Neuroanatomical correlates of macrostructural receptive abilities in narrative discourse in unilateral left hemisphere stroke: A behavioural and voxel-based morphometry study.

BACKGROUND: Little is known about story retelling and comprehension abilities in groups with lower levels of education and socio-economic status (SES). A growing body of evidence suggests the role of an extended network supporting narrative comprehension, but few studies have been conducted in clinical populations, even less in developing countries. AIMS: To extend our knowledge of the impact of a stroke on macrostructural aspects of discourse processes, namely main and complementary information, in individuals with middle-low to low SES and low levels of education. Relationships were tested between the performance in story retell and comprehension and reading and writing habits (RWH). Also, the associations between retelling and comprehension measures and their structural grey matter (GM) correlates were explored. METHODS & PROCEDURES: A total of 17 adults with unilateral left hemisphere (LH) chronic ischaemic stroke without the presence of significant aphasia and 10 matched (age, education and SES) healthy controls (HC) participated in the study. Retell and comprehension tasks were performed after listening or reading narrative stories. Voxel-based morphometry (VBM) analysis was conducted on a subgroup of nine individuals with LH stroke and the 10 matched controls using structural magnetic resonance imaging (MRI). OUTCOMES & RESULTS: Retelling and comprehension abilities were not significantly different between LH and HC, nonetheless quantitively lower in LH. Exploratory correlations showed that retelling and comprehension abilities in both written and auditory modalities were correlated with naming abilities. At the neural level, written comprehension positively correlated with GM density of the LH, including areas in the temporal pole, superior and middle temporal gyrus as well as the orbitofrontal cortex, precentral and postcentral gyri. Auditory narrative comprehension was associated with GM density of the lingual gyrus in the right hemisphere. CONCLUSIONS & IMPLICATIONS: The present results suggest that retelling and comprehension of auditory and written narratives are relatively well-preserved in individuals with a LH stroke without significant aphasia, but poorer than in HC. The findings replicate previous studies conducted in groups with higher levels of education and SES both at the behavioural and neural levels. Considering that naming seems to be associated with narrative retell and comprehension in individuals with lower SES and education, this research provides evidence on the importance of pursuing further studies including larger samples with and without aphasia as well as with various SES and education levels. WHAT THIS PAPER ADDS: What is already known on this subject Story retell and comprehension of auditory and written discourse have been shown to be affected after stroke, but most studies have been conducted on individuals with middle to high SES and high educational levels. What this paper adds to existing knowledge The study reports on narrative retell and comprehension in both auditory and written modalities in groups of HC and individuals with LH brain damage, with low-to-middle SES and lower levels of education. What are the potential or actual clinical implications of this work? This study highlights the importance of taking into consideration the sociodemographic and RWH of patients when assessing discourse retell and comprehension in both auditory and written modalities. It also underlines the importance of including patients without significant aphasia following LH stroke to look at the effect of both stroke and aphasia on narrative comprehension and story retelling.

Adolescent hope in the context of nursing care: A scoping review.

PROBLEM: Hope is a multidimensional concept with a multidisciplinary approach in different areas of health intervention. From the perspective of the discipline of nursing, the concept of hope in the adolescent has been defined. However, its characterization is not consensually established but is necessary for nurses to be able to plan interventions aimed at its promotion. This scoping review aims at mapping the existing knowledge about adolescent's hope in the context of nursing care and contributing to the improvement of nursing interventions. ELIGIBILITY CRITERIA: The review was conducted using Joanna Biggs Institute methodology, and was conducted in Pubmed, Cinahl, Scielo, Ebscohost, Open Grey, Mednar, Worldwidescience, and Science Direct. Inclusion criteria included quantitative, qualitative, or mixed studies as well as systematic reviews and opinion articles, published in Portuguese or English, without publication date limitation, with "adolescents" as the population, "hope" as a concept, and "nursing" as context. Overall studies quality was quite high. The extraction of relevant information from each selected article was summarized in a table that is publicly available at Open Science Framework. SAMPLE: A total of 1259 articles were identified by title and 1220 were excluded by abstract.25 empirical articles met the inclusion criteria. RESULTS: The concept of hope in this population was associated with other concepts such as resilience or well-being. Nursing interventions increase hope with positive outcomes in healthy or with chronic/complex diseases adolescents. CONCLUSION: Hope is an essential component of nursing care for healthy, with chronic or complex disease adolescents with increased interest in the scientific community. IMPLICATIONS: This review recommends orientations for the nursing process with a central focus in address human responses, nursing interventions, and the results of those interventions.

