A quasi-experimental study to assess the effect of Benson's relaxation on anxiety and depression among patients with heart failure in Jordan.

BACKGROUND: Despite advancements in treatment, heart failure (HF) remains a leading cause of death. Anxiety and depression (A&D) are highly prevalent among patients with HF, negatively impacting their mortality, and morbidity. The Benson relaxation technique (BRT) is a non-pharmacological approach that is easy to learn, use, and apply for reducing A&D. This study aimed to investigate the effectiveness of the BRT in reducing A&D among patients with HF in Jordan. METHODS: This quasi-experimental pre and post-design study involved a consecutive sample of 204 participants with a confirmed diagnosis of HF. Data were collected from four hospitals in Jordan. RESULTS: A total of 204 patients participated in this study, with 138 males and 66 females. The mean A&D scores for the sample at baseline were 11.09±2.60 and 10.80±2.30, respectively. In the intervention group, there was a statistically significant difference between pre-intervention anxiety and post-intervention anxiety levels (P<0.001), as well as between pre-intervention depression and post-intervention depression levels (P<0.001). In contrast, the control group showed no statistically significant differences between pre-intervention and post-intervention A&D levels (P=0.83 and P=0.34) respectively. CONCLUSIONS: BRT can be used as an adjunctive intervention for patients with HF to reduce A&D. Healthcare professionals should consider incorporating BRT into treatment plans, while nursing departments can lead its implementation.

Impact of transportation in freshwater and brackish water on Nile tilapia (Oreochromis niloticus) resistance.

BACKGROUND: Oreochromis niloticus has great economic value and potential for farming and development. Transportation of fish was done for breeding or trading purpose and it is a challenging aspect of aquaculture. This study aimed to investigate the effect of transportation in freshwater and brackish water on the resistance of O. niloticus as well as transportation stress mitigation effect of NaCl. Four equal groups were used; each of 50 fish, the 1st group served as the control (P 1), while the 2nd group (PT 2) was transported in water without salt, the 3rd (PT 3) and 4th (PT 4) groups were transported in water containing 5 gL- 1 and 10 gL- 1 salt respectively. PT 2, PT 3 and PT 4 were transported for 5 h without any rest or sedative drugs. RESULTS: The serum cortisol of O. niloticus significantly increased at 0 h and then decreased at 12 and 24 h post transportation in the PT 2 group and non-significantly increased at all point times in the PT 3 and PT 4 groups comparing to P 1 group. Mucin2 gene (MUC2) expression was non-significantly up regulated in the PT 2 group and down regulated in the PT 3 and PT 4 groups at 0 h comparing with P 1 group, but at 12 and 24 h it was significantly up regulated in the PT 2, PT 3 and PT 4 groups. The ß Defensin-1 (ß D1) and 2 (ß D2) genes expression was non-significantly down-regulated in the PT 2 group and significantly up regulated in the PT 3 and PT 4 groups at 0 h., while at 12 and 24 h was significantly down regulated in the PT 2 group and non-significantly down regulated in the PT 3 and PT 4 groups, it significantly down regulated in the PT 2 and PT 3 group and non-significantly down regulated in the PT 4 group at 24 h. Non-significant up regulation in interleukin - 1ß (IL-1ß) gene expression was reported in the PT 2 group and non-significant down regulation in the PT 3 and PT 4 groups at 0 h. However, significant up regulation was recorded in the PT 2, PT 3 and PT 4 groups at 12 and 24 h. The Tumor necrosis factor-alpha (TNF-α) gene expression was non-significantly up regulated in the PT 2 group and non-significantly down regulated in the PT 3 and PT 4 groups at 0 h. However, it was significantly up regulated in the PT 2, PT 3 and PT 4 groups at 12 and 24 h. CONCLUSION: The results of this study confirmed the stressful effect of transportation on O. niloticus as well as the transportation stress mitigation effect of NaCl.

Utilizing self-report diaries to explore task time distribution of school nurses in UAE.

