Validated Assessment Tools Research Articles

Climate change, mental health, and reproductive decision-making: A systematic review

The impact of climate change on reproductive decision-making is becoming a significant issue, with anecdotal evidence indicating a growing number of people factoring their concerns about climate change into their childbearing plans. Although empirical research has explored climate change and its relationship to mental health, as well as the motivations behind reproductive decision-making independently, a gap in the literature remains that bridges these topics at their nexus. This review endeavours to fill this gap by synthesising the available evidence connecting climate change-related concerns with reproductive decision-making and exploring the reasons and motivations behind this relationship. A systematic review using six databases was conducted to identify relevant literature. Included studies reported quantitative, qualitative, and mixed-methods data related to: (1) climate change, (2) mental health and wellbeing concerns, and (3) reproductive decision-making. Findings were synthesised narratively using a parallel-results convergent synthesis design and the quality of studies was appraised using three validated assessment tools. Four hundred and forty-six documents were screened using pre-defined inclusion criteria, resulting in the inclusion of thirteen studies. The studies were conducted between 2012 and 2022 primarily in Global North countries (e.g., USA, Canada, New Zealand, and European countries). Climate change concerns were typically associated with less positive attitudes towards reproduction and a desire and/or intent for fewer children or none at all. Four themes explaining this relationship were identified: uncertainty about the future of an unborn child, environmentalist views centred on overpopulation and overconsumption, meeting family subsistence needs, and environmental and political sentiments. The current evidence reveals a complex relationship between climate change concerns and reproductive decision-making, grounded in ethical, environmental, livelihood, and political considerations. Further research is required to better understand and address this issue with an intercultural approach, particularly among many highly affected Global South populations, to ensure comparability and generalisable results.

Moral Injury Among Interventional Radiologists

To evaluate moral injury (MI) among interventional radiologists using validated assessment tools. An anonymous 29-question online survey was distributed to interventional radiologists using the Society of Interventional Radiology Connect Open Forum website, Twitter, Facebook, LinkedIn, and electronic mail. The survey consisted of demographic and practice environment questions, a global quality of life (QoL) scale (scored 1-100), the MI Symptom Scale‑Healthcare Professional (MISS-HP) (scored 1-100), and two open-ended questions. A MISS-HP score ≥36 was indicative of experiencing MI. P<.05 was considered statistically significant for all two-sided tests. Beginning on March 30, 2023, 365 surveys were completed over 5days. Of the respondents, 299 (81.9%) were male, 65 (17.8%) were female, and one preferred not to disclose gender. The respondents included practicing interventional radiologists (299; 81.9%) and interventional radiologists-in-training (66; 18.1%). Practice settings included academic (146; 40.0%), community (121; 33.2%), hybrid (84; 23.0%), or other (14; 3.8%) centers. Mean QoL was 71.1±17.0 (range: 0-100) suggestive of "good" QoL. Mean QoL in the MI subgroup was significantly different from that for the rest of the group (67.6±17.0 vs. 76.6±16.0; P<0.05). 223 (61.1%) respondents scored ≥36 on the MISS-HP, and thus were categorized as having profession-related MI. Mean MISS-HP was 39.9±12.6 (range: 10-83). Mean MISS-HP in the MI subgroup was significantly different from that for the rest of the group (47.4±9.6 vs. 28.0±5.7; P<0.05). There was a negative correlation between MI and QoL (r=-0.4; P<0.001). Most common themes for greatest contribution to MI were ineffective leadership, barriers to patient care, corporatization of medicine, non-physician administration, performing futile procedures, turf battles, and reduced resources. Most common themes for ways to reduce MI were more autonomy, less bureaucracy, more administrative support, physician-directed leadership, adequate staffing, changes to the medical system, physician unionization, transparency with insurance companies, more time off, and leaving medicine/retirement. MI is prevalent among interventional radiologists, and it negatively correlates with QoL. Future work should investigate causative factors and mitigating solutions.

