Previous Experience Research Articles

Wastewater-Based Epidemiology of Influenza Viruses: a systematic review

Abstract Background Influenza viruses (IVs) are responsible for annual epidemic outbreaks during the winter months. Beyond conventional surveillance systems, the circulation of these pathogens can be monitored using Wastewater-Based Epidemiology (WBE), an epidemiological tool that describes the health status of an entire community by analyzing the presence of pathogens within wastewater. Systematically reviewing existing experiences in this emerging field is crucial to highlight the best practices to establish a WBE surveillance system providing useful information for public health actions. Methods The study protocol for this systematic review has been registered on the PROSPERO website (registration ID: CRD42024532435). Three academic databases (PubMed, Web of Science and Scopus) were accessed to collect studies examining the presence of IVs in wastewater. Studies included were those reporting quantitative measures of viral concentration or detailing molecular/phylogenetic characterization of IVs in wastewater. Results Databases were searched on July 8th, 2024. After de-duplication and screening of the 400 remaining records, 42 were included in the review. IVs detection in wastewater was reported in all papers except from one, although with high variability in terms of positivity titers and concentration levels. More than half of the collected papers (52.4%) evaluated association between environmental viral concentration and clinical data, generally showing concordance between the two aspects. Moreover, 28.6% of papers described subtyping of IVs in wastewater through different methods (specific PCR assays being the most used). Conclusions WBE is a promising approach for surveilling viral circulation, and IVs represent a high value target for implementing this innovative system. Systematically reviewing previous experiences can be useful to obtain information for the establishment of a novel environmental surveillance system of Influenza Viruses Key messages • Nucleic acids belonging to Influenza Virus are detectable in wastewater, even though we report high levels of variability in sampling techniques, laboratory methods and data management systems. • Association between environmental data and number of clinical cases is reported to be generally strong in collected papers; subtyping of IVs present in wastewater is also feasible.

Transcatheter closure of atrial septal defect (ASD) in adult and paediatric population without transoesophageal echocardiography/general anaesthesia

Abstract Background Transcatheter device closure is the preferred therapeutic option for ostium secundum atrial septal defect(OS-ASD). Standard practice is to perform it under transoesophageal echocardiography(TEE) guidance. However, TEE is performed under general anaesthesia (GA) and leads to increases in cost, procedural duration, ICU stay, total hospital stays, risk of oesophageal injury and complications of GA. Transthoracic echocardiography(TTE) is an excellent alternative and prior studies have shown it to be a safe alternative in paediatric population. In current study we analysed safety and efficacy of TTE-guided device closure of OS-ASD in all comer population irrespective of age, weight, defect size. Methods The study enrolled all patients who underwent device closure of OS-ASD between March 2017 and December 2023. All procedures were performed under LA for adults and conscious sedation for children. The device was placed under fluoroscopy guidance and position were confirmed on TTE. Procedural success, device, defect size ratio, procedural time, fluoroscopy time, complications, intensive care unit/hospital stay duration were analysed and compared with our own experience of 125 patients with TEE-guided closures before switching to complete TTE-guided procedure(before 2017). Results 340 patients underwent TTE-guided device closure of ASD. Procedure success was 97.4% with acceptable risk of major complications. Three(0.8%) had embolization into pulmonary artery, successfully operated surgically. Two had tamponade requiring drainage. In 9 patients, device could not be deployed despite multiple attempts and approaches. All of these had defect size of > 34mm and deficient IVC rim along with shorter (other than aortic) rim. Findings were compared with our own previous experience of TOE guided closure (practised before 2017). Compared to TOE group, TTE group had significantly lower total procedural duration (75±4 vs. 28 ±1 min; p < 0.01), intensive care unit stay (24±10 vs. 10.5±1 h; p < 0.01), and hospital (48±12 vs. 25.5±4h; p < 0.01) stay duration. Fluoroscopic time was similar in both. There was no mortality in either group. Major complications were comparable, TTE-guided group had less post-procedure complications of vomiting and headache. Additional findings of less pre-procedure fasting duration and early commencement of post procedure oral intake were noted in TTE group. Conclusion TTE-guided device closure of OS-ASD is a safe and feasible in all-comer population in experienced hands. It can definitely negate the use of TEE except in very poor echo window. The added advantages include utilization of physiological variations in PV/LV pressure during cough, Valsalva manoeuvres in awake patients. It definitely reduces the procedural duration, cost of procedure and dependence on GA and trained transoesophageal echocardiographer.