OBJECTIVE: This study aims to evaluate the roles and tasks of school nurses in the UAE, quantify the time spent on each, and identify areas for improvement in school health services. This aligns with the UAE government's initiative to enhance primary healthcare, focusing on illness prevention and health promotion for children and adolescents. METHODS: The research adopts an observational study design, utilizing self-observation through diary recordings by school nurses to collect data on their daily tasks and time allocation. A sample of total of 2024 school nurse activities were recorded and analyzed over 126 days and 1084 h of observation by eight school nurses using self-report diaries. This method allowed for the collection of detailed information on how nursing time is allocated between core and noncore tasks. RESULTS: In this study a total of 2024 tasks were observed over 1084 h. The findings reveal that core nursing tasks accounted for 78% of activities but only 53% of the total 1084 h observed, while non-nursing tasks, making up 22% of activities, disproportionately consumed 47% of the hours. This discrepancy highlights the inefficiency of time allocation, with non-nursing tasks such as administrative duties taking significantly longer than core patient care tasks. CONCLUSIONS: The study highlights a significant opportunity to enhance school health services in the UAE by optimizing the allocation of nursing time towards more illness prevention and health promotion interventions. By addressing the identified challenges, including the gaps in nurse competencies and the lack of structured practice frameworks, school health services can be improved.

Target Enzymes of Origanum majorana and Rosmarinus officinalis Essential Oils in Black Cutworm (Agrotis ipsilon): In Vitro and In Silico Studies.

In this study, in vitro and in silico approaches were employed to assess the toxicity of marjoram (Origanum majorana) and rosemary (Rosmarinus officinalis) essential oils (EOs) to A. ipsilon larvae. The study determined the activities of ATPases in the larvae after treatment with the LC20 and LC70 of each EO. α-esterase and glutathione-S-transferase (GST) activities were also determined after treatment with LC10 and LC30 of each EO. Furthermore, molecular docking was employed to determine the binding affinity of terpinene-4-ol and α-pinene, the major constituents of O. majorana, and R. officinalis EOs, respectively, compared to the co-crystallized ligand of α-esterase, diethyl hydrogen phosphate (DPF). Toxicity assays revealed that O. majorana EO was more toxic than R. officinalis EO to the A. ipsilon larvae at 96 h post-treatment. However, the LC20 and LC70 of the latter significantly inhibited the activity of the Na+-K+ pump at almost all intervals. The same concentrations significantly inhibited the Mg2+/Ca2+-ATPase and Ca2+ pump at 96 h post-treatment. In contrast, O. majorana EO showed a variable effect on the Na+-K+ pump across different time intervals. On the other hand, LC10 and LC30 of both EOs showed varied effects on α-esterase and GST over time. Molecular docking revealed energy scores of -4.51 and -4.29 kcal/mol for terpinene-4-ol and α-pinene, respectively, compared to a score of -4.67 for PDF. Our study demonstrated the toxicity of the tested EOs to A. ipsilon, suggesting their potential efficacy as insecticides.

Cardiothoracic surgery training in Africa: History and developments.

Objective: Cardiovascular disease is the leading cause of death globally, responsible for 17.5 million deaths each year, 80% of which occur in low- and middle-income countries, including countries in Africa. Cardiothoracic surgery, with its heavy financial outlay, is unavailable in many African countries. Many African healthcare givers are under the erroneous impression that the cardiovascular surgical landscape of Africa is blank. This review aims at describing the cardiothoracic surgery practice in Africa, the different training programs in the region, and its future prospects. Method: Through a literature review, the authors elaborate on key points, such as healthcare and cardiothoracic surgery in Africa, African cardiothoracic practice and training, and the future of cardiothoracic surgery in Africa. Results: African countries with established cardiothoracic surgery capacity and training programs still face several challenges across multiple levels, including a persistent low enrollment rate in residency programs, insufficient local expertise, a lack of financial resources, an inadequate health infrastructure, and a skewed health insurance reimbursement system. Thus, there is still a growing burden of surgically correctable cardiovascular disease in these countries. Conclusions: Cardiothoracic surgery in Africa has faced great challenges due to resource constraints, but it has demonstrated resilience and growth through diverse models and initiatives. The burden of cardiovascular diseases in Africa remains high, yet the capacity to provide cardiothoracic surgery is limited. With investment, support, and the implementation of comprehensive healthcare policies, cardiothoracic surgery practice can improve in this region and this can make a significant impact on the health and well-being of its population.

Assessing the Gap Between Women's Expectations and Perceptions of the Quality of Intrapartum Care in Jordan: A Two-Stage Study Using the SERVQUAL Model.

