Aus Klinik und Praxis / From Clinic and Practice. Autismus in der systemischen Gruppenpsychotherapie: "Gemeinsam Stark" ein Versorgungsmodell für Kinder- und Jugendliche aus der Praxis / Autism in Systemic Group Psychotherapy: "Strong Together" a Care Model for Children and Adolescents from Practice.

Autism in Systemic Group Psychotherapy: "Strong Together" a Care Model for Children and Adolescents from Practice Awareness of people with autism in our society is constantly increasing. Nevertheless, ambiguities and caution in dealing with autistic clients are still tangible. Due to the growing demand, there is a shortage of care for clients on the autism spectrum. This applies in particular to group therapy services in German-speaking countries. However, the international AWMF guidelines state that group therapy is the therapy method of choice for children and adolescents with autistic perception. In order to counteract this gap in care, this article presents a systemic group therapy for autistic people. It explains the extent to which the systemic approach in combination with a multimodal approach is a beneficial approach. It also highlights the importance of expanding the range of care services, interdisciplinary cooperation, and exchange. The compatibility of practice and research in systemic psychotherapy will be explained, teamwork in private practice will be emphasized, therapeutic experiences will be shared and an outlook on ongoing evaluation research will be presented.

Group Coordination Catalyzes Individual and Cultural Intelligence.

A large program of research has aimed to ground large-scale cultural phenomena in processes taking place within individual minds. For example, investigating whether individual agents equipped with the right social learning strategies can enable cumulative cultural evolution given long enough time horizons. However, this approach often omits the critical group-level processes that mediate between individual agents and multi-generational societies. Here, we argue that interacting groups are a necessary and explanatory level of analysis, linking individual and collective intelligence through two characteristic feedback loops. In the first loop, more sophisticated individual-level social learning mechanisms based on Theory of Mind facilitate group-level complementarity, allowing distributed knowledge to be compositionally recombined in groups; these group-level innovations, in turn, ease the cognitive load on individuals. In the second loop, societal-level processes of cumulative culture provide groups with new cognitive technologies, including shared language and conceptual abstractions, which set in motion new group-level processes to further coordinate, recombine, and innovate. Taken together, these cycles establish group-level interaction as a dual engine of intelligence, catalyzing both individual cognition and cumulative culture.

Prediction of patient cooperation before orthodontic treatment: Handwriting and artificial intelligence.

BACKGROUND: The purpose of this study was to compare the success of various convolutional neural network (CNN) models trained with handwriting samples in predicting patient cooperation. METHODS: A total of 237 (147 female and 90 male, mean age 14.94 ± 2.4) patients undergoing fixed orthodontic treatment were included in the study. In the 12th month of treatment, participants were divided into two groups based on the patient cooperation scale: cooperative or noncooperative. Then, for each patient, handwriting samples were obtained. Artificial neural network models were used to classify the patients as cooperative or noncooperative using the collected data. The accuracy, precision, recall, and F1-score values of nine different CNN models were compared. RESULTS: By overall success rate, InceptionResNetV2 (Accuracy: 72.0%, F1-score: 0.649) and NasNetMobil (Accuracy: 70.0%, F1-score: 0.417) were the two most effective CNN models. The two models with the lowest success rate were DenseNet121 (Accuracy: 59.0%, F1-score: 0.424) and ResNet50V2 (Accuracy: 46.0%, F1-score: 0.286). The success rates of the other five models were comparable. CONCLUSIONS: The artificial intelligence models trained with handwriting samples are not sufficiently accurate for clinical application in cooperation prediction.

Salmonella in the food chain within the Gulf Cooperation Council countries.

Infections caused by bacteria originating from tainted food sources are a widespread concern due to their large economic impact and detrimental effects on public health. We aimed to explore literature focusing on the presence of Salmonella in the food supply chains of Gulf Cooperation Council (GCC) countries and to provide an overview of available information concerning health-related issues and the status of salmonellosis in humans in GCC countries. The reviewed evidence underscored a gap in our comprehensive understanding of the prevalence of Salmonella in the food supply of GCC countries. Molecular characterization efforts to pinpoint the sources of Salmonella in these nations were limited. Surveys targeting Salmonella in the food supply of GCC countries have been infrequent. While qualitative data indicated the presence or absence of Salmonella, there was a noticeable lack of quantitative data detailing the actual quantities of these bacteria in chicken meat supplies across GCC countries. Although reports regarding Salmonella in animal-derived foods were common, the literature highlighted in this review emphasized the persistent challenge that Salmonella pose to food safety and public health in GCC countries. Addressing this issue requires concerted efforts to enhance surveillance, improve control measures, and promote greater awareness among stakeholders in the food supply chain.

Machine learning-based q-RASAR predictions of the bioconcentration factor of organic molecules estimated following the organisation for economic co-operation and development guideline 305.

In this study, we utilized an innovative quantitative read-across (RA) structure-activity relationship (q-RASAR) approach to predict the bioconcentration factor (BCF) values of a diverse range of organic compounds, based on a dataset of 575 compounds tested using Organisation for Economic Co-operation and Development Test Guideline 305 for bioaccumulation in fish. Initially, we constructed the q-RASAR model using the partial least squares regression method, yielding promising statistical results for the training set (R2 =0.71, Q2LOO=0.68, mean absolute error [MAE]training=0.54). The model was further validated using the test set (Q2F1=0.77, Q2F2=0.75, MAEtest=0.51). Subsequently, we explored the q-RASAR method using other regression-based supervised machine-learning algorithms, demonstrating favourable results for the training and test sets. All models exhibited R2 and Q2F1 values exceeding 0.7, Q2LOO values greater than 0.6, and low MAE values, indicating high model quality and predictive capability for new, unidentified chemical substances. These findings represent the significance of the RASAR method in enhancing predictivity for new unknown chemicals due to the incorporation of similarity functions in the RASAR descriptors, independent of a specific algorithm.

Burden of non-communicable diseases in Health Council of Gulf Cooperation (GCC) countries.

Objectives: This study was aimed at comparing deaths, years of potential life loss (YPLL), and economic loss due to nine non-communicable diseases (NCDs) among Health Council of Gulf Cooperation (GCC) countries. Methods: The number of deaths and life expectancy by age and sex in each country, obtained from the 2019 World Health Organization database, were used to calculate YPLL by disease and sex. Economic loss was estimated by combining the annual income adjusted for the present value multiplied by the YPLL for each disease by sex and country. Results: The nine NCDs were responsible for 152,854 deaths, 3 million YPLL, and 23.9 billion US$ economic loss in GCC countries. The most common cause of death was ischemic heart disease, which caused 82,232 deaths (54% of the total), 1.6 million YPLL (54% of the total), and a 12.8 billion US$ economic loss (53% of the total). The least common cause of death was lung cancer, which caused 1,960 deaths, 37,287 YPLL, and a 317.6 million US$ economic loss. KSA was the most affected country among all GCC countries in terms of deaths (68,027), YPLL (1.4 million), and economic loss (14.3 billion US$). Notably, KSA had 45%, 49%, and 60% of the entire region's deaths, YPLL, and economic loss, respectively. In contrast, Qatar was the least affected country in terms of deaths and YPLL, and Yemen was the least affected country in terms of economic loss. Conclusion: The burden of NCDs in GCC countries in terms of deaths, YPLL, and economic loss is substantial. Policymakers should pay greater attention to detecting, preventing, and controlling these NCDs and their risk factors.

When does antimicrobial resistance increase bacterial fitness? Effects of dosing, social interactions, and frequency dependence on the benefits of AmpC ß-lactamases in broth, biofilms, and a gut infection model.

One of the longstanding puzzles of antimicrobial resistance is why the frequency of resistance persists at intermediate levels. Theoretical explanations for the lack of fixation of resistance include cryptic costs of resistance or negative frequency-dependence but are seldom explored experimentally. ß-lactamases, which detoxify penicillin-related antibiotics, have well-characterized frequency-dependent dynamics driven by cheating and cooperation. However, bacterial physiology determines whether ß-lactamases are cooperative, and we know little about the sociality or fitness of ß-lactamase producers in infections. Moreover, media-based experiments constrain how we measure fitness and ignore important parameters such as infectivity and transmission among hosts. Here, we investigated the fitness effects of broad-spectrum AmpC ß-lactamases in Enterobacter cloacae in broth, biofilms, and gut infections in a model insect. We quantified frequency- and dose-dependent fitness using cefotaxime, a third-generation cephalosporin. We predicted that infection dynamics would be similar to those observed in biofilms, with social protection extending over a wide dose range. We found evidence for the sociality of ß-lactamases in all contexts with negative frequency-dependent selection, ensuring the persistence of wild-type bacteria, although cooperation was less prevalent in biofilms, contrary to predictions. While competitive fitness in gut infections and broth had similar dynamics, incorporating infectivity into measurements of fitness in infections significantly affected conclusions. Resistant bacteria had reduced infectivity, which limited the fitness benefits of resistance to infections challenged with low antibiotic doses and low initial frequencies of resistance. The fitness of resistant bacteria in more physiologically tolerant states (in biofilms, in infections) could be constrained by the presence of wild-type bacteria, high antibiotic doses, and limited availability of ß-lactamases. One conclusion is that increased tolerance of ß-lactams does not necessarily increase selection pressure for resistance. Overall, both cryptic fitness costs and frequency dependence curtailed the fitness benefits of resistance in this study.

Design and management considerations for the Kenya-Tanzania marine transboundary conservation area.

Although transboundary conservation areas (TCAs) are critical tools for protecting ecosystems and ecological processes that transcend national jurisdictions, they are challenging to create due to the differences in governance contexts and capacity and power dynamics among countries. Marine TCAs are also more difficult to enforce relative to terrestrial TCAs because most nations still treat oceans as open access. Current guidelines for TCA development and implementation also focus mostly on terrestrial TCAs, which are not practical for marine TCAs. Hence, we reviewed the challenges associated with the design and management of marine TCAs and devised analytical and practical approaches to support the application of spatial planning frameworks and adaptive governance mechanisms. We used the lessons from the review to examine the decisions made for the proposed marine TCA in the Kenya-Tanzania border region and created options and considerations to promote effective design and management processes. We found the obstacles to marine TCAs in general are related to issues of fit, particularly differences in environmental research capacity, socioeconomic contexts, and internal institutional arrangements. These included differences in knowledge and capacity for marine ecological research and conservation; ability to adjust and update data; differences in values, interests, and resource uses; conservation costs; jurisdictional differences; engagement of multiple levels of organization; and differences in legal bases and policy development processes. Understanding and reconciling these challenges during the TCA development process can help enhance meaningful discussions in the design of the TCA and cultivate the enabling conditions for collaborative governance across countries and within different levels of organization from national to local actors.

Consideraciones en el diseño y gestión del área marina de conservación transfronteriza en Kenia y Tanzania Resumen Aunque las áreas de conservación transfronterizas (ACT) son herramientas importantes para proteger los ecosistemas y los procesos ecológicos que trascienden la jurisdicción nacional, crearlas es un reto debido a la diferencia en los contextos de gobierno y la capacidad y las dinámicas de poder entre los países. Las ACT marinas también son más difíciles de ejecutar en relación a las terrestres porque la mayoría de los países todavía tratan al océano como de libre acceso. Los lineamientos actuales para el desarrollo e implementación de las ACT también se enfocan principalmente en las ACT terrestres, lo cual no es práctico para las ACT marinas. Por lo tanto, revisamos los retos asociados con el diseño y gestión de las ACT marinas y concebimos estrategias analíticas y prácticas para apoyar con la aplicación de los marcos de planeación espacial y los mecanismos de gobierno adaptativo. Usamos lo aprendido con la revisión para analizar las decisiones tomadas para la ACT marina propuesta en la región fronteriza de Kenia y Tanzania y creamos opciones y consideraciones para promover el diseño y procesos de manejo efectivos. Encontramos que los obstáculos para las ACT marinas en general se relacionan con temas de ajuste, en particular las diferencias en la capacidad de investigación ambiental, los contextos socioeconómicos y los acuerdos institucionales internos. Estos obstáculos incluyeron diferencias en el conocimiento y capacidad para la investigación ecológica marina; la habilidad para ajustar y actualizar datos; las diferencias en los valores, intereses y usos de los recursos; los costos de conservación; las diferencias jurídicas; la participación de varios niveles de organización; y las diferencias en las bases legales y los procesos de desarrollo de políticas. El entendimiento y reconciliación de estos retos durante el proceso de desarrollo de una ACT puede ayudar a mejorar las discusiones significativas en el diseño de la ACT y a cultivar las condiciones que permitan la gestión colaborativa entre los países y entre los diferentes niveles de organización, desde el nacional hasta los actores locales.

Montenegrin Digital Academic Innovation Hub: Experience in Supporting Digital Health Innovations.

Montenegrin Digital Academic Innovation Hub established within Erasmus+ project DigNEST is essential institutional support for developing innovations in the field of health in academic-business cooperation and partnership. Experience of 18 months in running Hub service provides preliminary results in analysis received innovation ideas, provided support and potentials/capacities in medical informatics advancements at national, regional and global level.

Hypnosis and nitrous oxide impact on the school aged patients' anxiety and cooperation candidate for tooth extraction: A randomized clinical trial.

Background: This randomized clinical trial (RCT) investigated whether hypnosis would lead to favorable outcomes in reducing anxiety, enhancing cooperation, and improving physiological responses in school-aged children undergoing tooth extraction compared to nitrous oxide/oxygen (N2O/O2) and conventional behavior guidance (CBG). Methods: Sixty-six school-aged children (mean age: 7.87 ± 1.18 years) who needed one posterior primary tooth extraction were included. Children with low-to-moderate anxiety were randomly divided into three groups (n = 22 each): hypnosis, N2O/O2, and CBG. Anxiety levels during and after anesthetic injection and tooth extraction were assessed using the Venham Clinical Anxiety Scale (VCAS) and the Venham Picture Test (VPT). Changes in heart rate (HR) and oxygen saturation (SpO2) were monitored. Children's cooperation levels were measured using the Venham Clinical Cooperation Scale (VCCS). Results: The VPT scores were significantly higher in the CBG group than in the N2O/O2 and hypnosis groups (p < 0.001). The VCAS scores in the N2O/O2 group were lower than those in the CBG group (p < 0.05) and were comparable to those in the hypnosis group. The VCCS scores were significantly higher in the CBG group than in the N2O/O2 and hypnosis groups (p < 0.05). HR changes in the N2O/O2 group were significantly lower than in the hypnosis and CBG groups (p < 0.05). No significant difference in pain was observed between the groups the day after the intervention. Conclusion: N2O/O2 inhalation and hypnosis are effective in reducing self-reported and observed anxiety and improving cooperation levels in pediatric patients during dental extraction. Moreover, the frequency of reported pain was lower in the hypnosis group compared to the other groups.

An academic cooperation between the Japan Sports Nutrition Association (JSNA) and the Korean Society for Exercise Nutrition (KSEN).

PURPOSE: The Japan Sports Nutrition Association (JSNA) is an academic society that aims to contribute to people's health and the development of sports in Japan. METHODS: After numerous communication and academic events, the JSNA and the Korean Society for Exercise Nutrition (KSEN) exchanged a Memorandum of Understanding (MoU) in 2018. RESULTS: Based on the MoU, the JSNA and KSEN organized academic exchange events until the Coronavirus Disease 2019 pandemic and subsequent travel restrictions and lockdowns. CONCLUSION: After four years of the pandemic and the downgrading of Coronavirus Disease 2019 infection risk, it is hoped that academic exchanges between the societies will resume gradually and enhance members' recognition of the cooperation between the JSNA and KSEN for active collaborations in the future.

Half a century of Japanese research on two Neglected Tropical Diseases (trypanosomiasis and leishmaniasis): Overseas scientific cooperation.

Trypanosoma and Leishmania species are responsible of a range of Neglected Tropical Diseases (NTDs) from disfiguring conditions to fatal processes in humans. Both genera also affect wild and domestic animals causing diseases of public health significance and high economic impact on farm economy of developing areas. Japan has been actively involved in overseas cooperation and the country has a large scientific community. However, there is no information on the scientific output of Japanese scientists and institutions on these two NTDs. To explore the Japanese contribution and its profile, we have mined Web of Science database from 1971 to 2022 the articles by Japanese scientists, scientific areas and institutions, time-related variations of these parameters, and involvement in cooperation activities with foreign scientists. Research on Trypanosoma has been present in all the studied period, with higher production, whereas Leishmania-related activities showed a delay. A steady increased of Japanese scientific output was found up to the beginning of 2000s, whereas a certain stagnation was found in the present century. Low growth rate of research output on these two NTDs by Japanese authors in the 21st century is not correlated neither to the pattern found globally nor the situation in other parasitic infections. Thus, other elements should be considered in future analysis including the actual number of scientists involved and the available funding. Reinforcement of research groups from Japanese institutions and widening the scope of collaborations, particularly with health and academic centers from endemic regions, could trigger the Japanese productivity in the research area.

Double-edged sword effects of sulfate reduction process in sulfur autotrophic denitrification system: Accelerating nitrogen removal and promoting antibiotic resistance genes spread.

This study proposed the double-edged sword effects of sulfate reduction process on nitrogen removal and antibiotic resistance genes (ARGs) transmission in sulfur autotrophic denitrification system. Excitation-emission matrix-parallel factor analysis identified the protein-like fraction in soluble microbial products as main endogenous organic matter driving the sulfate reduction process. The resultant sulfide tended to serve as bacterial modulators, augmenting electron transfer processes and mitigating oxidative stress, thereby enhancing sulfur oxidizing bacteria (SOB) activity, rather than extra electron donors. The cooperation between SOB and heterotroph (sulfate reducing bacteria (SRB) and heterotrophic denitrification bacteria (HDB)) were responsible for advanced nitrogen removal, facilitated by multiple metabolic pathways including denitrification, sulfur oxidation, and sulfate reduction. However, SRB and HDB were potential ARGs hosts and assimilatory sulfate reduction pathway positively contributed to ARGs spread. Overall, the sulfate reduction process in sulfur autotrophic denitrification system boosted nitrogen removal process, but also increased the risk of ARGs transmission.

Microbial culture collections: Stanley Morris Martin, the first international conference (Ottawa 1962), and beyond.

Culture collections originated in the 19th century, but it was not until 1962 that the first international conference was held at the National Research Council in Ottawa, Canada. Microbes-like epidemics-know no borders. Collectors were concerned with public health as well as science. For the 1962 meeting, 266 scientists came from 25 countries. They recommended a special section for collections within the International Association of Microbiological Societies. By 1970, it became the World Federation of Culture Collections, which still coordinates collections worldwide. Canadian microbiologist Stanley Morris Martin (1920-2007) who had handled local arrangements for the Ottawa meeting became the inaugural president, serving from 1970 to 1976. Originally an expert on enzymes, Martin embraced his role within the international network and championed peaceful uses of microbes and the establishment of collections in developing countries. But after his retirement, he seemed to disappear. Drawing upon scientific contributions, newspapers, and interviews, this article explores the conference, its programme, challenges, and legacy. It also tracks the long-forgotten career of Stanley Martin.

Children Sustain Cooperation in a Threshold Public-Goods Game Even When Seeing Others' Outcomes.

Many societal challenges are threshold dilemmas requiring people to cooperate to reach a threshold before group benefits can be reaped. Yet receiving feedback about others' outcomes relative to one's own (relative feedback) can undermine cooperation by focusing group members' attention on outperforming each other. We investigated the impact of relative feedback compared to individual feedback (only seeing one's own outcome) on cooperation in children from Germany and India (6- to 10-year-olds, N = 240). Using a threshold public-goods game with real water as a resource, we show that, although feedback had an effect, most groups sustained cooperation at high levels in both feedback conditions until the end of the game. Analyses of children's communication (14,374 codable utterances) revealed more references to social comparisons and more verbal efforts to coordinate in the relative-feedback condition. Thresholds can mitigate the most adverse effects of social comparisons by focusing attention on a common goal.

Do pet dogs reciprocate the receipt of food from familiar and unfamiliar conspecifics?

Reciprocity is one of the most prominent explanations for the evolution of stable cooperation. Although reciprocity has been studied for decades in numerous animal species and behavioural contexts, its underlying proximate mechanisms remain unclear. Domestic dogs provide a useful model species for the study of proximate mechanisms, though there are currently inconsistent findings regarding dogs' propensity to reciprocate. Here, we investigated whether, after minimal training, pet dogs would press a button, which remotely controlled a food dispenser, to deliver food to an enclosure occupied by a helpful conspecific that had provided them with food or an unhelpful conspecific that had not provided them with food. We included an asocial control condition in which the enclosure was unoccupied and a social facilitation control in which the food delivery mechanism was non-functional. Whether subjects were familiar with the helpful and unhelpful conspecifics was also varied. In addition, to investigate potential mechanisms underlying reciprocity, we measured subjects salivary oxytocin concentration before and after they experienced the helpful and unhelpful acts. There was no effect of the previous helpfulness or the familiarity of the partner on the number of times subjects pressed the button. However, there was also no effect of the presence of a partner or the operationality of the food delivery mechanism on the number of button presses, indicating that subjects were not pressing the button to provision the partner. Moreover, the experience of the helpful or unhelpful act did not influence subjects' salivary oxytocin concentration. Variation in findings of reciprocity across studies appears to correspond with differing training protocols. Subjects' understanding of the task in the current study may have been constrained by the limited training received. Additional tests to verify subjects' understanding of such tasks are warranted in future studies.

Reimagining the role of community health workers in SAARC countries.

Following the Alma Ata declaration, SAARC countries have established their workforce of community health workers (CHWs) to address primary healthcare needs. Initially focused on maternal and child health, the countries now confront a changing healthcare landscape characterized by noncommunicable diseases (NCDs), mental health issues, and surgical conditions. These developments have led to the emergence of specialized CHWs tasked with managing NCDs and mental health concerns, prompting a reevaluation of the balance between specialization and maintaining a generalist approach. The effectiveness of CHWs during crises hinges on critical factors such as standardized training, opportunities for career advancement, and equitable compensation. This viewpoint makes a call to introduce a specialist category of CHW to align with evolving healthcare requirements in SAARC countries.

Modular morals: Mapping the organization of the moral brain.

Is morality the product of multiple domain-specific psychological mechanisms, or one domain-general mechanism? Previous research suggests that morality consists of a range of solutions to the problems of cooperation recurrent in human social life. This theory of 'morality as cooperation' suggests that there are (at least) seven specific moral domains: family values, group loyalty, reciprocity, heroism, deference, fairness and property rights. However, it is unclear how these types of morality are implemented at the neuroanatomical level. The possibilities are that morality is (1) the product of multiple distinct domain-specific adaptations for cooperation, (2) the product of a single domain-general adaptation which learns a range of moral rules, or (3) the product of some combination of domain-specific and domain-general adaptations. To distinguish between these possibilities, we first conducted an anatomical likelihood estimation meta-analysis of previous studies investigating the relationship between these seven moral domains and neuroanatomy. This meta-analysis provided evidence for a combination of specific and general adaptations. Next, we investigated the relationship between the seven types of morality - as measured by the Morality as Cooperation Questionnaire (Relevance) - and grey matter volume in a large neuroimaging (n = 607) sample. No associations between moral values and grey matter volume survived whole-brain exploratory testing. We conclude that whatever combination of mechanisms are responsible for morality, either they are not neuroanatomically localised, or else their localisation is not manifested in grey matter volume. Future research should employ phylogenetically informed a priori predictions, as well as alternative measures of morality and of brain function.

Mutational cooperativity of RUNX1::RUNX1T1 isoform 9a and oncogenic NRAS in zebrafish myeloid leukaemia.

RUNX1::RUNX1T1 (R::RT1) acute myeloid leukaemia (AML) remains a clinical challenge, and further research is required to model and understand leukaemogenesis. Previous zebrafish R::RT1 models were hampered by embryonic lethality and low penetrance of the malignant phenotype. Here, we overcome this by developing an adult zebrafish model in which the human R::RT1 isoform 9a is co-expressed with the frequently co-occurring oncogenic NRASG12D mutation in haematopoietic stem and progenitor cells (HSPCs), using the Runx1+23 enhancer. Approximately 50% of F0 9a+NRASG12D transgenic zebrafish developed signs of haematological disease between 5 and 14 months, with 27% exhibiting AML-like pathology: myeloid precursor expansion, erythrocyte reduction, kidney marrow hypercellularity and the presence of blasts. Moreover, only 9a+NRASG12D transplant recipients developed leukaemia with high rates of mortality within 40 days, inferring the presence of leukaemia stem cells. These leukaemic features were rare or not observed in animals expressing either the NRAS or 9a oncogenes alone, suggesting 9a and NRAS cooperation drives leukaemogenesis. This novel adult AML zebrafish model provides a powerful new tool for investigating the basis of R::RT1 - NRAS cooperativity with the potential to uncover new therapeutic targets.

Examination tolerance, pre-examination anxiety, knowledge needs and cooperation in gastroscopic examinees: A prospective, correlational analysis in a health screening population.

AIM: To explore the correlations between examination tolerance and anxiety, knowledge needs and examination cooperation in sedation-free gastroscopy examinees. DESIGN: Cross-sectional survey using convenience sampling. METHODS: A total of 170 healthy adults who underwent sedation-free gastroenteroscopy were asked to complete a visual analogue scale (VAS) to rate their examination tolerance, the state anxiety questionnaire (S-AI), a newly designed knowledge needs questionnaire and a cooperation questionnaire. RESULTS: The VAS score was 4.47 ± 1.96, the state anxiety score was 39.46 ± 9.81, the total score for knowledge needs was 44.89 ± 11.02, and the average cooperation score was 2.47 ± 0.38. The VAS score during the examination positively correlated with the pretest state anxiety score and pretest knowledge needs score and negatively correlated with the examination cooperation score. The results of multiple linear regression analysis showed that after undergoing the examination for the first time, anxiety, body position and swallowing control were the main factors influencing the examination tolerance of sedation-free gastroscopy examinees. PATIENT OR PUBLIC CONTRIBUTION: We would like to thank the staff and patients of the participating hospital for their assistance and cooperation in performing the current study.