIS PADA KOPERASI DI KOTA BANJAR, JAWA BARAT)

The research aims to answer the phenomenon that occurs in the preparation of cooperative financial reports regarding changes in financial accounting standards from SAK ETAP to SAK EP by conducting an in-depth analysis through the Luder contingency model to identify and analyze accounting perceptions and knowledge of SAK EP. It is qualitative research with observation, interviews, and documentation as data collection techniques. The data collection is processed through 3 stages; orientation, exploration, and member check. The results concluded that; Stimuli: standardization of private entity financial reports (SAK EP) was approved by DSAK IAI on 30 June 2021. Producers Information: Explain that there is no information and training regarding changes to financial accounting standards to SAK EP. Implementation Barriers: The lack of literacy in financial accounting standards and the development of accounting guidelines in cooperatives have made cooperatives unaware of the accounting standard guidelines used and those that are currently being developed. The research implications expect the government to plan seminars and training programs so that cooperative human resources can prepare themselves for the change from SAK ETAP to SAK EP which will take effect in 2025.

Cognitive-behavioral urban planning: Criteria and principles of adaptive urban environment

Purpose: The aim of the work is to identify the influence of the urban environment on psychological behavior of large groups of people with the subsequent evaluation of formation criteria and principles of the adaptive urban environment.Methodology: The analysis and systematization of Russian and foreign experience in the formation of the adaptive urban environment in architecture, urban planning, psychology, and sociology. Various types of human perception of the urban environment are studied. Based on sociological data, the percentage of people with different perception of space is determined.Research findings: In cognitive urban studies, cognitive-behavioral urban studies are determined. Various models of human perception of the urban environment are studied. Criteria for assessing the urban environment are developed, which identify adaptive and maladaptive elements of urban space. The selected criteria make it possible to predict a positive or negative impact on the development of urban spaces at the initial design stage. A thorough analysis of the territory development allows choosing the most effective of them to provide the formation of the adaptive urban environment affecting the human psyche.Practical implications: Research results can be used in theory and practice of architecture and urban planning and complement training programs for specialists. Formation criteria and principles of the adaptive urban environment can be included in the design of urban spaces at various levels. Research contributes to further actualization of the human-oriented approach in urban studies and can be integrated in the Human Ecology discipline.Originality/value: The paper proposes monitoring of adaptability of urban spaces according to the given criteria. The principles are developed to carry out a new design, reconstruction or renovation of urban areas. The environment created in this way can have a positive impact on the psychological state of a person.

Evaluation of an Advanced Care Planning Training Program Incorporating Online Skills in Shared Decision Making: A Preintervention and Postintervention Comparative Study.

This study evaluated an advanced care planning (ACP) training program incorporating online skills in shared decision making (SDM). The New World Kirkpatrick Model was employed to assess the efficacy of the training program at four levels: reaction, learning, behavior, and results. Reaction measured the participants' satisfaction and difficulty with the training program alongside the status of support received from workplaces engaging in ACP. Learning evaluated the changes in SDM skills. Behavior assessed the changes in the relationship between patients and healthcare professionals when the latter were involved in the SDM process. Results evaluated whether the participants were willing to participate in ACP educational programs as a facilitator and whether their motivation for continuous learning changed through throughout the training program. The relationships among patients, healthcare providers, and third-party roles were analyzed in SDM role-playing via structural equation modeling (SEM). Between September 2020 and June 2022, 145 multidisciplinary participants completed the entirety of the training program. The most common responses to the training were "satisfied", "slightly difficult", and "I received some support from my workplace". The SDM skills significantly improved from the first to the third workshop, evaluated using the Wilcoxon rank-sum test. In the first workshop, SDM was primarily performed by healthcare providers; however, in the third workshop, patient-centered SDM was adopted. Of the participants who completed the program, 63% intended to participate in future ACP educational programs as ACP education facilitators. This study ascertained the validity of this training.

