Development and application of a nitrogen oxides analyzer based on the cavity attenuated phase shift technique.

Nitrogen oxides (NOx) are crucial in tropospheric photochemical ozone (O3) production and oxidation capacity. Currently, the widely used NOx measurement technique is chemiluminescence (CL) (CL-NOx), which tends to overestimate NO2 due to atmospheric oxidation products of NOx (i.e., NOz). We developed and characterized a NOx measurement system using the cavity attenuated phase shift (CAPS) technique (CAPS-NOx), which is free from interferences with nitrogen-containing species. The NOx measured by the CAPS-NOx and CL-NOx analyzers were compared. Results show that both analyzers showed consistent measurement results for NO, but the NO2 measured by the CAPS-NOx analyzer (NO2_CAPS) was mostly lower than that measured by the CL-NOx analyzer (NO2_CL), which led to the deviations in O3 formation sensitivity regime and Ox (= O3 + NO2) sources (i.e., regional background and photochemically produced Ox) determined by the ozone production efficiencies (OPE) calculated from NO2_CL and NO2_CAPS. Overall, OPE_CL exceeded OPE_CAPS by 18.9%, which shifted 3 out of 13 observation days from the VOCs-limited to the transition regime when judging using OPE_CL, as compared to calculations using OPE_CAPS. During the observation period, days dominated by regional background Ox accounted for 46% and 62% when determined using NO2_CL and NO2_CAPS, respectively. These findings suggest that the use of the CL-NOx analyzer tends to underestimate both the VOCs-limited regime and the regional background Ox dominated days. The newly built CAPS-NOx analyzer here can promote the accurate measurement of NO2, which is meaningful for diagnosing O3 formation regimes and Ox sources.

La aplicación del saber médico. Hipertensión y daño cognitivo

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Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

Psychometric properties of an online psychotherapy advantages and disadvantages instrument: Preliminary results of a multi-center pilot study.

We verified the need for instruments that could assess the perceptions of patients, therapists, and psychotherapy supervisors about online Psychotherapy. OBJECTIVES: to Build a scale of advantages and disadvantages of online psychotherapy. METHOD: A pilot cross-sectional multicenter sample collected from 2020 to 2021 of 129 patients, 20 therapists, and 35 supervisors. We used several analyses. The final scale contained 22 items divided into two domains: advantages and disadvantages. RESULTS: Cronbach's alpha showed good internal consistency (0.88 and 0.85). The scale showed discriminative ability. Convergent validity showed significant correlations between WAI-SR domains (p ã€ˆ0,001). The scale showed a good data fit in the confirmatory factor analysis (X2 = 255,859; DF = 197; p = .003; CFI = 0.95; RMSEA = 0.047; GFI = 0.84 TLI = 0.94). CONCLUSION: This pilot study showed that the instrument proved preliminary good psychometric properties but needs to be evaluated in a larger sample.

Self-care behaviours in patients with restless legs syndrome (RLS): development and psychometric testing of the RLS-Self-care Behaviour questionnaire.

Restless legs syndrome (RLS) is a highly prevalent condition that significantly disrupts sleep and causes reduced quality of life. While previous RLS research has mainly focused on the pharmacological treatment, this study presents the first instrument to measure self-care, the RLS-Self-care Behaviour questionnaire (RLS-ScBq). Self-care, defined as an active decision-making process, can empower patients to effectively participate in their own healthcare through awareness, self-control, and self-reliance to cope with their disease. Self-care can in a RLS context include actions such as physical exercise, meditation, and massage. Hence, the aim of this study is to explore the psychometric properties of the RLS-ScBq in patients with RLS. A cross-sectional design, including 788 patients with RLS (65% women, mean age 70.8 years, [standard deviation (SD) =11.4]) was used. Sociodemographics, comorbidities, and RLS-related treatment data, including insomnia symptoms (i.e., Insomnia Severity Index), daytime sleepiness (i.e., Epworth Sleepiness Scale) and RLS symptoms (i.e., RLS-6 scale) were collected. The validity and reliability of the RLS-ScBq were investigated using exploratory factor analysis and Rasch models. The two-factor solution (i.e., physical, and mental actions) showed an explained variance of 32.33% for The Self-care Behaviour Frequency part and 36.28% for The Benefit of Self-care Behaviour part. The internal consistency measured by Cronbach's α was 0.57 and 0.60, and McDonald's ω was 0.60 and 0.67, respectively. No differential item functioning was identified for gender, age, insomnia, daytime sleepiness, or RLS severity. The eight-item RLS-ScBq can serve as a tool enabling healthcare personnel to explore use and benefit of self-care activities in patients with RLS.

