This paper addresses JECP aims in clinical services organisation and health system improvement by evaluating how organisational conditions (staffing, coordination, and management processes) and role clarity in emergency departments are associated with job satisfaction, a workforce outcome linked to service reliability. Emergency departments are high-demand clinical environments in which perceived organisational problems may undermine role clarity and staff well-being, with potential implications for workforce stability and care delivery. To examine the interrelationships between perceived organisational problems, role conflict/ambiguity, job performance, and job satisfaction among emergency department workers. A quantitative cross-sectional survey was conducted with 408 emergency department employees from 23 hospitals in Trabzon, Turkey (data collected November-December 2023). Measures included the Problems Experienced in Emergency Services (PES) scale, role conflict/ambiguity, self-rated job performance, and job satisfaction. Linear mixed-effects models with random intercepts for hospitals were used to account for clustering. Higher perceived organisational problems were associated with lower job satisfaction. Role conflict/ambiguity showed a strong negative association with job satisfaction, and self-rated job performance was positively associated with job satisfaction; hospital-level clustering was modest (ICC 0.05). Findings suggest that interventions to improve job satisfaction in emergency services should prioritise structural and managerial improvements that reduce organisational problems and strengthen role clarity and coordination, alongside individual-level supports.

How do people rapidly judge numerosity-the number of objects in a scene? Theories of human numerical judgements are constrained by the behavioural patterns emerging when people estimate numerosity, such as exact enumeration of small sets, underestimation of large sets, and scalar variability. Current computational models capture how properties of stimulus representations can lead to characteristic behavioural patterns under rapid viewing conditions. Here, we examined which decision-level processes people engage during such tasks, and whether these processes contribute to behavioural patterns. We combined qualitative, correlational, and experimental studies of participants estimating brief (100ms) and backward-masked dot patterns. In interviews, participants reported relying on visual memory to mentally compare a stimulus to previously estimated stimuli, count dots, and approximately add or multiply groups of dots. Quantitative multiple-choice surveys confirmed that the reported processes were systematically associated with numerosity, response time, and estimates. Preregistered experiments further showed that three decision-level processes-comparing, partitioning, and counting-contribute to several behavioural patterns reported in prior research. These results suggest that many estimation patterns may reflect the flexible use of decision-level processes that depend both on individual factors and task demands. Formal models that integrate these decision-level processes with representation-level mechanisms may substantially enhance our understanding of rapid numerical judgements.

Dyslexia is a common learning disability affecting language processing and literacy acquisition. In China, although prevalence rates are comparable to Western countries, awareness among teachers remains limited. Teachers are key to the early identification and support of students with dyslexia, yet many feel unprepared or hold misconceptions about the condition. This quantitative survey included 909 mainstream primary and secondary school teachers from Guangdong Province, China. A structured questionnaire assessed teachers' knowledge of developmental dyslexia, attitudes toward affected students and self-efficacy in supporting them. Teachers generally lacked sufficient knowledge of dyslexia and held notable misconceptions about its causes and interventions. Many expressed uncertainty about their ability to support students with dyslexia and showed ambivalent attitudes regarding these students' potential for improvement. Correlation and regression analyses indicated that teachers' knowledge and attitudes were significantly associated with and positively predicted their self-efficacy in teaching students with dyslexia. These findings reveal significant gaps in teachers' knowledge and confidence related to dyslexia, which may hinder effective inclusive education. The results highlight the need for targeted teacher training and professional development to address misconceptions, foster positive attitudes and enhance self-efficacy, ultimately improving support for students with dyslexia in mainstream classrooms.

Skin quality attributes are defined inconsistently in clinical and research settings, which can impede communication between patients and health care professionals (HCPs) and hinder optimization of patient outcomes. The authors aimed to develop a skin quality vocabulary/lexicon applicable across multiple stakeholders, including aesthetic HCPs, patients, researchers, and regulatory agencies. The authors convened advisory boards comprising 15 global aesthetic dermatologists to develop consensus definitions for 15 skin quality attributes based on a previously proposed framework. These definitions were used in qualitative patient focus groups ( n = 54) and quantitative online surveys of aesthetic HCPs ( n = 201) and patients ( n = 1,050) to assess preferred terms for each attribute. The advisory board developed definitions with 100% consensus for all 15 attributes after 2 meetings. The quantitative surveys demonstrated substantial agreement in terminology used between HCPs. However, as expected, terminology used by patients and HCPs differed for a number of conditions, including uneven pigmentation, crepiness, and laxity. This research identified skin quality attribute terminology/definitions used among HCPs and patients. The authors hope this work will establish a foundation for consistent definitions that will help support patient-HCP communication, optimize outcomes, and bring clarity to the indication for approval by regulators.

