Choice Response Research Articles

Assessment of Health Disparities and Sexual Orientation Response Choices Used in Two US National Population-Based Health Surveys, 2020‒2021.

Objectives. To (1) compare responses to 2 survey questions designed to measure sexual orientation and (2) understand how variation in responses is associated with mental health. Methods. Data were from the National Longitudinal Study of Adolescent to Adult Health (Add Health) Sexual Orientation/Gender Identity, Socioeconomic Status, and Health Across the Life Course (SOGI-SES) study (2020-2021) in the United States. We used the adjusted Wald test to compare proportions of respondents who were (1) categorized as heterosexual or straight and sexual minorities using the sexual orientation questions designed for the Add Health study and the National Health Interview Survey (NHIS) and (2) diagnosed with depression or anxiety or panic disorder. Results. The Add Health question detected more than twice as many sexual minority respondents as the NHIS question. Those who responded as sexual minorities to the Add Health question but as heterosexual or straight to the NHIS question, primarily "mostly heterosexuals," had mental health outcomes that were more like those who were consistently classified as sexual minorities versus those consistently classified as heterosexual or straight. Conclusions. Current measures of sexual orientation in national-level surveys may underestimate the sexual minority population and sexual orientation‒related health disparities. Public Health Implications. Results illustrate the need for further research to expand measurement of sexual orientation on population-based health surveys. (Am J Public Health. 2024;114(12):1375-1383. https://doi.org/10.2105/AJPH.2024.307839).

OGC SO29 - Patient perceptions survey on the best timed oesophago-gastric dietetic pathway

Abstract Background It is well established that patients with oesophago-gastric (OG) cancer often present with malnutrition and impact symptoms such as anorexia, dysphagia and abdominal symptoms. Dietetic input is imperative in assessing and managing these symptoms early to improve outcome measures such as nutritional status, clinical outcomes and quality of life. A service evaluation was conducted to explore patient perceptions of early dietetic intervention in the Greater Manchester OG two week wait (TWW) pathway. There is no known prior research exploring the aims of this project. The results provide a novel insight into patient perceptions. Method A mixed methods survey using Microsoft Forms including open and close-ended questions was completed using transcription of responses via telephone consultation for 8 participants. For multiple choice responses, quantitative analysis was undertaken utilising Microsoft Forms analytics. Thematic analysis was completed with the use of computer assisted qualitative data analysis software (CAQDAS). Results 100% of respondents strongly agreed that receiving information about eating and drinking during investigations was important to them. 100% of respondents disagreed that dietetic advice was difficult to understand and follow. 75% of respondents felt dietetic input to be helpful in managing nutritional impact symptoms. 25% of participants responded neutrally. 100% of respondents felt their individual needs and concerns were addressed and would recommend the service to friends/family (88% strongly agreed; 12% agreed respectively). Conclusion Dietetic input was viewed positively by service users undergoing the OG TWW pathway. Patients reported feeling reassured, and valued communication, accessibility, and a personal approach. Some patients experienced delays in receiving prescribed nutritional supplements. Consistency of nutritional information requires improvement across the multidisciplinary team. Unfamiliarity with dietetic input limits the ability of participants to provide perspectives on service improvement. These findings suggest that specialist nutritional assessment and advice is beneficial to patients. Future research should be conducted to explore the long-term impact of early dietetic interventions on health outcomes in OG cancer patients.

Abstract 4114994: Nursing Management Practice Variations related to Externalized Ventricular and Lumbar Drains