Caregiver strain among patients of palliative care in Sri Lanka: validation of modified caregiver strain index - Sinhala version

BackgroundCare givers of Palliated patients are at risk of adverse physical, psychosocial and emotional sequelae in varied nature. Efficient and valid assessment tools facilitate early detection to take corrective measures. The Modified Caregiver Strain Index (MCSI), composed of domains associated with caregiver strain is a simple and brief tool that can be used in both clinical and field settings. This study aimed to adapt and validate this in order to cater effective palliative care services in Sri Lanka.MethodsAfter cross-cultural adaptation, 200 primary caregivers in 3 teaching hospitals were recruited. The internal consistency, item-total correlations, of the 13-item S-MCSI were performed. The criterion validity was assessed by Pearson correlation between the total scores of S-MCSI, the Karnofky Performance Scale and the Barthel index. Construct validity was determined by the principal component analysis keeping the Varimax with Keiser normalization as the rotation method. The Kaiser-Meyer-Olkin test (KMO) and Bartlett’s test of sphericity statistics were also performed to determine the adequacy of the sample and correlations between items, respectively. The number of factors was determined by the Scree plot, percentage of variance explained by each component and number of Eigen values over 01 (Kaiser-Guttman rule).ResultsThe total MCSI score ranged 0 to 26. The overall Cronbach’s alpha of the 13-item questionnaire was 0.80 while item-total corrections ranged 0.34 to 0.62, exception of one item (0.11). Inverse correlations were demonstrated in total scores of MCSI and Karnofky Performance Scale (r =- 0.32, p < 0.001) and Barthel index (r =-0.34, P < 0.001). A Kaiser-Meyer-Olkin value of 0.79 (p < 0.001) for Bartlett’s test indicated adequate sampling and nonlinearity of factors. The Scree plot showed a three-factor structure explaining 57% of the variation. Items regarding personal wellbeing of caregiver loaded together while the effects on the family loaded separately. Adjustment of personal concerns and family issues along with time alteration grouped as the third factor.ConclusionsThe study showed that the Sinhala version of MCSI has adequate psychometric properties and reliability to be used as a validated tool to estimate the caregiver burden within a short time period for any health care workers.

The Nepean Belief Scale (NBS) as a tool to investigate the intensity of beliefs in anorexia nervosa: psychometric properties of the Italian version

BackgroundPeople with anorexia nervosa (AN) show a peculiar impairment of insight regarding their condition, often manifesting a denial of extreme emaciation and sometimes hiding or underreporting socially undesirable abnormal eating patterns. Sometimes the intensity of the beliefs held by patients with AN reach a delusional intensity.ObjectivesIn this study, the Italian version of the Nepean Belief Scale was applied to a sample of patients diagnosed with AN to investigate the intensity of their beliefs and convictions and its clinical correlates.MethodsThe Nepean Belief Scale (NBS) was translated and adapted to Italian and applied to a sample of patients diagnosed with AN based on the Structured Clinical Interview for DSM-5 (SCID-5).ResultsThe Italian version of the 5-item NBS showed excellent reliability. Convergent validity was proved by negative association with levels of insight measured with the Schedule for the Assessment of Insight in Eating Disorders. Beliefs of delusional intensity were reported by 10% of participants. Those with a greater intensity of beliefs, either overvalued or delusional ideas, were more likely to report poorer general cognitive performances on the Montreal Cognitive Assessment. No association was observed between NBS score and age, body mass index, symptoms of eating disorders, body dissatisfaction, or levels of depression. Fear of weight gain and control seeking were the most often reported themes at the NBS.ConclusionsThe Italian version of the NBS is a reasonably reliable, valid, and usable tool for the multidimensional assessment of insight in AN.Level of evidence Level III, Evidence obtained from well-designed cohort or case–control analytic studies.

The Arabic Hospital Anxiety and Depression Scale: validation in a sample of Lebanese patients with cancer

BackgroundDepression and anxiety are common comorbid psychological disorders among patients with cancer. Despite the wide use of the Arabic Hospital and Anxiety Scale (HADS) in oncological settings, it has not been yet validated among Lebanese patients with cancer. We aimed to assess the reliability and validity of the HADS in a sample of Lebanese patients with cancer. One-hundred one Lebanese patients diagnosed with cancer presenting to the Ambulatory Care Center in the Hematology Oncology Department at the American University of Beirut Medial Center filled the Arabic version of the HADS. The Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire 9-Item Scale (PHQ-9) were used to assess its concurrent validity in capturing anxiety and depression, respectively.ResultsReliability analysis using Cronbach’s alpha (α) coefficient revealed good internal consistency for the Arabic HADS (α = 0.89) and both subscales (α = 0.86 for depression and α = 0.78 for anxiety). Correlations between HADS with both GAD-7 and PHQ-9 were statistically significant and strong for both depression (r = 0.795; p < 0.0001) and anxiety (r = 0.727; p < 0.0001). Confirmatory factor analysis revealed that the observed data fits the two-factor model of depression and anxiety (Kaiser–Meyer–Olkin = 0.86; Tucker Lewis Index = 0.879; root-mean-square error of approximation = 0.08). Depression and anxiety rates were approximately 52% and 25%, respectively.ConclusionWe conclude that the Arabic version of the HADS is a credible and valid tool for clinical assessment of psychological distress (anxious and depressive states) among Lebanese patients with cancer.