Early adoption of innovation is important for the implementation of evidence-based practices. Care of older adults using Age-Friendly practices optimizes the What Matters, Medication, Mobility, and Mentation (4Ms) framework. Within the first year of availability, over 1900 individuals acquired Age-Friendly pharmacist recognition. The purpose of this study is to characterize the demographics, preparedness, motivation, and professional association affiliation of pharmacists who received Age-Friendly recognition. A quantitative survey was administered to all participants as the last of four steps in Age-Friendly pharmacist recognition. The target population was Age-Friendly pharmacists who self-administer the online questionnaire. New practitioners (within 6 years of graduation) and pharmacists with 6+ (6+) years of practice were compared using descriptive statistics. Between March 2025 and February 2026, 1953 individuals received Age-Friendly Pharmacist recognition, 285 (15.4% of cohort) of whom were new practitioners with a mean age of 29.7 ± 4.4 years and 74.4% female. The 6+ group comprised 1567 (84.6% of cohort) pharmacists, meanage 45.3 ± 9.1 years, and 74.6% female. One quarter of new practitioners and 57.4% of the 6+ group were board-certified. Of those who were board-certified, 34% of new practitioners were board-certified in geriatrics and pharmacotherapy, whereas geriatrics certification was prevalent (82.2%) in the 6+ group. Improving the quality of care was the primary motivation to seek Age-Friendly recognition for both groups, followed by free continuing education, a digital badge, and advancing their skill set. New practitioners learned about Age-Friendly recognition from employers (46.7%), peers (39.1%), and social media (18.6%), whereas the 6+ group learned about Age-Friendly on the ASCP website (43.3%). For both groups, employers played an important role in disseminating information about and in supporting pharmacists to achieve Age-Friendly recognition. Highly qualified pharmacists were motivated to seek Age-Friendly recognition by a desire to improve the quality of care for older adults, free continuing education, a digital badge, and to advance their skill set.

Obesity, diabetes, and cardiovascular disease often co-exist in people with chronic kidney disease, placing them at high risk for adverse health outcomes. Availability of highly effective medications that span cardiovascular-kidney-metabolic (CKM) conditions, but limited uptake in real world settings, calls for a new transformative practice paradigm. We sought to identify key gaps, barriers, and facilitators to implementing a standardized CKM-focused comprehensive medication management (CMM) intervention, including needs/solutions among various care team members involved in CKM care in diverse health systems across the United States. This was a qualitative study guided by the Consolidated Framework for Implementation Research (CFIR) deployed in five health care systems across the United States. Clinical pharmacists, pharmacist administrators, primary care and specialty (nephrology, cardiology, endocrinology) physicians, and advanced practice professionals were interviewed using open-ended questions that were informed by results from three mainly quantitative online surveys. A total of 26 interviews were conducted with 42 participants. Practitioners and administrators reported many similar challenges to successfully implement CMM for people with CKM including lack of standardized CMM practice and workflow across the health system, electronic medical record integrated tools to identify and track patients with CKM, automatic pharmacist referrals, broad clinical practice agreements, and holistic CKM performance metrics, as well as pharmacist time constraints and limited reimbursement. Participants also highlighted CMM-CKM practice facilitators including recognition across most health care professionals that CKM should be a system priority, requiring strong supportive professional relationships among physician and/or administrator champions, and tools, knowledge, and resources that could be shared with others. Successful implementation of a transformative, holistic CMM-CKM interprofessional team-practice will require a tailored implementation strategy for each health system including consolidated tools such as a CMM-CKM Change Package, integrated with coaching, field experts, and peer-to-peer learning.