INTRODUCTION: Although Jordan has made significant progress toward expanding the utilization of facility-based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. METHODS: Utilizing a pre-post design, quality gaps in intrapartum care were assessed among 959 women pre- and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. RESULTS: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was -0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, -0.24 (±0.39) and -0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (ß = 0.61), mode of birth (ß = -0.60), admission timing (ß = -0.41), continuity of midwifery care (ß = -0.43), physician's gender (ß = -0.62), active labour duration (ß = 0.37), and pain management (ß = -0.33) to be the key determinants of the overall quality gap in intrapartum care. CONCLUSION: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. PATIENT OR PUBLIC CONTRIBUTION: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan.

EPI-Trans: an effective transformer-based deep learning model for enhancer promoter interaction prediction.

BACKGROUND: Recognition of enhancer-promoter Interactions (EPIs) is crucial for human development. EPIs in the genome play a key role in regulating transcription. However, experimental approaches for classifying EPIs are too expensive in terms of effort, time, and resources. Therefore, more and more studies are being done on developing computational techniques, particularly using deep learning and other machine learning techniques, to address such problems. Unfortunately, the majority of current computational methods are based on convolutional neural networks, recurrent neural networks, or a combination of them, which don't take into consideration contextual details and the long-range interactions between the enhancer and promoter sequences. A new transformer-based model called EPI-Trans is presented in this study to overcome the aforementioned limitations. The multi-head attention mechanism in the transformer model automatically learns features that represent the long interrelationships between enhancer and promoter sequences. Furthermore, a generic model is created with transferability that can be utilized as a pre-trained model for various cell lines. Moreover, the parameters of the generic model are fine-tuned using a particular cell line dataset to improve performance. RESULTS: Based on the results obtained from six benchmark cell lines, the average AUROC for the specific, generic, and best models is 94.2%, 95%, and 95.7%, while the average AUPR is 80.5%, 66.1%, and 79.6% respectively. CONCLUSIONS: This study proposed a transformer-based deep learning model for EPI prediction. The comparative results on certain cell lines show that EPI-Trans outperforms other cutting-edge techniques and can provide superior performance on the challenge of recognizing EPI.

Dietary algal-sourced zinc nanoparticles promote growth performance, intestinal integrity, and immune response of Nile tilapia (Oreochromis niloticus).

BACKGROUND: Trace elements play a crucial role in fish nutrition, with zinc (Zn) being one of the most important elements. BIO-sourced zinc nanoparticles were synthesized using the green microalga Pediastrum boryanum (BIO-ZnNPs, 29.35 nm). 30 or 60 mg/ kg dry feed of the BIO-ZnNPs (BIO-ZnNPs30 and BIO-ZnNPs60) were mixed with the Nile tilapia (Oreochromis niloticus) basal diet and fed to the fish for 8 weeks to evaluate their impact on fish growth, digestion, intestinal integrity, antioxidative status, and immunity. RESULTS: A significant enhancement was observed in all investigated parameters, except for the serum protein profile. BIO-ZnNPs at 60 mg/kg feed elevated the activities of reduced glutathione (GSH) and catalase (CAT), enzymatic antioxidants, but did not induce oxidative stress as reflected by no change in MDA level. Fish intestinal immunity was improved in a dose-dependent manner, in terms of improved morphometry and a higher count of acid mucin-producing goblet cells. Interleukin-8 (IL-8) was upregulated in BIO-ZnNPs30 compared to BIO-ZnNPs60 and control fish groups, while no significant expressions were noted in tumor necrosis factor-alpha (TNFα), nuclear factor kappa B (NFkB), and Caspase3 genes. CONCLUSION: Overall, BIO-ZnNPs inclusion at 60 mg/kg feed showed the most advantage in different scenarios, compared to BIO-ZnNPs at 30 mg/kg feed. The positive effects on growth and intestinal health suggest that BIO-ZnNPs supplementation of aquafeeds has many benefits for farmed fish.

Knowledge, Attitude, and Practice of Teledentistry in Periodontal Diagnosis Among Dental Interns at a College in Sebha, Libya: A Cross-Sectional Questionnaire Study.