The experience of school-aged children with hospitalisation.

AIMS AND OBJECTIVES: This study intended to contribute to the improvement of nursing care for both children and their parents and aimed to identify the best and worst experiences of school-aged children during hospitalisation. BACKGROUND: Child hospitalisation has traditionally been studied from the parent's perspective, but studies in which the child is the subject are scarce and mainly focus on to the hospitalisation experiences. DESIGN: A cross-sectional, observational and descriptive exploratory design was used, and STROBE reporting guidelines were followed. METHODS: A paper survey was applied by the primary researcher within a 3 months period to 252 children. It presented two open-ended statements: 'In my opinion the best thing about the hospital is …' and 'In my opinion the worst thing about the hospital is…'. The study was submitted and approved by the national data protection commission and also by the ethics committees of each of the six institutions where the study was undertaken. Informed consent was also obtained from children and parents. RESULTS: Answers were analysed through content analysis. Five categories were identified for each of the open-ended statements. Children identified 'people', 'physical environment', 'activities', 'outcomes' and 'food' as best experiences. The worst experiences included: 'feelings', 'activities', 'food', 'environment' and 'outcomes'. CONCLUSIONS: The results allowed the identification of the children's most valued aspects of hospitalisation. RELEVANCE TO CLINICAL PRACTICE: The results should be considered by healthcare professionals in order to make the hospitalisation experience more positive from the perspective of the school-aged children.

Nursing care satisfaction from school-aged children's perspective: An integrative review.

AIM: This integrative review synthesizes the current knowledge on school-aged children's satisfaction with nursing care in acute care settings. BACKGROUND: Children identify aspects of nursing care that are not valued by their parents. This fact confirms the relevance of properly assessing children's satisfaction. DESIGN: An integrative review was performed. DATA SOURCES: A search for empirical studies was carried out in databases using the following search terms: satisfaction AND views OR opinions OR perceptions AND child AND nurs*. REVIEW METHODS: The search was limited to full-text studies involving children from 6 to 12 years old, written in English or Portuguese, and published between 1 January 2000 and 31 August 2016. Twenty qualitative studies and three quantitative studies were included for revision and were analysed by two independent reviewers. RESULTS: Three themes emerged: expectations of nursing care, experiences with care, and suggested strategies. Expectations and experiences allowed us to identify work within three main domains: personal domain (nurses' characteristics), professional domain (nurses' activities), and environmental domain (interaction between nurses and the environment). CONCLUSION: It is important to recognize children's rights to express their opinions about the nursing care they receive. Evaluation of both patients' and children's satisfaction should be systematically performed.

Interoception in Autism: A Narrative Review of Behavioral and Neurobiological Data.

While exteroceptive sensory processing is a hallmark of autism spectrum disorder, how interoceptive processing may impact and contribute to symptomatology remains unclear. In this comprehensive narrative review on interoception in autism, we discuss: 1) difficulties with assessing interoception; 2) potential interoceptive differences; 3) interactions between neural systems for interoception, attention, sensorimotor processing, and cognition; and 4) potential differences in neural circuits involved in interoception. In general, there are mixed findings on potential interoception differences in autism. Nevertheless, some data indicate differences in integration of interoceptive and exteroceptive information may contribute to autism symptomatology. Neurologically, interoceptive processing in autism may be impacted by potential differences in the development, morphometry, and connectivity of key interoceptive hubs (vagal processing, brainstem, thalamus, insula), though much work is needed on this topic.

Coping strategies and social support in nursing students during clinical practice: A scoping review.