The Gifted Rating Scales - School Form in Greek elementary and middle school learners: a closer insight into their psychometric characteristics.

The Gifted Rating Scales - School Form (GRS-S), an evaluation tool for the identification of gifted elementary and middle school children, was the subject of the current study, which focused on its psychometric features (internal consistency reliability and structural validity). Four hundred and eighty-nine teachers (342 women, 139 men, and 8 without gender declaration) used the GRS-S to estimate the dimensions of giftedness in their students for the current study. Particularly, 489 children (253 girls and 236 boys) were evaluated by their teachers. Eight elementary and middle school classes and sixteen 6-month age bands were used to stratify the student population. The scales' outstanding internal consistency and good factorial validity were revealed by statistical analyses (EFA, CFA, and Cronbach's coefficients). According to the current research findings, the GRS-S as a reliable and valid assessment tool for identifying gifted students (by their teachers) within the Greek cultural environment.

Development and validation of a photograph-based instrument to assess nutrition literacy: the NUTLY

Abstract Background Most instruments measuring nutrition literacy are difficult to apply to less educated people, or assess theoretical knowledge, not necessarily evaluating the ability to make healthy food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. Methods NUTLY assesses the ability to identify the food with the highest energy/sodium content from sets of three photos (two foods with similar content and one with higher content). A version of 79 sets was obtained after a stepwise process involving expert and lay panels. It was applied to a sample representing different age, gender and education level groups (n = 329). We assessed internal consistency (Cronbach's α) and associations between each test item (set of three photos) and the overall score, defined as the sum of correct answers (latent trait models); sets performing worse were excluded. Reproducibility was assessed after one month (n = 158). To assess construct validity, NUTLY was compared to the Medical Term Recognition Test (METER) and the Newest Vital Sign (NVS), and across groups with varying education and training in nutrition/health. Latent class and Receiver Operating Characteristic (ROC) analyses were used to define the cut-off point. Results The final NUTLY includes 48 sets (energy: 33; sodium: 15; α = 0.74). Mean scores were highest in nutritionists (39.9), health professionals (38.5) and decreased with decreasing education (p &amp;lt; 0.001). Those with adequate nutrition literacy (based on NVS) showed higher NUTLY scores (37.9 vs. 33.9, p &amp;lt; 0.001). For METER, the differences were not significant. Reproducibility was high (ICC=0.77). The Area Under the ROC Curve was 0.97. Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Conclusions NUTLY is a valid and reliable tool for assessment of nutrition literacy, with the potential to be adapted to other cultures and specific population groups. Key messages • A new photograph-based nutrition literacy measuring tool was developed and validated in Portugal, overcoming some limitations of previous instruments. • In the future, this instrument could be used as part of a public health surveillance system, and as a tool to assess the success of nutrition education interventions.

Nursing Students’ Clinical Performance and their Perception towards OSCE and their OSCE Exam Results

The objective of the research was to correlate between clinical performance of the nursing students and their perception towards OSCE and their OSCE exam results. A Comparative cross-sectional study was conducted among 224 Female students (167 female students and 57 male students) who enrolled in the clinical courses from level 4 to 8 in the department of nursing; sample were selected through stratified random sample method. A questionnaire was used to assess the students’ perception towards OSCE; whereas to assess the correlation between nursing students’ perceptions and their OSCE exam results and to find the correlation between nursing students’ clinical performance score, lab score and their OSCE exam results, the real grades were taken from each course. Current study showed that students had a positive overall impression of the OSCE exam (M = 41.3, SD 12.7). Students' attitudes towards the OSCE exam were rated on a mean scale of 11 (SD 3.45). Researchers found positive correlation between the students' OSCE grade and their lab competency grade (r s = .445, P = &lt;0.001) and their clinical performance grade (r s = .503, P = &lt;0.001) grades. However, there was no relationship (r s =.085, P =.207) between the students’ OSCE grade and their perception toward the OSCE exam. The majority of respondents were identified to have positive attitudes towards OSCE as well as overall positive impression of the OSCE exam. OSCE is a reliable and valid assessment tool in the nursing profession. OSCE at the same time can inspire students' critical thinking and promote their communication skills. Through the continuous application of OSCE in nursing education from the beginning, it may have some potential impact on the clinical field.