Prevalence and measurement of post-exertional malaise in post-acute COVID-19 syndrome: A systematic review and meta-analysis.

OBJECTIVE: Post-exertional malaise (PEM) is a common and debilitating symptom of post-acute COVID-19 syndrome (PACS), and it is also included in the core outcome set for PACS. Our aims are to determine the prevalence of PEM in patients with PACS, and to review the measurement tools utilized in studies assessing PEM among these patients. METHODS: A systematic literature search was conducted up to 29 February 2024 across four databases: PubMed, EMBASE, Web of Science, and Cochrane Library. Studies were included if they evaluated PACS individuals who had at least one persistent symptom, with the mean or median follow-up duration of at least 3 months after COVID-19 diagnosis or hospital discharge, and specially reported on PEM or any measurement tools utilized to assess PEM. Data extraction and quality assessment were performed independently by two authors. RESULTS: After screening 953 articles, 12 studies comprising 2665 patients were included in the meta-analysis, and 16 studies were included in the narrative review. The pooled prevalence of PEM among PACS patients at 3 months or more after COVID-19 diagnosis was 0.55 (95 % CI, 0.38, 0.71). Moreover, narrative review identified seven questionnaires used to assess PEM in PACS individuals, with the DePaul Symptom Questionnaire-Post Exertional Malaise (DSQ-PEM) being the most frequently utilized instrument. CONCLUSION: Our findings indicate that over half of the PACS individuals experience PEM, and seven questionnaires have been identified for researchers to assess PEM. It is imperative to develop effective intervention strategies to treat and alleviate the burden of PEM.

Validity and reliability of the new NIMHANS intellectual disability screening instrument (NID-Screener) for children and adolescents in India.

INTRODUCTION: There is a gap in tools specifically designed for assessing Intellectual Disability (ID) in Indian settings. To address this, the NIMHANS intellectual disability screening instrument (NID-Screener) was developed by the Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences. METHODS: Ten non experts/language and ten experts rated face and content validity of NID-Screener respectively. Content validity was measured by Content Validity Ratio, Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Construct validity was calculated by performing Exploratory Factor Analysis(EFA) on responses from 275 parent(s)/guardian(s) of children and adolescents (6-17 years). Criterion Validity was tested against Brief Intellectual Disability Scale (BIDS) and Clinical Diagnosis by Child and Adolescent Psychiatrist. Kappa Statistics was used to calculate inter - method and inter-Rater Reliability. Cronbach's alpha was used to assess Internal Consistency. This study was approved by NIMHANS ethics committee. RESULTS: Findings revealed that NID-Screener has good face and content validity (S-CVI/Average = 0.917). Criterion Validity was excellent (Kappa Value=0.862, p-value<0.001) when compared with BIDS. Sensitivity and specificity were found to be 84.7 %, 89 % respectively against Clinical Diagnosis. On EFA, only one underlying factor with Eigen value > 1 was identified (55.8 % of total variance). Kappa value was found to be 0.971 and 0.942 for inter- rater and inter -method reliability respectively(p-value<0.001). NID-Screener has good internal consistency [Cronbach's alpha = 0.841]. CONCLUSIONS: NID-Screener is a reliable and valid tool for screening ID among children and adolescents in India, facilitating its early detection through diagnostic assessments and subsequent interventions.

Risk factors for positive cervical cytology during early pregnancy screening and awareness of positive cytological results in Japan: a report from the Pregnant Women Health Initiative.