Introduction/Background: Nursing management of neurologic patients may include placement of externalized ventricular drains (EVDs) or lumbar drains (LDs) to monitor/drain cerebrospinal fluid (CSF), but knowledge and practice related to EVD management varies widely, despite a high potential for life-threatening complications. Limited data exists relative to the relationship between intracranial pressure (ICP) and CSF drainage. These gaps may undermine patient safety. Research Question: What are the nursing practices and perspectives regarding management of EVDs and LDs? Methods/Approach: A 16-question multiple-choice/text entry survey was distributed electronically to nurses and advanced practice nurses who were members of the American Association of Neuroscience Nurses. Data analysis included chi-square test for multiple choice responses, and qualitative data was analyzed using a six-step thematic analysis and an inductive approach. Results/Data: Of 219 participants, 42.8% reported roles as Neuroscience ICU nurses, and 39.2% managed an EVD at least 75% of the time. Neuro ICU nurses were most likely to have a patient with an EVD ( p =.002). Approximately 63% of respondents reported consulting with colleagues about EVDs nearly every time they cared for a patient with an EVD. Nurses reported a very high care burden, including re-leveling the transducer 4 or more times per shift (n=76), and re-zeroing every 8 hours (n=72) to assure accurate calibration. Of these 82.2% reported that they re-zeroed the EVD more often to obtain an accurate reading. Approximately 25% reported accidental over-drainage, some with negative outcomes. Many (79.3%) reported caring for patients with LDs, 47.4% to diagnose normal pressure hydrocephalus. The nursing care workload was described as 30-120 minutes each shift. Conclusion: A wide heterogeneity of nursing practices was revealed in EVD and LD management. No standardized nursing care practices have been adopted by nurses for the management of CSF. The complications of these practice variations have been shown to result in untoward patient outcomes. Increased patient morbidity and mortality are linked to catheter infection and over/under drainage of CSF and may be directly related nursing practice. This reveals critical need for improved, standardized care nursing practices in the management of EVDs and LDs, and an empiric understanding of the relationship between intracranial pressure and the volume and rate of CSF drainage.

How “Light” Is “Light Smoking”? On the Cognitive Power of Nicotine Dependence

In recent years, habits related to smoking have been changing. An increasing portion of light/occasional smokers tend to define themselves as non-smokers, leading to an incorrect perception of the risks that smoking even a few cigarettes can entail. In this study, we investigated the nicotine-induced cognitive distortion in young, higher-education students with low/moderate dependence (as indexed by the Fagerstrom questionnaire). The study involved 111 participants (62 female; mean age 24.43 ± 3.77) divided into smokers and non-smokers, who responded to specific questionnaires to evaluate their attachment style, emotion dysregulation, and state anxiety. Their response to smoking-related cues following emotional stimulation was experimentally evaluated, with participants being made to choose between care- or smoking-related images, following the presentation of threatening or neutral stimuli. The results show a cognitive bias in smokers, with participants choosing smoking-related stimuli significantly more often than non-smokers, with a slower reaction time, regardless of emotional cues. Emotion dysregulation and attachment style were also significantly correlated with response choice but not with response latency. Overall, our data indicate that there is no such thing as light use of nicotine and that smoking, even if not continuous, determines cognitive biases that lead to a vision of the environment as a function of substance seeking.

“I think we should wait and see”: A qualitative study of call-takers’ decision-making in consultations with patients suffering unrecognized myocardial infarction

ObjectivesCall-takers face a complex situation when assessing medical problems in emergency medical services calls. Patients with myocardial infarction experiencing atypical symptoms risk misinterpretation. We examined development in call-takers' decision-making process in telephone consultations with patients having imminent myocardial infarction. MethodsRecording of 38 calls among 19 patients (two per patient) who contacted Copenhagen Emergency Medical Services (Denmark) at least twice within one week before myocardial infarction diagnosis. The penultimate and last call were compared using qualitative content analysis. ResultsCall-takers’ assessment of the condition changed from symptom picture and dismissal of heart disease in penultimate call to severe condition, not heart-related, and possible heart disease in last call. Call-takers recommended watchful waiting in the penultimate call. Both calls involved response negotiation, while caution regarding misinterpretation was only seen in the penultimate call. ConclusionCall-takers used different decision-making approaches when the caller’s symptom descriptions appeared unclear and not corresponding with the medical understanding of severe conditions. Call-takers did not negotiate the condition's assessment but engaged in discussions about the response choice. Practice implicationsA protocol to negotiate response choice with callers having unclear clinical conditions should be developed. Clarifying watchful waiting as a recommendation may assist call-takers’ decision-making.

A study of professional practices, attitudes and barriers to blended tube feeding in Australia and New Zealand.