AIM: To identify the coping strategies and social support received by nursing students during clinical practice. DESIGN: Scoping review. METHODS: Primary studies on coping strategies and social support, in full text, in English, French, Spanish or Portuguese and published in 2018 or later were included. Search was carried out in January 2023 on EBSCOhost, PubMed, SciELO, ScienceDirect, OpenAIRE, MedNar Search, WorldWideScience and the references of previously selected articles. RESULTS: A total of 24 studies were identified. Seven studies mentioned social support as a useful strategy and several instruments were identified that allow measurement. CONCLUSIONS: Few studies establish a direct relationship between the effectiveness of coping strategies with stressful situations. Positive coping strategies are associated with effective stress management. The relationship between social support and stress reduction is scarcely addressed. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Stressful situations can have an impact on students' health and on the quality of care. Nursing schools and healthcare institutions must work together in programmes to improve students coping abilities. IMPACT: This review addressed coping strategies used by nursing students during clinical practice. A set of relevant coping strategies were identified that can be used by teachers to improve students' outcomes. REPORTING METHOD: The review was performed according to Preferred Reporting Items for Scoping Reviews (PRISMA-ScR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Exploring Spoken Discourse and Its Neural Correlates in Women With Alzheimer's Disease With Low Levels of Education and Socioeconomic Status.

PURPOSE: Early impairments in spoken discourse abilities have been identified in Alzheimer's disease (AD). However, the impact of AD on spoken discourse and the associated neuroanatomical correlates have mainly been studied in populations with higher levels of education, although preliminary evidence seems to indicate that socioeconomic status (SES) and level of education have an impact on spoken discourse. The purpose of this study was to analyze microstructural variables in spoken discourse in people with AD with low-to-middle SES and low level of education and to study their association with gray matter (GM) density. METHOD: Nine women with AD and 10 matched (age, SES, and education) women without brain injury (WWBI) underwent a neuropsychological assessment, which included two spoken discourse tasks, and structural magnetic resonance imaging. Microstructural variables were extracted from the discourse samples using NILC-Metrix software. Brain density, measured by voxel-based morphometry, was compared between groups and then correlated with the differentiating microstructural variables. RESULTS: The AD group produced a lower diversity of verbal time moods and fewer words and sentences than WWBI but a greater diversity of pronouns, prepositions, and lexical richness. At the neural level, the AD group presented a lower GM density bilaterally in the hippocampus, the inferior temporal gyrus, and the anterior cingulate gyrus. Number of words and sentences produced were associated with GM density in the left parahippocampal gyrus, whereas the diversity of verbal moods was associated with the basal ganglia and the anterior cingulate gyrus bilaterally. CONCLUSIONS: The present findings are mainly consistent with previous studies conducted in groups with higher levels of SES and education, but they suggest that atrophy in the left inferior temporal gyrus could be critical in AD in populations with lower levels of SES and education. This research provides evidence on the importance of pursuing further studies including people with various SES and education levels. WHAT IS ALREADY KNOWN ON THIS SUBJECT: Spoken discourse has been shown to be affected in Alzheimer disease, but most studies have been conducted on individuals with middle-to-high SES and high educational levels. WHAT THIS STUDY ADDS: The study reports on microstructural measures of spoken discourse in groups of women in the early stage of AD and healthy women, with low-to-middle SES and lower levels of education. CLINICAL IMPLICATIONS OF THIS STUDY: This study highlights the importance of taking into consideration the SES and education level in spoken discourse analysis and in investigating the neural correlates of AD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24905046.

Cortisol dynamics in undergraduate nursing students during clinical practice: protocol for an exploratory cross-sectional study.

INTRODUCTION: This paper presents a protocol for the Investigation of Cortisol Dynamics in Undergraduate Nursing Students, a funded project aiming to understand the fluctuations in anxiety and salivary cortisol levels due to clinical setting changes and the anxiety associated with clinical practice. METHODS AND ANALYSIS: This study is an exploratory, cross-sectional, observational study that will be conducted at a health and science school in Portugal. Data collection will involve phycological assessment instruments for personality, anxiety, stress, depression and saliva cortisol levels. The target population consists of undergraduate nursing students enrolled in our institution for the academic year of 2022/2023 (N=272), of whom we aim to recruit 35% (N=96) to the study. ETHICS AND DISSEMINATION: The project obtained approval from the Institutional Review Board of the Egas Moniz-Cooperativa de Ensino Superior, CRL, on 5 July 2022 (ID: 116/21.22) and ethical approval from the Egas Moniz Ethics Committee on 28 July 2022 (ID:1110.22). Informed consent will be obtained from those who wish to participate, ensuring students' voluntary participation in the project. The results of this study will be disseminated through open-access peer-reviewed publications and presented at scientific events.

The relationship between alexithymia, interoception, and neural functional connectivity during facial expression processing in autism spectrum disorder.

