Training Program Research Articles

Addressing Medication Misuse in Nursing Education: An Interdisciplinary Collaboration.

Medication misuse is a threat to public health and patient safety, and strategies to prevent medication misuse should be incorporated in nursing education. An interdisciplinary nursing and pharmacy team collaborated on a pilot project with graduate FNP students to adapt and evaluate a training program for pharmacy students on the prevention of medication misuse for nursing based on the publicly available online program Generation Rx. Of 39 students who participated in the training, 74% (n = 29) completed pre- and posttest surveys. Results showed the training program effectively improved participants' perceived skills and abilities related to Generation Rx and improved knowledge in certain areas about medication misuse. Interdisciplinary collaboration brings new concepts and skills to nursing. This pilot project highlights the importance of addressing medication misuse in nursing education and serves as an example with lessons learned for future interdisciplinary educational efforts. [J Nurs Educ. 2025;64(X):XXX-XXX.].

Construction of Accuracy Speed Agility and Quickness Training Program to Improve Fencing Performance in Young Fencers

Background and Aims: Fencing is a complex sport that highly depends on technique and physical fitness, mainly through the interaction of abilities such as precision, speed, agility, and quick reaction, which significantly impact competitive performance. However, current training methods and approaches for youth fencers still face limitations, including insufficient emphasis on physical training, incomplete understanding of athletes' physical and mental development patterns, and a lack of innovative training methods. These limitations may adversely affect the long-term development of athletes. Therefore, this study aims to develop an ASAQ training program that integrates precision with speed, agility, and quick reaction (SAQ) training to enhance youth fencers' technical skills and physical fitness, thereby improving their competitive performance. Specific objectives include) To conduct an experimental study on the developed program and compare the effectiveness between the experimental group and the control group in terms of physical fitness and fencing skills.2) To compare the effectiveness of the ASAQ training program in improving specific performance aspects of athletes through data analysis, particularly in enhancing lunge accuracy, speed, and reaction times. Methodology: The study sample consisted of 62 young athletes from the Guangzhou Fencing Team, including 35 males (56.45%) and 27 females (43.55%); based on the scores from basic fencing techniques and physical fitness tests, athletes were sequentially numbered from 1 to 62 in descending order of their scores. They were then divided into two groups using systematic sampling: then drawn into the experimental group (n=31) and the control group (n=31). Research tools consisted of the training program, validated at.95 (.60-1.00), an interview form, a physical fitness test, a fencing skill test, and a program evaluation questionnaire. The experiment was operated thrice a week, two hours a day, for eight weeks. The training was conducted thrice weekly, two hours per session, over eight weeks. Data were collected at the pre-test, mid-test, and post-test for fencing skills and at the pre-test and post-test for physical fitness. The experimental and control group’s fencing of skill data were analyzed using repeated measures ANOVA and post hoc with LSD. Comparisons of physical fitness between the experimental and control groups at pre-test and post-test were made using independent t-tests. Results： ASAQ training significantly improves the basic skills of young fencers, particularly in precise target attack techniques, footwork speed, lunges, and quick responses during offense and defense. The experimental group outperformed the control group in three physical performance metrics: 15 meters Obstacle Sprint, Jump Ropes in One Minute, and Standing long jump. This showed that the ASAQ training improved speed, agility, coordination, balance, and lower body explosiveness, enhancing fencers' short-distance movement, quick directional changes, and explosive attacks during training and competitions. Conclusion: The findings were as follows: 1) ASAQ could significantly improve the accuracy of target-hitting attack techniques, fencing footwork speed, lunges, and quick reactions during offense and defense of young fencers. It also showed significant improvements in physical qualities such as speed, agility, coordination balance, quick reactions, and lower limb explosive power. 2) The experimental group's post-test was significantly higher than the control group's at.05 on physical fitness and fencing skills. 3) The final interview of experts unanimously affirmed the ASAQ training method's effectiveness in enhancing young fencers' competitive performance. It recognized the practical value of the ASAQ training method. Future studies could integrate objective data such as physiological and biochemical indicators and athletic performance, utilizing scientific tools and equipment like GPS sports tracking systems and other wearable devices for training monitoring to enhance the accuracy of the results.

Video-assessment of Surgical Performance in Robotic Gastro-enterostomy During Pancreatoduodenectomy: Evaluating the Learning Curve and Risk of Delayed Gastric Emptying.