With the Cannabis Act (CanG), the German government aimed to improve health protection and to curb the illegal cannabis market. Apartial success of the CanG would be evident in the shift from illegal to legal supply channels. The following questions were central: How did sources of cannabis supply change overall and across different groups due to the Cannabis Act? Which groups subjectively benefit the most from the Cannabis Act? To address these research questions, anon-representative, quantitative online survey was conducted from 24March 2025 to 10June 2025 among cannabis users aged 14 and older. Participants were asked about their sources of supply before and after the Cannabis Act took effect as well as the subjectively perceived effects. The sample included N = 11,471 participants. Since the CanG came into effect, ashift from illegally to legally produced cannabis has been observed among adults overall, particularly among men and people in rural areas, as home cultivation and pharmacy purchases have increased significantly. In contrast, little change was observed among adolescents. Participants reported predominantly positive subjective effects of the law. Gender and regional differences showed that men and residents of major cities-particularly Berlin and Hamburg-more frequently perceived positive subjective effects. The results suggest that certain subgroups face barriers in accessing the legal market, including adolescents, women, and the urban population. For these groups, targeted measures aimed at reducing such barriers could contribute to further curbing illegal sources of supply.

Linking leaders' sustainability commitment with SME sustainability performance via serial mediation of green human resource management, psychological ownership for sustainability, and employee green innovation behavior: The role of organizational culture.

This paper investigates the extent of compliance by two State-Owned Utility Companies (SOUCs) in Sierra Leone with international best-practice corporate governance principles as prescribed by the Commonwealth Association of Corporate Governance (CACG) Code. The CACG Code (1998) is generally considered a benchmark for best-practice corporate governance in commonwealth and some non-Commonwealth countries worldwide. The study used a descriptive cross-sectional case study survey design with a quantitative approach, in which two purposively selected SOUCs, Electricity Distribution and Supply Authority (EDSA) and Guma Valley Water Supply Company (GVWC) were considered. Primary data were collected through a questionnaire survey of the selected SOUCs supplemented with secondary data from document sources. Quantitative survey data analysis was conducted using SPSS and Excel programs. It used simple descriptive statistics to describe corporate governance compliance of SOUCs. Using a compliance checklist of 39 provisions from the CACG Code, the study found that majority (62%) of the responses recorded a negative opinion about standard corporate governance compliance in the SOUCs, and that both SOUCs have an overall weak (47%) corporate governance compliance, with weak compliance at 48% and 46% in EDSA and GVWC respectively. The results indicate that SOUCs did not adhere to international best practice corporate governance, which could signal a lack of investor appeal. It could also be a signal to stakeholders that necessary steps must be taken to address poor corporate governance mechanisms in the SOUCs.

Global warming has become a major environmental issue worldwide. According to the Climate Transparency Report (2022), In Indonesia, the transportation sector is responsible for about 33% of the country’s total carbon emissions, with the majority originating from vehicles powered by fossil fuels. This condition has encouraged innovations in environmentally friendly transportation, such as electric motorcycles. This research examines how green product knowledge, green marketing, and green trust affect consumers’ intention to purchase Uwinfly electric motorcycles in Pamekasan Regency, Indonesia. A quantitative survey was conducted with 80 respondents from two official Uwinfly dealerships. The findings indicate that both green product knowledge and green marketing significantly and positively influence consumers’ intention to make green purchases, while green trust does not significantly influence it. Green product knowledge enhances consumers’ awareness of environmental and economic benefits, fostering sustainable consumption patterns. Green marketing strategies, including eco-friendly promotions and sustainability-focused branding, positively shape consumer interest and perceptions. The model explains 30.3% of the differences observed in green purchase intention, indicating that additional factors such as green brand image, environmental concern, and social influence may also contribute.