The Athletic Religious Faith Scale: Part II—Development and Initial Validation

The Athletic Religious Faith Scale (ARFS) is an instrument measuring religious faith in a sporting context. This study validated the ARFS using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to reach a final version of the scale. Using the EFA, seven domains were classified: religious coping (9 items), religious psychological effects (5 items), dependence on faith (5 items), religious mental healing (6 items), flow (4 items), athletic identity (4 items), and religious dietary practices (7 items). Using CFA, all construct factor loadings were over 0.5. Composite reliability and Cronbach’s alpha values indicated adequate reliability (0.81–0.94) for all ARFS domains. The convergent validity and discriminant validity of all constructs were also established. Overall, the ARFS is a reliable and valid assessment tool for measuring religious faith in athletes. The ARFS could potentially be used with athletes of various religious affiliations in different countries, cultures, and sporting contexts.

Translation, cross-cultural adaptation and validation of the Rett syndrome motor evaluation scale (RESMES): Spanish version

ObjectiveTo develop a Spanish version of the Rett Syndrome Motor Evaluation Scale (RESMES) for the locomotor function of Rett Syndrome (RTT) using a transcultural methodology. MethodsThe RESMES was cross-culturally adaptated and validated in the Spanish language (RESMES-sp). This study was divided into two well-differentiated phases: 1) a cross-cultural translation and adaptation; 2) psychometric characteristics analysis of the RESMES-sp (reliability, test-retest, construct validity, criteria validity, error measurements). For criteria validity, PAINAD questionnaire, the scoliosis values and PedsQL™, were used. ResultsA total of 63 girls and women diagnosed with RTT participated in this validation study. The total value of the RESMES-sp correlates significantly with all its dimensions, with the correlation value oscillating between 0.645 and 0.939. The correlation value with PAINAD ranges between 0.439 and 0.805; the scoliosis values ranges between 0.245 and 0.564; with PedsQOL™ questionnaire, the correlation values range between 0.273 and 0.663 for the PedsQL™ dimensions, and between 0.447 and 0.648 for the total value of PedsQOL™ questionnaire. The reliability values of Crombach's alpha ranged between 0.897 and 0.998 for the intra-observer analyses and between 0.904 and 0.998 for the inter-observer reliability. The SEM showed a value of 2,829, while the MDC90 showed a value of 6601. The Exploratory Factor Analysis showed 6 factors and values of variance of 86.163%. ConclusionsThe Spanish version of the RESMES is a reliable and valid tool for the functional assessment and follow-up of patients with RTT.

Momentary PERMA: An Adapted Measurement Tool for Studying Well-Being in Daily Life

PERMA is a multidimensional framework that explains well-being through five hedonic and eudaimonic psychological elements–Positive emotions, Engagement, Relationships, Meaning, Accomplishment. Soon after the PERMA framework was proposed, PERMA-Profiler was introduced as a validated assessment tool for measuring these five elements of well-being from a global perspective. The current study aimed to shed further light onto the measurement of PERMA elements, extending it beyond global evaluations, to daily life assessments and the examination of individual differences in their dynamic characteristics. We introduce mPERMA (momentary PERMA), as an EMA-adapted version of the PERMA-Profiler measure, to assess well-being in daily life. Using data collected in an Ecological Momentary Assessment (EMA) study (N = 160), we first demonstrate the factor structure of mPERMA through a multilevel factor analysis and next examine within-person means and the dynamics of change (e.g., intra-individual variability) in the PERMA elements. Findings revealed that mPERMA displays convergent validity with two global measures of hedonic and eudaimonic well-being, namely Flourishing and Subjective Well-Being. Moreover, dynamical characteristics of the five elements of well-being measured over time, map onto their corresponding hedonic or eudaimonic global measures of well-being. Results of this paper present how dynamical features of well-being in daily life provide novel insights into predicting global well-being.

