Digital proficiency: assessing knowledge, attitudes, and skills in digital transformation, health literacy, and artificial intelligence among university nursing students.

BACKGROUND: Implementing digital transformation and artificial intelligence (AI) in education and practice necessitates understanding nursing students' attitudes and behaviors as end-users toward current and future digital and AI applications. PURPOSE: This study aimed to assess the perceived knowledge, attitudes, and skills of nursing students regarding digital transformation, as well as their digital health literacy (DHL) and attitudes toward AI. Furthermore, we investigated the potential correlations among these variables. METHODS: A descriptive correlational design was employed in a Saudi nursing college utilizing a convenience sample of 266 nursing students. A structured questionnaire consisting of six sections was used, covering personal information, knowledge, skills and attitudes toward digital transformation, digital skills, DHL, and attitudes toward AI. Descriptive statistics and Pearson correlation were employed for data analysis. RESULTS: Nursing students exhibited good knowledge of and positive attitudes toward digital transformation services. They possessed strong digital skills, and their DHL and positive attitude toward AI were commendable. Overall, the findings indicated significant positive correlations between knowledge of digital transformation services and all the digital variables measured (p = < 0.05). Senior students reported greater digital knowledge and a positive attitude toward AI. CONCLUSION: The study recommends an innovative undergraduate curriculum that integrates opportunities for hands-on experience with digital healthcare technologies to enhance their digital literacy and skills.

Examining the effectiveness of a training program on improving knowledge, functional skills, and attitude in natural disaster volunteers.

Introduction: Disaster relief volunteers must have certain psychological and cognitive characteristics. Therefore, the present study aimed to investigate the effectiveness of the training program on improving knowledge, functional skills, and attitude among disaster volunteers. Methods: A quasi-experimental study was conducted in 2023 in Iran, including an intervention and control group and follow-ups. Ninety health volunteers were randomly selected and divided into two groups of 45. The experimental group received the training program for an hour a week for three months. The control group received no intervention. The participants of both groups completed the disaster preparedness questionnaire at the pre-test, post-test, and one and three months after the intervention. Data was analyzed using SPSS "version 26" software in the methods section. Results: The intervention effect were significant in increasing the volunteers' functional skills (F = 3.75), knowledge (F = 166.50), and attitude (F = 1.74), all in (p = 0.001). According to the results, this effect was stable over time for functional skills (F = 1.83) and knowledge (F = 18.04) all in (p < 0.05). Conclusion: Training programs can help improve skills, attitudes and knowledge in natural disaster volunteers. Researchers interested in the field of natural disaster relief, particularly health researchers, could consider further examining the aforementioned topics in their studies.

Basic life support training: Is student confidence enhanced by advanced levels of simulation?

BACKGROUND: Basic life support (BLS) is a mandatory skill for nurses. The confidence of the BLS provider should be enhanced by regular training. Traditionally, BLS training has used low-fidelity manikins, but more recent studies have suggested the use of high-fidelity manikins and alternative levels of simulation such as virtual reality. METHODS: A quasi-experimental study including 125 nursing students. Data on confidence levels in various elements of BLS were collected using pre-validated questionnaires and analysed using SPSSv23. RESULTS: The study revealed that high-fidelity simulation had a significant impact on the BLS learner's confidence levels. CONCLUSION: The study identified the importance of high-fidelity simulation in BLS training in preparing students for clinical practice. This highlights the need for further exploration of simulation technologies, such as virtual reality, to enable students to gain the knowledge, skills, confidence and competence required to enable safe and effective practice.

Early assessment of communicative competence in children with hearing loss using the Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE) method.

