Depression, anxiety, and sleep attributes: A cross-sectional study of chiropractic college students.

OBJECTIVE: To measure degree of depression, anxiety, and hours of sleep of chiropractic college students through an anonymous paper survey. METHODS: A convenience sample of 164 chiropractic college students completed a Major Depression Inventory (MDI) survey, a 2-item Generalized Anxiety Disorder (GAD-2) survey, and were asked the number of hours of sleep they had per night and demographic questions. The survey was distributed to trimester 1-6 students 4 weeks into their 15-week semester. RESULTS: Chiropractic students had an average MDI score of 18.1 ± 10.6 (mean ± SD), indicating the average chiropractic college student did not display depression. However, subset analysis revealed 18.9% of students had MDI scores over 30, which is associated with possible severe depression. Of students who demonstrated possible severe depression, 80.6% were female. Body mass index demonstrated no correlation with the number of respondents at risk for severe depression. Average GAD-2 score was 3.0 ± 1.9; male students scored 2.4 ± 1.8 and female 3.6 ± 1.8, indicating female students expressed anxiety more. Last, survey respondents reported they averaged 6.3 ± 1.1 hours of sleep per night with females reporting approximately 30 minutes less sleep per night than males. CONCLUSION: Chiropractic students, on average, did not display depression. However, a subset of female students near the age of 26 were at an increased risk of severe depression. Chiropractic students displayed a rate of anxiety greater than that of undergraduate college students based on existing data sets and reported approximately 6 hours of sleep per night.

Technology in Education: Riding the Wave of the Future. Chiropractic Educators Research Forum (CERF), June 22, 2024.

The Chiropractic Educators Research Forum convened a conference on June 22, 2024. During this meeting, attendees shared what chiropractic programs are doing, specifically focusing on education research related to technology. Presenters and panelists discussed what technology chiropractic programs should be using to educate chiropractors for the future.

Emotional Impact of COVID-19 and Emotional Eating and the Risk of Alcohol Use Disorder in Peruvian Healthcare Students.

BACKGROUND: This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students. METHODS: We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman's correlations were calculated and two multiple linear regression models were developed. RESULTS: 68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder. CONCLUSIONS: To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling.

The Right to Rehabilitation for People With Dementia: A Codesign Approach to Barriers and Solutions.

INTRODUCTION: People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia are unable to access rehabilitation for promoting function and quality of life. Conducted in Australia, this study was designed to (1) explore barriers to access to dementia rehabilitation and (2) identify solutions that improve access to rehabilitation. METHODS: People living with dementia (n = 5) and care partners (n = 8) and health professionals (n = 13) were recruited nationally. Experience-based codesign across three virtual workshops was used to understand barriers and design solutions to improve access to rehabilitation treatments. Socio-ecological analyses, using the Levesque Access to Health care framework, were applied to findings regarding barriers and to aid selection of solutions. RESULTS: There was high attendance (92.3%) across the three workshops. Barriers were identified at a user level (including lack of knowledge, transport, cost and difficulty navigating the health, aged care and disability sectors) and health service level (including health professional low dementia knowledge and negative attitudes, inequitable funding models and non-existent or fragmented services). Solutions focused on widespread dementia education and training, including ensuring that people with dementia and their care partners know about rehabilitation therapies and that health professionals, aged care and disability co-ordinators know how to refer to and deliver rehabilitation interventions. Dementia care navigators, changes to Australia's public funding models and specific dementia rehabilitation programmes were also recommended. CONCLUSIONS: Barriers to accessing rehabilitation for people with dementia exist at multiple levels and will require a whole-community and systems approach to ensure change. PATIENT OR PUBLIC CONTRIBUTION: People with living experience (preferred term by those involved) were involved at two levels within this research. A Chief Investigator living with dementia was involved in the design of the study and writing of the manuscript. People with living experience, care partners and service providers were participants in the codesign process to identify barriers and design potential solutions.

The status of interprofessional education for healthcare students in South Korea: a scoping review focusing on simulation-based education.