Point-of-care Ultrasound (POCUS) is increasingly introduced in obstetrics and gynecology as a focused bedside extension of conventional ultrasound, although evidence on its implementation in routine care remains limited. This study examined physicians' attitudes towards POCUS, their perceived diagnostic confidence across different clinical scenarios, and their preference for POCUS compared with standard ultrasound devices. These outcomes were assessed during early implementation in routine care accompanied by structured training. In this prospective, longitudinal implementation study, 22 physicians from a university department of gynecology and obstetrics evaluated standard ultrasound devices at baseline (T0a), completed a structured hands-on POCUS training, and assessed POCUS immediately after training (T0b) and after 2 weeks (T1), 1 month (T2), and 3 months (T3) of clinical use. Evaluations were conducted using repeated quantitative surveys. Outcomes were attitude (4 items, 7-point Likert), perceived diagnostic confidence in obstetric and gynecologic scenarios (17 items, 7-point Likert), and device preference (7-point Likert and dichotomous). Quantitative analyses included descriptive statistics, paired tests, mixed-effects models, and non-parametric sensitivity analyses. Attitude toward POCUS was significantly more favorable than attitude toward standard devices at baseline (T0a 3.69 vs. T0b 5.83; p < .001) and remained high throughout follow-up. Perceived diagnostic confidence for POCUS was not higher immediately after training but increased significantly over time in both obstetrics and gynecology after independent clinical use (both p < .001). Highest confidence was observed in focused bedside scenarios relevant to rapid orientation and immediate decision-making, including fetal vitality assessment, placental localization, amniotic fluid assessment, postvoid residual urine measurement, and urinary tract obstruction, whereas confidence remained lower for more complex applications such as cervical length assessment, Doppler-based examinations, and fetal growth restriction. Preference for POCUS was already high at baseline and remained stable over time. POCUS showed high acceptance in gynecologic and obstetric care from early implementation to routine use. Its clinical relevance appears greatest for focused mobile use and rapid bedside decision-making. These findings were observed during early implementation and support the role of POCUS as a complement to comprehensive ultrasound. German Registry of Clinical Trials; registration number: DRKS 00036941; date of registration: July 16, 2025; title: GO-POCUS: Point-Of-Care UltraSound in Gynecology and Obstetrics: Attitude and Perceived Diagnostic Confidence among Physicians.

With the aging population increasing, it is important to identify effective psychological and spiritual support factors to help individuals experience the aging process in a healthier and more meaningful way. This study aims to examine the effect of spiritual transcendence and kinesiophobia on successful aging. A quantitative cross-sectional descriptive survey method was used in this research. The study was conducted between February and July 2025 with 871 elderly individuals. Hierarchical regression analysis was performed using SPSS 25.0. Machine learning analysis and estimation were performed using the R programming language version 4.1.3. The mean age of the participants was 70.75 ± 5.40. According to regression analysis, the level of spiritual transcendence explains 51.9% of the level of successful aging (R²=0.519), and this relationship was found to be statistically significant (t = 30.619, p<0.001). When spiritual transcendence and kinesiophobia levels were evaluated together, the explained variance ratio reached 67.5% (R²=0.675). An increase in spiritual transcendence (t = 14.122, p<0.001) and a decrease in kinesiophobia (t=-20.418, p<0.001) show a statistically significant relationship with the level of successful aging. SHAP values show the extent to which each variable influences the model's predictions and the magnitude of this influence. According to these values, kinesiophobia is identified as the most important variable in predicting the successful aging variable. The findings from our study indicate that supporting the psychological and spiritual resources of older adults plays an important role in strengthening the successful aging process. Longitudinal studies on successful aging are recommended.

This study investigates the perceptions of Egyptian university academics regarding the use of artificial intelligence (AI) in academic research. Adopting a quantitative descriptive survey design, the study administered a structured questionnaire to a purposive sample of 105 participants affiliated with Egyptian universities, including lecturers (n = 50), researchers (n = 40), instructors (n = 10), and students (n = 5). The instrument comprised 20 items organized across four dimensions: AI awareness, actual AI use, challenges to AI adoption, and expected impact of AI on research quality. Data were analyzed using descriptive statistics. Findings reveal high overall AI awareness (M = 2.37 on a 3-point scale) alongside low-to-moderate actual use (M = 2.00), indicating a pronounced awareness-to-practice gap. The challenges dimension recorded the highest mean (M = 2.52), with insufficient professional training (85.7% agreement) and ethical concerns about research originality (71.4% agreement) emerging as the most salient barriers. Participants held guarded optimism about AI's expected impact on research quality (M = 2.34), particularly regarding efficiency and creativity. These findings, understood as participants’ perceptions rather than objective measures of institutional reality, highlight the urgent need for structured AI literacy programs, institutional policy frameworks, and digital infrastructure investments at Egyptian universities. The study contributes to the limited empirical literature on AI adoption in Egyptian and broader MENA higher-education contexts and identifies directions for future research.