OBJECTIVE: Cervical cancer screening rates are low in Japan. Therefore, when a woman is pregnant, this is a good opportunity to visit an obstetrics and gynecology clinic to have cervical cytology. This study aimed to clarify the association between cervical cancer screening and the management of pregnant women's health. METHODS: We prospectively examined the relationships between cervical cytological results during prenatal checkups and the following factors: participant's background, cytological sampling instruments, and awareness of cytological results. RESULTS: Of the 2725 participants, 71 showed abnormal results defined as atypical squamous cells of undetermined significance or higher grade (ASC-US+). ASC-US+ detection rates were higher in smokers, younger participants, those with a low education, those without cancer screening in the past 2 years, and those who received cytology using a spatula or brush. A multivariable logistic regression analysis identified smoking (adjusted odds ratio: 2.99 [95% confidence interval: 1.41-6.33]) and a spatula/brush (adjusted odds ratio: 2.46 [95% confidence interval: 1.09-5.53]) as independent variables associated with detecting ASC-US+. Among the participants, 39.4% (28/71) self-reported "no abnormalities," despite obtaining an ASC-US+ result. CONCLUSIONS: Pre-pregnancy smoking and cytological sampling tools may contribute to detecting ASC-US+. Patients with detected abnormalities need accurate information and reliable follow-up.

Development and Psychometric Testing of the Existential Distress Scale for Palliative Care Cancer Patients.

OBJECTIVE: Existential distress is a common phenomenon in palliative care cancer patients. Developing a reliable and easy-to-use assessment scale for existential distress of palliative care cancer patients is crucial. The aim of this study was to develop a measurement of existential distress for palliative care cancer patients and test its properties. METHODS: The guidelines for developing a scale proposed by DeVellis were followed. Palliative care cancer patients were invited to test the draft scale. Two-hundred and nineteen valid questionnaires were included for the item analysis and exploratory factor analysis. Three-hundred and two valid questionnaires were included for confirmatory factor, convergent validity, discriminant validity, and internal consistency reliability analyses. Twenty repeated data were measured for test-retest reliability analysis. RESULTS: The Existential Distress Scale for Palliative Care Cancer Patients was developed with nine items and three dimensions, including meaninglessness, alienation, and death anxiety. The confirmatory factor analysis showed that the developed scale had a stable factor structure. The Cronbach's α for the whole scale was 0.81, and that for each dimension was 0.76, 0.67, and 0.70, respectively. The test-retest reliability of the scale was 0.79, and that of each dimension was 0.58-0.64. CONCLUSIONS: The Existential Distress Scale for Palliative Care Cancer Patients is a simple but reliable and valid tool.

An Efficiency Model for Decreasing Operative Room Turnover Time for Total Joint Arthroplasties.

Objectives: Despite an increased demand for total joint arthroplasty (TJA), rising health-care costs and bundling of payments by payers have shifted the focus to improving operating room (OR) efficiency. This study aimed to assess the efficacy of an efficiency model that optimized instrument trays on decreasing OR turnover time (TOT) and the benefits made possible by this improved efficiency. Methods: All primary TJA procedures performed by a single fellowship-trained surgeon from January 2022 to August 2023 were reviewed. The surgeon partnered with Zimmer Biomet to condense the total knee and total hip arthroplasty instrument trays from seven to three trays each. Patient in OR time and patient out of OR times were collected and used to calculate TOT. Mean TOTs pre-efficiency model implementation (January - October 2022) and post-efficiency model implementation (March - August 2023) were compared. Annual cost savings were calculated based on an average cost per one minute of OR time of $47.99 and an average cost for the Sterile Processing Department (SPD) to process a single TJA tray of $79.41. Results: Following implementation of the efficiency model, the average OR TOT significantly decreased by 19 minutes (P < 0.0001), a greater than 44% reduction in TOT. At this surgeon's current case volume, conservatively estimated at 280 primary TJA cases per year, annual savings in OR and SPD processing costs were $169,597 and $88,939, respectively. Moreover, this led to increased case volume per operative day. Conclusion: A small-scale intervention such as optimizing instrument trays for TJA is a valuable and sustainable solution to improve efficiency in the OR by decreasing OR TOT, thereby generating considerable cost-savings and opportunity to increase surgical volume.

Supporting adherence to the cystic fibrosis regimen: Development and validation of The Daily Care Check-In (DCC).

