The effectiveness of physical activity interventions in improving higher education students' mental health: A systematic review.

Traditional interventions aiming to improve students' mental health and quality of life include meditation or canine therapy. The development of physical activity-related interventions has increased over the past decade. We aimed to review all studies using physical activity for improving the mental health and quality of life in higher education students whilst describing the interventions, measurements and effectiveness. A systematic search of six electronic databases including: ProQuest, MEDLINE, Embase, CINAHL, SPORTDiscus and CENTRAL, was conducted following PRISMA guidelines. Randomized or non-randomized controlled trial physical activity-related interventions involving higher education students aiming to improve their mental health and quality of life were included. Searches yielded 58 articles with interventions involving martial arts, sport, mind-body exercises and anaerobic exercises. Psychological measures varied across studies including the State Trait Anxiety Inventory, Beck Depression Inventory and the Perceived Stress Scale. Over half of the studies included in this review (n = 36) were effective in improving students' mental health or quality of life. Findings from our review suggest that interventions aiming to be effective in improving students' mental health quality of life should aim to deliver moderate-vigorous intensity exercises such as dance or Pilates. This systematic review was based on a published protocol in PROSPERO (registration number: CRD42022325975).

An IT-based self-checking system of spreadsheet exercises for learners with visual impairments.

PURPOSE: In vocational education and training of computer literacy as part of vocational rehabilitation, learners often work on problem-solving exercises as self-study assignments, and check if their answers are correct. Sighted learners can get information on their incorrect answers by comparing their answers with the correct answers. However, learners with visual impairments largely depend on their teachers for getting this feedback. To remove this dependence, we designed a self-checking system for learners with visual impairments to verify the correctness of their answers. In this paper, we report the results of a usability study to evaluate whether learners with visual impairments can self-check spreadsheet problem-solving exercises using our system in a teacherless environment. METHODS: Usability evaluation experiment was conducted using 2 × 2 crossover design with people with visual impairments (n = 11). The participants checked their answers (detected and corrected errors) after working on problem-solving exercises in two ways: (i) manually; and (ii) using our system. The system usability was evaluated by measuring Detection-And-Correction (DAC) ratio as effectiveness, time taken and the number of steps required for DAC as efficiency, and System Usability Scale score as satisfaction. RESULTS AND CONCLUSIONS: The results show that all the participants could complete the DAC task by using our system, and the time required for DAC task was significantly reduced by using our system as compared to by checking manually. Our system enables learners with visual impairments to self-check problem-solving exercises answers. However, to increase the user satisfaction, the number of required keystrokes needs to be decreased.

Vocational rehabilitation for learners with visual impairments to improve their computer literacy is becoming increasingly important.Learners with visual impairments have the potential to acquire computer literacy in a teacherless environment by using simple assistive software like our self-checking system.Simple assistive software for learners with visual impairments like our self-checking system may have a positive effect not only on learners with visual impairments but also on sighted people.Moreover, our system reduces the teaching load of the teachers so that they can be more effective in helping learners with visual impairments.

Translation, cross-cultural adaptation, and validation of the Chinese version of the COVID-19 health literacy scale in nursing students.

BACKGROUND: Effective communication is an essential component of high-quality nursing care. Health literacy, the ability to access, describe, evaluate and apply health information to make informed decisions, is an important component of effective communication in nursing. Nurses, including student nurses, with good levels of health literacy (HL) are well positioned to communicate reliable public health-related information effectively, at times like the COVID-19 global pandemic. At this time, many nursing students have been at the frontline of patient education, as such, it would be expected that they have high levels of HL. However, it has been suggested that there is the need to improve HL levels in nursing students. AIMS: The aim of this study was to analyse the structure of item response of a back translated Chinese version of the COVID-HLS-Q22 questionnaire and to assess the coronavirus-related HLof Chinese speaking nursing students in Hong Kong using the COVID-HLS-Q22-CN. METHODS: A cross-sectional study of 97 undergraduate nursing students was conducted using two self-reported questionnaires. The HLS-EU-16 scale, with face validity already established, was used to assess scale equivalence Using a cross-over study approach, student participants were randomly assigned in sequential order. The validation process was performed in five phases: direct translation, translation synthesis, back translation, consolidation with experts, and testing with the students. The intended outcome of this study will be a formally tested model of the Chinese version of the COVID-HLS-Q22-CN, that can be replicated in Chinese population. RESULTS: Factorial equivalence was present across language versions in both questionnaires. Internal consistency was excellent for COVID-HLS-Q22-CN (coefficient alpha for Chinese version of questionnaire, 0.957 and English version, 0.953). This suggested that the four subscale are stable across the two questionnaires. CONCLUSION: The COVID-HLS-Q22-CN has proven to be a feasible and reliable tool in the assessment of Hong Kong based Chinese speaking nursing students. The emergence of issues around COVID-related HL further highlights the need to include the teaching of critical health literacy skills within nurse education, preparing the healthcare professionals of the future for public health emergencies.