An ACNAP survey assessing the cardiology multidisciplinary learning needs to support lipid management

Abstract Background/ Introduction: Reducing LDL cholesterol is a high priority in cardiovascular care but requires knowledge and skills to deliver effectively. Nurses and allied professionals (NAPs) can play a major role in supporting lipid optimisation. Most NAPs will work together with patients prescribed lipid lowering therapies, and some may be more closely involved in initiation and monitoring. The Association of Cardiovascular Nursing and Allied Professionals (ACNAP) wanted to gauge the level of understanding, confidence and learning needs of cardiology professionals to better implement European Society of Cardiology (ESC) lipid lowering guidelines. Purpose The aim of the project was to highlight gaps in knowledge to better inform needs for training and educational programmes developed by ACNAP. Methods A 29 question electronic survey was developed by expert consensus, exploring previous experience, clinical knowledge, and perceptions of learning needs. It was launched at the EuroHeartCare conference in June 2023, on social media, and members of the ESC were emailed inviting participation. Results 123 people responded. 29.5% of the respondents were physicians and 70.5% NAPs. Most respondents were involved in lipid optimisation of some description with only 7.0% of respondents having no direct involvement in their patient cohort. A higher percentage of respondents responded "totally agree" when asked it they knew what cholesterol targets to aim for in secondary prevention, compared to primary prevention (61% v 41.5%). 94% of respondents felt comfortable when to initiate statins and and 82% ezetimibe. This reduced to 45% for inclisiran and 40% for bempedoic acid. Similarly, the majority felt comfortable counselling a patient newly initiated on statins or ezetimibe, but significantly fewer the newer lipid lowering therapies. Experience and understanding of familial hypercholesterolaemia (FH) was also explored. Only half the respondents would be comfortable in identifying and diagnosing FH and a further 25% unsure. A large percentage (37%) were unaware of the Simon Broome criteria or the Dutch Lipid Criteria Network (49%). When considering learning needs, 71% of NAP respondents needed extra support to help make lipid lowering decisions. This rises to 84% and 74% when looking at nurses and pharmacists separately, respectively. Nearly 76% would prefer any learning to be delivered online, with interactive online training packages being the most popular method. Conclusions The three main gaps identified by NAPs were: management in primary prevention (initiation and targets), the newer innovative medicines (bempedoic acid, inclisiran and PCSK9 monoclonal antibodies) and FH. Interestingly, these are the same gaps highlighted by physician responders. These findings can help guide ACNAP and ESC in the development of educational programmes with the aim to improve better lipid management overall.

Linguistic and Non-linguistic Factors Affecting International Teaching Assistants’ Comprehensibility and Teaching Quality

ABSTRACT Previous studies have examined linguistic and non-linguistic factors affecting the comprehensibility of L2 English speakers. However, there is a relative scarcity of empirical studies specifically investigating how these factors influence the comprehensibility of international teaching assistants (ITAs) as perceived by their undergraduate (UG) students. The current study aimed to fill this gap by examining how linguistic and non-linguistic factors affect American UGs’ judgments of ITAs’ speech comprehensibility and teaching quality. One hundred and ninety-eight U.S. UGs reported their previous experience with and attitudes towards ITAs through a Qualtrics survey, and gave their ratings about ITAs’ speech comprehensibility, segmental and suprasegmental errors, and teaching quality. Results from step-wise regression analyses indicated that segmental errors were statistically significant predictors of UGs’ ratings of ITAs’ comprehensibility and teaching quality, and that UGs who had taken more courses with ITAs had higher ratings of ITAs’ comprehensibility. More notably, UGs’ attitudes towards ITAs were found to contribute to their perceptions of ITAs’ speech comprehensibility and teaching quality. This study concluded with recommendations about how to counter the potential negative effects of biased UG ratings of ITAs so as to promote a healthier environment for ITAs’ professional identity development in higher educational settings.