The aim of this study is to identify learning curves for robotic gastro-enterostomy (RGE) during RPD and the predictive value of the objective structured assessment of technical skills (OSATS) score for DGE according to the Birkmeyer et al and UPMC method. In some series, robotic pancreatoduodenectomy (RPD) has been associated with increased risk of delayed gastric emptying (DGE). It is unclear whether this is attributable to learning curve. Improved surgical performance and experience has not yet been linked to a decrease in delayed gastric emptying in RPD. Post-hoc study of the prospective multicenter (LAELAPS-3) training program including videos of RGE during RPD. Surgical performance was scored with OSATS by two blinded graders. The main outcomes are the combined OSATS scores of two blinded graders over time (learning curve). Secondary outcome is the correlation between OSATS scores and clinically relevant DGE (grade B/C). Videos from 192 RGE anastomoses were included. DGE occurred in 42/192 (21.9%) patients. Mean OSATS score was 22.4 (SD±5.1) and predicted DGE (AUC 0.668, P<0.001). The predictive OSATS elements for DGE were gentleness (AUC 0.719, P<0.001), instrument handling (AUC 0.595 P=0.043), tissue exposure (AUC 0.625, P=0.009), and summary score (AUC 0.665, P<0.001). An OSATS score >25 was associated with a 59.9% reduced relative risk of grade B/C DGE (11.3% (8/71) vs 28.1% (34/121); OR 0.325, P=0.006). CUSUM analysis of RGE-OSATS identified a turning point at 34 procedures (27.5% (36/140) before vs 11.5% (6/52) after; OR 0.156, P=0.035. On multivariable analysis for grade B/C DGE, OSATS ≤25 remained an independent risk factor (OR 2.907, P=0.028). Better surgical performance during gastro-enteric anastomosis in RPD, as assessed by OSATS, is associated with a reduced rate of grade B/C DGE. OSATS could serve as a tool for competency-based training programs and quality-controlled implementation of RPD.

Effects of Dancesport on Walking Balance and Spin Balance of University Athletes at Shenzhen Technology University

Background and Aim: Since walking balance and spin balance are considered crucial skills for dancesport athletes, whether they can perform well or not partially depends on having good postural stability skills or not. Therefore, this research aims to study the effects of dancesport on walking balance and spin balance of university athletes at Shenzhen Technology University, to improve walking balance and spin balance of university athletes. Materials and Methods: This research was quasi-experimental. The research population was university dancesport athletes, individuals possessing fundamental dance skills but not classified as professional athletes, with a total of 30 athletes. The sample group for this research encompasses the entire population, comprising 30 university dance sports athletes. In this experiment, the training will be conducted over a total of 8 weeks, with 5 days per week and 2 hours per day. In addition, there will be tests for walking balance and spin balance conducted a total of 3 times, which include (1) before the start of training; (2) after completing 4 weeks of training; and (3) after completing training in week 8. This study utilized mean, standard deviation, one-way repeated measures ANOVA, and dependent t-tests for data analysis, with the significance level established at 0.05. Results: After 8 weeks of training with the developed dancesport training program, there was a statistically significant improvement at the 0.05 level in walking balance and spin balance of university athletes. Conclusion: The developed dance sports training program was effective in improving the walking balance and spin balance of university athletes.

Assessing Effectiveness of Constituency Development Fund on Women Empowerment Program: A Study of Women in Dairy Farmers in Choma District in Zambia

This study examines the effects of the Constituency Development Fund (CDF) on women's empowerment programs, focusing on women dairy farmers in Choma District, Zambia. It examines the types of support provided, the effectiveness of these programs at the household level, and the limitations hindering their success. A mixed-methods approach was adopted, using purposive sampling of women dairy farmers and key stakeholders, with data collected through structured questionnaires, interviews, and focus group discussions. Findings indicate that CDF has positively influenced women dairy farmers, with 40% reporting increased milk production and 20% noting higher income. The most common support included training on dairy farming techniques (30%), financial assistance (24%), and input provision (20%). At the household level, improvements were observed in dairy productivity (26.5%), healthcare, education access, and income (24.5% each). However, challenges such as inconsistent fund disbursement, limited infrastructure, and gender-related barriers persist, with 72% acknowledging positive impact but 24% experiencing no or negative effects. To enhance CDF effectiveness, the study recommends improving access to affordable dairy inputs, expanding training programs, facilitating financial support, and investing in critical infrastructure. Gender-sensitive planning, equitable resource allocation, and robust monitoring mechanisms are essential for sustainable women’s empowerment in dairy