BACKGROUND: The cystic fibrosis (CF) regimen is time-consuming and burdensome leading to barriers to self-management. This mixed-methods study developed the Daily Care Check-in (DCC) that is specific to the barriers faced by people with CF (PWCF) and evaluated its validity. METHODS: Qualitative methods were used to identify barriers to self-management and develop items, with "think aloud" cognitive interviews conducted to refine the items. A multisite, cross-sectional study was conducted to test the internal consistency, test-retest reliability, and validity of the DCC scores, comparing them to objective medication adherence (composite medication possession ratio (cMPR)) and psychosocial measures (self-efficacy, medication beliefs, executive functioning, depressive and anxiety symptoms, treatment burden, and treatment complexity). RESULTS: The DCC (18 items) includes two scales: Occurrence (score range 0-18) and Interference (score range 0-90). 405 participants completed the DCC, 344 (85 %) completed the survey, and 365 (90 %) had a cMPR calculated. On average, 6.8 barriers were reported (SD = 4.2 Occurrence Scale), and the Interference Scale had a mean score of 18.4 (SD = 14.0). Reliability was acceptable to good. cMPR was negatively correlated with the DCC (rho=-0.26, Occurrence and rho = -0.31, Interference, p-values<0.0001). A priori hypotheses between the DCC and the other measures were supported and demonstrated construct validity. CONCLUSIONS: This study provides evidence supporting the validity of the DCC for assessing the presence and impact of barriers to CF self-management, including medication adherence. Formal screening of self-management barriers (e.g., using the DCC) should be considered to facilitate conversations with the care team and identify tailored interventions to support CF self-management.

Comparing scissors and scalpels to a novel surgical instrument: a biomechanical sectioning study.

BACKGROUND: This study introduces a novel surgical instrument to reduce iatrogenic nerve injuries during procedures such as carpal tunnel and ulnar nerve decompression surgery. These injuries often result from direct damage to surrounding tissues by surgical instruments, whose designs have remained largely unchanged over the past decades. The novel device is a modified surgical forceps that has a deployable surgical scalpel that runs along a groove on the forceps. This design protects important anatomical structures while allowing fast dissection and cutting of fascial layers. METHODS: The process used to develop a novel instrument included computer-aided design (CAD) modeling, 3D printing for prototyping, and the fabrication of an aluminum prototype. Biomechanical testing was performed with the novel device, iris scissors, bandage scissors, and a scalpel on an MTS Static Materials Test System. The peak force to slide-cut, number of cut attempts, and percentage cut on first attempt were compared between the prototype and traditional surgical tools. The materials cut in testing were Ace™ bandage, stockinette, and gauze. Statistical analyses were performed using Welch's t-tests and Fisher's exact tests. RESULTS: Compared to conventional bandage and iris scissors, the novel surgical instrument required significantly less force to cut through an Ace™ bandage, stockinette, and gauze (p < 0.01). The number of cuts required to transect those same materials with the novel device was comparable to that of the scalpel and bandage scissors. Additionally, while there were no differences between the novel device and the other devices for an Ace™ bandage and stockinette, the novel device tended to cut a greater percentage of gauze in one pass than did the iris scissors. CONCLUSION: The novel surgical instrument designed in this study required less force compared to conventional scissors, demonstrated cutting efficiency similar to that of a scalpel blade, and had more safety features than either instrument. This study highlights the value of collaboration between biomedical engineering and orthopedic surgery departments on innovation in medical technology, through which new technologies with improved design and functionality demonstrate the potential to reduce iatrogenic injuries.

'Development and Psychometric Testing of the Lean Management Scale for Nursing Services in Hospitals'.

AIM: The aim of this study is to develop a new instrument (The Lean Management Scale for Nursing Services in Hospitals- LMS-N) to evaluate the lean levels of nursing services in hospitals and to evaluate its psychometric properties. METHOD: A three-phase construct was used to develop this scale and to determine its psychometric properties: (1) creating the item pool, (2) preliminarily evaluating items and (3) evaluating psychometric properties. This methodological study evaluated the scale's face, content and construct validities, internal consistency, and temporal stability. The psychometric properties of the scale were tested with a total of 695 nurses in different sample groups. Data were collected between 18 November 2020 and 15 May 2021. RESULTS: The scale's content validity index was 0.75. According to principal component analysis, the scale included 22 items and five subdimensions, and the total variance was 60.32%. In confirmatory factor analysis, the fit indices were good or acceptable for this construct. Its internal consistency was good or acceptable according to reliability analysis. Test-retest showed that the scale had temporal stability. CONCLUSION: Lean Management Scale in Nursing Services in Hospitals is a valid and reliable tool that can evaluate the level of leanness of nursing services. It provides a comprehensive evaluation with five subdimensions: management support, visual stock management, work environment layout, preventive notification system and waste detection.