Background Teledentistry, a subspecialty of telemedicine dedicated to dentistry, has shown promise in improving access to dental care, particularly in rural and isolated areas. It integrates digital and telecommunication technology with dentistry, allowing for the remote distance exchange of relevant clinical information and digital dental imaging for dental consultation and treatment planning. Periodontal disease diagnosis is crucial for effective treatment and prevention of irreversible loss of periodontal structures. Early identification of periodontal disease can be pivotal in preventing periodontal tissue destruction and tooth loss and improving the overall quality of patients' lives. Sebha is a city located in the Fezzan region of southwestern Libya. It is the capital of the Sabha District and the Sabha Governorate. The city is situated in the Libyan part of the Sahara desert and is known for its strategic location as a gateway to the Sahara desert. However, there is a lack of information on the use of teledentistry in Libya in general and the use of teleperiodontics, especially in periodontal diagnosis. Hence, the aim of this questionnaire study was to evaluate knowledge, attitudes, and practice of teledentistry among dental interns at Sebha, Libya. Materials and methods A paper-based questionnaire consisting of 28 close­ended Likert scale questions, including sections assessing the knowledge, attitude, and practice of teledentistry and teleperiodontics, was administered to dental interns at the Faculty of Dentistry, Sebha University, Sebha, Libya. Results The study surveyed 42 dental interns of the Faculty of Sebha, Libya, in total, with an 82.35% response rate among them. The majority of participants (59.5%) felt that teledentistry is reliable in arriving at periodontal diagnosis. The majority of participants (64.3%%) also had acceptable levels of trust in teledentistry equipment. However, over 45% percent of dental practitioners voiced their worries about patient privacy. Most of the participants suggested using teledentistry in some form in their future practice. Conclusion Teledentistry and its branch teleperiodontics are recent developments and its penetration among dental healthcare workers, and their knowledge, attitude, and practice remain to be thoroughly understood. The changing trends in attitudes and practice as a consequence of changes in Internet and technological awareness and the effects of the pandemic warrant closer observation and study.

The Synergistic Effect of Lemongrass Essential Oil and Flometoquin, Flonicamid, and Sulfoxaflor on Bemisia tabaci (Genn.) (Hemiptera: Aleyrodidae): Insights into Toxicity, Biochemical Impact, and Molecular Docking.

The whitefly, Bemisia tabaci (Genn.), is one of the most dangerous polyphagous pests in the world. Eco-friendly compounds and new chemical insecticides have gained recognition for whitefly control. In this study, the toxicity and biochemical impact of flometoquin, flonicamid, and sulfoxaflor, alone or combined with lemongrass essential oil (EO), against B. tabaci was studied. In addition, a molecular docking study was conducted to assess the binding affinity of the tested compounds to AchE. Based on the LC values, the descending order of the toxicity of the tested compounds to B. tabaci adults was as follows: sulfoxaflor > flonicamid > flometoquin > lemongrass EO. The binary mixtures of each of the tested compounds with lemongrass EO exhibited synergism in all combinations, with observed mortalities ranging from 15.09 to 22.94% higher than expected for an additive effect. Sulfoxaflor and flonicamid, alone or in combination with lemongrass EO, significantly inhibited AchE activity while only flonicamid demonstrated a significant impact on α-esterase, and none of the tested compounds affected cytochrome P450 or GST. However, the specific activity of P450 was significantly inhibited by the lemongrass/sulfoxaflor mixture while α-esterase activity was significantly inhibited by the lemongrass/flometoquin mixture. Moreover, the lemongrass EO and all the tested insecticides exhibited significant binding affinity to AchE with energy scores ranging from -4.69 to -7.06 kcal/mol. The current findings provide a foundation for utilizing combinations of essential oils and insecticides in the integrated pest management (IPM) of B. tabaci.

Nursing students' stressors and coping strategies during their first clinical training: a qualitative study in the United Arab Emirates.

BACKGROUND: Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses' sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study. METHODS: A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes. RESULTS: During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students' clinical experiences. We extracted three main themes that described students' stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies. CONCLUSIONS: This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

In Vitro Antiviral and Anticancer Effects of Tanacetum sinaicum Essential Oil on Human Cervical and Breast Cancer.