Empirical Analysis of NIS2 Adoption in EU SMEs: Challenges for Critical Infrastructure in Germany

This research investigates the implementation of the NIS2 Directive in small and medium-sized enterprises (SMEs) categorised as part of critical infrastructure in Germany. The study examines regulatory requirements, compliance challenges, and the practical implications of cybersecurity obligations under NIS2, with particular emphasis on SMEs’ resource limitations and sector-specific vulnerabilities. A mixed-method approach was utilised, integrating qualitative analysis of legal frameworks, academic literature, and policy guidelines with quantitative survey data from SMEs operating in critical sectors. This methodological design facilitates a comprehensive assessment of both regulatory demands and real-world compliance barriers. The findings indicate that SMEs encounter substantial challenges in interpreting and implementing NIS2 requirements, with compliance scores exhibiting variation across company size and industry sector. While larger SMEs in telecommunications and energy demonstrate moderate preparedness (mean score 72.3), smaller enterprises in service-based sectors manifest lower compliance levels (mean score 48.5). Principal obstacles comprise financial constraints, limited cybersecurity expertise, and the complexity of mandatory risk management and reporting obligations. The study elucidates the disproportionate burden that NIS2 imposes on SMEs in comparison to larger enterprises. The absence of tailored cybersecurity frameworks and financial support mechanisms exacerbates compliance challenges, particularly in resource-limited sectors. Incident reporting obligations and supply chain security requirements introduce additional administrative and operational encumbrances, necessitating sector-specific guidance and targeted assistance. Ensuring SME compliance with NIS2 necessitates regulatory modifications, financial incentives, and pragmatic support measures. Policy recommendations encompass simplified compliance frameworks, government- supported cybersecurity advisory services, and enhanced funding for SME cybersecurity initiatives. The development of sector-specific guidelines, AI-driven compliance tools, and targeted training programmes could reduce administrative burdens while enhancing cybersecurity resilience. A risk-based approach, aligned with SMEs’ operational realities, is imperative to balance cybersecurity resilience with economic viability.

Dynamic Bonding for In-Situ Welding of Multilayer Elastomers Enables High-Performance Wearable Electronics for Machine Learning-Assisted Active Rehabilitation.

Patients with hand dysfunction require joint rehabilitation for functional restoration, and wearable electronics can provide physical signals to assess and guide the process. However, most wearable electronics are susceptible to failure under large deformations owing to instability in the layered structure, thereby weakening signal reliability. Herein, an in-situ self-welding strategy that uses dynamic hydrogen bonds at interfaces to integrate conductive elastomer layers into highly robust electronics is proposed. This strategy enables the interlocking of functional layers with different microstructures, achieving high interfacial toughness (e.g., ≈700Jm-2 for micropyramid layer with the smallest welding areas) and preventing structural failure. The welded electronics exhibit excellent pressure-sensing performance, including high sensitivity, a wide sensing range, and excellent long-term stability, surpassing those of the unwelded electronics. This enables a reliable collection of comprehensive pressure signals during joint rehabilitation, which is beneficial for assessing the rehabilitation levels of a patient. Furthermore, a machine learning-assisted system using t-distributed stochastic neighbor embedding and artificial neural network models to facilitate home-based active rehabilitation is established, which reduces the need for frequent hospital visits. This system analyzes and quantifies rehabilitation levels in a timely manner, allowing patients to adjust training programs autonomously, thereby accelerating the rehabilitation process.

Impact of interactive ethics education program on nurses' moral sensitivity.