Neural processing differences of emotional facial expressions, while common in autism spectrum disorder (ASD), may be related to co-occurring alexithymia and interoceptive processing differences rather than autism per se. Here, we investigate relationships between alexithymia, interoceptive awareness of emotions, and functional connectivity during observation of facial expressions in youth (aged 8-17) with ASD (n = 28) compared to typically developing peers (TD; n = 37). Behaviorally, we found no significant differences between ASD and TD groups in interoceptive awareness of emotions, though alexithymia severity was significantly higher in the ASD group. In the ASD group, increased alexithymia was significantly correlated with lower interoceptive sensation felt during emotion. Using psycho-physiological interaction (PPI) analysis, the ASD group showed higher functional connectivity between the left ventral anterior insula and the left lateral prefrontal cortex than the TD group when viewing facial expressions. Further, alexithymia was associated with reduced left anterior insula-right precuneus connectivity and reduced right dorsal anterior insula-left ventral anterior insula connectivity when viewing facial expressions. In the ASD group, the degree of interoceptive sensation felt during emotion was positively correlated with left ventral anterior insula-right IFG connectivity when viewing facial expressions. However, across all participants, neither alexithymia nor interoceptive awareness of emotions predicted connectivity between emotion-related brain regions when viewing emotional facial expressions. To summarize, we found that in ASD compared to TD: 1) there is stronger connectivity between the insula and lateral prefrontal cortex; and 2) differences in interhemispheric and within left hemisphere connectivity between the insula and other emotion-related brain regions are related to individual differences in interoceptive processing and alexithymia. These results highlight complex relationships between alexithymia, interoception, and brain processing in ASD.

[Participated observation of nursing child health consultation]. / Observação participada da consulta de enfermagem de saúde infantil.

Situation diagnosis using exploratory and descriptive scientific methodology (participant observation with descriptive statistical treatment) in order to identify nursing' practices in the area of health promotion during a nursing child health consultation. The 31 consultations observed (n = 31) showed that the majority of observations occurred in children younger than 2 years being the most discussed topic feed with predominant use of expository methodology. There was also little use of informational support and when used relate to the themes of security and nutrition. Most providers raised questions and there was limited registration of the interaction between provider and child with an expenditure averaging of 23 minutes per consultation. Given the results and reflecting about them stands out as intervention the construction of a health promotion manual with the integration of theory and evidence of good practice in this area.

Instruments to evaluate hospitalised children parents' satisfaction with nursing care: a scoping review.

AIM: To identify instruments that allow the evaluation of parent's satisfaction regarding nursing care during their child hospitalisation. METHODS: A review was performed using Preferred Reporting Items for Scoping Reviews. The study was prospectively registered in Open Science Framework. Research was carried out on EBSCOhost, PubMed, SciELO, Web of Science and ScienceDirect platforms as well as grey literature. Additionally, the references of selected articles were also examined. RESULTS: A sample of 65 articles allowed the identifications of 38 distinctive instruments to evaluate parents' satisfaction in different hospital settings. Most studies were applied in paediatric wards (n=28), followed by neonatal intensive care units (n=21), paediatric intensive care units (n=9) and emergency departments (n=7). Sample size ranged from 13 to 3354 and 3 studies used mixed methods, 20 were methodological studies of instruments construction or validation and 43 were quantitative studies. 21 different instruments previously existent were found. In 3 studies, adapted instruments were used and, in 14 studies, structured instruments were purposively designed for the study. Instruments had between 1 and 13 domains and total number of items ranged between 13 and 92. Most studies assessed overall satisfaction (n=53) and instrument reliability (n=49) and/or validity (n=37). CONCLUSION: Most instruments consider nursing care as a domain of satisfaction. Only two instruments focused specifically on nursing care. In most of the studies, there was a concern to evaluate instruments psychometric properties. This review clearly shows that there is still a gap in the literature on the range of aspects that influence satisfaction and a lack of consensus on ideal conditions for instrument use and application.

On "Parents' Experiences With a Model of Integrated Maternity and Neonatal Care Designed to Empower Parents".

The idea of intervening with the family as a whole using an integrated model of care is an important goal for practice and future research.

Use of Digital Educational Technologies among Nursing Students and Teachers: An Exploratory Study.