Simulation-based education is gaining attention worldwide as it is recognized as effective in fostering collaborative skills in healthcare students. We conducted a comprehensive review of simulation-based interprofessional education (IPE) to examine the current state of simulation-based IPE. This scoping review systematically analyzed studies on simulation-based IPE in South Korean healthcare education, following established guidelines. Relevant articles were comprehensively searched, and key data on simulation methods, implementations, and educational effectiveness were extracted for analysis. The present study included nine quantitative studies and one mixed-methods study. The majority of participants were undergraduate nursing and medical students. The duration of IPE interventions ranged from 2 hours to 2 weeks. Education methods included standardized patients, high-fidelity simulators, and role-playing. Educational outcomes focused on measuring IPE competencies and satisfaction levels, concentrating on Kirkpatrick levels 1 and 2. While most studies reported high satisfaction levels, there is a need for objective evaluation of educational effectiveness. As simulation-based IPE in Korean healthcare education evolves, there is a need for greater inclusivity of diverse roles, multidisciplinary respect, and scenario development allowing active participation across professions. Establishing institutional frameworks, community linkages, and a deep understanding of IPE's purpose and essence among practitioners is crucial for its academic maturation.

Onset and Prevalence of Musculoskeletal Disorders Among Undergraduate Health Science Students at the University of Johannesburg During the COVID-19 Regulations.

Objective: This study aimed to investigate the onset and prevalence of musculoskeletal disorders (MSD) in undergraduate students from the Faculty of Health Sciences at the University of Johannesburg during the COVID-19 pandemic. Methods: This was an explorative cross-sectional survey. The sample consisted of 106 Faculty of Health Sciences students recruited through 4 departments. The study was conducted through Google Forms and made use of a questionnaire that was adapted from 2 existing questionnaires, namely "Physical Activity and Sedentary Lifestyle in University Students: Changes During Confinement Due to the COVID-19 Pandemic" and "Musculoskeletal Health Questionnaire (MSK-HQ)." Variables that were tested included dietary changes, habitual and activity changes, perceived MSK health before COVID-19 and during COVID-19 restrictions, and the development and regional distribution of MSD. Data were analyzed using frequency tables for single-response questions, custom tables for multiple responses and Likert-type questions, summary statistics to analyze continuous variables, and paired samples t tests to analyze statistically significant differences in MSK health before and during the COVID-19 lockdown periods. Results: Prior to the implementation of the institutional academic restrictions, 33.0% of respondents reported having no MSD, while 67.0% reported already having had an MSD present. The prevalence of new MSD in descending order by region were back (78.3%), neck (71.7%), head (41.5%), lower limb (27.4%), pelvis and perineum (20.8%), thorax/chest (12.3%), abdomen (12.3%), and upper limb (11.3%). Of these new-onset MSD, 11.3% were induced by physical trauma, while 76.4% were not from any form of physical trauma. Of the 106 participants, 28 stated that their MSK health deteriorated over the 2 compared points in time, 18 remained unchanged, and 60 showed improvement in MSK health. Conclusion: Our findings suggest that even though students had MSD before the pandemic lockdown restrictions, new conditions were recorded as developing during the restricted period. Complaints of new-onset back, neck, and head pain were reported the most, although overall, MSK health appeared to have improved.

Outcomes of the My Therapy self-management program in people admitted for rehabilitation: A stepped wedge cluster randomized clinical trial.

BACKGROUND: Self-management programs can increase the time spent on prescribed therapeutic exercises and activities in rehabilitation inpatients, which has been associated with better functional outcomes and shorter hospital stays. OBJECTIVES: To determine whether implementation of a self-management program ('My Therapy') improves functional independence relative to routine care in people admitted for physical rehabilitation. METHODS: This stepped wedge, cluster randomized trial was conducted over 54 weeks (9 periods of 6-week duration, April 2021 - April 2022) across 9 clusters (general rehabilitation wards) within 4 hospitals (Victoria, Australia). We included all adults (≥18 years) admitted for rehabilitation to participating wards. The intervention included routine care plus 'My Therapy', comprising a sub-set of exercises and activities from supervised sessions which could be performed safely, without supervision or assistance. The primary outcomes were the proportion of participants achieving a minimal clinically important difference (MCID) in the Functional Independence Measure, (FIM™) and change in total FIM™ score from admission to discharge. RESULTS: 2550 participants (62 % women) were recruited (control: n = 1458, intervention: n = 1092), with mean (SD) age 77 (13) years and 37 % orthopedic diagnosis. Under intervention conditions, participants reported a mean (SD) of 29 (21) minutes/day of self-directed therapy, compared to 4 (SD 14) minutes/day, under control conditions. There was no evidence of a difference between control and intervention conditions in the odds of achieving an MCID in FIM™ (adjusted odds ratio 0.93, 95 % CI 0.65 to 1.31), or in the change in FIM™ score (adjusted mean difference: -0.27 units, 95 % CI -2.67 to 2.13). CONCLUSIONS: My Therapy was delivered safely to a large, diverse sample of participants admitted for rehabilitation, with an increase in daily rehabilitation dosage. However, given the lack of difference in functional improvement with participation in My Therapy, self-management programs may need to be supplemented with other strategies to improve function in people admitted for rehabilitation. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12621000313831), https://www.anzctr.org.au/.