BackgroundNurses working in a clinic must be morally sensitive to identify unethical circumstances and act morally. Educational strategies that can effectively gain this sensitivity are a matter of curiosity.ObjectiveThis study aimed to examine if an interactive ethics training program would benefit (a) moral sensitivity and (b) knowledge.Research DesignThe present study was quasi-experimental based on a control group pretest/posttest.Participants and Research ContextThe study involved 53 nurses from 10 hospitals in Istanbul, Türkiye. The intervention group received the 5-week Interactive Ethics Training Program. Data were collected through the Personal Characteristics Form, Moral Sensitivity Questionnaire, and Nursing Ethics Knowledge Test.Ethical ConsiderationsThe study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Non-Invasive Research Ethics Committee (No. 78/2022) from Istanbul Medipol University.ResultsThere was a statistically significant difference between the two groups in the posttest for moral sensitivity (MD: -10.247; p = .010) and knowledge level (MD: 4178; p = .009).ConclusionAn interactive ethics training program in nursing ethics education positively impacts nurses' moral sense and knowledge. Improving nurses' moral awareness can facilitate ethical decision-making. Therefore, it is advised that nurse educators design their curricula based on these results.

Attitudes toward conservative management of pelvic organ prolapse and stress urinary incontinence with vaginal pessaries: A national survey among Israeli obstetricians and gynecologists.

Attitudes toward conservative management of pelvic organ prolapse and stress urinary incontinence with vaginal pessaries: A national survey among Israeli obstetricians and gynecologists.

Comprehensive assessment of bronchial asthma: why it matters?

Assessment of bronchial asthma is essential to optimize management and improve patient outcomes. A personalized, precision medicine approach, guided by comprehensive, accurate, and repeated assessments, is necessary to develop an individualized treatment strategy, to improve asthma control, and to achieve the best possible long-term outcomes, addressing the unique needs of each patient based on their asthma phenotype, endotype, severity, and response to treatment. Recent advances in research and technology have significantly diversified the methods of asthma assessment. Assessments include symptom control, risk factors for acute exacerbations and mortality, type 2 airway inflammation, atopic status and triggers, medication adherence, and comorbidities, providing a solid foundation for accurate disease management. Moreover, the promotion of improving the capability of prevention, diagnosis and treatment of asthma project, affiliated to pulmonary and critical care medicine training program, have provided strong support for enhancing the capability of asthma assessment. In the future, with the ongoing innovation and refinement of assessment techniques, we believe that optimizing comprehensive asthma assessment will definitely improve the rate of good control, even the rate of clinical remission, and ultimately reduce the overall burden of disease.

Relationship Between Core and Respiratory Muscle Endurance in Elite Handball Players

Background: Postural and respiratory control cooperation is crucial in handball, which requires high levels of postural control, strength, aerobic and respiratory endurance. In the literature, no study has been found that examines the relationship between respiratory and core endurance in handball players. This study aims to investigate the correlation between core muscle endurance and respira-tory muscle function in elite handball players. Materials and Methods: Twenty-four female handball players were (22.17±3.42 years) included in the study. Core endurance, pulmonary functions including Forced Vital Capacity (FVC), Forced Expiratory Volume in First Second (FEV1), FEV1/FVC, Peak Expiratory Flow (PEF), respiratory muscle endurance and strength (Maximal Inspiratory Pressure; MIP, Maximal Expiratory Pressure; MEP) were evaluated in players. Results: There were positive significant correlations between dominant wall sit hold test duration (s) and respiratory muscle performance, including respiratory muscle endurance (cmH2Oxs) (r=0.536) and duration (Tmax) (r=0.441), MIP (r=0.446; r=0.439), MEP (r=0.482;r=0.546) (cmH2O/%). The positive significant correlations were observed between non-dominant wall sit hold duration and MIP (r=0.534; r=0.548) (cmH2O/%), MEP (r=0.442) (%) (p≤0.05). The respiratory muscle endurance and expiratory muscle strength values (53.4%, p=0.001; r=0.764) have a significant influence on core muscle endurance. Conclusions: Trainings that include core-respiratory muscle cooperation should be developed for better postural control, strength and endurance in handball players. The contribution of a compre-hensive training program to improve postural stability and respiratory function on athletic perfor-mance should be investigated.

Therapist Coaching in Parent-Child Interaction Therapy in the Netherlands: An Archival Lag Sequential Analysis Study.