The emergence of digital educational technologies (DET) raises questions regarding the personalization of both teaching and care. DET use implies profound changes with consequences in nursing care and in nursing teaching-learning process. With the purpose of contributing to the improvement of the teaching-learning process through the use of DET, an exploratory-descriptive, cross-sectional, and observational study, with a quantitative approach (descriptive and inferential statistics), was developed. Online questionnaires were applied (n = 140 students and n = 23 teachers) after ethics committee approval. Results point to low cost and access without time/space limits as the main benefits, and decreased interaction, less physical contact, and technical difficulties as constraints. Globally, there was no difference between students and teachers in the use of DET. Still, men report more constraints than women. In this sample, the use of DET is still at an early stage. Both students and teachers are still unfamiliar with the scope and possibilities of these tools, not taking full advantage of the potential they have to offer. The impact of DET used in personalized nursing care is still yet to be understood.

Interventions to Promote a Healthy Sexuality among School Adolescents: A Scoping Review.

Schools are particularly suitable contexts for the implementation of interventions focused on adolescent sexual behavior. Sexual education and promotion have a multidisciplinary nature. Nurses' role and the spectrum of the carried-out interventions is not clear. We aimed to identify interventions that promote a healthy sexuality among school adolescents. Our review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and was registered in the Open Science Framework. Published articles on sexuality in adolescents in school contexts were considered. The research limitations included primary studies; access in full text in English, Spanish, or Portuguese; and no data publication limitation. Research was carried out on the EBSCOhost, PubMed, SciELO, and Web of Science platforms; gray literature and the bibliographies of selected articles were also searched. A total of 56 studies were included in the sample. The studies used a broad range of research methods, and 10 types of interventions were identified. Multi-interventional programs and socio-emotional interventions showed a greater impact on long-term behavioral changes, and continuity seemed to be a key factor. Long-term studies are needed to reach a consensus on the effectiveness of interventions. Nurses' particular role on the multidisciplinary teams was found to be a gap in the research, and must be further explored.

Theoretical nursing conceptions in hospitalized child care: scoping review.

OBJECTIVE: Identify the theoretical concepts that have been used in the context of nursing care for hospitalized children. METHODS: Scoping review was carried out according to the PRISMA-ScR methodology. The research limitations included: primary studies dealing with the use of theoretical concepts of nursing in the provision of care to hospitalized children, access in full text, in Portuguese or English and published between 2000 and 2019. Research was carried out on grassroots platforms (EBSCOhost, PubMed, SciELO and Web of Science), gray literature and in the bibliography of selected articles. RESULTS: 21 studies were found and 10 theoretical conceptions of nursing were identified, with family-centered care being the most used. FINAL CONSIDERATIONS: The variability of the identified theoretical conceptions is emphasized, with no evidence to support the use of one in detriment of the other. A more integrative theoretical conception, which adds care centered both on the family and the child, emerges as a research trend.

Neuroanatomical Correlates of Macrolinguistic Aspects in Narrative Discourse in Unilateral Left and Right Hemisphere Stroke: A Voxel-Based Morphometry Study.

Background A growing body of literature has demonstrated the importance of discourse assessment in patients who suffered from brain injury, both in the left and right hemispheres, as discourse represents a key component of functional communication. However, little is known about the relationship between gray matter density and macrolinguistic processing. Purpose This study aimed to investigate this relationship in a group of participants with middle-low to low socioeconomic status. Method Twenty adults with unilateral left hemisphere (n = 10) or right hemisphere (n = 10) chronic ischemic stroke and 10 matched (age, education, and socioeconomic status) healthy controls produced three oral narratives based on sequential scenes. Voxel-based morphometry analysis was conducted using structural magnetic resonance imaging. Results Compared to healthy controls, the left hemisphere group showed cohesion impairments, whereas the right hemisphere group showed impairments in coherence and in producing macropropositions. Cohesion positively correlated with gray matter density in the right primary sensory area (PSA)/precentral gyrus and the pars opercularis. Coherence, narrativity, and index of lexical informativeness were positively associated with the left PSA/insula and the superior temporal gyrus. Macropropositions were mostly related to the left PSA/insula and superior temporal gyrus, left cingulate, and right primary motor area/insula. Discussion Overall, the present results suggest that both hemispheres are implicated in macrolinguistic processes in narrative discourse. Further studies including larger samples and with various socioeconomic status should be conducted. Supplemental Material https://doi.org/10.23641/asha.14347550.