Development and Implementation of the “Exercise is Medicine” Elective at an Osteopathic Medical School

Abstract Introduction Lifestyle changes are a powerful way to combat many chronic illnesses. However, education on appropriate instruction of physical activity appears to be insufficient among medical students. This manuscript highlights development, incorporation, and feedback of the Exercise is Medicine elective at the West Virginia School of Osteopathic Medicine. Materials and Methods Twenty-four medical students attended ten weekly sessions, each of which lasted 2 h and covered a different topic. Participants were selected based on previous experience with exercise-based medicine and their personal beliefs on incorporating it into clinical encounters. Outcomes were gathered using surveys consisting of the Likert Scale, rating, yes/no/maybe, and free text questions. Results Confidence in prescribing lifestyle changes increased (p < 0.0001) from pre- to post-elective. Feelings of incorporating course material into practice increased (p < 0.05) after the elective. Feelings that physicians could impact their patients’ physical activity did not change. Conclusion Implementation of the Exercise is Medicine elective was well received among students and increased student knowledge and confidence in prescribing lifestyle changes to a variety of patient populations.

A Cross-Sectional Study of the Perception of Individualized Nursing Care Among Nurses in Acute Medical and Perioperative Settings

Background/Objectives: Individualized nursing care allows for systematic assessment and intervention; considers a patient’s preferences, values, and context; and contributes to a positive care trajectory. However, its operationalization has proven to be challenging. This research aimed to evaluate nurses’ perceptions of individualized care and analyze their relationship with sociodemographic variables. Methods: A cross-sectional study was conducted on 122 eligible and registered nurses at a Hospital Center, in the Ophthalmology (operating room and inpatient ward) service, the Cardiology service, the Internal Medicine service, and the Medical Emergency Unit, for adults/older adults in Portugal. The nursing version of the Individualized Care Scale (ICS-Nurse) was used for the assessment, including three sub-dimensions: clinical situation, personal life situation, and decisional control over care-related decisions. Cronbach’s alpha and principal component analysis were used for the data analysis. The STROBE checklist was used to report this study. Results: No statistically significant differences were found based on the age, gender, level of education, or years of professional experience of the nurses within the sub-dimensions of individualization. The nurses overall had a good perception of the importance of individualized care (4.06 ± 0.46 ICS-A-NURSE) but faced difficulties in its implementation during the last shift they worked (3.97 ± 0.49 ICS-B-NURSE). Conclusions: The items considered to be of greatest importance were the response to the physical and emotional needs arising from illness and assistance in decision-making through educational instructions. Aspects related to the personal lives of patients, such as family inclusion in an individual’s care plan, everyday habits, and previous experiences of hospitalization, received the lowest scores. Recognizing priority areas for improvement in the individualization of nursing care can contribute to developing training programs and policies that promote a holistic approach. Future studies should consider patient outcomes related to their needs for individualization.

The First Surgery Experienced Through Virtual Reality: A Knee Surgery Case Report

The decision to undergo surgery and the significance of the operating theater environment are influenced by several factors, which vary from person to person. Negative perceptions of the operating room environment can influence the decision to undergo surgery and the process of treatment. Virtual reality (VR) technology offers the potential to alter individuals' environmental encounters through the provision of diverse environmental perceptions. This case study evaluates the results of a VR simulation applied during surgery to an individual with no previous surgical experience. A male patient scheduled for arthroscopic meniscus surgery was the subject of a VR simulation. The patient's perception of the simulated environment was transmitted through VR goggles from the time he entered the operating room until he left. However, the VR application was terminated during the administration of anesthesia, and no premedication was administered to the patient. The VR application included nature walks in various regions, including forests, lakeshores, and meadows, accompanied by the sound of birds. Data were collected using a visual analog scale to assess pain levels and a walking test form. The patient, a 35-year-old male, is a high school graduate and is undergoing his first surgical procedure. The patient expressed concerns and fears regarding the decision to undergo surgery. The patient's preoperative anxiety was rated at 9 out of 10 but subsequently decreased to 1 out of 10 following the surgical procedure. The patient rated his satisfaction with the surgical experience as 9 out of 10. The patient did not require sedatives or analgesics during the intraoperative period or for the first 10 hours following the operation. The patient was successfully mobilized at the 15-hour mark following surgery. The patient was highly satisfied with the application. The utilization of VR during surgical procedures has the potential to reduce the necessity for premedication and enhance postoperative compliance among patients.