Acute effect of moderate and high-intensity interval exercises on asprosin and BDNF levels in inactive normal weight and obese individuals

This study aimed to examine the acute effects of moderate-intensity aerobic and high-intensity interval exercise protocols on Asprosin and Brain-Derived Neurotrophic Factor (BDNF) levels in inactive normal weight and obese individuals. A total of 20 male individuals aged 18–65 years, ten normal weight (NW) (Body Mass Index (BMI): 18.5–24.99 kg/m2) and 10 obese (Ob) (BMI: 24.99–35.00 kg/m2) participated in this study, voluntarily. Moderate aerobic exercise (AE) (main circuit 30 min, between 40 and 59% of Heart Rate Reserve: HRR) and High-Intensity Interval exercise (HIIE) running protocols (main circuit 20 min, between 75 and 90% of the HRR for 1 min*10 times, and 1-min active rest at 30% of the HRR) was applied to the volunteer participants in the morning hours (08.00–10.00 a.m.), following the night fasting (at least 8–10 h) for at least 3 days between each other. Blood samples were collected from the participants before and immediately after each exercise protocol, and serum asprosin and BDNF hormone levels were determined by Enzyme-Linked Immunosorbent Assay” method. Basal serum asprosin was found to be significantly higher in the Ob group compared to the NW group (p < .001), while the basal serum BDNF hormone was found to be lower (p < 0.05). It was observed that the serum asprosin level of both groups decreased significantly after both AE and HIIE protocols (p < 0.05). In addition, there was a significantly higher decrease in serum asprosin level in the Ob group compared to the NW group after HIIE protocol. For the Ob group, serum BDNF level increased considerably after HIIE protocol compared to AE protocol (p < 0.05). Serum asprosin was found to be higher in the Ob group, while the serum BDNF was found to be lower. In addition, the acute exercises of different intensity significantly affected hormones that regulate appetite metabolism. In particular, it was observed that the HIIE protocol had a greater effect on the regulation of appetite (hunger-satiety) in the Ob group. This result can be taken into account when planning training programs for these individuals.

Explaining the Role of Faculty members of medical sciences universities in Dealing with Epidemics: A Qualitative Study

Background: The roles of Faculty members of medical sciences universities in responding to and controlling critical situations and epidemic diseases are critical and of great importance. Objective: This study was aimed to explain the role of faculty members in dealing with epidemics and crises. Materials and Methods: This qualitative study was conducted using a content analysis method at Guilan University of Medical Sciences in 2020. Thirteen faculty members (physician, Ph.D. in nursing, anesthesiologist, PhD in reproductive health, and Ph.D. in disaster and emergency health) were selected through purposive sampling method, and their viewpoints were surveyed until data saturation was reached. Data were collected through semi-structured interviews. Qualitative content analysis was used to analyze the data. Results: Based on participants’ experiences, several roles could be considered under 3 main categories: a public educator, a clinical therapist, and a manager. Each of these main categories included several sub-categories. Based on the participants’ experiences, among faculty members’ roles, the public educator, as the most central role, influences other duties of faculty members. Conclusions: The results of this study showed that medical faculty members have numerous and significant roles in dealing with crises and emerging diseases. Identifying the medical faculty’s roles in coping with epidemics can help better understand the capabilities of these instructors and plan a basis for their greater cooperation and participation in controlling, preventing, and managing crises and emerging diseases. The results of this study can be advantageous in planning training programs and preparing faculty members to deal with epidemics and crises.

English

Rural women face different obstacles in joining and being active participants in typically male dominated farmers&rsquo; cooperatives. The purpose of this study was to assess factors affecting rural women&rsquo;s participation in multipurpose cooperatives in the Agarfa district. A multi-stage sampling technique was used to select 204 women members of the multipurpose farmer&rsquo;s cooperatives from whom data were obtained through semi-structured interview, key informant interview and focus group discussion. Findings revealed that the women have low, medium and high participation in cooperatives with 23.5, 60.8 and 15.7% respectively. The result of the ordered regression showed that education level, land holding size, years of membership, attitudinal level, source of information use and access to training have a positive and significant effect on women&rsquo;s participation in multipurpose farmer cooperatives, while household working hours, family size and cooperative distance have a negative and significant effect.&nbsp; The study concluded that women have medium level participation which is attributed to a lack of economic and culture embedded gender equality.&nbsp; The study recommended that there is a need to design and implement policies and legal enforcement that will plan training and intervention programs; income-generating farms; off-farm schemes; introduce and promote the use of appropriate technologies that will help to reduce women&#39;s domestic workload; support women&rsquo;s participation in cooperatives leadership and management. Key words:&nbsp; Education level, family size, land holding size, multipurpose cooperatives, rural women

The association between abortion restrictions and patient-centered care for early pregnancy loss at US obstetrics-gynecology residency programs