Fly-CURE, a multi-institutional CURE using Drosophila, increases students' confidence, sense of belonging, and persistence in research.

The Fly-CURE is a genetics-focused multi-institutional Course-Based Undergraduate Research Experience (CURE) that provides undergraduate students with hands-on research experiences within a course. Through the Fly-CURE, undergraduate students at diverse types of higher education institutions across the United States map and characterize novel mutants isolated from a genetic screen in Drosophila melanogaster. To date, more than 20 mutants have been studied across 20 institutions, and our scientific data have led to eleven publications with more than 500 students as authors. To evaluate the impact of the Fly-CURE experience on students, we developed and validated assessment tools to identify students' perceived research self-efficacy, sense of belonging in science, and intent to pursue additional research opportunities. Our data, collected over three academic years and involving 14 institutions and 480 students, show gains in these metrics after completion of the Fly-CURE across all student subgroups analyzed, including comparisons of gender, academic status, racial and ethnic groups, and parents' educational background. Importantly, our data also show differential gains in the areas of self-efficacy and interest in seeking additional research opportunities between Fly-CURE students with and without prior research experience, illustrating the positive impact of research exposure (dosage) on student outcomes. Altogether, our data indicate that the Fly-CURE experience has a significant impact on students' efficacy with research methods, sense of belonging to the scientific research community, and interest in pursuing additional research experiences.

Person-Centered Care and Clinical Judgment: Mapping the AACN Essentials with Simulation in Prelicensure Nursing Programs

The purpose of this article is to describe simulation as a strategy for teaching and mapping the AACN Essentials domain of Person-Centered Care and the concept of clinical judgment with prelicensure nursing students. A validated assessment tool, Lasater clinical judgment Rubric, may be used to evaluate the AACN concept of clinical judgment with simulation. A variety of high-fidelity simulation scenarios, standardized clients, and embedded participants increase realism and student learning. Encompassing a variety of clients across the lifespan, while incorporating cultural diversity in each scenario, offers an opportunity to teach the AACN domain of Person-Centered Care. Evaluating student performance progressively in interactive simulation activities aims to prepare practice-ready nurses.

TRANSLATION AND VALIDATION OF A BAHASA MALAYSIA (MALAY) VERSION OF THE ACTIVITIES OF DAILY LIVING QUESTIONNAIRE (ADLQ)

The ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) can indicate the functional status of elderly individuals with dementia. The Activities of Daily Living Questionnaire (ADLQ) is a widely used informant-based assessment tool for measuring functional abilities in individuals with dementia. However, the original ADLQ is in English and not applicable to the Bahasa Malaysia language. This study aimed to translate and validate the ADLQ into Bahasa Malaysia to address this gap of knowledge. The study conducted a cross-sectional study among primary caregivers of elderly individuals with dementia. Forward and backward translations were used to translate the ADLQ into Bahasa Malaysia. The validity of the translated ADLQ was evaluated through face and content validity, concurrent and convergent validity, and test-retest reliability. The Bahasa Malaysia version of the ADLQ achieved excellent agreement in both face and content validity, with an average Face Validity Index (FVI) score of 0.95 and an average Content Validity Index (CVI) score of 0.94. The Modified Kappa (k*) agreement for the translated ADLQ was 0.93, indicating substantial agreement between the translators. Concurrent validity was established through a strong correlation between the original English version and the translated ADLQ for the total score (r = 0.93, p &lt; 0.05), total percentage (r = 0.94, p &lt; 0.05), and total points (r = 0.84, p &lt; 0.05). Convergent validity was established through a strong correlation between the ADLQ-BM and the Bristol Activities of Daily Living Scale (BADLS) (r = 0.85, p &lt; 0.05). Finally, the test-retest reliability achieved very strong correlations for the total score (r = 0.94, p &lt; 0.05) and total percentage (r = 0.95, p &lt; 0.05), and a strong correlation for the total points (r = 0.88, p &lt; 0.05). In conclusion, the Bahasa Malaysia version of the ADLQ is a valid and reliable assessment tool for measuring functional abilities among elderly individuals with dementia. The excellent agreement in the face and content validity and the strong correlation in concurrent and convergent validity indicate that the translated ADLQ is a robust tool for assessing functional abilities in elderly individuals with dementia in Malaysia. The findings of this study can provide valuable information for clinicians and researchers in Malaysia who wish to evaluate the functional abilities of elderly individuals with dementia.