Metered dose inhalers versus nebulizers for aerosol bronchodilator delivery for adult patients receiving mechanical ventilation in critical care units.

BACKGROUND: Nebulizers and metered dose inhalers (MDI) have both been adapted for delivering aerosol bronchodilation to mechanically ventilated patients, but there is incomplete knowledge as to the most effective method of delivery. OBJECTIVES: To compare the effectiveness of nebulizers and MDIs for bronchodilator delivery in invasively ventilated, critically ill adults. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 5); Ovid MEDLINE (1950 to Week 19 2012); Ovid EMBASE (1980 to Week 19 2012); CINAHL via EBSCOhost (1982 to Week 19 2012) and reference lists of articles. We searched conference proceedings and reference lists of articles. We also contacted manufacturers and researchers in this field. There were no constraints based on language or publication status. SELECTION CRITERIA: Randomized controlled trials (RCTs), including randomized cross-over trials where the order of the intervention was randomized, comparing the nebulizer and MDI for aerosol bronchodilation in mechanically ventilated adult patients in critical care units. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information where required. We collected information about adverse effects from the trials. MAIN RESULTS: This review included three trials, two addressing the primary outcome measure of a reduction of airway resistance (measured as a reduction in interrupter and additional airway resistance) with a total of 28 patients (n =10, n =18) and two addressing adverse changes to haemodynamic observations with a total of 36 patients (n =18, n =18). Limitations in data availability and reporting in the included trials precluded meta-analysis and therefore the present review consisted of a descriptive analysis. Risk of bias in the included trials was judged as low or of unknown risk across the majority of items in the 'Risk of bias' tool.Cautious interpretation of the included study results suggests that nebulizers could be a more effective method of bronchodilator administration than MDI in terms of a change in resistance. No apparent changes to haemodynamic observations (measured as an increase in heart rate) were associated with either mode of delivery. Due to missing data issues, meta analyses were not possible. Additionally, small sample sizes and variability between the studies with regards to patient diagnoses, bronchodilator agent and administration technique mean that it would be speculative to infer definitive recommendations based on these results at this time. This is insufficient evidence to determine which is the most effective delivery system between nebuliser and MDI for aerosol bronchodilation in adult patients receiving mechanical ventilation. AUTHORS' CONCLUSIONS: Existing randomized controlled trials, including randomized cross-over trials where the order of the intervention was randomized, comparing nebulizer and MDI for aerosol bronchodilation in mechanically ventilated adult patients do not provide sufficient evidence to support either delivery method at this time.

Online video in clinical skills education of oral medication administration for undergraduate student nurses: a mixed methods, prospective cohort study.

BACKGROUND: Improvements in the safety of the prescribing, dispensing and administration of medicines are identified as a priority across international healthcare systems. It is therefore essential that higher education institutions play their part in helping to meet this patient safety objective. New developments in clinical skills education which are aligned to emerging educational theory are available, but evaluations and supportive evidence are limited. OBJECTIVES: To evaluate the use of an online best practice exemplar as an adjunct to the clinical skills teaching of oral medication administration to undergraduate student nurses. DESIGN: Mixed-methods prospective cohort design. SETTINGS AND PARTICIPANTS: Two intakes of undergraduate nursing students (n=168, n=154) undertaking a first year clinical skills based module at a British university. METHODS: The Control group received standard teaching using lectures and skills classes facilitated by experienced clinical skills lecturers. The Intervention group received the standard teaching and unlimited access to an online video clip of medication administration. Performance and satisfaction were measured using module assessment results and a satisfaction questionnaire. Qualitative data were gathered using focus groups (n=16, n=20). RESULTS: The Intervention group was significantly (p=0.021) more likely to pass the assessment and rate their satisfaction with the teaching significantly higher (p<0.05) on more than half of the items from the Student Satisfaction Survey. Two Categories were identified from focus group data; Classroom Learning and Transfer to Practice. Classroom Learning included four themes of Peers, Self, Teaching and Time and when Classroom Learning was positive, the Transfer to Practice of the clinical skill was enhanced. CONCLUSIONS: An online video of a best practice exemplar as an adjunct to taught clinical skills sessions improves student assessment results and satisfaction ratings. The video was also reported to positively influence all themes identified in Classroom Learning and was perceived to promote the Transfer to Practice of teaching input.