This study investigates the utilisation of blended tube feeding by health professionals in Australia and New Zealand, assessing factors influencing its implementation following the Australasian Society of Parenteral and Enteral Nutrition blended tube feeding consensus statement. A cross-sectional survey was conducted targeting health professionals across Australia and New Zealand. The survey comprised 35-questions including multiple choice, Likert scales and open-ended responses, to gain insights into blended tube feeding practices and perspectives. The effect of the health professional factors on outcomes was explored in pairs with a series of Chi-squared tests. Odds ratios (ORs) were calculated using standard univariate logistic regression. An exploratory content analysis was used to code the open-ended text responses to the survey questions which were then categorised and further synthesised into overarching themes. Out of 89 health professionals who completed the survey, the majority were dietitians, 63% reported managing fewer than five patients using blended tube feeding within their services. Parental request was the leading reason for adoption. Notable barriers included clinician time constraints, resource limitations and a lack of formal guidelines. Some health professionals considered the primary risk associated with blended tube feeding to be poor growth and/or weight loss. Professional development was pivotal in increasing confidence and advocating for blended tube feeding, with significant correlations observed between blended tube feeding training and clinical practice. This study emphasises the essential role of education, resource availability and institutional policy in promoting blended tube feeding practices for health professionals. Findings suggest that focusing on professional development and standardised resources could significantly enhance knowledge, confidence and competence of health professionals in blended tube feeding application. The outcomes point towards the need for a coordinated approach to support evidence-based blended tube feeding practices, aligning with the Australasian Society of Parenteral and Enteral Nutrition blended tube feeding resources and recommendations.

Promoting social competence and social inclusion in the preschool: a peer-based relational intervention

ABSTRACT Reviews concerning the enhancement of preschool children’s social competencies reveal areas within which teacher approach, definitions of social competence and methods of study can be enhanced. In response, teachers and researchers co-developed and introduced a peer-based relational intervention to support children’s communication, empathic response and non-homophilic choice of friendship/work mates. Within this design-based approach, a three-phase comparison was made in 14 English preschool classrooms. Results identified changes attributed to the intervention regarding: teacher behaviour (movement from giving directions to observation and support); child behaviour (enhanced reciprocal communication, empathic response to others and engagement in cognitively challenging activities) and an expansion of socially inclusive play/work mates. Not all teachers/classes responded to the relational approach in the same manner: those that engaged actively in the approach encouraged more social competence enhancements amongst children; those with lower engagement identified support/implementation problems and children showed less social competence advances.

Using stated preference methods to design gender-affirming long-acting PrEP programs for transgender and nonbinary adults.

Integrating gender-affirming care with biomedical HIV prevention could help address the disproportionate HIV risk experienced by transgender and nonbinary (trans) adults. This discrete choice experiment assesses and identifies the most important programming factors influencing the decisions of trans adults to use injectable long-acting HIV pre-exposure prophylaxes (LA-PrEP). From March to April 2023 n = 366 trans adults in Washington state chose between four different choice profiles that presented hypothetical programs (each comprised of 5 attributes with 4 levels). We analyzed ranked choice responses using a mixed rank-ordered logit model for main effects. Respondents preferred to receive LA-PrEP from a gender-affirming care provider and a co-prescription for both oral and injectable hormones. Trans adults strongly favored 12-month protection and injection in the upper arm. No strong preferences emerged surrounding the type of health facility offering the gender-affirming LA-PrEP program. Our findings show that integrating and leveraging gender-affirming health systems, inclusive of medical services such as hormone therapy, with HIV biomedical products like LA-PrEP is strongly preferred and influential to trans adults' decision to use LA-PrEP. Leveraging choice-based design experiments provides informative results for optimizing gender-affirming LA-PrEP programming tailored to trans adults.

Perceptual training with implicit and explicit learning improves the prediction of ball direction in soccer penalty kicks.

Perceptual training enhances the ability to anticipate crucial information for decision-making, for example, a soccer goalkeeper predicting penalty kick direction. However, it remains unclear whether perceptual practice alone (implicit method) is sufficient for optimal decision-making improvement, or whether emphasising pertinent details during practice (explicit method) could yield better results. This study compared implicit and explicit methods of learning ball direction prediction during soccer penalties, involving both goalkeepers and non-soccer players (novices). Participants engaged in a single training session, either through the explicit method (watching videos highlighting relevant information) or implicit method (watching regular videos). Specialised software was used to display penalty kick videos, mimicking the goalkeeper's viewpoint up to 200 ms before ball contact, and measuring reaction time and response choice. Both implicit and explicit training led to consistent performance gains for goalkeepers and novices alike, notably enhancing ball direction prediction accuracy. Reaction time was unaffected by training. This suggests that both explicit and implicit training methods exhibit similar effectiveness, applicable to soccer goalkeepers and novices.