Validation and application of the Chinese version of the Columbia-Suicide Severity Rating Scale: Suicidality and cognitive deficits in patients with major depressive disorder

BackgroundDepression is a significant risk factor for death by suicide. Additionally, patients with depression who have neurocognitive dysfunction are at a higher risk of exhibiting suicidal behaviors. We aimed to validate the Chinese version of the Columbia Suicide Severity Rating Scale (C-SSRS) and then employ it to examine the association between suicidality and cognitive deficits in patients with Major Depressive Disorder (MDD). MethodsData from 456 patients with MDD who underwent baseline assessment and 3-month follow-up were used for psychometric validation of the C-SSRS. 430 patients were divided into a mild cognitive impairment group (N = 390) and a severe cognitive impairment group (N = 40) using cluster analysis and compared with healthy controls. The relationship between C-SSRS scores and the degree of cognitive impairment was analyzed. Results1) The Chinese version of C-SSRS demonstrated good internal consistency (Cronbach's alpha = 0.884/0.842), convergent and divergent validity. 2) The severity of suicidal ideation (SI), the intensity of SI, and the lifetime history of suicide attempts were significant independent predictors of short-term suicide attempts. 3) Higher worst-point lifetime SI severity and intensity scores in patients with MDD were significantly associated with severe cognitive impairment. LimitationsThe analysis of cognition and suicide was based on cross-sectional studies. Hence, changes in SI and cognitive function over time could not be analyzed. ConclusionsThe Chinese C-SSRS is a reliable and valid assessment tool for suicidal ideation and behavior in patients with depression. Suicidal ideation in patients with MDD is associated with cognitive dysfunction. These findings provide a reference for suicide prevention in patients with depression.

Assessing Teleworkforce and Electronic Leadership Favorable for an Online Workforce Sustainability Framework by Using PLS SEM

The sudden impact of COVID-19 has created a rift in the way the world, organizations, and individuals work. Although imminent, the e-organizational challenge was deemed to create a working business environment that would ensure companies and workforce adaptability to e-leadership. The previous literature shows that effective e-leadership can enhance organizational workforce sustainability and is assessed as an opportunity for teleworking. The aim of the current research is to develop an online working trajectory that implies the study of the teleworkforce and workforce sustainability relation under an electronic leadership umbrella. This analysis was performed with the help of SmartPLS (v. 4.0.0.) software and performed a structural equation model, including an online-developed 103-item questionnaire, which developed 5 constructs and 17 subconstructs. Data reveal a reliable and valid assessment tool that provides proof that workforce sustainability is connected to telework in general while being partially moderated by e-leadership. The importance of the current study stresses the need for (inter)national organizational environments to adapt to rapid technological movements, where sustainability of the teleworkforce and the adaptability of the online leadership formats and practices could result in increasing the organizational achievements from both economic and organizational perspectives.

S5-2 Co-creating a feasible and valid physical literacy assessment tool for children for use in both educational and community physical activity settings, within England

Abstract Purpose Physical literacy (PL) has been described as a gateway to lifelong participation in physical activity, with relevance to the education, health, and sports contexts. That said, it remains a contested term in research and practice, meaning existing PL assessment tools (PLAT) are inconsistent, with divergent ways to assess PL and the encompassing domains. Furthermore, PLATs often lack feasibility, especially when looking to gain population-level data. Therefore, we are developing a feasible and valid PLAT for children (ages 5-11) for use in both educational and community physical activity settings, within England. Method To develop an England-specific PLAT, the project includes four stages: (1) a review of reviews to identify existing strengths and weaknesses of existing tools, (2) identifying stakeholders’ facilitators and barriers to using a PLAT in an education and/or community sports setting, (3) co-developing a feasible PLAT through a multi-stakeholder co-creation event (researchers, practitioners, policymakers), and (4) pilot testing to assess the tools validity and feasibility. Results The results of the scoping review of reviews revealed very few tools exist that assess all domains of PL. Of the identified tool, where the validity and reliability of the tool were more promising, the feasibility of the tool lacked. These findings were akin to tools assessing one domain of PL. Stages 2 and 3 are currently in process. We anticipate sharing findings from the stakeholder survey, and insights from the co-creation event that will have led to a newly developed PLAT for England. Conclusion The co-created PLAT tool will bring together stakeholders across the education, sport, and health sector to gain consensus around the importance of assessing children’s PL in a bid to improve their physical activity levels. We anticipate the co-developed tool will provide surveillance data on children’s PL levels, which will enhance our understanding of the specific needs of children and young people to improve their PL. Thus, better targeting and tailoring support for children and young people to be physically active throughout their lives. Support/Funding Source The project has been externally funded by Sport England and the London Marathon Group.