PURPOSE: This work presents a new frame-by-frame video analysis method called Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE), developed in the context of pediatric hearing loss as a rehabilitation tool for assessing children's early communication skills. CC-CARE stems from the commonly used Tait video analysis and extends it by including a new set of parameters aimed at disentangling between hearing-dependent and hearing-independent aspects of communication. METHOD: In this paper, we collected video samples of child-caregiver interactions in a group of 65 normal-hearing children and a group of 165 hearing-impaired children. For each group, we present the CC-CARE method and describe the parameters, their score distributions, correlations and we estimate the adherence of the CC-CARE scores with children's developmental trajectory. Moreover, we compare the results of CC-CARE scores between the two groups having had different development of the auditory system. Finally, a fully-data driven approach was employed to assess the consistency of the communicative efficacy index (CEI), a score aiming to capture a global result of the CC-CARE procedure. RESULTS: Correlations among parameter scores were found in each within-group analysis, revealing CC-CARE's internal consistency in measuring associated but nonoverlapping communication dimensions. For both groups, CC-CARE scores were associated with participants' age. Differences between scores emerged for a between-group analysis, indicating CC-CARE sensitivity to extract communication differences as a function of the hearing status. For both groups, the data analysis revealed that the CEI captures large variance portions across all parameter scores of the CC-CARE method. CONCLUSIONS: Results provide the first evidence that the CC-CARE video analysis method could be a reliable tool capable of highlighting the cascading effects of hearing impairment on children's preverbal communicative efficacy. The CC-CARE method aims to support early rehabilitation of hearing loss by describing a child's communicative efficacy.

Mapping skills between symbols and quantities in preschoolers: The role of finger patterns.

Mapping skills between different codes to represent numerical information, such as number symbols (i.e., verbal number words and written digits) and non-symbolic quantities, are important in the development of the concept of number. The aim of the current study is to investigate children's mapping skills by incorporating another numerical code that emerges at early stages in development, finger patterns. Specifically, the study investigates (i) the order in which mapping skills develop and the association with young children's understanding of cardinality; and (ii) whether finger patterns are processed similarly to symbolic codes or rather as non-symbolic quantities. Preschool children (3-year-olds, N = 113, Mage = 40.8 months, SDage = 3.6 months; 4-year-olds, N = 103, Mage = 52.9 months, SDage = 3.4 months) both cardinality knowers and subset-knowers, were presented with twelve tasks that assessed the mappings between number words, Arabic digits, finger patterns, and quantities. The results showed that children's ability to map symbolic numbers precedes the understanding that such symbols reflect quantities, and that children recognize finger patterns above their cardinality knowledge, suggesting that finger patterns are symbolic in essence. RESEARCH HIGHLIGHTS: Children are more accurate in mapping between finger patterns and symbols (number words and Arabic digits) than in mapping finger patterns and quantities, indicating that fingers are processed holistically as symbolic codes. Children can map finger patterns to symbols above their corresponding cardinality level even in subset-knowers. Finger patterns may play a role in the process by which children learn to map symbols to quantities. Fingers patterns' use in the classroom context may be an adequate instructional and diagnostic tool.

The (dis)organization of leg ulcer care: A realist synthesis.

BACKGROUND: Venous leg ulcers affect 1.5% of the UK adult population. Leg ulcers are painful, can be malodourous and are associated with poor quality of life. Leg ulcers are predominantly cared for by nurses in the community. Frequently, patients receive suboptimal treatment through unwanted variations in care and simple ulcers deteriorate to become hard-to-heal wounds. It is important to understand the current UK system of care and how nurses and patients navigate through it. AIM: The aim of this paper was to understand how, when, for whom and in what context leg ulcers are cared for in the United Kingdom and specifically, the current system of care, the nurses' role and the patients' experience in this system of care. DESIGN: A realist synthesis of the literature was undertaken, reported following the RAMESES publication standards: Realist syntheses. DATA SOURCES: An iterative literature search was conducted across three recognized health collections from January 2010 to January 2022 that included descriptive studies as well as primary research. RESULTS: 73 papers were included. CONCLUSION: In the absence of UK national guidance that recommends how leg ulcer care is organized and delivered, care is commissioned locally, with variable outcomes. Patients with venous leg ulcers would like to be looked after by knowledgeable, skilled and confident nurses, in well-equipped and staffed clinics; nurses who have the ability to make clinical judgements to alter their treatment when necessary and are empowered to refer to specialist centres when further support is required. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This synthesis offers guidance to commissioners and providers to change how leg ulcer care is organized. PATIENT OR PUBLIC CONTRIBUTION: The views of a patient and public group was sought at each stage of the synthesis.