Association Between Serum Galectin-3 and Parkinson's Disease: A Two-Sample Mendelian Randomization Study.

BACKGROUND: Parkinson's disease (PD) is a prevalent neurodegenerative disorder with poor prognosis. Observational studies have demonstrated a significant correlation between serum galectin-3 and PD, suggesting a potential role of galectin-3 as a biomarker for PD. However, it is still unclear whether galectin-3 contributes to the risk of the disease. METHODS: A two-sample Mendelian randomization (MR) approach was used in this study. Genetic instruments for serum galectin-3 level were selected from a genome-wide association study (GWAS), including 30,931 European individuals. Summary-level statistics for PD were derived from another published GWAS, including 33,674 cases and 449,056 controls. Primary analysis was conducted using the inverse-variance weighting (IVW) method. Weighted median, MR-Egger, simple mode, weighted mode, and MR-pleiotropy residual sum and outlier (MR-PRESSO) methods were used as complementary analyses. To detect heterogeneity, Cochran's Q statistic and leave-one-out analysis were used. For testing potential horizontal pleiotropy, the MR-Egger intercept test and MR-PRESSO global test were conducted. RESULTS: MR analysis using IVW model (OR 1.112, 95% CI 1.025-1.206, p = 0.010), weighted median (OR 1.135, 95% CI 1.037-1.242, p = 0.006), weighted mode (OR 1.142, 95% CI 1.038-1.257, p = 0.030), and MR-PRESSO (OR 1.112, 95% CI 1.046-1.182, p = 0.012) presented a consistent result, indicating that increased serum galectin-3 was associated with a higher risk of PD. No heterogeneity or horizontal pleiotropy was detected in the analyses. CONCLUSIONS: The study shows a suggestive association between galectin-3 and PD. Increasing serum galectin-3 was associated with an increase in PD risk. Galectin-3 may play an important role in the causal pathway to PD.

Functional and Structural Long-Term Effects of Repetitive Instrument-Assisted Manual Therapy (IAMT) of the Lumbar Back on the Dorsal Myofascial Chain Among Female Soccer Players: A Randomized, Placebo-Controlled Pilot Trial.

INTRODUCTION: Instrument-assisted manual therapy (IAMT) is suitable for optimizing movement prerequisites, such as range of motion, flexibility, microcirculation, and pain inhibition along myofascial chains, potentially leading to a reduction in hamstring injuries. To date, however, IAMT's modes of action remain largely unclear. This study aimed to examine the functional and structural effects of repetitive IAMT after 2.5 and five weeks. METHODS: Sixteen healthy female soccer players (age: 21.4 (±5.1) years) were randomly grouped into an intervention group and a placebo control group. The intervention group received nine IAMT sessions twice weekly at the right lumbar region. The placebo group received a single pressureless "therapy" at baseline. In addition to structural ultrasound analyses (absolute motion and shear motion), functional mobility tests (passive straight leg raise (PSLR) test and lumbar and thoracic double inclinometry) were performed 4.0 (±2.0) days after the fourth IAMT and 3.4 (±1.1) days after the ninth IAMT in both groups. RESULTS: Hamstring flexibility in the PSLR test improved significantly after the ninth IAMT compared with the placebo group (p < 0.05, effect size: 0.913). No systematic differences were seen at the structural level. CONCLUSION: Repetitive IAMT can improve hamstring flexibility. Further studies in larger groups and diverse collectives are necessary to additionally test the postulated preventive effect also on hamstring injuries. Whether ultrasound is the right method for detecting structural changes in this context needs to be verified in the future.

Healthcare Professionals' Knowledge, Skills, and Information Needs Pertaining to Hearing Loss and Hearing Aids in Swedish Nursing Homes: A Cross-Sectional Study and Psychometric Evaluation.

Background: Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids. Objective: The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals' self-reported knowledge, experience, skills, competence, and information needs pertaining to residents' hearing loss and hearing aids in the Swedish context. Materials and Methods: A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned. Results: An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance. Conclusion: Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.