The Effectiveness of Virtual Simulation in Knowledge of Nurses: A Protocol for Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract:&#x0D; Background: Nursing education is evolving with technological advancements, including the adoption of virtual simulation. This protocol outlines a systematic review and meta-analysis aimed at evaluating the effectiveness of virtual simulation in improving nurses' knowledge.&#x0D; Methods: The study adheres to PRISMA guidelines and is registered in PROSPERO (registration number CRD42022352907). Eligible studies encompass randomized controlled trials (RCTs) that examine virtual simulation's impact on registered nurses, student nurses, or nursing professionals. The intervention involves various virtual simulation tools (virtual reality, augmented reality, serious games) compared against traditional methods or control groups. The primary outcome is improved nursing knowledge, measured through validated assessment tools. Methodological quality will be assessed using the Cochrane Risk of Bias tool.&#x0D; Results: Electronic databases (PubMed, Scopus, Web of Science, PsycINFO) will be systematically searched for eligible studies. The search strategy combines controlled vocabulary terms and keywords to ensure comprehensive retrieval. Two reviewers will independently screen titles, abstracts, and full texts. Data extraction will be standardized to collect study details, participant characteristics, intervention specifics, outcome measures, and findings related to knowledge enhancement.&#x0D; Analysis: Quantitative synthesis (meta-analysis) will be conducted if sufficient homogeneity exists among the included studies. Heterogeneity will be assessed using statistical tests, with subgroup and sensitivity analyses for further exploration. The GRADE approach will assess evidence quality and recommendation strength, considering bias risk, heterogeneity, indirectness, precision, and publication bias.&#x0D; Conclusion: The systematic review aims to provide evidence-based insights into the impact of virtual simulation on nurses' knowledge enhancement. By synthesizing data from RCTs, the study intends to guide educational practices and policy decisions for optimizing nursing education through innovative methods.

Histomorphological Changes in Fish Gut in Response to Prebiotics and Probiotics Treatment to Improve Their Health Status: A Review.

The gastrointestinal tract (GIT) promotes the digestion and absorption of feeds, in addition to the excretion of waste products of digestion. In fish, the GIT is divided into four regions, the headgut, foregut, midgut, and hindgut, to which glands and lymphoid tissues are associated to release digestive enzymes and molecules involved in the immune response and control of host-pathogens. The GIT is inhabited by different species of resident microorganisms, the microbiota, which have co-evolved with the host in a symbiotic relationship and are responsible for metabolic benefits and counteracting pathogen infection. There is a strict connection between a fish's gut microbiota and its health status. This review focuses on the modulation of fish microbiota by feed additives based on prebiotics and probiotics as a feasible strategy to improve fish health status and gut efficiency, mitigate emerging diseases, and maximize rearing and growth performance. Furthermore, the use of histological assays as a valid tool for fish welfare assessment is also discussed, and insights on nutrient absorptive capacity and responsiveness to pathogens in fish by gut morphological endpoints are provided. Overall, the literature reviewed emphasizes the complex interactions between microorganisms and host fish, shedding light on the beneficial use of prebiotics and probiotics in the aquaculture sector, with the potential to provide directions for future research.

Developing a Scale to Measure the Economic Justice

In this study, it is aimed to develop a scale for economic justice and to examine its validity and reliability. A total of 838 people participated in this study. The sample group consisted of unemployed, disabled (who are able to work), retired employees, the most disadvantaged people, minimum wage earners and uninsured workers living in different cities in Turkey. SPSS 21 and AMOS 22 programs were applied. Items with a value below 0.50 were not evaluated in the study. A three-factor structure and a 26-item scale were revealed. The correlation number of the candidate scale with the similar scale was 0.902 (p &amp;lt; 0.001). The Cronbach coefficient is 0.938. The test-retest correlation parameter was r = 0.802 (p &amp;lt; 0.001). In summary, the economic justice scale has a good fit criterion, a valid and reliable assessment tool.