BACKGROUND: Cervical cancer has been linked to human papillomavirus (HPV) types 16 and 18. Essential oils (EOs) are vital natural products of plants with various therapeutic and biological properties. OBJECTIVES: The purpose of this study is to investigate and assess Tanacetum sinaicum essential oil's possible antiviral and anticancer properties, with a focus on its in vitro effects on human cervical cancer and human breast adenocarcinoma cell lines. MATERIALS AND METHODS: Tanacetum sinaicum EO was extracted via hydrodistillation (HD) and characterized using gas chromatography-mass spectrometry (GC-MS). MTT assay was used to determine the cell viability of Hela (a human epithelial cervical cancer) and MCF-7 (human breast adenocarcinoma) cell lines. Quantitative real-time polymerase chain reaction (PCR) was utilized to assess the antiviral efficacy of EO against HPV-16 and 18, and anti-metastatic characteristics. The biological activity of EO was assessed using Autophage and Cell genotoxicity via the comet assay. RESULTS: EO is mostly composed of chrysanthenyl acetate, thujone, and verbenol. The cell viability was reduced after 24 hours of incubation at doses from 100 to 400 µg/ml. Concentrations of 800 to 3,200 µg/ml significantly inhibit cell growth. After a 24-hour incubation period, doses ranging from 100 to 400 µg/ml reduced cell viability from 62 to 72%. Concentrations of 800 to 3,200 µg/ml significantly suppress cell growth by over 95%. In MCF7 and HeLa cell lines, EO lowered virus copy numbers in a dose-dependent manner, with higher concentrations of the oil inhibiting virus replication more effectively. EO treatment increased the number of autophagosomes/autolysosomes and acidic vesicular organelles in both cell lines. On the HeLa and MCF7 cell lines, EO demonstrated antiproliferative and antimetastatic effects. The results demonstrated that EO had dose-dependent genotoxic effects on both cancer cell lines, as evidenced by DNA damage. CONCLUSION: Tanacetum sinaicum EO is a prospective source of natural bioactive compounds that can be employed in pharmaceutical and medicinal applications due to its antiviral, antiproliferative, anti-metastatic and genotoxic properties.

Phosphine-incorporated Metal-Organic Framework for Palladium Catalyzed Heck Coupling Reaction.

As an emerging material with the potential to combine the high efficiency of homogeneous catalysts and high stability and recyclability of heterogeneous catalysts, metal-organic frameworks (MOFs) have been viewed as one of the candidates to produce catalysts of the next generation. Herein, we heterogenized the highly active mono(phosphine)-Pd complex on surface of UiO-66 MOF, as a catalyst for Suzuki and Heck cross coupling reactions. The successful immobilization of these Pd-monophosphine complexes on MOF surface to form UiO-66-PPh2-Pd was characterized and confirmed via comprehensive set of analytical methods. UiO-66-PPh2-Pd showed high activity and selectivity for both Suzuki and Heck Cross Coupling Reactions. This strategy enabled facile access to mono(phosphine) complexes which are challenging to design and require multistep synthesis in homogeneous systems, paving the way for future MOF catalysts applications by similar systems.

Utilising UPLC-QTOF-MS/MS to determine the phytochemical profile and in vitro cytotoxic potential of Ziziphora capitata L. with molecular docking simulation.

Ziziphora capitata (Lamiaceae family) aerial parts extract contains 57 metabolites, including flavonoids, phenolic acids, anthocyanins, and coumarins, as assessed by UPLC-QTOF-MS/MS. Successive extracts (hexane, chloroform, ethyl acetate, ethanol 95%, and water) were tested in vitro cytotoxic activity against HepG-2, MCF-7, HCT-116, A549, and PC3 cell lines. The results revealed that hexane extract exhibited the most potent cytotoxic activity among PC3 and A549 cell lines, IC50 = 47.1 ± 1.75 and 49.2 ± 1.08 µg/mL compared to Vinblastine IC50 = 42.47 ± 1.95 and 24.64 ± 1.18 µg/mL, respectively, and had a moderate impact on the remaining cell lines. Moreover, the chloroform and ethyl acetate extracts exhibited moderate affinity among all tested cell lines. Furthermore, the total phenolic and flavonoid contents were assessed. The molecular docking simulation was performed inside the effective sites of VEGFR-2 and TS as anticancer targets for the top ten phytochemicals. The results showed higher binding energy values for VEGFR-2 than for TS compared to vinblastine and co-crystallized ligands.

Listening to the voices of mothers in Indonesia: Qualitative content analysis of experiences in parenting children with down syndrome.