Ensuring Clinical Excellence: The Mindray SAL9000 Biochemical Immunoassay System.

This study aimed to evaluate the performance and clinical laboratory adaptability of the Mindray SAL9000 biochemical immunoassay automation system, ensuring compliance with ISO 15189 standards and relevant national requirements. We conducted comprehensive performance verification tests on 21 biochemical analytes and 15 immunoassays, including precision, accuracy, linear bias, measurement range assessments, interference testing, reference range validation, inter-instrument comparison, and carryover verification. The Mindray SAL9000 demonstrated high performance across various parameters, with all analytes showing good linearity and minimal bias. While specific interfering substances affected some analytes, the system showed excellent resistance to common interferences such as hemolysis, ascorbic acid, and jaundice. The inter-instrument comparison with the BS2000M and Roche 702 indicated a good correlation, with most parameters showing biases of less than 10%, although exceptions were noted for ALT and AST. In conclusion, the Mindray SAL9000 meets clinical requirements through its high precision, excellent accuracy, and broad measurement range, making it a reliable and adaptable choice for clinical outpatient and emergency laboratories.

The Practical and Social Functioning (PSF) scale: development and measurement properties of an instrument for assessing activity and social participation among people with serious mental illness.

BACKGROUND: Participation in society and the ability to perform various activities are crucial aspects of everyday functioning. The intertwined relationship between functioning, disability, and health is emphasized in the "International Classification of Functioning, Disability and Health (ICF)" framework. In recent decades, mental health care units have increasingly focused on this aspect. The Practical and Social Functioning scale (PSF) was developed and validated in Norwegian as an easy-to-administer instrument to assess practical and social functioning among patients with serious mental illness in different clinical settings. METHODS: The PSF was developed and revised using data from different Norwegian studies. Data from a total of 562 patients with serious mental illness in different clinical settings were included. The validation process included the evaluation of items into categories by 25 professionals. Development and revision took place in three different stages, and factor analyses were conducted. The quality of the PSF was assessed according to the COSMIN standards for systematic reviews on patient-reported outcome measures. RESULTS: The final version of the PSF comprises seven subscales, each consisting of four items, resulting in a total of 28 items. These subscales, along with their corresponding items, are loaded onto two factors representing the main dimensions of functioning: activity and participation. Content validity comprises three domains: relevance, comprehensiveness, and comprehensibility. Relevance and comprehensibility were found to be adequate, whereas comprehensiveness was doubtful. Structural validity was adequate, internal consistency was very good, and construct validity was adequate compared to the Global Assessment of Functioning scale. Responsiveness was found to be doubtful in our study with data from an 18-month observation period. Nearly 60% of the items showed a ceiling effect. No items showed a floor effect. CONCLUSION: The development and validation of the Norwegian version of the PSF resulted in an instrument consisting of seven subscales and a total of 28 items. The items and subscales assess functioning related to two key factors according to the ICF framework: activity and participation. Our results show that the PSF is an easy-to-administer instrument that may be particularly sensitive for detecting variation among persons with severely impaired functioning. TRIAL REGISTRATION: The study Implementation of Guidelines for the Treatment of Psychoses was registered retrospectively on 31 August 2017 at ClinicalTrials.gov (NCT03271242).

The questions on violence (FOV) tool for interpersonal violence inquiry in Swedish healthcare settings - evaluation of content validity, face validity and test-retest reliability.