Record linkage in Scotland and its applications to health research.

AIMS AND OBJECTIVES: This paper will focus on the key concepts behind record linkage and describe how probability matching of Scottish health records can be used for national health research. BACKGROUND: Record linkage can bring together two or more records relating to the same individual. This allows information from multiple sources to be joined together to produce richer data sets for research purposes and has wide applicability in public health and epidemiological research. The probability matching techniques underpinning record linkage bring together records on a patient basis using key identifying information on each record. Scotland has a strong track record for performing linkage for research purposes owing to routinely collected and well-maintained national administrative health data sets, the emergence of the Scottish record linkage system and organisations like the Information Services Division of NHS National Services Scotland who centrally hold permanently linked patient-based databases. Design. A record linkage retrospective population cohort study is described within this paper. METHODS: The paper will describe current linkage methodology before discussing typical applications in the setting of Information Services Division and focusing on a particular linkage study investigating rates and risk factors for gastroschisis. RESULTS: Conclusions from the gastroschisis study are typical of the types of important findings drawn from analysing linked health data. CONCLUSIONS: Scotland's good track record for linking records for health research is evidenced by the high volume of research projects, publications and findings resulting from probability matching of national health data. Relevance to clinical practice. Record linkage allows information relating to the same person held across different data sources to be brought together. Probabilistic record linkage can overcome data quality issues, producing accurate matches. This allows linked, analysable, patient-based databases, capable of answering complex research questions, to be produced from several data sources with wide applications in the field of health research.

The use of data-mining to identify indicators of health-related quality of life in patients with irritable bowel syndrome.

AIM: To examine the health-related quality of life in a cohort of individuals with irritable bowel syndrome and to explore the use of several data-mining methods to identify which socio-demographic and irritable bowel syndrome symptoms are most highly associated with impaired health-related quality of life. BACKGROUND: Health-related quality of life can be adversely affected by irritable bowel syndrome. Little is presently known about the predictive factors that may influence the quality of life in these patients. DESIGN: Cross-sectional survey design involving the general population of the UK. Methods. Individuals with symptoms of irritable bowel syndrome were recruited to a longitudinal cohort survey via a UK-wide newspaper advert. Health-related quality of life was measured using a battery of validated questionnaires. Several data-mining models to determine which factors are associated with impaired health-related quality of life are considered in this study and include logistic regression, a classification tree and artificial neural networks. RESULTS: As well as irritable bowel syndrome symptom severity, results indicate that psychological morbidity and socio-demographic factors such as marital status and employment status also have a major influence on health-related quality of life in irritable bowel syndrome. CONCLUSION: Health-related quality of life is impaired in community-based individuals in the UK with irritable bowel syndrome. Although not always as easily interpreted as logistic regression, data-mining techniques indicate subsets of factors that are highly associated with impaired quality of life. These models tend to include subsets of irritable bowel syndrome symptoms and psychosocial factors. RELEVANCE TO CLINICAL PRACTICE: Identification of the role of psychological and socio-demographic factors on health-related quality of life may provide more insight into the nature of irritable bowel syndrome. Greater understanding of these factors will facilitate more flexible and efficient nursing assessment and management of this patient group.

Approaches for dealing with missing data in health care studies.

AIM: The aims of this study were to highlight the problems associated with missing data in healthcare research and to demonstrate the use of several techniques for dealing with missing values, through the use of an illustrative example. BACKGROUND: In healthcare research studies, it is almost impossible to avoid at least some missing values during data collection, which in turn can threaten the validity of the study conclusions. A range of methods for reducing the impact of missing data on the validity of study findings have been developed, depending on the nature and patterns which the missing values may take. DESIGN: A discursive study. METHODS: Several techniques designed to deal with missing data are described and applied to an illustrative example. These methods include complete-case analysis, available-case analysis, as well as single and multiple imputation. CONCLUSIONS: If research data contain missing values that are not randomly distributed, then the study results are likely to be biased unless an effective approach to dealing with the missing values is implemented. RELEVANCE TO CLINICAL PRACTICE: If nursing and healthcare practice is to be informed by research findings, then these findings must be reliable and valid. Researchers should report the details of missing data, and appropriate methods for dealing with missing values should be incorporated into the data analysis.