Temporary treatment cessation compared with continuation of tyrosine kinase inhibitors for adults with renal cancer: the STAR non-inferiority RCT.

There is interest in using treatment breaks in oncology, to reduce toxicity without compromising efficacy. A Phase II/III multicentre, open-label, parallel-group, randomised controlled non-inferiority trial assessing treatment breaks in patients with renal cell carcinoma. Patients with locally advanced or metastatic renal cell carcinoma, starting tyrosine kinase inhibitor as first-line treatment at United Kingdom National Health Service hospitals. At trial entry, patients were randomised (1 : 1) to a drug-free interval strategy or a conventional continuation strategy. After 24 weeks of treatment with sunitinib/pazopanib, drug-free interval strategy patients took up a treatment break until disease progression with additional breaks dependent on disease response and patient choice. Conventional continuation strategy patients continued on treatment. Both trial strategies continued until treatment intolerance, disease progression on treatment, withdrawal or death. To determine if a drug-free interval strategy is non-inferior to a conventional continuation strategy in terms of the co-primary outcomes of overall survival and quality-adjusted life-years. For non-inferiority to be concluded, a margin of ≤ 7.5% in overall survival and ≤ 10% in quality-adjusted life-years was required in both intention-to-treat and per-protocol analyses. This equated to the 95% confidence interval of the estimates being above 0.812 and -0.156, respectively. Quality-adjusted life-years were calculated using the utility index of the EuroQol-5 Dimensions questionnaire. Nine hundred and twenty patients were randomised (461 conventional continuation strategy vs. 459 drug-free interval strategy) from 13 January 2012 to 12 September 2017. Trial treatment and follow-up stopped on 31 December 2020. Four hundred and eighty-eight (53.0%) patients [240 (52.1%) vs. 248 (54.0%)] continued on trial post week 24. The median treatment-break length was 87 days. Nine hundred and nineteen patients were included in the intention-to-treat analysis (461 vs. 458) and 871 patients in the per-protocol analysis (453 vs. 418). For overall survival, non-inferiority was concluded in the intention-to-treat analysis but not in the per-protocol analysis [hazard ratio (95% confidence interval) intention to treat 0.97 (0.83 to 1.12); per-protocol 0.94 (0.80 to 1.09) non-inferiority margin: 95% confidence interval ≥ 0.812, intention to treat: 0.83 > 0.812 non-inferior, per-protocol: 0.80 < 0.812 not non-inferior]. Therefore, a drug-free interval strategy was not concluded to be non-inferior to a conventional continuation strategy in terms of overall survival. For quality-adjusted life-years, non-inferiority was concluded in both the intention-to-treat and per-protocol analyses [marginal effect (95% confidence interval) intention to treat -0.05 (-0.15 to 0.05); per-protocol 0.04 (-0.14 to 0.21) non-inferiority margin: 95% confidence interval ≥ -0.156]. Therefore, a drug-free interval strategy was concluded to be non-inferior to a conventional continuation strategy in terms of quality-adjusted life-years. The main limitation of the study is the fewer than expected overall survival events, resulting in lower power for the non-inferiority comparison. Future studies should investigate treatment breaks with more contemporary treatments for renal cell carcinoma. Non-inferiority was shown for the quality-adjusted life-year end point but not for overall survival as pre-defined. Nevertheless, despite not meeting the primary end point of non-inferiority as per protocol, the study suggested that a treatment-break strategy may not meaningfully reduce life expectancy, does not reduce quality of life and has economic benefits. Although the treating clinicians' perspectives were not formally collected, the fact that clinicians recruited a large number of patients over a long period suggests support for the study and provides clear evidence that a treatment-break strategy for patients with renal cell carcinoma receiving tyrosine kinase inhibitor therapy is feasible. This trial is registered as ISRCTN06473203. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment Programme (NIHR award ref: 09/91/21) and is published in full in Health Technology Assessment; Vol. 28, No. 45. See the NIHR Funding and Awards website for further award information.

Relation of general-perceptual cognitive abilities and sport-specific performance of young competitive soccer players.