Social Skills and Reciprocal Behavior with a Virtual Player Among Children With and Without SLD/ADHD.

The study aimed to compare reciprocal behavior during interaction with a virtual-player in a computer game between children with typical development (TD) and children with specific-learning-disabilities (SLD) and/or with attention-deficit/hyperactivity disorder (ADHD), and to examine its correlation with social skills. A total of 120 children (43 SLD/ADHD, 77 TD) aged 9-11 years participated. Participants completed self-reported questionnaires focusing on social skills and reciprocity and played a computer game in which such social situations arose. Results indicated no difference between the groups in self-reported social skills or reciprocity. However, the children's actual reciprocal behavior during gameplay revealed different results: the SLD/ADHD group exhibited higher levels of selfish (helping others for personal gain) and lower levels of altruistic reciprocity (helping others for their benefit) compared to the TD group. Furthermore, a correlation was found between self-reported social skills and reciprocity, as well as with the reciprocal-patterns observed in the gameplay.

Unraveling the synergy: how organizational intelligence fuel soft skills and nurses' thriving: a cross-sectional study.

AIM: Investigate the influence of organizational intelligence on the development of soft skills and the overall thriving of nurses at Alexandria Main University Hospital in Egypt. DESIGN: A cross-sectional descriptive design following STROBE guidelines examined the relationship between organizational intelligence, soft skills, and nurses' thriving. METHODS AND TOOLS: Data were collected from 740 nurses working across critical care units using structured questionnaires. The questionnaires assessed organizational intelligence, soft skills, and thriving at work. Sociodemographic characteristics, including age, gender, education, and nursing experience, were also collected. Statistical analyses were used to analyze the data, including ANOVA, t-tests, Pearson correlation, and stepwise regression. RESULTS: The findings revealed nurses' positive perceptions of organizational culture and documentation skills. However, areas such as measures and rewards and staff relations and communication indicated opportunities for improvement. Nurses reported high vitality levels but needed more learning opportunities at work. Significant correlations were found between demographic variables, organizational intelligence, soft skills, and thriving. Organizational intelligence demonstrated a robust positive relationship with both soft skills and thriving. Age, gender, education, and experience significantly influenced nurses' soft skills and thriving. CONCLUSION: The study highlights the importance of organizational intelligence in enhancing nurses' professional capabilities and well-being. Addressing demographic factors and fostering a supportive work environment is crucial for optimizing nursing practice and organizational effectiveness. NURSING IMPLICATIONS: Insights from this study can inform targeted interventions and policy decisions to enhance nursing practice, organizational development, and healthcare outcomes in Egypt. Fostering organizational intelligence and soft skills among nurses can improve patient care, increase job satisfaction, and overall organizational success.

Shared Decision-Making at the Intersection of Disability, Culture, and Language Accessibility: An Educational Session for Medical Students.

Introduction: People with disabilities and those with non-English language preferences have worse health outcomes than their counterparts due to barriers to communication and poor continuity of care. As members of both groups, people who are Deaf users of American Sign Language have compounded health disparities. Provider discomfort with these specific demographics is a contributing factor, often stemming from insufficient training in medical programs. To help address these health disparities, we created a session on disability, language, and communication for undergraduate medical students. Methods: This 2-hour session was developed as a part of a 2020 curriculum shift for a total of 404 second-year medical student participants. We utilized a retrospective postsession survey to analyze learning objective achievement through a comparison of medians using the Wilcoxon signed rank test (α = .05) for the first 2 years of course implementation. Results: When assessing 158 students' self-perceived abilities to perform each of the learning objectives, students reported significantly higher confidence after the session compared to their retrospective presession confidence for all four learning objectives (ps < .001, respectively). Responses signifying learning objective achievement (scores of 4, probably yes, or 5, definitely yes), when averaged across the first 2 years of implementation, increased from 73% before the session to 98% after the session. Discussion: Our evaluation suggests medical students could benefit from increased educational initiatives on disability culture and health disparities caused by barriers to communication, to strengthen cultural humility, the delivery of health care, and, ultimately, health equity.