Early pregnancy loss is a common medical problem, and the recommended treatments overlap with those used for induced abortions. The American College of Obstetricians and Gynecologists recommends the incorporation of clinical and patient factors when applying conservative published imaging guidelines to determine the timing of intervention for early pregnancy loss. However, in places where abortion is heavily regulated, clinicians who manage early pregnancy loss may cautiously rely on the strictest criteria to differentiate between early pregnancy loss and a potentially viable pregnancy. The American College of Obstetricians and Gynecologists also notes that specific treatment modalities that are frequently used to induce abortion, including the use of mifepristone in medical therapy and surgical aspiration in an office setting, are cost-effective and beneficial for patients with early pregnancy loss. This study aimed to determine how US-based obstetrics and gynecology residency training institutions adhere to the American College of Obstetricians and Gynecologists recommendations for early pregnancy loss management, including the timing and types of interventions, and to evaluate the relationship with institutional and state abortion restrictions. From November 2021 to January 2022, we conducted a cross-sectional study of all 296 US-based obstetrics and gynecology residency programs by emailing them and requesting that a faculty member complete a survey about early pregnancy loss practices at their institution. We asked about location of diagnosis, use of imaging guidelines before offering intervention, treatment options available at their institution, and program and personal characteristics. We used chi-square tests and logistic regressions to compare the availability of early pregnancy loss care based on institutional indication-based abortion restrictions and state legislative hostility to abortion care. Of the 149 programs that responded (50.3% response rate), 74 (49.7%) reported that they did not offer any intervention for suspected early pregnancy loss unless rigid imaging criteria were met, whereas the remaining 75 (50.3%) programs reported that they incorporated imaging guidelines with other factors. In an unadjusted analysis, programs were less likely to incorporate other factors with imaging criteria if they were in a state with legislative policies that were hostile toward abortion (33% vs 79%; P<.001) or if the institution restricted abortion by indication (27% vs 88%; P<.001). Mifepristone was used less often in programs located in hostile states (32% vs 75%; P<.001) or in institutions with abortion restrictions (25% vs 86%; P<.001). Similarly, office-based suction aspiration use was lower in hostile states (48% vs 68%; P=.014) and in institutions with restrictions (40% vs 81%; P<.001). After controlling for program characteristics, including state policies and affiliation with family planning training programs or religious entities, institutional abortion restrictions were the only significant predictor of rigid reliance on imaging guidelines (odds ratio, 12.3; 95% confidence interval, 3.2-47.9). In training institutions that restrict access to induced abortion based on indication for care, residency programs are less likely to holistically incorporate clinical evidence and patient priorities in determining when to intervene in early pregnancy loss as recommended by the American College of Obstetricians and Gynecologists. Programs in restrictive institutional and state environments are also less likely to offer the full range of early pregnancy loss treatment options. With state abortion bans proliferating nationwide, evidence-based education and patient-centered care for early pregnancy loss may also be hindered.

Investigating the impact of written emotion disclosure on the level of occupational stress among intensive care nurses.

The present study was conducted with the aim of determining the impact of rewriting pleasant events on the level of occupational stress in Intensive Care Unit (ICU) nurses. This is a quasi-experimental research conducted on nurses working in the intensive care units of Imam Khomeini and Golestan hospitals in Ahvaz, from July to November 2021. Seventy-six nurses were selected based on the inclusion criteria, and were then randomly assigned to the intervention and the control groups. The nurses' demographic information form and the Expanded Nursing Stress Scale (ENSS) were used to collect data. In the intervention group, the technique of rewriting pleasant events was used for 8 weeks, at least once a week. The data was analyzed with SPSS V20. No significant difference in the demographic characteristics was observed between the intervention and the control groups (p > 0.05). The pre-intervention occupational stress of the nurses in the intervention and the control groups were reported to be 173.86 ± 26.75 and 173.05 ± 24.47, respectively, showing no statistically significant difference (p = 0.89). After the intervention, the occupational stress scores were 134.21 ± 16.09 and 172.36 ± 24.33, respectively, showing a significant difference between the two groups (p < 0.001). Considering the impact of rewriting pleasant events on the level of occupational stress of ICU nurses, it is recommended that nursing managers and nurses plan training programs for nurses in this area, and encourage other nurses to do so, too. It is also suggested to implement this intervention on the nurses of other wards as well.