In soccer, skill is significantly influenced by motor skills and physical constitution. In addition, perceptual-cognitive abilities are thought to affect sport-specific performance. Nevertheless, there are hardly any studies investigating the relationship of general cognitive abilities with sport-specific performance. Therefore, the aim of this study was to analyze relationships between general perceptual-cognitive abilities and soccer-specific performance in competitive youth sports. Thirty highly talented male youth soccer players aged 12-14years completed various perceptual-cognitive (selective attention, cognitive flexibility, inhibition, working memory, peripheral perception, and choice response) and sport-specific on-field tests. Cognitive abilities were assessed using a computer-based test system. Soccer-specific performance skills were evaluated by two sport-specific on-field tests. The relation between perceptual-cognitive abilities and soccer-specific performance was examined using a correlation analysis as well as a four-stage regression analysis. Overall, the expression of general perceptual-cognitive abilities was found to have an impact on performance in soccer-specific test situations, particularly cognitive flexibility and selective attention. Our results suggest that general cognitive tests could be an important tool for the evaluation of cognitive abilities in soccer. This study brings together key approaches in expertise research and makes a significant contribution to a better understanding of expertise in soccer.

Feasibility and acceptability of studying full-time nurse faculty salaries

BackgroundThe nursing shortage is driven, in part, by the critical shortage of nursing faculty. Consequently, qualified potential nursing students are being turned away from nursing schools each year. The preeminent issue influencing the United States nurse faculty workforce shortage is salary; financial compensation is higher in clinical and private-sector settings than educational settings. The purpose of this study is to describe current full-time nurse faculty salary, sources of income, and perceived need for more income, as well as the feasibility and acceptability of research focused on full-time nurse faculty salaries, so to guide future nursing faculty workforce research.MethodsUsing a cross-sectional study design, full-time nursing faculty working in a Midwestern state in the United States completed a survey inclusive of fixed choice and free text response options focused on income (individual gross, faculty, and secondary), demographics, and feasibility/acceptability of the survey instrument. Descriptive statistics were used to describe salary, sources of income, and perceived need for additional income. Feasibility and acceptability were evaluated by descriptive statistics examining three feasibility and acceptability questions, and by comparing demographic differences between participants who answered income questions compared to those who did not using t tests, x2 tests, and Wilcoxon signed rank tests.ResultsOne hundred and eighty-three full-time nurse faculty completed the survey in six weeks, representing 27% of the full-time nurse faculty workforce in the state. Over half of participants, 57%, reported having another job(s) in addition to their full-time faculty position to support basic living expenses. Most respondents reported willingness to share financial/salary data and viewed the survey to be acceptable.ConclusionsResearch focused on nursing faculty salaries was feasible and acceptable to those who chose to participate in the study. Perceived income needs may be an important factor driving career decisions for nursing faculty. Future research should focus on delineating how salary influences the decision to enter or stay in the nursing faculty workforce. Further, this study can inform policy recommendations on how to best measure and report nurse faculty salary and the gap between clinical salaries and faculty salaries.

Single-Trial Representations of Decision-Related Variables by Decomposed Frontal Corticostriatal Ensemble Activity.

The frontal cortex-striatum circuit plays a pivotal role in adaptive goal-directed behaviors. However, it remains unclear how decision-related signals are mediated through cross-regional transmission between the medial frontal cortex and the striatum by neuronal ensembles in making decision based on outcomes of past action. Here, we analyzed neuronal ensemble activity obtained through simultaneous multiunit recordings in the secondary motor cortex (M2) and dorsal striatum (DS) in rats performing an outcome-based left-or-right choice task. By adopting tensor component analysis (TCA), a single-trial-based unsupervised dimensionality reduction approach, for concatenated ensembles of M2 and DS neurons, we identified distinct three spatiotemporal neural dynamics (TCA components) at the single-trial level specific to task-relevant variables. Choice-position-selective neural dynamics reflected the positions chosen and was correlated with the trial-to-trial fluctuation of behavioral variables. Intriguingly, choice-pattern-selective neural dynamics distinguished whether the incoming choice was a repetition or a switch from the previous choice before a response choice. Other neural dynamics was selective to outcome and increased within-trial activity following response. Our results demonstrate how the concatenated ensembles of M2 and DS process distinct features of decision-related signals at various points in time. Thereby, the M2 and DS collaboratively monitor action outcomes and determine the subsequent choice, whether to repeat or switch, for action selection.