INTRODUCTION: Generally, mothers provide the majority of caring for children who have Down syndrome. They pose challenges not only with regard to the acceptability of the child situation but also with regard to the provision of care for children with DS. AIM: To explore the experiences of mothers parenting children with DS in Indonesia, to give a better understanding of their needs, which is necessary for the delivery of treatment. METHODS: A descriptive qualitative research with content analysis was used. Study participants (15 mothers) were purposively sampled from attendees of a State Special School for students with disabilities. Data was collected via semi-structure interviews and were audio recorded. Participant's statements underwent content analysis, and the principle of trustworthiness was subsequently applied. RESULTS: Five main themes describing participants' experiences were identified: (1) parenting experiences - the impacts, (2) special needs, (3) parenting barriers, (4) parenting facilitators, and (5) mothers' expectations. CONCLUSIONS: The study findings showed that the mothers viewed their situation in both positive and negative ways. Despite the limited sample size in this exploratory study, the results offer new insights into raising a child with DS in a particular cultural setting. IMPLICATIONS FOR PRACTICE: This study offers important information to families and healthcare providers to improve awareness of the disorder and its appropriate management methods. It is important that an exploration of the experiences of mothers will provide healthcare professionals and families with an understanding of the situation. This understanding is essential for the effective management and delivery of treatment.

Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study.

BACKGROUND: The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals. AIMS: This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia. METHODS: This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis. RESULTS: Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns. CONCLUSIONS: The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.

Salutogenesis: A sense of coherence and health among British military veterans exposed to impactful life challenges - the emergence of post-traumatic growth and positive deviance within a life-story approach.

Background: This study sought to capture the perspectives and experiences of two sub-groups of military veterans, namely those who had previously been identified as offenders and those employed as practitioners within the criminal justice system in the United Kingdom. Methods: The lead author undertook narrative inquiry in the form of life story research. The life stories of 17 in-depth interviews were conducted across England and Wales, allowing for insight into the lived experiences of two life story trajectories of the health of military veterans. Existing literature on salutogenesis, health, post-traumatic growth, and positive deviance has also been investigated. Results: Life story interviews were transcribed verbatim and analyzed concurrently using thematic analysis to identify emergent themes. The researchers used thematic analysis as an analytical framework to allow descriptive themes from the literature on salutogenesis, health, post-traumatic, and positive deviance to be compared with those of life-story interviews. Conclusion: The study adopts a salutogenic approach, which suggests that an important indicator for a sense of coherence is enabled through the positive utilization of resilience through the reconstruction of military identity and experience. Notably, the concept of salutogenesis demonstrates the ability to draw from internal and external resources as circumstances require, to survive, and because of this, the participants' health is maintained or improved. Hence, adaptation was notable through the coherence identified by the identity of being a veteran noted between the two subgroups and represents a continuous and dynamic process. The study suggests that the development of a sense of coherence is not restricted to the early decades of life but is a continuous process as contexts, personal circumstances, and opportunities arise. This later point is realized through the presence of post-traumatic growth and positive deviance, as they aid in the nurturing and development of a renewed sense of coherence via the known identity of military service and life.

A multi-country mixed-method study identifying the association between perceived ethical work climate and problems among critical care nurses.

BACKGROUND: Given the grave ethical tension and dilemmas posed continuously which are aggravated in the intensive care unit context and its related caregiving provision, combined with their impact on critical care nurses' job satisfaction and work-related risks, exploring and analyzing these tensions and conflicts is crucial. This study was conducted to examine the relationship between perceived ethical work climate and problems among critical care nurses in addition to exploring their perspectives on the ethical work climates while caring for patients with infectious diseases. DESIGN AND METHOD: A mixed-method research design was used to conduct this study among 635 participants, comprising 170 from Egypt, 144 from Jordan, 161 from Saudi Arabia, and 160 from the United Arab Emirates. Online or paper-based survey forms were distributed to all eligible critical care nurses who agreed to take part in the study. The survey contained both quantitative and qualitative data that were analyzed separately and integrated during the discussion. The study was reported following the STROBE guidelines. FINDINGS: The overall ethical work climate was fairly good and was significantly associated with ICU nurses' personal and professional characteristics. The findings also identified three main themes: (1) an ethical sense of failure, (2) environmental condemnation, and (3) an instant action plan for resolving ethical conflicts. CONCLUSIONS: ICU nurses perceived that ICU ethical climate was fairly good. The results indicated that ICU nurses generally had a relatively fair perception of the ethical work climate, with implications for addressing ethical issues and conflicts in various settings. IMPACT: Mentorship and/or close supervision concerning ethical resilience, consultation, and decision-making is crucial in the ICU milieu. Metacognitive strategies to reinforce problem-solving and decision-making ICU nurses' skills could help them overcome the different ethical challenges. Adequate resources, teamwork, and organizational support are promising tactics to improve ICU nurses' ethical skills. TRIAL REGISTRATION: Not applicable.