On your terms or mine: pigs’ response to imposed gentle tactile contact vs. free form interaction with a familiar human

AbstractPositive human–animal interactions (HAIs) can be intrinsically rewarding and facilitate positive human–animal relationships. However, HAI paradigms vary across studies, and the influence of different interaction paradigms on the animal’s response has been overlooked. We compared the behavioural responses of pigs (n = 28) individually tested with two types of gentle tactile interactions with a familiar human: ‘free form (FF)’ where the pig could voluntarily approach and interact as they normally would, and ‘imposed contact (IC)’ where the human imposed tactile contact on the pig according to a standardised protocol. Pigs did not differ in their level of engagement with the human between the two types of interactions. However, they differed in their behaviour as they explored the pen more during the FF test, while they emitted more low-pitched vocalisations (grunts) during the IC test. These differences can likely be imputed to the IC test differing to the pigs’ habituation to human contact, which could have evoked greater attention to the human or triggered frustration due to violation of expectation. These findings highlight the influence of the predictability of the interaction or level of agency provided to the animal in HAI tests and relation to their previous experience of interacting.

Reflections beyond the thesis—exploring wellbeing, emotional work and research identity following a PhD

This paper reflects on the experience of my PhD in Interactive Textiles for wellbeing and intends to provide ways for other PhDs to reflect and understand their PhD beyond the data. I provide context for my research, methodology and approach; Research through Design and a Person Centred Approach. Reflecting using the Gibbs Cycle I explore the emotional work required to conduct my studies, particularly within Dementia Friendly Communities. Alongside this I explain how my background and previous experience contributed to my overall approach and identity as a researcher. My key learnings from my experience form an action plan, offering ways for future researchers to; Reflect on and manage wellbeing; Reflect as a researcher working on challenging and emotional topics; Reflect on how researcher identity can influence research approaches. In addition, this paper provides training and networking suggestions.

Trainee growth vs. fixed mindset in clinical learning environments: enhancing, hindering and goldilocks factors

BackgroundDoctors in training (trainees) have higher rates of burnout, anxiety and depression than other professionals. An important psychological tool to combat this crisis is promotion of a growth mindset, which increases resilience and improves mental health outcomes. How growth mindset might be promoted within the clinical learning environment is underexplored. This study aimed to explore the factors promoting a growth mindset versus fixed mindset in trainees from the perspective of the trainees.MethodsThis constructivist study employed a novel method of encouraging trainees’ reflections on mindset adoption in the clinical learning environment. Trainees played Mindset, a tabletop simulation board game that included challenges encountered within training. This was followed by a facilitated debriefing, focusing on factors that promoted growth or fixed mindset adoption in the clinical learning environment. Debriefing transcripts were analysed using template analysis.ResultsThree groups of oncology trainees and one group of medical education fellows participated (16 participants in total). Factors promoting growth mindset adoption included passion, collaboration, diverse career and role modelling. Factors promoting fixed mindset adoption included burnout and competition. Some factors, such as grit, previous success experience and singular training location promoted a fixed mindset when too much or too little were present, and promoted a growth mindset when they were in balance (the Goldilocks principle).ConclusionsThe importance of balance versus excess of certain factors, and the ubiquitous competitive culture in medicine promoting a fixed mindset, were compelling reflections. This study may aid invested parties to reflect on what factors they can upregulate and down regulate to optimise trainees’ adoption of a growth mindset.

Employing structural equation modeling to discern teachers’ perspectives and their embrace of the Metaverse within the classroom setting

The rise of smart learning environments and the transformative potential of the Metaverse are increasingly evident across various sectors, particularly in education. While substantial attention has been directed toward student engagement within the Metaverse, the evolution of teaching methodologies enabled by this technology remains under-examined. This study investigates the influence of teachers’ prior experience with technology on their willingness to adopt the Metaverse in diverse educational contexts. Utilizing a sample of 311 educators from the Brazilian Amazon, partial least squares structural equation modeling (PLS-SEM) was employed to validate the theoretical model. The findings emphasize the significant relationship between previous technological experiences, the mediating role of social influence in adoption, and performance expectations. Furthermore, the results underscore the pivotal role of technological engagement in shaping educators’ perceptions and their readiness to adopt emerging innovations, such as the Metaverse.