Evidence of reliability and validity of the Brazilian Portuguese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration.

Interprofessional collaboration leads to better health outcomes. Measuring attitudes related to interprofessional collaboration is not a simple task, and in Brazil, there are few instruments for this evaluation. This study aimed to evaluate the evidence of validity and reliability of the Brazilian Portuguese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration in a population of undergraduate healthcare students. It included 108 undergraduates from medicine, nursing, physiotherapy, dentistry, pharmacy, psychology, and physical education academic programmes. The median age was 22 (18 and 58) and 75% were females. The scale comprises 20 items divided into two domains: working relationships, consisting of 12 items, and accountability, consisting of 8 items. The instrument showed good reliability (Cronbach's alpha = 0.77, 95% CI 0.71-0.83) and no item was considered inconsistent in improving the scale significantly. The scale demonstrated good evidence of validity and reliability for application among a population of Brazilian healthcare students.

Hesitancy Towards COVID-19 Vaccine Among Students of Medical and Allied Health Sciences in Khyber Pakhtunkhwa.

Objective: To measure COVID-19 vaccine hesitancy and its associated factors among medical and allied health sciences students of Khyber Pakhtunkhwa. Methodology: This cross-sectional survey was conducted online using Google survey platform in March 2021. Study population comprised of medical and allied health sciences students studying in medical/allied health sciences academic institutes in Khyber Pakhtunkhwa. The web-based online link was provided to around 800 students to fill in the questionnaire via email, WhatsApp and/or social media network. Response rate was around 50%. The main outcome variable was vaccine hesitancy. Factors associated with vaccine hesitancy were explored by bivariate and multivariate regression analysis. Results: Out of 398 medical and allied health sciences students, there were 193 (48.5%) males and 205 (51.5%) females with mean age was 22.6± 2.8 years. The vaccine hesitancy rate was found to be 52.8%. A significant relationship between vaccine hesitancy and gender was observed. Other factors including lack of adequate knowledge about vaccines (p < 0.001), Chinese origin of vaccines (p < 0.001), lack of knowledge that vaccination can reduce the chances of acquiring infection (p < 0.001), fear of potential side effects (p < 0.001) and hidden agenda behind free forceful vaccination (p = 0.045), were found to be main barriers or reasons responsible for COVID-19 vaccine hesitancy among medical and allied health sciences students. Conclusion: Important associated barriers with COVID-19 vaccine hesitancy included gender, lack of information, fear of side effects, lack of trust in imported and Chinese vaccines, and perception of hidden agenda behind COVID-19 vaccination.

Interventions to decrease health students' stigma toward schizophrenia: A scoping review.

BACKGROUND: Schizophrenia is heavily stigmatized among health professionals. Given that health professional students are future members of the workforce and will provide care for people with schizophrenia, it is essential to implement interventions aimed at reducing stigma among this group. OBJECTIVE: This scoping review aimed to identify and synthesize existing literature on interventions to decrease schizophrenia stigma among health professional students, and to determine the possible gaps in the literature. DESIGN: Nine electronic databases and gray literature were searched, including PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, MEDLINE, Web of Science, Scopus, China National Knowledge Infrastructure, WanFang, and Google on 5 May 2023. Two researchers independently conducted data screening, data extraction, and assessed study risks. A most updated search was also done on 22 May 2024. The Cochrane risk of bias tool version 2 for randomized trials and Risk of Bias in Non-randomized Studies were used to assess the studies' risk of bias. Data synthesis and analysis were conducted by two reviewers using a narrative approach. Reporting adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. RESULTS: This review included twenty-one studies with 2520 health professional students. The majority of included studies were non-randomized controlled trials (38 %) and pre-post studies (52 %). Most of the included studies were conducted in the United States (24 %). The participants in ten (48 %) studies were medical students. The number of intervention sessions ranged from one to 13, with an average of three. Seven (33 %) studies had an intervention duration of less than four weeks and 16 (76 %) studies had no follow-up. Various scales were used to assess the outcomes of schizophrenia stigma. Only two studies (10 %) indicated the intervention's ineffectiveness, with the majority of interventions led by psychiatry department faculty and individuals with schizophrenia. CONCLUSIONS: Most studies (90 %) utilized various approaches, including face-to-face or online education, direct contact with individuals with schizophrenia, or a combination thereof, to diminish stigma among health professional students. However, none addressed cultural and empathy factors in their intervention designs, and the included studies lacked theoretical guidance. The review only comprised English quantitative studies with significant heterogeneity, with 17 studies (81 %) displaying serious or high risk of bias, limiting comprehensive discussions. These findings offer valuable insights for future systematic review. TWEETABLE ABSTRACT: Studies on reducing health professional students' schizophrenia stigma need to address cultural and empathy factors.