Determining confidence and anxiety of Australian community podiatrists in managing foot ulceration: A cross-sectional study.

Diabetes related foot ulcer (DFU) is a leading cause of impaired quality of life, disability, hospitalisation, amputation and mortality in people with diabetes. It is therefore critical that podiatrists across all settings, including community settings, are confident and capable of providing care for diabetes-related foot complications. This study aims to describe current practice, confidence and anxiety levels of community podiatrists in the management of patients with foot ulceration. Furthermore, current barriers to service provision and interest in future educational opportunities will also be explored. An online cross-sectional survey was distributed to Australian community podiatrists. Descriptive variables including gender, age, professional experience, practice location and practise setting were elicited. A modified competitive State Anxiety Inventory-2 (CSAI-2) was utilised to measure anxiety related to managing a foot ulcer. Other questions included a combination of multiple choice and open-ended free-text responses relating to assessment, confidence and referral pathways. One hundred and twenty-two Australian community-based podiatrists responded to the survey. A variety of ulcer sizes and complexity were reported to be managed in community settings. Confidence in DFU management was high in most manual skill domains including: stabilisation of the foot (85.7%, standard deviation [SD] 17.42), scalpel control (83.0%, SD 20.02), debridement with a scalpel (82.7%, SD 18.19) and aseptic technique (81.0%, SD 18.62, maintaining integrity of healthy tissue (77.3%, SD 21.11), removal of appropriate tissue (75.6%, SD 22.53), depth of ulceration (73.7%, SD 23.99) and ability to manage messy wounds (69.1%, SD 26.04). Curette debridement had substantially lower levels of reported confidence (41.0%, SD 34.24). Performance anxiety was low with somatic and cognitive anxiety of 6/24 and 3/8 on the CSAI-2, respectively. Community podiatrists are managing foot ulcers of varying size and complexity. Confidence and anxiety do not pose a barrier to care. Adherence to wound assessment clinical guidelines is low and confidence with the use of curette was sub-optimal. Further educational programs may overcome these barriers and support shared models of care between community and acute podiatry services.

Knowledge and Utilization of Sex-Specific Lead Aprons Among Pediatric Orthopaedic Surgeons.

Orthopaedic surgeons routinely face exposure to ionizing radiation during intraoperative use of fluoroscopy. Lead personal protective equipment reduces occupational radiation exposure. Female-specific lead aprons are designed with expanded lateral coverage to improve protection of breast tissue against radiation beams. The purpose of this study was to identify current trends in knowledge and utilization of female-specific lead aprons as well as any barriers to utilization. An anonymous electronic survey including 20 multiple choice and multiple selection responses was distributed to all members of the Pediatric Orthopaedic Society of North America (POSNA). Respondents who reported the use of intraoperative fluoroscopy in their practice were included in the study. Most respondents were attending surgeons (91%) and practiced in an academic setting (85%) in an urban environment (75%). Most respondents reported using a lead apron for every case (76%) and a thyroid shield for every case (75%), while most respondents reported they do not wear lead glasses (73%). Fifty-one percent of respondents were aware of female-specific lead aprons. The majority of respondents reported female-specific lead is unavailable (45%) or available in insufficient quantities (5.5%) at their institution. Ninety percent of females reported they do not wear female-specific lead with the common reasons being lack of availability and discomfort. Knowledge of female-specific lead is low with lack of availability as a common barrier to utilization. As female presence in the field of orthopaedic surgery expands, efforts should be made to improve education and availability of sex-specific lead aprons.

Consumers’ knowledge and experiences of adverse drug reaction reporting in Australia: a national survey