Analysis of time to regulatory approval in an exception from informed consent trial in trauma patients

BACKGROUND The interactive media–based approach to community consultation and public disclosure (CC/PD), a key step when conducting exception from informed consent (EFIC) clinical trials, is intended to be completed in 4 months. This analysis characterizes the process, from initiation of CC/PD activities to institutional review board approval, to better understand the barriers and how these can be mitigated. METHODS This is a retrospective post hoc analysis of data collected as part of the CC/PD campaigns conducted for a large trial involving up to 90 trauma centers in the United States. Each site was provided with templated materials that had been reviewed and approved by a central institutional review board (cIRB). We collected the dates of milestones, including the study “kickoff call,” start of the social media campaign, dates of online community meetings, date of submission of site report to the cIRB, and cIRB approval date. RESULTS Sixty-two sites were cIRB approved at the time of this analysis. The median time from the kickoff call to the start of the social media campaign was 79 days, with an interquartile range of 33 to 126 days (range, 0–285 days). All social media campaigns ran for the prescribed period of at least 2 months. All sites conducted at least four online community meetings. The median number of days from the kickoff call to cIRB approval was 216 days (interquartile range, 168–281 days; range, 116–459 days). There was no significant difference between sites that had previous experience of EFIC trials. CONCLUSION Using the interactive media–based approach, CC/PD can be completed quickly; however, there are barriers that can incur substantial delays. Greater harmonization of local administrative processes would shorten the time to conduct CC/PD activities and facilitate the timely commencement and execution of EFIC trials. LEVEL OF EVIDENCE Systematic Review without Meta-analysis; Level III.

Prevalence, Reasons, and Prevention for Drug Related Death After Release from Prisons: A Systematic Review and Meta-analysis

Context: Drug-related mortality is a major concern in public and global health discussions. Objectives: Therefore, the aim of this study was to investigate the prevalence, causes, and prevention of death after individuals are released from prison. Methods: This study was conducted systematically using MeSH keywords with no language or time restrictions. PubMed, Scopus, and Web of Science databases were extensively searched for observational studies from 1980/1/1 to 2023/12/30, following the PRISMA checklist. Fourteen research studies were ultimately included in the systematic review process. The CRD code is CRD42024571756. Results: The two-week period following release, with an 18% prevalence, was identified as the time when most overdose deaths occurred. The leading causes of death included prior heroin use, previous experiences with drug withdrawal, drug injection, and sedative use within six months before death. Compared to other unnatural causes of death, there was an increased risk of fatal drug overdose for individuals who died within the first two months of release. Men had higher death rates from all causes compared to women. Most studies reported that substance abuse treatment during imprisonment and providing take-home naloxone for emergencies protected against mortality from all causes. Conclusions: In conclusion, evidence from these systematic investigations highlights the urgent need for targeted interventions to address substance use disorders and overdose prevention among individuals recently released from prison. Efforts to bridge the gap between incarceration and community reintegration should prioritize comprehensive substance abuse treatment programs to reduce the heightened risk of mortality in this vulnerable population.

Navigating patient journeys across healthcare borders: hot potatoes, medical professionalism and a negotiated order