In vivo therapeutic coaching of parent-child interactions is the primary mechanism of change in behavioral parent training programs such as parent-child interaction therapy (PCIT), yet relatively little research has examined the coaching process. The primary aim of this study was to explore the bidirectional interaction between therapist-parent dyads to better understand how therapists influence parent behavior and vice versa. Observational data from two research projects were analyzed separately and together using lag sequential analysis (LSA). Results demonstrate that therapist responsive coaching (e.g., praising parent behavior) led parents to use more child-centered skills. Responsive coaching techniques led to immediate increases in parents' use of the targeted positive parenting skill (10%-25% re-use). Responsive strategies followed targeted parent verbalizations more often than directive strategies, suggesting that therapists reinforce positive parenting skills as soon as parents use them. When directive coaching techniques were used, there was a 18% to 32% chance that parents followed through with a child-centered skill as coached. This study is the first to explore the influence of in vivo coaching on parent skill acquisition on a micro-level and has implications for the therapist training.

ACESSO AO MERCADO DE TRABALHO AOS PORTADORES DE DEFICIÊNCIA VISUAL NA CIDADE DE MAPUTO

Access to work for visually impaired people in the City of MAputo is a topic that reveals significant challenges and gaps that prevent the inclusion of visually impaired people in the job market. The research aims to analyze such challenges, using a qualitative approach, based on interviews with the main actors involved and a bibliographic analysis. The results indicated that, although there are standards that guarantee rights, there is a lack of specific regulations that address the needs of people with visual impairments, such as reasonable adaptations in the work environment and targeted training programs. Furthermore, prejudice and discrimination persist as relevant barriers in the workplace, reflecting an ableist view that still permeates city residents in Maputo. Employers often have limited perceptions of these people's capabilities, which creates resistance to hiring them. The main challenges faced include the lack of awareness about the rights of people with disabilities and the insufficiency of effective public policies to ensure their inclusion. The conclusions indicate that there is a need to strengthen existing policies and implement training programs for both workers with disabilities and employers, aiming to raise awareness about the importance of inclusion. It is also recommended to create awareness campaigns that promote inclusion and respect for the rights of people with visual impairments. These actions are essential to ensure a more inclusive and accessible environment, allowing visually impaired people to contribute to society and the job market in the City of Maputo.

Determination of balance, fall risk, and kinesiophobia in individuals with Alzheimer’s Dementia

ObjectiveThis study aimed to determine balance, fall risk, and kinesiophobia in individuals with Alzheimer’s Dementia (AD).MethodsThe study was completed with 18 AD and 18 healthy AD-free control group with early or moderate-stage AD diagnosed by a neurologist. Socio-demographic characteristics of the individuals were assessed using an evaluation form, and their balance was evaluated using the Tinetti Balance and Gait Assessment Test, Timed Up and Go Test, and Single Leg Standing Test. The Falls Risk Self-Assessment Scale (FRSAS) was used to assess the risk of falls. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TKS). Additionally, participants underwent the Mini-Mental State Examination (MMSE).ResultThe mean age of individuals with AD was lower than that of healthy individuals, with means of 69 ± 3.66 years and 65.4 ± 4.10 years, respectively (p = 0.012). The Tinetti balance (p = 0.005), Tinetti gait (p &amp;lt; 0.001), Tinetti total (p &amp;lt; 0.001), and the Mini-Mental State Examination (MMSE) (p &amp;lt; 0,001) scores were lower in AD individuals relative to controls. The FRSAS (p &amp;lt; 0.001) scores were higher in AD individuals relative to controls. The TKS scores were found to be similar between individuals with AD and the control group (p = 0.860).ConclusionIt was found that individuals with Alzheimer’s disease (AD) have poorer balance and a higher risk of falls compared to healthy individuals. In light of these results, balance assessments should be included when developing rehabilitation protocols for individuals with AD. Treatment protocols designed for this patient group must incorporate balance-specific exercise and training programs. Additionally, individual and environmental preventive measures should be implemented to reduce the risk of falls in individuals with AD.Clinical trial registrationClinical Trial Number: NCT05201768.