An epidemiological study of Henoch-Schönlein purpura.

AIM: To describe the incidence of hospital admission among children in the Scottish population for Henoch-Schönlein purpura (HSP). METHOD: The annual, quarterly and monthly incidences of HSP were derived from routinely collected data for Scotland from 1995 to 2007. RESULTS: Annual incidences of childhood cases of HSP in Scotland ranged from 20.3 to 26.7 per 100,000 of the child population over 1995-2007. Quarterly rates were highest in winter and lowest in summer. Monthly rates were highest in the months between December and March and consistently low in July and August. CONCLUSION: The annual incidence of childhood HSP in Scotland appears high compared with rates reported in other countries, and the results demonstrate a seasonal pattern. Health professionals should be aware of the symptoms, and of the best treatments and care available. Further research is needed to gain a better understanding of this disease, as the aetiology remains unknown and there are no clear evidence-based treatments or interventions.

An examination of subgroup classification in irritable bowel syndrome patients over time: a prospective study.

BACKGROUND: Irritable bowel syndrome (IBS) is a complex functional gastrointestinal disorder which to date remains poorly understood. Therapies for irritable bowel syndrome (IBS) patients are usually aimed at relieving the predominant symptom; however, little evidence exists as to whether or not the predominant symptom changes with time. Nurses are becoming increasingly involved in the assessment and management of IBS patients. OBJECTIVES: To categorise IBS patients into one of three sub-types, namely diarrhoea-predominant, constipation-predominant and a third group who alternate between the two, and to investigate changes in patient sub-type classification over time. DESIGN: Observational cohort study. SETTING: The general population of the United Kingdom (UK). METHODS: A cohort of 494 IBS patients, with a confirmed Rome II classification diagnosis, was recruited in the UK. Patients' IBS symptoms were recorded throughout a 26-week period. Proportions of individuals in each IBS subgroup were calculated and probabilities of moving from one subgroup to another between consecutive weeks were estimated. RESULTS: The percentage of patients given an overall subgroup classification of diarrhoea-predominant IBD (D-IBS) is 40.9%; 58.1% and 1% were classified as belonging to the alternator (A-IBS) and constipation-predominant (C-IBS) subgroups, respectively. PATIENTS: classified as an alternator or as diarrhoea-predominant have a high probability (0.67 and 0.71, respectively) of remaining in the same subgroup; however this probability is lower for constipation-predominant patients (0.35). CONCLUSION: Although many patients remain in the same IBS subgroup classification over time, there are individuals whose subgroup classification varies. As such, patients' IBS subgroup classification should be reviewed regularly and treatment adjusted accordingly in order to optimise patient care.

A comparison of irritable bowel syndrome patients managed in primary and secondary care: the Episode IBS study.

BACKGROUND: It is thought that people with irritable bowel syndrome (IBS) who consult secondary care have more severe symptomatology than those treated mainly in primary care. AIMS: To describe the physical and psychological symptoms of IBS, and the health-related quality of life of patients managed in primary and secondary care. DESIGN OF STUDY: Cross-sectional observational survey. SETTING: The general population of the United Kingdom (UK). METHODS: A cohort of people with IBS symptoms was recruited via a UK-wide newspaper advertisement. Frequency, duration and severity of symptoms, and health-related quality of life data were collected by semi-structured telephone interviews. Descriptive analysis allowed the comparison of those managed in primary care with those consulting secondary care. Logistic regression was used to identify factors associated with patients consulting secondary care. RESULTS: Data on 486 participants with confirmed IBS (Rome II criteria) were examined. Similar patterns in symptom severity were found in primary and secondary care groups. Factors associated with IBS patients consulting secondary care were: male sex, a longer length of time since diagnosis, having frequent bowel motions, not having dyspepsia in the past 3 months, and having used medication and alternative therapies. Although patients managed in secondary care have greater impairment to their usual activities, both groups had similar health-related quality-of-life profiles. CONCLUSION: High levels of physical and psychological morbidity were present in population-based volunteers managed in both primary and secondary care. This study suggests that patients with IBS managed solely in primary care are affected as much as those attending secondary care.