Framework proposal for Role-Playing Games as mental health intervention: the Critical Skills methodology.

Gamified interventions are an emerging approach in mental health treatment and prevention. Their positive effects on managing various clinical conditions stem from enhancing social skills. However, cost-effective options like Table-top Role-Playing Games (TTRPGs), which offer similar benefits to other game-based interventions, lack standardized methods for ensuring replicability. In this regard, the method outlined in this study endeavors, in a structured and guided manner drawing from the Consolidated Framework for Implementation Research (CFIR), to establish a six-step protocol for developing an intervention method utilizing TTRPGs. In all Steps, we aim to anchor ourselves in robust literature concerning social skills training (SST), cognitive behavioral therapy (CBT), and gamification comprehensively. Thus, the method presented encompasses the objectives of SST, the strategies of CBT, and the dynamics of gamification via TTRPGs. Furthermore, we demonstrate a possible application of the method to illustrate its feasibility. Ultimately, the final method is structured, evidence-based, easily applicable, cost-effective, and thus viable. Mental health professionals seeking a structured and instructional tool for protocol development will find support in the method proposed here.

[Psychosomatic medicine for patients with Meniere's disease]. / Psychosomatik bei an M. Menière Erkrankten.

BACKGROUND: Unpredictable attacks of vertigo with or without emesis, unilateral hearing loss, and tinnitus characterize the inner ear disorder that is classified as part of Meniere's disease (MD). While the pathological final stage with cochleovestibular hydrops seems to be certain as a component of MD, there are many uncertainties with respect to the multifactorial pathogenesis. It is certain that the disease can have effects in addition to the attack, which questions the treatment of things that were previously taken for granted. Persistent perceptual and postural dizziness [19] and reactive psychogenic dizziness [18] can occur, so that during the course of the disease, a mixed picture of organic and psychogenic dizziness can develop. In addition, there is an increased anxiety and depression comorbidity. The course, suffering, and experience of the disease depend essentially on the processing and the active acquisition of coping strategies as well as-also the medical-treatment of the patient(s), who in their distress seek and need a knowledgeable and reliable practitioner at their side. OBJECTIVE: The effects on the affected persons and suggestions for the most helpful treatment of Meniere's disease sufferers shall be described here in detail.

A Review of Transdiagnostic Mechanisms in Cognitive Behavior Therapy.

Cognitive behavior therapies (CBTs) are the gold standard treatment for many psychiatric conditions. However, relatively little is known about how CBTs work. By characterizing these mechanisms, researchers can ensure CBTs retain their potency across diagnoses and delivery contexts. We review 3 classes of putative mechanisms: CBT-specific skills (eg, cognitive restructuring, behavioral activation), transtheoretical mechanisms (eg, therapeutic alliance, treatment expectancies, self-efficacy beliefs), and psychopathological mechanisms (aversive reactivity, positive affect, attachment style). We point to future research within each class and emphasize the need for more intensive longitudinal designs to capture how each class of mechanisms interacts with the others to improve outcomes.

Examining Profiles of U.S. Children's Screen Time and Associations with Academic Skills.