ABSTRACT This study examines the effect of school principals’ distributed leadership behaviors on teacher collaboration and investigates the mediating role of teacher agency in this relationship within the Turkish context. Employing a quantitative correlational survey design, the study draws on data from 525 teachers working in public K–12 schools across 12 provinces in Türkiye. The results indicate that distributed leadership has significant and positive direct effects on both teacher agency and teacher collaboration. In addition, teacher agency partially mediates the relationship between distributed leadership and teacher collaboration. Enhancing teacher autonomy and participation strengthens sustainable collaborative professional practices.

This study examines aquaculture risk financing strategies and food safety practices among selected fish farmers in Lagos Metropolis, Nigeria. The study investigated the ranking of financing strategies and food safety practices using a quantitative survey approach. A descriptive survey design was adopted with a sample of 141 respondents selected through multistage sampling. Data were collected using structured questionnaires and analyzed with descriptive statistics and Friedman rank test in SPSS version 25. Results showed significant differences in risk financing strategies with χ² = 18.545, df = 4, p &lt; .001. Personal savings and cooperative societies ranked highest (mean rank = 3.11), while credit facilities ranked lowest (2.66). Food safety practices also showed significant variation χ² = 16.315, p &lt; .001, with HACCP ranking highest. The study concludes that informal financing dominates while food safety compliance is generally high. It recommends financial inclusion policies, insurance awareness, and strengthened extension services. The study contributes by applying Friedman ranking to link financing preferences and food safety priorities. Future research should extend to other regions and use longitudinal and mixed methods to enhance generalizability and policy relevance in aquaculture development and food security frameworks in Nigeria for sustainable sectoral growth and resilience policy implementation improvement.

Yoga is rapidly gaining popularity as a mind-body intervention with notable benefits on both physical and mental health for survivors of traumatic experiences, such as human trafficking. Among trauma survivors, yoga is associated with significant improvements in psychological symptoms and social functioning. However, little is known about the specific mechanisms through which mind-body practices improve social functioning. In this study, we assessed changes in perceived social support and compassion among female human trafficking survivors (N = 10) in Kampala, Uganda, who participated in a mind-body intervention in a shelter setting. Quantitative survey measures indicate increases, though not statistically significant, in perceived social support and compassion toward others. We also conducted a qualitative analysis of interviews with intervention participants. Qualitative findings highlight the importance of having structured opportunities to interact with fellow survivors and opportunities to discuss prior traumatic experiences that may or may not have been related to human trafficking. Findings from this study have important implications for the utilization of mind-body interventions among trauma survivors. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Introduction Village Health Volunteers (VHVs) constitute a crucial community health workforce in communicable disease prevention and control. Despite generally strong performance, persistent gaps in digital literacy, data management, and risk communication indicate a need for a structured competency development model. Methods A mixed-methods Multiphase Research design was employed from March 2022 to July 2024, integrating quantitative surveys with qualitative focus group discussions and in-depth interviews. Phase 1 comprised quantitative ( n = 416) and qualitative ( n = 100) data collection using multi-stage stratified random sampling and purposive sampling, respectively. Phase 2 ( n = 34) employed the Plan–Act–Observe–Reflect cycle to develop the competency model. Phase 3 ( n = 33) evaluated the intervention. Results Baseline assessment indicated that most VHVs were female (80.53%), aged 51–60 years (43.03%), and had 11–20 years of experience (45.19%). Overall self-reported competency was at a high level (mean = 3.71, SD = 0.46), with strong performance in practices (mean = 4.34, SD = 0.42), moderate-to-high skills (mean = 3.60, SD = 0.45), and the lowest scores in knowledge (mean = 3.59, SD = 0.49). Qualitative findings identified substantive competency gaps in epidemiological reasoning, digital literacy, systematic data recording, risk communication, and leadership. The SMART VHV Plus Model, comprising five components (communicable disease control, management, technology, leadership and teamwork, and community health planning), was subsequently developed and delivered through five structured training programmes. Post-intervention assessment demonstrated a statistically significant improvement in overall competency scores: from a pre-intervention mean of 86.14% (SD = 7.65, classified as moderate) to a post-intervention mean of 98.16% (SD = 1.95, classified as high), representing a mean difference of 12.02 percentage points (95% CI: 9.84–14.20, p &amp;lt; 0.05). Discussion The SMART VHV Plus Model was associated with meaningful improvements in VHV competencies in communicable disease prevention and control. Its participatory design and integration of digital literacy, leadership, and community health planning provide a potentially sustainable framework for strengthening community health workforce capacity.