PurposeThis study explores the dynamics of patient transfers within the Polish healthcare system during the COVID-19 pandemic, focusing on the roles of negotiation, boundary work and systemic flexibility. Despite extensive literature on patient transfers, gaps remain in understanding the general mechanisms that complicate these processes, especially under crisis conditions.Design/methodology/approachBy interviewing 18 specialists across various medical fields, our research provides empirical evidence from Poland, highlighting the experiences of medical practitioners who navigated the complex landscape of patient transfers during the pandemic.FindingsBy integrating negotiation and boundary work theories, we reveal how healthcare professionals manage patient flows and the challenges they face. Our findings show that during the unique situation caused by the uncertainties and lack of preparedness for the pandemic, while standardization and rationalization tools have limited effectiveness, proactive involvement and strategic negotiation are crucial for successful patient management.Research limitations/implicationsThe study's primary limitation is its focus solely on the Polish healthcare system during the COVID-19 pandemic, which may not fully represent other contexts or healthcare systems.Originality/valueThe study underscores the importance of communication and interpersonal skills in facilitating patient transfers. We also argue that the previous experiences with negotiating orders, dealing with limited resources and making constant compromises had, in a way, built resilience in Polish medical experts and prepared them for the uncertainties encountered while treating COVID-19 patients. These insights contribute to academic theories and offer practical recommendations for enhancing healthcare system resilience and adaptability in future crises. Ultimately, the study emphasizes that flexibility and strategic negotiation are key to managing patient transfers in a fragmented and complex healthcare environment.

Exploring knowledge, perception, and use of surface electromyography in physiotherapy post graduate trainees in Italy: a single center preliminary survey.

Surface electromyography (sEMG) is a non-invasive technique that records muscle electrical activity using skin-surface electrodes, aiding physiotherapists in assessing and treating muscular and neuromuscular conditions. Despite its potential, sEMG remains underutilized in Italy. This study aims to evaluate Italian physiotherapists' knowledge and use of sEMG, specifically among those who completed the Master's Degree in Rehabilitation of Musculoskeletal and Rheumatological Disorders at the University of Genoa. This cross-sectional study, approved by the University of Genoa's Ethical Committee, utilized an anonymous web survey to gather data from physiotherapy students in the master's program. The survey, developed based on the International Handbook of Survey Methodology, consisted of 12 questions covering demographics, previous sEMG experience, the importance of sEMG in practice and research, and educational satisfaction. Data collection spanned from January to May 2024, with a response rate of 72.7% (93 participants). Descriptive analysis was used to summarize the data. The average age of respondents was 26.5 years, with 55.9% being male. Only 3.2% reported using sEMG in their practice. While 46.2% considered sEMG moderately important for practice, 40.9% deemed it extremely important for research. Most participants felt their undergraduate education inadequately prepared them for using sEMG, with 81.7% rating their preparation as insufficient. Although the master's program improved sEMG knowledge, 66.7% indicated no significant proficiency gain. Italian physiotherapists view sEMG mainly as a research tool rather than a clinical one. The findings highlight the need for curriculum reforms to enhance both theoretical and practical sEMG education. Simplifying and standardizing sEMG protocols and integrating sEMG training into physiotherapy curricula are essential steps to better prepare clinicians for its clinical application.

MiniCandidate: An Innovative Method for Enhancing Employee Selection

The importance of effective decision-making in human resource management, particularly in employee selection, cannot be overstated. While education helps in identifying best practices, some individuals still struggle with myopic views toward selection, often overlooking crucial attributes. In response, the MiniCandidate exercise emerges as a novel intervention, integrating LEGO® minifigures into a playful, yet realistic, simulation. Tailored for physical classroom settings, participants construct minifigures symbolizing job candidates, with each component representing different attributes like general mental ability, the Big Five personality dimensions, and previous experience. Critiquing these minifigures fosters substantive discussions on person-job fit. This innovative exercise stands as a promising tool for developing future managers adept at navigating the complexities of hiring processes.

Domesticating energy flexibility. Learning from great britain’s 2022–2023 demand flexibility service

Demand-response is essential for balancing electricity grids with increasing proportions of intermittent renewable sources of generation. Harnessing the potential for demand-response in domestic settings could deliver widespread benefits for electricity systems and householders. This study applies domestication theory to a major national domestic electricity demand-response programme in Great Britain, exploring how participants integrate demand-response sessions into their everyday routines. The study uses empirical data from twenty-five participants who completed diaries reflecting on their experience of taking part in thirteen demand-response sessions scheduled over a five-month period in winter 2022–23. The study identifies and analyses five pathways for domesticating demand-response, making recommendations to support system-actors in boosting and sustaining the adoption of demand-response. The study concludes that designing electricity demand-response programmes, as a staple of secure low-carbon energy systems, will need to take full account of users’ non-financial motivations, previous experiences of demand-response, and access to enabling technology.