BACKGROUND: Previous research indicates that routine inquiry or screening conducted by healthcare providers may significantly increase the identification of interpersonal violence. There is a lack of comprehensive instruments to routinely assess patients about interpersonal violence and violence against children in the household. The purpose of this study was to assess the content validity, face validity and reliability of the Questions on Violence (FOV) tool, an instrument specifically designed for routine inquiries about interpersonal violence in healthcare settings within the Swedish context. METHODS: The content validity, face validity and reliability of the FOV instrument was assessed through (1) a content validity index with six experts in the field of intimate partner violence, (2) cognitive interviews with nine patients recruited from a primary healthcare facility, and (3) an evaluation of the test-retest reliability based on responses from 37(50.0%) university students. The intraclass correlation coefficient, model 2.1, was calculated to assess the degree of correlation and agreement between the two measurements. RESULTS: Calculations based on the content validity index indicated that five out of seven items had excellent content validity (≥ 0.78). The average content validity index of included items was 0.88, which is slightly below the recommended threshold for excellent content validity. The results based on the cognitive interviews revealed that participants found the seven items to be relevant and easy to understand. Overall, the participants agreed that the concept of 'close relationships' primarily encompassed intimate partners, family members, and close friends. The value of the intraclass correlation coefficient was 0.85 (0.77-0.91; CI 95%), indicating good reliability with an interval of good to excellent test-retest reliability. CONCLUSIONS: The results demonstrate that the seven-item FOV instrument has good content and face validity as well as good to excellent test-retest reliability. The current study provides healthcare professionals with a short yet comprehensive instrument for identifying patients who have experienced or perpetrated different forms of interpersonal violence.

Assessing the influence of thermal structure variation on Fe and P mobility in sediments cores using Yellow Spring Instrument, diffusive gradient technology, and HR Peeper for sustainable water quality management.

The freshwater ecological characteristics in terms of the daily inventory of thermal stratification, spatial variation of O2 distribution, and the mobility of potentially toxic elements (PTEs) at the water sediment interface (WSI) are prudent freshwater assessment indices for water quality management protocol. The study conducted daily observations within a monsoon-influenced region, utilizing high-resolution techniques such as HR Peeper, Yellow Spring Instrument (YSI), and ZrO-Chelex diffusive gradient technology (DGT) to analyze PTEs, specifically phosphorus (P) and iron (Fe),within the water-sediment interface (WSI) under different temperatures and oxygen conditions. The 66-day field study showed that high thermal structure contributed significantly to production Fe ions and P from sediment under reductive dissolution of FeOOH. The study also revealed that P and Fe exhibited comparable spatial distribution patterns at the WSI, indicating a linked relationship between these PTEs. This correlation was reinforced by high Pearson correlation coefficients ranging from 0.7 to 0.9 (bilateral, p < 0.05) indicating that the concentrations of labile P were predominantly influenced by the release of phosphorus bound to iron. The fluxes of the PTEs were positive with a range of Fe, 3.3-81.5 mg/m2 day and P, 0.03-0.5 mg/m2 day showing the sediments liberated the PTEs into the benthic water. Again, high positive fluxes (Fe≈60 mg/m2 day, P≈0.5 mg/m2 day) for PTEs were obtained when stratification was high (anoxic conditions) and low (Fe≈5 mg/m2 day, P≈0.08 mg/m2 day) when stratification did not exist. This depicts that Fe/P dynamics were hinged mainly on hypoxic conditions in the benthic water under the reductive dissolution of FeOOH. The findings showed that organic materials (both solid and dissolved) correlated (> 0.7) significantly with (positive high values) Fe. This indicates that their interaction contributed to the reservoir water deterioration. However, Ca2⁺ and Mg2⁺ had little impact on the liberation of Fe-DOC-P from sediments due to their inability to compete with Fe for binding to DOC and P, as shown by their low correlation values. The research provides in-depth insights into the dynamics of PTEs on a daily timescale and offers valuable information for water management practices in inland reservoirs, particularly concerning the cycling of phosphorus (P) and its effects on ecosystem health.

Disparities in Child Development by Maternal Birthplace and Child Sex among Kindergarten Children in Manitoba, Canada: A Population-Based Data Linkage Study.

Little is known about differences in child developmental vulnerability before school entry according to maternal birthplace and sex. Official immigration records were linked with the Early Development Instrument assessments among children in kindergarten in the province of Manitoba, Canada (2005-2017). Logistic regression was used to estimate odds ratios of vulnerability in five developmental domains associated with maternal birthplace and child sex. Children of immigrant mothers from most birthplaces had higher adjusted odds of developmental vulnerability than non-immigrants in domains related to language and communication skills, except those of the rest of North America & Oceania. Children of Sub-Saharan African mothers were more vulnerable in four domains. Boys were consistently more vulnerable than girls across domains and maternal birthplaces. Children of immigrant mothers exhibited higher developmental vulnerability than non-immigrants in domains related to language and communication skills, potentially reflecting exposure to English and French as second languages.