This study aimed to investigate the current knowledge and experiences of consumers in Australia on adverse drug reaction (ADR) reporting and their reasons for reporting or not reporting ADRs, with a focus on the use of digital tools for ADR reporting.MethodsA cross-sectional online survey was conducted among adults who had taken medicine in Australia. A structured questionnaire with multiple choice or Likert scale responses with an option for participants to provide free-text responses and pretested for face validity was used. Consumer characteristics, knowledge, and ADR reporting practices were analyzed using descriptive statistics and the chi-square test or Fisher’s exact test.ResultsA total of 544 survey responses were included in the analysis. The majority of respondents were women (68%), and 22% were aged between 65 and 74 years. Fifty-eight percent (n = 317) of respondents knew that they could report ADRs to either the Therapeutic Goods Administration (TGA), state or territory government health department, or healthcare professionals. Three-quarters (n = 405) of respondents stated that they had experienced an ADR; of these, 36% reported an ADR to either the TGA, state or territory government health department, or healthcare professionals. Among those who reported ADRs, 58% were unaware that they could use digital tools to report ADRs. The main reason for not reporting was that they did not think the ADR was serious enough to report (39%).ConclusionOver half of consumers knew that they could report ADR; however, improved consumer awareness about using digital tools for ADR reporting and increased ADR reporting is needed.

The Endosomal Sorting Complex, ESCRT, has diverse roles in blood progenitor maintenance, lineage choice and immune response.

Most hematological malignancies are associated with reduced expression of one or more components of the Endosomal Sorting Complex Required for Transport (ESCRT). However, the roles of ESCRT in stem cell and progenitor maintenance are not resolved. Parsing signaling pathways in relation to the canonical role of ESCRT poses a challenge. The Drosophila hematopoietic organ, the larval lymph gland, provides a path to dissect the roles of cellular trafficking pathways such as ESCRT in blood development and maintenance. Drosophila has 13 core ESCRT components. Knockdown of individual ESCRTs showed that only Vps28 and Vp36 were required in all lymph gland progenitors. Using the well-conserved ESCRT-II complex as an example of the range of phenotypes seen upon ESCRT depletion, we show that ESCRTs have cell-autonomous as well as non-autonomous roles in progenitor maintenance and differentiation. ESCRT depletion also sensitized posterior lobe progenitors to respond to immunogenic wasp infestation. We also identify key heterotypic roles for ESCRT in position-dependent control of Notch activation to suppress crystal cell differentiation. Our study shows that the cargo sorting machinery determines the identity of progenitors and their adaptability to the dynamic microenvironment. These mechanisms for control of cell fate may tailor developmental diversity in multiple contexts.

Academic Stress among College Students

Academic stress refers to the strain experienced by students, resulting in a state of distress that often manifests itself as various psychological and behavioral challenges. This research investigates into the pervasive issue of academic stress among college students, emphasizing its consequences and gender disparities. Employing a comprehensive mixed-methods approach, the study utilized a structured questionnaire to quantitatively assess academic stress level among selected students of a college using the Academic Stress Scale for College Students (ESSCS) that featured 16 items with six response choices. Findings indicated a notable gender difference in academic stress levels, highlighting the importance of addressing societal factors rather than inherent gender distinctions. Female students reported higher stress levels, emphasizing the need to address sources like pressure, anxiety, conflict, and frustration to improve their mental well-being. The study calls for collaborative efforts among educational institutions, parents, and educators to reduce workloads and implement innovative teaching methods, fostering divergent thinking and supporting diverse abilities. It serves as a call to action for institutions to prioritize students' mental health and create a more balanced and nurturing academic experience, advocating for a holistic approach to address the multifaceted challenges associated with academic stress.

Development and Validation of a Knowledge Checklist of Cognitive Therapy for Nurses(KCCTN)

This study aimed to develop a Knowledge Checklist of Cognitive Therapy for Nurses (KCCTN) to assess theeffectiveness of cognitive-behavioral therapy-based training. Sixteen items were collected from the provisional KCCTN; four response choices were created for each item with one correct response. The reliability and validity study results showed that Cronbach’s alpha was 0.63. The intra-class correlation was calculated using the data on the number of correct answers before and after the training of nursing college students, and the reliability was confirmed at r=0.65 (p&lt;0.01). The uncorrelatedness of KCCTN and KBPAC helped establish discriminatory validity. Two-way analysis of variance with the dependent variable being the KCCTN score of the intervention group (nurses, N=30) and control group (nursing students, N=76) implementing cognitive-behavioral therapy, and pre-and post-intervention factors were calculated for hospital nurses. The results showed a significant interaction with a significant improvement in the intervention group.

10. Effects of Dextroamphetamine on Choice, Momentary Mood, and Affective Responses to Reward in a Counterfactual Decision-Making Task

10. Effects of Dextroamphetamine on Choice, Momentary Mood, and Affective Responses to Reward in a Counterfactual Decision-Making Task