Impact of the mini-map on the interpretation of spatial situations in the virtual geographical space of a video game

ABSTRACT Mini-map as a world map in miniature format is often used as the most important cartographic element to facilitate the navigation and orientation of users in virtual geographical space. It provides detailed information about the position, orientation, nearby objects or terrain around the user in a compact and comprehensive way. The authors of this article wanted to find out whether the mini-map helps users with different levels of knowledge about the game to understand and interpret spatial situations that occur when playing in the virtual geographical space. The study was conducted in the form of an offline survey that required respondents to watch five short videos depicting different spatial situations during the League of Legends game. The 60 respondents were divided into 3 different groups whose responses were analyzed using statistical tests and mini-map heatmap eye-tracking analysis. The results of the study confirm that there is a correlation between the mini-map and the correctness of the interpretation of spatial situations in the game in all groups investigated. Previous gaming experiences were found to reduce the need to use a mini-map to interpret spatial situations, proving that video games provide players with comprehensive information about various events on the user interface.

Physical Symptoms and Coping Strategies With Earthquake Stress Among Adults Living in Tent Cities: A Cross-Sectional Study.

This study aimed to examine the physical symptoms, coping strategies for earthquake stress and factors predicting coping strategies among adults staying in tent cities after an earthquake. A cross-sectional design was conducted. The study sample consisted of 706 adults residing in tent cities in three cities of earthquake-affected regions. Data were collected through face-to-face surveys and the Earthquake Coping Strategies Scale, starting from the 16th day after the earthquake in February-March 2023. Independent samples t-test, one-way analysis of variance, McNemar test and multiple linear regression analysis used for data analysis. The first three physical symptoms with the highest frequency after the earthquake were insomnia, frequent waking and difficulty falling asleep, respectively. Individuals with chronic illnesses, lower education levels, no previous experience with earthquakes and having undamaged homes more frequently used religious coping strategies. Individuals with higher incomes, employed individuals, non-smokers and those with having undamaged homes more frequently used positive reappraisal strategies. The present study concluded that physical symptoms were common among individuals in the post-earthquake period and that many individuals adopted religious coping strategies. Nurses can develop effective interventions for preventing physical and mental health problems in the post-earthquake period. They can contribute significantly as caregivers, leaders, researchers and advisors in health monitoring and improvement practices for individuals after earthquakes. The results of the study are instructive for designing prevention and improvement practices to minimise future destructive effects of earthquakes. Individuals mostly experienced sleep problems and preferred different coping styles in the early post-earthquake period. The physical and mental health of individuals can be improved by early intervention and encouraging effective coping methods after an earthquake. STROBE checklist. No patient or public involvement.

Understanding Medical Students' Perceptions of E-Learning: A Study at the Faculty of Medicine and Pharmacy in Casablanca

Introduction: E-learning is essential in today's medical education, since it enhances the learning outcomes through easy access to resource materials and interactivity. Nonetheless, obstacles like technological aspects and the limited interaction of the student-teacher can impact its effectiveness. The purpose of this study was to understand how medical students perceive e-learning. Methods: A cross sectional study was conducted at the Faculty of Medicine and Pharmacy in Casablanca in 2023. A stratified cluster sampling method was adopted to select the participants. A self administrated questionnaire was distributed. We asked students about their demographic data, previous experience with online learning, learning formats preference and perception of e-learning. Results: A total of 373 students participated in the survey, with a mean age of 20.4 years and 61.4% being female. Just over half supported implementing e-learning (55.8%), about 63% of students had prior experience with the university's platform, and 59.8% found it easy to use. Most students preferred blended learning (74.8%) and asynchronous online learning (79.9%), additionally 72% favored live streaming with recordings as an e-learning resource. The primary advantage cited was flexibility (93.6%), whereas challenges included technical issues (71.5%) and limited interaction (54.8%). Prior experience significantly influenced students' positive perceptions of e-learning (p<0.001). Conclusion: Overall, medical students have a positive perception regarding e-learning, valuing its flexibility and convenience. However, technological difficulties must be resolved. These insights can help policymakers put effective e-learning infrastructure and strategies into place.