Children's screen time (ST) increased in recent years, but investigations of the content and context (e.g., parental presence, and device type) of ST in predicting early academic skills remains understudied. In this study of 127 four- and five-year-olds, we examined whether the educational content and contextual information about children's ST from time diary interviews at age 4 predicted direct assessments of academic skills at age five. Cluster analyses detected three unique groups: Cluster One was "lowest ST and highest non-educational TV, with little parental presence," Cluster Two was "moderate ST and highest educational mobile devices, with moderate parental presence," and Cluster Three was "highest total ST and moderate educational ST and high parental presence." Children in Cluster Two scored significantly higher in literacy skills at age five than peers in Cluster One and Cluster Three. Children in Cluster One scored significantly higher in spatial skills compared to those in Cluster Three. No significant associations were detected between children's ST and number skills. Findings suggest that educational content and contextual features of ST combine in meaningful ways and appear to better predict children's literacy and spatial skills compared to variable-centered approaches. Methodological implications of this research and future directions are discussed.

It takes two: examining the dynamic nature of cooperative behavior in adolescents.

Cooperating with those around us is an important facet of functioning in modern-day society. Forming successful cooperative relationships requires trust, reciprocity, and other interpersonal skills that continue to develop during adolescence. This study examined the dynamic nature of how trust is formed and broken among 248 adolescents (Males = 110, M Age = 15.1 years) throughout an iterative cooperative task (i.e., the Trust Game) and the interindividual differences that alter the success of their relationships. In our study, adolescents from the same classroom were anonymously paired and played a 10-trial version of the Trust Game, which examines trust and reciprocity. We found that trust is formed in the first half of the game and decreases as the threat of defection nears in the last trial. As the game progressed, the relationship between trial number and investments on the subsequent trial was mediated by percent return (ab = -0.09, 95% CI = [-0.15, -0.02]). Importantly, this relationship was moderated by social skills (p = 0.003) and impulsivity (p = 0.001), such that increases in either were associated with decreased percent return and investments on future trials. Overall, we found that cooperation is an adaptive behavior which requires trust and reciprocity, and adolescents need to exhibit both of these behaviors to have fruitful interactions. These findings suggest that interventions to help students think about their partner's perspective and stress the longer-term nature of interactions with peers would foster successful cooperation in social situations.

Effects of on-site Supportive Communication Training (On-site SCT) on doctor-patient communication in oncology: Study protocol of a randomized, controlled mixed-methods trial.

BACKGROUND: The quality of communication in oncology significantly impacts patients' health outcomes, as poor communication increases the risk of unnecessary treatment, inadequate pain relief, higher anxiety levels, and acute hospitalizations. Additionally, ineffective communication skills training (CST) is associated with stress, low job satisfaction, and burnout among doctors working in oncology. While acknowledging the importance of effective communication, the specific features of successful CST remain uncertain. Role-play and recorded consultations with direct feedback appear promising for CST but may be time-consuming and face challenges in transferring acquired skills to clinical contexts. Our aim is to bridge this gap by proposing a novel approach: On-site Supportive Communication Training (On-site SCT). The concept integrates knowledge from previous studies but represents the first randomized controlled trial employing actual doctor-patient interactions during CST. METHODS: This randomized multicenter trial is conducted at three departments of oncology in Denmark. Doctors are randomized 1:1 to the intervention and control groups. The intervention group involves participation in three full days of On-site SCT facilitated by a trained psychologist. On-site SCT focuses on imparting communication techniques, establishing a reflective learning environment, and offering emotional support with a compassionate mindset. The primary endpoint is the change in percentage of items rated "excellent" by the patients in the validated 15-item questionnaire Communication Assessment Tool. The secondary endpoints are changes in doctors' ratings of self-efficacy in health communication, burnout, and job satisfaction measured by validated questionnaires. Qualitative interviews will be conducted with the doctors after the intervention to evaluate its relevance, feasibility, and working mechanisms. Doctors have been actively recruited during summer/autumn 2023. Baseline questionnaires from patients have been collected. Recruitment of new patients for evaluation questionnaires is scheduled for Q1-Q2 2024. DISCUSSION: This trial aims to quantify On-site SCT efficacy. If it significantly impacts patients/doctors, it can be a scalable CST concept for clinical practice. Additionally, qualitative interviews will reveal doctors' insight into the most comprehensible curriculum parts. TRIAL REGISTRATION: April 2023 - ClinicalTrials.gov (NCT05842083). April 2023 - The Research Ethics Committee at the University of Southern Denmark (23/19397).