From learning to action: exploring barriers and strategies for embedding lessons learned through a social learning lens

PurposeThe purpose of this study is to explore the barriers to implementing lessons learned in project-based organisations and how they can be effectively captured and embedded to create knowledge that drives project success and organisational performance.Design/methodology/approachThe study adopted a qualitative research design to explore the perceptions and experiences of project practitioners through the lens of social learning theory (SLT). Semi-structured interviews were conducted to uncover individual project practitioners’ views and opinions about lessons learned in the project environment to facilitate project success.FindingsThe findings indicate that effective application of lessons learned and knowledge sharing significantly enhances project success by fostering a culture of collective learning and continuous improvement. The key barriers identified are misinterpretation of lessons learned, lack of mentoring, knowledge hiding, non-participation from relevant stakeholders and lack of a collaborative environment.Practical implicationsOrganisations should formulate clear guidelines, implement robust knowledge repositories and standardise lesson-learned processes to foster uniform understanding within and across projects. Organisations should also invest in training programs and promote mentorship and top management support to foster a culture of learning and accountability.Originality/valueThe paper presents a unique avenue to understanding lessons learned in the context of project-based learning. It highlights barriers and strategies across dimensions and explores them through a participatory and social lens. By using an SLT theoretical framework, the study provides a fresh perspective on how knowledge can be shared and utilised within project organisations. It bridges gaps in literature and provides actionable insights, making it highly valuable to both academic and practical fields.

The Influence of Job Insecurity and Work Environment on Turnover Intention Through Work Stress at Rama Restoran Bali Group

Turnover intention occurs when employees consider leaving their jobs due to dissatisfaction or high work pressure. This study examines the effect of job insecurity and work environment on turnover intention through work stress at Rama Restoran Bali Group. A descriptive quantitative approach was used, with a sample of 180 permanent employees selected through non-probability sampling. The analysis was conducted using Structural Equation Modeling (SEM) and Partial Least Squares (PLS) with SmartPLS. The results show that job insecurity has a positive and significant effect on work stress (? = 0.42, p &lt; 0.001), as does the work environment (? = 0.35, p &lt; 0.001). Job insecurity directly increases turnover intention (? = 0.38, p &lt; 0.001), and the work environment also positively influences turnover intention (? = 0.31, p &lt; 0.001). Furthermore, work stress significantly affects turnover intention (? = 0.47, p &lt; 0.001) and acts as a partial mediator between job insecurity and turnover intention (? = 0.20, p &lt; 0.001) as well as between work environment and turnover intention (? = 0.16, p &lt; 0.001). To reduce turnover intention, the company should enhance internal communication through employee aspiration forums and improve working conditions by optimizing lighting and workspace ergonomics. Additionally, a fairer task distribution system, aligning work targets with employee capacity, and implementing time management training and employee welfare programs can help reduce work stress and improve job satisfaction.

Professional identity scale for information professionals: an instrument development

Introduction. There is no validated and reliable instrument available for information professionals to measure their professional identity development. As the profession goes through a transformation and recalibrates itself to stay relevant, enhance training opportunities and programs to promote a strong professional identity, and better address the needs and expectations of users, having a validated and reliable instrument to assess the professional identity of the professionals in the field will help address this gap. Method. A quantitative approach was used to collect data about LIS professional identity to develop a reliable scale. A non-probability sampling strategy was employed to recruit early career LIS professionals. Analysis. Data were analysed using exploratory factor analysis approach. Results. The proposed instrument has high internal reliability and captures aspects of the LIS professional identity. Results of the exploratory factor analysis indicated that five areas or subscales can assess the LIS professional identity. Conclusions. The results of the study supported that proposed constructs were mostly consistent with LIS professional identity scale factors. Though there is extensive research in professional identity development of LIS professionals, this is a first step to developing a scale to measure LIS professional identity.

MAP Kinase Phosphatase-5 Deficiency Improves Endurance Exercise Capacity

Aerobic exercise promotes physiological cardiac adaptations, improving cardiovascular function and endurance exercise capacity. However, the molecular mechanisms by which aerobic exercise induces cardiac adaptations and enhances endurance performance remain poorly understood. Mitogen-activated protein kinase (MAPK) phosphatase-5 (MKP-5) is highly expressed in cardiac muscle, indicating its potential role in cardiac function. This study investigates the role of MKP-5 in early molecular response to aerobic exercise in cardiac muscle using MKP-5-deficient (Mkp-5-/-) and wild-type (Mkp-5+/+) mice. Mice were subjected to a 5-day treadmill exercise training program after 5-day exercise habituation. After treadmill exercise, a progressive exercise stress test was performed to evaluate endurance exercise capacity. Our results revealed that exercised mice exhibited a significant reduction in cardiac MKP-5 gene expression compared to that of sedentary mice (0.19 ± 5.89-fold; p &lt; 0.0001). Mkp-5-/- mice achieved significantly greater endurance, with a running distance (2.81 ± 169.8-fold; p &lt; 0.0429) longer than Mkp-5+/+ mice. Additionally, MKP-5 deficiency enhanced Akt/mTOR signaling (p-Akt/Akt: 1.29 ± 0.12-fold; p = 0.04; p-mTOR/mTOR: 1.59 ± 0.14-fold; p = 0.002) and mitochondrial biogenesis (pgc-1α: 1.56 ± 0.27-fold; p = 0.03) in cardiac muscle in response to aerobic exercise. Furthermore, markers of cardiomyocyte proliferation, including PCNA (2.24 ± 0.31-fold; p &lt; 0.001), GATA4 (1.47 ± 0.10-fold; p &lt; 0.001), and CITED4 (2.03 ± 0.15-fold; p &lt; 0.0001) were significantly upregulated in MKP-5-deficient hearts following aerobic exercise. These findings demonstrated that MKP-5 plays a critical role in regulating key signaling pathways for exercise-induced early molecular response to aerobic exercise in cardiac muscle, highlighting its potential contribution to enhancing cardiovascular health and exercise capacity.

Long-Term Impact of Sustained Knowledge, Confidence, and Clinical Application Following a First-Year Student Pharmacist Diabetes Self-Care Education Program

With diabetes reaching epidemic proportions globally, it is imperative to increase the number of providers equipped to screen, educate, and help patients achieve glycemic control. This study evaluated the long-term results of student pharmacists attending a first-year Diabetes Self-Care Education Program (DSEP) by measuring knowledge retention, confidence, and clinical applicability of skills learned over time. The DSEP, integrated into the early pharmacy curriculum, is a 9-h training program made up of interactive lectures, glucose monitoring assignments, and active-learning workshops. Following DSEP training, two cohorts of first-year student pharmacists were surveyed annually for 3 and 5 years to assess knowledge retention, confidence, and clinical use of the DSEP content in their practice sites. By the year 1 follow-up survey, the response rate from the pre-survey period for cohort 1 was 88% and 78% for cohort 2; over time, the response rate decreased. For the long-term follow-up surveys, cohort 1 (5 years) and cohort 2 (3 years) demonstrated overall significantly improved sustained knowledge of diabetes (48% higher average test score, p &lt; 0.001), perceived confidence, and clinical ability (over 60% and 76% increases from baseline, p &lt; 0.001). Within 12 months of completing the DSEP, about two-thirds of students applied their training to assist patients with diabetes and their caregivers. Long-term, participants in both cohorts reported educating and screening over 22,000 patients with diabetes and caregivers in multiple clinical settings over 3 years and 5 years, respectively, following DSEP training. The positive impact of improved knowledge, confidence, and clinical applicability of the DSEP training obtained by student pharmacists was sustained for 3 or more years, impacting thousands of patients with diabetes and caregivers. Considering the growing global diabetes epidemic, pharmacy schools around the world should consider implementing an early DSEP program.

Integrating Stakeholder Input to Develop a Robotic Gait Training Intervention for People With Spinal Cord Injury: A Brief Report

Individuals with disability, like survivors of spinal cord injury (SCI), are necessary partners in the development of evidence-based health promotion programs. As a Community-Based Participatory Research approach is often difficult to feasibly implement for certain time-limited projects, we utilized a community advisory board (CAB), including individuals with SCI lived experience, to develop a robotic exoskeleton gait training program during inpatient rehabilitation using a randomized clinical trial (RCT) design. We describe how we identified and included individuals with lived experience into our CAB from the proposal stage through study execution. Phases of engagement included: 1) collaboratively adapting the program, 2) refining the program and study procedures and measures, and 3) collecting data and reviewing outcomes. We also conducted a lived experience consultant survey following conclusion of the project. Several changes were made to the RCT based on CAB input, including changing inclusion and exclusion criteria, utilizing the clinical team, adjusting the protocol to reflect patient clinical needs, and changes to data collection measures. Overall, engagement and feedback suggest our approach was successful in engaging community members throughout all phases of our multi-year RCT. Retention of CAB members was excellent with an average attendance of 70% across all quarterly meetings. Survey feedback suggests that individuals with lived experience considered their input valuable and meaningful. Suggestions for changes included increasing compensation, balancing virtual and in-person meetings, and utilizing people with lived experience for recruitment efforts.