ABSTRACT This study analyses residents’ perceptions towards the effects of tourism in a low-density cross-border region between northern Portugal and Spain. Based on Social Exchange Theory, it examines how tourism dependence, gender, and length of residence shape perceptions of the economic, sociocultural, and environmental effects. Quantitative survey was conducted with 622 residents from 10 municipalities on both sides of the border, and statistical tests were applied. Results indicate favourable attitudes towards tourism, driven by perceived economic benefits, while concerns remain moderate. Tourism dependence significantly influences positive and negative perceptions, whereas gender and length of residence do not. The findings suggest that, in early-stage and low-intensity cross-border destinations, traditional predictors of residents’ attitudes operate differently from those observed in saturated tourism contexts.

Healthcare workers (HCWs) have been disproportionately affected by the COVID-19 pandemic, both as carers and as patients. Many individuals developed persistent symptoms following an acute SARS-CoV-2 infection, known as post-COVID-19 syndrome (PCS). Previous research indicates that a significant proportion of HCWs experience long-lasting and debilitating symptoms of PCS. The aim of this study is to investigate the longitudinal symptom burden as well as the care pathways and treatment experiences of PCS-affected HCWs insured by the German Social Accident Insurance Institution for Health and Welfare. The study uses a mixed-methods approach. The longitudinal survey will extend a cohort study of n=2436 HCWs (started in 2023) affected by PCS, adding two measurement points, set in 2025 (T3) and 2026 (T4). Additionally, interviews on care pathways and treatment experiences will be conducted with a subsample of n=60 PCS-affected HCWs. Another subsample of n=30 HCWs will be asked to participate in ecological momentary assessments of symptom burden, emotional well-being and coping strategies. Analyses of routinely collected data by the insurance company will complement the study data. The study is supported by an advisory board comprising PCS-affected HCWs who assist with the content of both qualitative and quantitative surveys. This study was approved by the Local Ethics Committee of the University Medical Center Hamburg-Eppendorf, Germany (LPEK-0909, 1 May 2025; amendment: LPEK-0954, 18 September 2025). The results of the study will be presented at conferences and published in peer-reviewed journals. https://drks.de/search/de/trial/DRKS00035957.

Family-centered care (FCC) has become the gold standard of intensive care practice, especially in the neonatal intensive care units (NICUs), due to its positive impact on family and neonatal health outcomes. However, there are few validated instruments specifically designed to assess FCC practices in low-resource NICU settings. This study adopted the Family Systems Theory (FST) as a theoretical framework to develop and validate an instrument for assessing the implementation of FCC in low-resource NICUs. This study was an instrument development and validation in a three-phased mixed-method triangulation design. Phase I consisted of a scoping review, 24 interviews, and 12 focus group discussions to generate a 40-item draft. Phase II involved piloting (n = 30) the drafted instrument for two quantitative surveys (n = 446) among family (n = 346) and clinicians (n = 100) for item reduction with exploratory and confirmatory factor analysis. Phase III entailed instrument validation by estimating validity and reliability through a two-round modified Delphi study with experts (n = 25). The study conforms to the STROBE checklist of instrument development and validation. Factor analysis produced a validated 20-item instrument, the Family Acceptance (4 items), Education (6 items), Environmental Design (6 items), and Sufficient Resources (4 items) (FEES) instrument. The instrument has acceptable validity and reliability; Kaiser-Meyer-Olkin (KMO) was 0.943, CFI = 0.969, TLI = 0.995, ω = 0.955, Cronbach's alpha = 0.949, and average Intra-Class Correlation of 0.951. The expert validation of the item-level content validity index (I-CVI) ranged from 0.88 to 0.96, and the scale-level content validity index (S-CVI/Ave) is 0.924. An instrument has been developed and validated, which demonstrates acceptable psychometric properties, potentially contributing to knowledge and practice in paediatric nursing. The FEES instrument provides a reliable tool to assess FCC practices in NICUs in neonatal care, which could result in the adjustment of nursing interventions to improve healthcare outcomes for critically ill infants and their families. The FEES instrument has further illuminated the importance of FCC in healthcare, especially NICU practice. It could guide the design of future research methodology, instrument development, and advanced statistical analysis to enhance practice and education in nursing science.