The human factor and ergonomics in Patient Safety.

The human condition is linked to error in any activity that is performed, and the healthcare world is no exception. The origin of human error does not lie within the perversity of human nature, instead, it has its origins in latent failures in the healthcare environment and is a consequence of the processes and procedures applied. The science of the Human Factor deals with the application of knowledge to people (capabilities, characteristics and limitations), with the design and the management of the equipment they use and with the environments in which they work and the activities they carry out. Part of the Human Factor are the non-technical skills. These skills greatly influence people's behavior and, therefore, their performance and the quality of healthcare in a very complex socio-technical system.

Psychosocial Training Program for Lifeguards: A Pilot Study.

Research has highlighted the need for training lifeguards in psychosocial skills. Therefore, this study aims to analyze the effectiveness of a short 10-h training program encompassing dimensions associated with emotional management, focus of attention, interpersonal relationships, and lifeguard behavior, and its effects on their psychosocial skills. A total of 64 lifeguards with experience ranging from 1 to 25 years (M = 5.93, SD = 6.07), randomly divided into experimental and control groups, participated in this study. The d2 Test of Attention, the Social Intelligence Test of O'Sullivan and Guilford, and the MSCEIT Emotional Intelligence Test were used to assess psychosocial skills. A multivariate analysis of variance for repeated measures (2 × 3 (Group × Time) MANOVA) was performed to analyze the effects of the training program on psychosocial skills. The results revealed that the experimental group showed statistically significant improvements in focus of attention and emotional intelligence compared to the control group. However, it is worth noting that no statistically significant group interactions were observed for measures of social intelligence. Taken together, these results seem to highlight the importance of including psychosocial content in the general training of lifeguards.

A blocking and distance management staff training intervention for torso- and head-directed aggression.

Although decades of behavior-analytic studies have focused on decreasing the aggressive behavior of clients, relatively little research has been conducted on preventing injuries for the staff members who implement treatment plans. In this study, three direct-care staff members working with clients presenting with aggressive behavior were taught targeted blocking and distance management techniques designed to keep the clients safe while preventing injuries to the participants. Findings indicated that all staff members acquired the target skills in simulations, after which the skills for two participants generalized to the natural work environment.

Differences in the organization of the primary motor cortex in people with and without low back pain and associations with motor control and sensory tests.

Differences in organization of the primary motor cortex and altered trunk motor control (sensing, processing and motor output) have been reported in people with low back pain (LBP). Little is known to what extent these differences are related. We investigated differences in 1) organization of the primary motor cortex and 2) motor and sensory tests between people with and without LBP, and 3) investigated associations between the organization of the primary motor cortex and motor and sensory tests. We conducted a case-control study in people with (N=25) and without (N=25) LBP. The organization of the primary motor cortex (Center of Gravity (CoG) and Area of the cortical representation of trunk muscles) was assessed using neuronavigated transcranial magnetic stimulation, based on individual MRIs. Sensory tests (quantitative sensory testing, graphaesthesia, two-point discrimination threshold) and a motor test (spiral-tracking test) were assessed. Participants with LBP had a more lateral and lower location of the CoG and a higher temporal summation of pain. For all participants combined, better vibration test scores were associated with a more anterior, lateral, and lower CoG and a better two-point discrimination threshold was associated with a lower CoG. A small subset of variables showed significance. Although this aligns with the concept of altered organization of the primary motor cortex in LBP, there is no strong evidence of the association between altered organization of the primary motor cortex and motor and sensory test performance in LBP. Focusing on subgroup analyses regarding pain duration can be a topic for future research.

Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury.

Introduction: Low back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain. Methods: Twenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery. Results: DP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure). Discussion: Thus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles.