Striking Differences in Kendo Headgear.

BACKGROUND:  Kendo, a martial art developed by the samurai, is rooted deep in Japanese culture with traditional armor that has seen little change over the past centuries. Despite its century-old design, kendo helmets are manufactured without third-party testing to verify their quality and effectiveness against head trauma. OBJECTIVE: To evaluate the effectiveness of different helmet stitching patterns and padding materials in mitigating impact forces that could lead to sports-related concussions (SRC) in kendo, and to assess variations in safety performance across different genders and kendo ranks (Dan and Kyu). METHODS: We collected data from 10 kendo practitioners (six males and four females), analyzing over 4,000 strikes using shinai on a sensor-equipped mannequin. Various helmet stitching patterns (ranging from 2 mm to 9 mm) and padding types (polyurethane-based and different thicknesses of cotton-based pads) were tested under controlled conditions simulating realistic impacts encountered in kendo practice. RESULTS: The results indicated that helmets with wider stitching patterns (e.g. 8 mm and 9 mm) generally offered better energy absorption, exhibiting statistically significant lower mean g-forces with a 95% confidence interval compared to tighter patterns (2 mm, 4 mm, 6 mm, and 8 mm x 2 mm) (p < 0.001). Additionally, the polyurethane-based padding outperformed cotton-based padding by a statistically significant reduction of impact force (p < 0.001). Significant differences in striking force were also observed between genders and ranks, with male and higher-rank (Dan) practitioners delivering stronger impacts (both p < 0.001). CONCLUSIONS: This study highlights the critical influence of helmet stitching patterns and padding materials on the protective capabilities against concussions in kendo. Even though helmets with narrower stitching patterns cost more, helmets with wider stitching patterns and polyurethane padding material provide enhanced safety benefits. We do not know how the difference in striking force between genders and ranks affects the outcome of a kendo match.

Cost-effectiveness analysis of the pediatric 20-valent pneumococcal conjugate vaccine compared with lower-valent alternatives in Argentina.

OBJECTIVES: The 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for infants in Argentina's national immunization program (NIP) in a 2 + 1 schedule since 2012. Licensure of the 15-valent vaccine (PCV15) is anticipated soon, and the 20-valent vaccine (PCV20) recently received regulatory approval. This cost-effectiveness analysis examined the public health and economic implications of transitioning from PCV13 to either PCV15 or PCV20 in Argentina's pediatric NIP. METHODS: A decision-analytic Markov model was used with a 10-year time horizon and a 3.0% annual discount rate for costs and benefits. Vaccine effectiveness estimates were derived from Argentinian surveillance data, PCV13 clinical effectiveness and impact studies, and PCV7 efficacy studies. Population, epidemiologic, and economic inputs were obtained from literature and Argentinian-specific data. The study adopted a healthcare system perspective; sensitivity and scenario analyses were conducted to assess input parameters and structural uncertainty. RESULTS: Compared with PCV13, PCV20 was estimated to avert an additional 7,378, 42,884, and 172,389 cases of invasive pneumococcal disease (IPD), all-cause pneumonia, and all-cause otitis media (OM), respectively, as well as 3,308 deaths, resulting in savings of United States Dollars (USD) 50,973,962 in direct medical costs. Compared with PCV15, PCV20 was also estimated to have greater benefit, averting an additional 6,140, 35,258, and 142,366 cases of IPD, pneumonia, and OM, respectively, as well as 2,624 deaths, resulting in savings of USD 37,697,868 in direct medical costs. PCV20 was associated with a higher quality-adjusted life year gain and a lower cost (i.e., dominance) versus both PCV13 and PCV15. Results remained robust in sensitivity analyses and scenario assessments. CONCLUSION: Over a 10-year horizon, vaccination with PCV20 was expected to be the dominant, cost-saving strategy versus PCV13 and PCV15 in children in Argentina. Policymakers should consider the PCV20 vaccination strategy to achieve the greatest clinical and economic benefit compared with lower-valent options.

A Systematic Review of Modeling Approaches to Evaluate Treatments for Relapsed Refractory Multiple Myeloma: Critical Review and Considerations for Future Health Economic Models.

BACKGROUND AND OBJECTIVE: Multiple myeloma is a rare incurable hematological cancer in which most patients relapse or become refractory to treatment. This systematic literature review aimed to critically review the existing economic models used in economic evaluations of systemic treatments for relapsed/refractory multiple myeloma and to summarize how the models addressed differences in the line of therapy and exposure to prior treatment. METHODS: Following a pre-approved protocol, literature searches were conducted on 17 February, 2023, in relevant databases for models published since 2014. Additionally, key health technology assessment agency websites were manually searched for models published as part of submission dossiers since 2018. Reported information related to model conceptualization, structure, uncertainty, validation, and transparency were extracted into a pre-defined extraction sheet. RESULTS: In total, 49 models assessing a wide range of interventions across multiple lines of therapy were included. Only five models specific to heavily pre-treated patients and/or those who were refractory to multiple treatment classes were identified. Most models followed a conventional simple methodology, such as partitioned survival (n = 28) or Markov models (n = 9). All included models evaluated specific interventions rather than the whole treatment sequence. Where subsequent therapies were included in the model, these were generally only considered from a cost and resource use perspective. The models generally used overall and progression-free survival as model inputs, although data were often immature. Sensitivity analyses were frequently reported (n = 41) whereas validation was only considered in less than half (n = 19) of the models. CONCLUSIONS: Published economic models in relapsed/refractory multiple myeloma rarely followed an individual patient approach, mainly owing to the higher need for complex data assumptions compared with simpler modeling approaches. As many patients experience disease progression on multiple treatment lines, there is a growing need for modeling complex treatment strategies, leading to more sophisticated approaches in the future. Maintaining transparency, high reporting standards, and thorough analyses of uncertainty are crucial to support these advancements.

Medical Error Prevalence, Nursing Power, and Structural Empowerment: A Serial Mediation Analysis.

Aim: To investigate how structural empowerment and power may contribute to and predict the reduction of medical errors. Background: Medical errors threaten patient well-being, leading to adverse outcomes. Improving work conditions holds promise for reducing medical errors among nurses. Methods: A multisite correlational cross-sectional design was utilized. Data were completed by 375 nurses from four hospitals in Jordan. Data collection occurred between September and November 2023 using sociodemographic, structural empowerment, and medical error questionnaires. The study employed descriptive statistics, Pearson r correlation, and serial mediation analysis. Informed consent was obtained from each participant. Results: Pearson r correlation revealed significant negative correlations between medical error and structural empowerment, formal power, and informal power. The conceptual framework was significant and predicted 16% of the variance in medical errors. The mediation analysis confirmed that formal power and informal power mediate the relationship between structural empowerment and medical error. Conclusions and Implications. This study sheds light on the intricate connection of structural empowerment, formal and informal power, and their collective impact on reducing medical errors. Understanding and addressing these dynamics allows nurses and administrators to achieve a culture of patient safety. Reduction of medical errors is paramount to a safe healthcare environment that prioritizes patient outcomes. Strategies should be fostered to enhance structural empowerment, refine formal power structures, and leverage the positive aspects of informal networks.

Self-Medication and its Associated Factors among University Students: A Cross-Sectional Study.

Background: Self-medication is a global concern among professionals and non-professionals, with a rapid increase in prevalence. The study aims to assess the prevalence of self-medication and its associated factors among university students. Materials and Methods: A cross-sectional, descriptive study was conducted in three universities, and a total of 817 college students participated in this study. Results: About 75.40% of the participants reported using medications without a professional prescription. The category of analgesics was the most commonly used in self-medication (82.80%), while the most common symptom was a headache (81.50%). Almost 74.10% percent of participants who have practiced self-medication stated that the reason was the "lack of time to consult a physician." Most participants who have used self-medication (90.30%) stated that the source of knowledge was "previous prescription." Conclusions: Health education programs concerning self-mediation should be held in university settings to improve attitudes and practices toward self-mediation.

Cost-effectiveness of PCV20 to Prevent Pneumococcal Disease in the Pediatric Population: A German Societal Perspective Analysis.

INTRODUCTION: Since 2009, a pneumococcal conjugate vaccine (PCV) covering 13 serotypes (PCV13) has been included by Germany's Standing Committee on Vaccinations for infants, resulting in major reductions in pneumococcal disease (PD). Higher-valent vaccines may further reduce PD burden. This cost-effectiveness analysis compared 20-valent PCV (PCV20) under a 3+1 schedule with 15-valent PCV (PCV15) and PCV13, both under 2+1 schedule, in Germany's pediatric population. METHODS: A Markov model with annual cycles over a 10-year time horizon was adapted to simulate the clinical and economic impact of pediatric vaccination with PCV20 versus lower-valent PCVs in Germany. The model used PCV13 clinical effectiveness and impact studies as well as PCV7 efficacy studies for vaccine direct and indirect effect estimates. Epidemiologic, utility, and medical cost inputs were obtained from published sources. Benefits and costs were discounted at 3% from a German societal perspective. Outcomes included PD cases, deaths, costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). RESULTS: In the base case, PCV20 provided greater health benefits than PCV13, averting more cases of invasive pneumococcal disease (IPD; 15,301), hospitalized and non-hospitalized pneumonia (460,197 and 472,365, respectively), otitis media (531,634), and 59,265 deaths over 10 years. This resulted in 904,854 additional QALYs and a total cost saving of €2,393,263,611, making PCV20 a dominant strategy compared with PCV13. Compared to PCV15, PCV20 was estimated to avert an additional 11,334 IPD, 704,948 pneumonia, and 441,643 otitis media cases, as well as 41,596 deaths. PCV20 was associated with a higher QALY gain and lower cost (i.e., dominance) compared with PCV15. The robustness of the results was confirmed through scenario analyses as well as deterministic and probabilistic sensitivity analyses. CONCLUSION: PCV20 3+1 dominated both PCV13 2+1 and PCV15 2+1 over 10 years. Replacing lower-valent PCVs with PCV20 would result in greater clinical and economic benefits, given PCV20's broader serotype coverage.

Pneumococcal diseases (e.g., ear infections, pneumonia, bloodstream infections) are among the leading causes of illness and death in children worldwide. The pneumococcal conjugate vaccine protects against pneumococcal diseases and has significantly reduced the number of newly diagnosed cases. Higher-valent vaccines (which provide coverage for a greater number of disease-causing serotypes) have recently received European Commission approval for use in adults and  children. This study examined costs and health benefits associated with the 20-valent pneumococcal conjugate vaccine (PCV20) under a 3+1 (i.e., three primary doses and one booster dose) schedule in Germany's childhood vaccination program compared with 13-valent pneumococcal conjugate vaccine (PCV13) and the 15-valent pneumococcal conjugate vaccine (PCV15), both under a 2+1 (two primary doses, one booster) schedule. PCV20 was estimated to result in greater health benefits from avoiding more cases in pneumococcal diseases and lower costs compared with both PCV13 and PCV15. PCV20, therefore, is considered the best option among the three vaccines for children in Germany.

Incorporating solvent effects in DFT: insights from cation exchange in faujasites.

Zeolites are versatile materials renowned for their extra-framework cation exchange capabilities, with applications spanning diverse fields, including nuclear waste treatment. While detailed experimental characterization offers valuable insight, density functional theory (DFT) proves particularly adept at investigating ion exchange in zeolites, owing to its atomic and electronic resolution. However, the prevalent occurrence of zeolitic ion exchange in aqueous environments poses a challenge to conventional DFT modeling, traditionally conducted in a vacuum. This study seeks to enhance zeolite modeling by systematically evaluating predictive differences across varying degrees of aqueous solvent inclusion. Specifically focusing on monovalent cation exchange in Na-X zeolites, we explore diverse modeling approaches. These range from simple dehydrated systems (representing bare reference states in vacuum) to more sophisticated models that incorporate aqueous solvent effects through explicit water molecules and/or a dielectric medium. Through comparative analysis of DFT and semi-empirical DFT approaches, along with their validation against experimental results, our findings underscore the necessity to concurrently consider explicit and implicit solvent effects for accurate prediction of zeolitic ionic exchange.

Friends or Foes: Fundamental Principles of Th-Organic Scaffold Chemistry Using Zr-Analogs as a Guide.

The fundamental interest in actinide chemistry, particularly for the development of thorium-based materials, is experiencing a renaissance owing to the recent and rapidly growing attention to fuel cycle reactors, radiological daughters for nuclear medicine, and efficient nuclear stockpile development. Herein, we uncover fundamental principles of thorium chemistry on the example of Th-based extended structures such as metal-organic frameworks in comparison with the discrete systems and zirconium extended analogs, demonstrating remarkable over two-and-half-year chemical stability of Th-based frameworks as a function of metal node connectivity, amount of defects, and conformational linker rigidity through comprehensive spectroscopic and crystallographic analysis as well as theoretical modeling. Despite exceptional chemical stability, we report the first example of studies focusing on the reactivity of the most chemically stable Th-based frameworks in comparison with the discrete Th-based systems such as metal-organic complexes and a cage, contrasting multicycle recyclability and selectivity (>97%) of the extended structures in comparison with the molecular compounds. Overall, the presented work not only establishes the conceptual foundation for evaluating the capabilities of Th-based materials but also represents a milestone for their multifaceted future and foreshadows their potential to shape the next era of actinide chemistry.

The role of organizational culture and communication skills in predicting the quality of nursing care.

AIMS: This study aims to identify the level of nursing care quality and examine its predictors considering nurses' demographic data, organizational culture, and communication skills. BACKGROUND: Quality of care is a determinant of the sustainability of any healthcare organization. Therefore, it is imperative to understand how factors may contribute to the quality of nursing care. Limited research is available on the interaction between the concepts of quality of nursing care, communication skills, and organizational culture. METHODS: A cross-sectional multi-site correlational design was used in this study. A convenience sample of 200 nurses from four Jordanian hospitals was recruited. Data was collected using self-reported questionnaires. Descriptive statistics, Pearson correlations, and multiple regression were performed to achieve the study's aims. RESULTS: The majority of the nurses in this study were females with bachelor's degrees. Age ranged between 22 and 53 years whereas experience ranged from 1 to 30 years. Communication skills significantly predicted the quality of nursing care; however, organizational culture was not a significant predictor of the quality of nursing care. Nevertheless, Pearson r correlation results revealed a significant correlation between organizational culture and communication skills (r = 0.57, p < 0.05). CONCLUSION: Nurses and organizational managers can increase the level of quality of nursing care by investing in programs that target improving nurses' communication skills. Providing a good environment in the hospital can increase communication skills between staff members, ultimately increasing the quality of nursing care. Further studies are recommended to elaborate and further uncover concerns related to the current research.

Twists and Turns: A Chiropractic Roller Coaster Experience Unraveling the Intricacies of Bilateral Vertebral Artery Dissection.

The primary insult in vertebral artery dissections (VADs) involves a tear in the vertebral artery intima, resulting in potential thrombus formation and an elevated risk of cerebrovascular events, such as stroke. Despite its relatively low overall incidence rate, VADs contribute to a significant proportion of ischemic strokes within the younger population. VAD has been associated with various risk factors including but not limited to neck trauma from chiropractic manipulation and significant neck movements. Our patient initially presented with a worsening occipital headache but was discharged due to the absence of any red-flag symptoms. However, the patient shortly returned to the ED upon worsening symptoms, and despite the lack of apparent neurological deficits, the patient's history of cervical spine manipulation and exposure to neck trauma risk activities (roller coaster riding) increased suspicion for VAD. This case highlights the importance of considering VAD as a differential diagnosis in young patients presenting with unexplained headaches and neck pain following events that exert stress on the vertebral arteries, such as roller coaster rides and chiropractic neck manipulation. When managed properly, the long-term prognosis of VAD is generally favorable; however, the risk of recurrent dissection and stroke still remains. Thus, this case further emphasizes the need for timely intervention and the role of dual anti-platelet therapy (DAPT) in the management of VAD to prevent further complications such as stroke.

Breakfast Skipping and Associated Factors Among Jordanian University Students.

Background: Although breakfast skipping among university students is a significant concern, its prevalence and the contributing factors among university students have received little attention in the literature. This study aims to determine the prevalence of skipping breakfast among Jordanian university students and examine the associated factors and variations in rates of skipping breakfast by day of the week. Materials and Methods: A cross-sectional study was conducted among undergraduate students between March and May 2022 through a self-questionnaire. A convenience sample of 891 students was chosen at four Jordanian public universities. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of skipping breakfast among university students was 66%. The reasons for skipping breakfast were having no time due to oversleeping and having no feeling of hunger (59% for both), followed by having no energy to prepare the breakfast and making no difference (49% and 48%), and not being able to afford to eat or buy breakfast (19%). There is a strong correlation between eating fast food and skipping breakfast. With whom the student eats breakfast is significantly associated with breakfast skipping, revealing that the highest percentages of skipping occur with friends. About 63% of students skipped breakfast through university days compared with 37% on the weekend, while 37% of them had breakfast through university days compared with 67% on the weekend. Conclusions: A high percentage of university students in Jordan skip breakfast. More attention should be paid to correlating factors and developing interventions to help students adhere to the breakfast.

Validation and cross-cultural adaptation of the six-dimension scale of nursing performance- arabic version.

BACKGROUND: Nursing performance is a key indicator of patients' care quality and safety. Most healthcare research tools are available in the English language; however, nurses around the world can employ these tools if rigorously adapted and cross-culturally validated. AIMS AND OBJECTIVES: This study aims to provide a cross-cultural adaptation and validation of the six-dimension scale of nursing performance to be used among Arabic-speaking nurses. DESIGN: The study employed a descriptive, correlational design with a cross-sectional approach. METHODS: A five-step cross-cultural adaptation process was adopted. The scale was administered to 216 Jordanian nurses between January 2022 to April 2022. SPSS and AMOS were used for descriptive and correlation analyses and testing the six-dimension model through structural equation modeling (SEM). RESULTS: The current study produced a valid, reliable, culturally adapted Arabic language version of the six-dimension scale of nursing performance. The internal consistency of the tool was supported by a Cronbach Alpha's value of 0.99. The model's goodness of fit indices were: CFI = 0.96, RMSEA = 0.048, and CMIN/df = 1.49. The exploratory factor analysis (EFA) of the scale identified three factors with eigenvalues greater than 1.00., explaining 75.22% of the variance. A subsequent EFA, specifying six factors, yielded 79.79% explained variance. All item factor loadings exceeded 0.30, confirming the scale's robust factor structure. CONCLUSIONS: This study proved that following a robust cross-cultural adaptation process results in a reliable and valid measure of nursing performance to be used among Arabic-speaking nurses. The study supports the dimensionality of nursing performance as evidenced by the SEM results. Therefore, the findings have the potential to considerably enhance studying nursing performance in healthcare fields in Arabic-speaking nurses. RELEVANCE TO CLINICAL PRACTICE: The validation and cross-cultural adaptation of the Arabic version of the Six-Dimension Scale of Nursing Performance have direct implications for improving the quality of nursing services, enhancing patient safety, promoting cultural competence, and supporting the professional growth of Arabic-speaking nurses.

Cost Effectiveness of Endovascular Ultrasound Renal Denervation in Patients with Resistant Hypertension.

BACKGROUND: Resistant hypertension (rHTN) is defined as blood pressure (BP) of ≥ 140/90 mmHg despite treatment with at least three antihypertensive medications, including a diuretic. Endovascular ultrasound renal denervation (uRDN) aims to control BP alongside conventional BP treatment with antihypertensive medication. This analysis assesses the cost effectiveness of the addition of the Paradise uRDN System compared with standard of care alone in patients with rHTN from the perspective of the United Kingdom (UK) health care system. METHODS: Using RADIANCE-HTN TRIO trial data, we developed a state-transition model. Baseline risk was calculated using Framingham and Prospective Cardiovascular Münster (PROCAM) risk equations to estimate the long-term cardiovascular risks in patients treated with the Paradise uRDN System, based on the observed systolic BP (SBP) reduction following uRDN. Relative risks sourced from a meta-analysis of randomised controlled trials were then used to project cardiovascular events in patients with baseline SBP ('control' patients); utility and mortality inputs and costs were derived from UK data. Costs and outcomes were discounted at 3.5% per annum. Modelled outcomes were validated against trial meta-analyses and the QRISK3 algorithm and real-world evidence of RDN effectiveness. One-way and probabilistic sensitivity analyses were conducted to assess the uncertainty surrounding the model inputs and sensitivity of the model results to changes in parameter inputs. Results were reported as incremental cost-effectiveness ratios (ICERs). RESULTS: A mean reduction in office SBP of 8.5 mmHg with uRDN resulted in an average improvement in both absolute life-years (LYs) and quality-adjusted life-years (QALYs) gained compared with standard of care alone (0.73 LYs and 0.67 QALYs). The overall base-case ICER with uRDN was estimated at £5600 (€6500) per QALY gained (95% confidence interval £5463-£5739 [€6341-€6661]); modelling demonstrated > 99% probability that the ICER is below the £20,000-£30,000 (€23,214-€34,821) per QALYs gained willingness-to-pay threshold in the UK. Results were consistent across sensitivity analyses and validation checks. CONCLUSIONS: Endovascular ultrasound RDN with the Paradise system offers patients with rHTN, clinicians, and healthcare systems a cost-effective treatment option alongside antihypertensive medication.

Exploring the relationships between stress, resilience and job performance among nurses in Jordan.

BACKGROUND: Nurses are a crucial part of healthcare organisations, constituting around half of the global healthcare workforce. Therefore, it is important to examine the factors that may affect their job performance, which is central to the delivery of effective healthcare services. AIM: To examine the relationships between stress, resilience and job performance within the nursing context in Jordan. METHOD: A cross-sectional descriptive correlational design was used. A self-administered questionnaire comprising stress, resilience and job performance scales was completed by a convenience sample of 207 nurses working in five hospitals in the northern and middle regions of Jordan. RESULTS: Overall, respondents self-reported moderate stress levels, normal resilience levels and moderate job performance. The study identified: a moderate positive correlation between stress and resilience; a weak negative correlation between stress and job performance; and a weak positive correlation between resilience and job performance. CONCLUSION: It is essential that nurse managers, leaders and policymakers implement measures to mitigate the stressors encountered by nurses, increase resilience and foster effective coping mechanisms. Such measures could enhance nurses' resilience and job performance, ultimately improving patient care.

Depression stigma, depression literacy, and psychological help seeking attitudes among school and university students.

Very little research has specifically investigated depression stigma and its correlation with depression literacy and help-seeking attitudes among students. This study aimed to assess the levels and correlations of stigma, literacy, and psychological help-seeking attitudes related to depression among a sample of high school and university students in Jordan. A descriptive, correlational, cross-sectional design was employed using an anonymous, online, self-report survey. This study included a total of 650 students aged 16 to 24 years. The participants were found to have high levels of depression stigma, low levels of depression literacy, and negative attitudes towards seeking psychological help. The most frequently reported sources of psychological help were family members, relatives, and friends. A significant negative correlation was found between depression stigma and depression literacy. The predictive factors of depression stigma were depression literacy, age, gender, education, father's educational level, family size, and having history of mental health problems among family members, relatives, or friends. This study provides valuable information on the common mental health needs and concerns among students in Jordan. The findings also highlight the importance of developing and implementing depression awareness and prevention education campaigns for students in schools and universities. Such campaigns may increase students' knowledge about depression, enhance their use of mental healthcare services, and prevent or decrease their risk of developing depression.

Psychometric properties of the Arabic version of Barratt Impulsiveness Scale 11: The development of short form.

Impulsivity is an important mental health-related variable that has been associated with various human behaviors. The Barratt Impulsiveness Scale is the most frequently used measure to examine impulsivity. However, its psychometric and factor structure was not examined in Arabic speaking population. The goal of the current study was to examine the psychometric properties and factor structure of the Barratt Impulsiveness Scale in Arabic speaking population. The current study used a cross-sectional design. Two independent samples were recruited: college students (N = 250) and persons with heart failure (N = 165). Exploratory factor analysis, then a series of confirmatory factor analyses were used to assess one- and three-factor models of the Barratt Impulsiveness Scale (30 items; i.e., BIS-11) and Barratt Impulsiveness Scale (15 items; i.e., BIS-15). Because our analysis did not support the factor structure of the previous versions of the Barratt Impulsiveness Scale, we used confirmatory factor analysis to evaluate the model structure of the single-factor measure. To assess the measurement invariance, the newly developed measure was examined across different genders and populations. Due to poor psychometrics of BIS-11 and BIS-15, a short form (BIS-SF) was developed; and validity, reliability, and measurement invariance were supported. The current analysis showed that BIS-11 and BIS-15 have poor psychometrics. Thus, there was a need to improve the measure by reducing the number of items and re-evaluating the psychometrics of the new measure. The BIS-SF is a reliable, valid tool to assess impulsivity in our samples. Other studies need to support the current study findings in populations with other chronic illnesses.

The effectiveness of COPA-based training program on the infection-control competencies of newly hired healthcare professionals.

Competency-based education that relies on nurses' and healthcare professionals' needs assessment is crucial to tackling healthcare crises such as COVID-19. Strengthening the capacities of human resources by implementing customized infection control training programs is therefore mandatory. This study aims to measure the effectiveness and satisfaction of the Competency Outcomes and Performance Assessment (COPA)-based training program. The study implemented a single group pretest-posttest experimental design. A single-stage cluster sampling technique was used. All field hospitals in Jordan were listed, and one hospital was randomly selected. A total of 87 personnel from different disciplines agreed to participate after reading the letter of information and signing the informed consent. A panel of experts representing different disciplines and hospital units initially met and agreed upon a list of competencies required for the training program, and the program was accordingly developed. The study measured the healthcare professionals' competencies in infection control and prevention before and after the administration of the competency-based training program. The results revealed significant differences between participants' pretest and posttest scores in all infection control domains and the total scores. For example, the increase in participants' total competency scores after the training was statistically significant (P < 0.007). The mean total satisfaction score was 61.18 + 7.00 reflecting that the participants were highly satisfied with the provided training. In conclusion, it is imperative to provide healthcare professionals with adequate clinical training to ensure that healthcare services are going to be delivered in the highest possible quality and minimize the possible adverse events.

Assessing Professional Competencies Among Undergraduate Nurses: An Exploratory Study.

AIM: The study aimed to identify nursing students' professional competencies and examine which factors of the clinical learning environment affect these competencies. BACKGROUND: Professional competencies are vital for the quality and safety of nursing practice. The learning environment is important for the development of professional competencies. METHOD: Data were collected from 178 nursing students using the Clinical Learning Environment and Supervision Scale and the Nursing Professional Competencies Scale-Short Form. RESULTS: The highest competency was achieved in value-based nursing care; the lowest competency was achieved in development, leadership, and organization of nursing. Factors such as positive pedagogical atmosphere, nursing care on the ward, and good supervisory relationship affected learning and, in turn, improved professional competencies. CONCLUSION: The results establish a link between the clinical environment and reported professional competencies, leading to a call for more focused coverage of these factors in the academic curricula.

Health literacy of university employees: The role of sociodemographic characteristics and nutritional status.

BACKGROUND: Health literacy plays a key role in promoting overall health and preventing diseases among individuals and communities. However, the literature regarding health literacy among university employees is still evolving and not thoroughly understood. OBJECTIVE: This study was conducted to examine the association between health literacy and sociodemographic characteristics and nutritional status of university employees in Jordan. METHODS: This study was conducted using a cross-sectional design. A total of 163 university employees participated by completing a demographics questionnaire and the Health Literacy Questionnaire. The Health Literacy Questionnaire is considered a comprehensive tool to assess health literacy, and it encompasses nine distinct scales. The body mass index was calculated by obtaining the participants' height and weight. RESULTS: The results of multivariate analysis of variance showed that three factors had a statistically significant effect on the linear composite of the Health Literacy Questionnaire scales. These factors were the university employees' age, highest level of education, and body mass index. Follow-up analyses revealed that university employees' sociodemographic characteristics and nutritional status affect different domains of health literacy. Compared to overweight employees, those with normal body mass index had higher mean average scores on six (out of nine) scales of the Health Literacy Questionnaire. CONCLUSION: These results highlight the need for addressing the nutritional status and sociodemographic characteristics as a source of disparity in university employees' health literacy. Such factors should be addressed in designing tailored health promotion interventions for university employees.