Comparative accuracy of ChatGPT-4, Microsoft Copilot and Google Gemini in the Italian entrance test for healthcare sciences degrees: a cross-sectional study.

BACKGROUND: Artificial intelligence (AI) chatbots are emerging educational tools for students in healthcare science. However, assessing their accuracy is essential prior to adoption in educational settings. This study aimed to assess the accuracy of predicting the correct answers from three AI chatbots (ChatGPT-4, Microsoft Copilot and Google Gemini) in the Italian entrance standardized examination test of healthcare science degrees (CINECA test). Secondarily, we assessed the narrative coherence of the AI chatbots' responses (i.e., text output) based on three qualitative metrics: the logical rationale behind the chosen answer, the presence of information internal to the question, and presence of information external to the question. METHODS: An observational cross-sectional design was performed in September of 2023. Accuracy of the three chatbots was evaluated for the CINECA test, where questions were formatted using a multiple-choice structure with a single best answer. The outcome is binary (correct or incorrect). Chi-squared test and a post hoc analysis with Bonferroni correction assessed differences among chatbots performance in accuracy. A p-value of < 0.05 was considered statistically significant. A sensitivity analysis was performed, excluding answers that were not applicable (e.g., images). Narrative coherence was analyzed by absolute and relative frequencies of correct answers and errors. RESULTS: Overall, of the 820 CINECA multiple-choice questions inputted into all chatbots, 20 questions were not imported in ChatGPT-4 (n = 808) and Google Gemini (n = 808) due to technical limitations. We found statistically significant differences in the ChatGPT-4 vs Google Gemini and Microsoft Copilot vs Google Gemini comparisons (p-value < 0.001). The narrative coherence of AI chatbots revealed "Logical reasoning" as the prevalent correct answer (n = 622, 81.5%) and "Logical error" as the prevalent incorrect answer (n = 40, 88.9%). CONCLUSIONS: Our main findings reveal that: (A) AI chatbots performed well; (B) ChatGPT-4 and Microsoft Copilot performed better than Google Gemini; and (C) their narrative coherence is primarily logical. Although AI chatbots showed promising accuracy in predicting the correct answer in the Italian entrance university standardized examination test, we encourage candidates to cautiously incorporate this new technology to supplement their learning rather than a primary resource. TRIAL REGISTRATION: Not required.

Stemming the Tide: The Proactive Role of Allied Health Therapy in Parkinson's Disease.

Motor and nonmotor symptoms occur in early Parkinson's disease (PD), or even in the prodromal stage. Many of these symptoms can be addressed by allied health therapies, including physical therapy, occupational therapy, speech therapy, and psychological therapies. However, referrals to these services early in the disease are low. We provide a review summarizing the efficacy of proactive allied health interventions on motor and nonmotor symptoms and daily function in prodromal and early disease. We also highlight areas for additional research and provide recommendations to improve care for individuals with early PD within each discipline. We recognize the overlapping roles of the allied health disciplines and support integrated or transdisciplinary care beginning soon after diagnosis to help stem the tide in the progression of PD symptoms and disability.

Many people with Parkinson's disease start having symptoms years before their diagnosis. These symptoms can affect movement, communication, mood, work, and other aspects of daily life. Allied health therapies can be used soon after diagnosis, or even when diagnosis is suspected, to address these challenges proactively. This article reviews the roles of physical, occupational, speech, and psychological therapies. We highlight interventions for early Parkinson's disease that are strongly supported by research, such as exercise and self-management.

Association of anaesthesia provider sex with perioperative complications: a two-centre retrospective cohort study.

BACKGROUND: Previous studies suggested that surgeon sex is associated with differential patient outcomes. Whether this also applies to anaesthesia providers is unclear. We hypothesised that female sex of the primary anaesthesia provider is associated with lower risk of perioperative complications. METHODS: The first case for all adult patients undergoing anaesthesia care between 2008 and 2022 at two academic healthcare networks in the USA was included in this retrospective cohort study. The primary exposure was the sex of the anaesthesia provider who spent the most time in the operating theatre during the case. The primary outcome was intraoperative complications, defined as hypotension (mean arterial blood pressure <55 mm Hg for ≥5 cumulative minutes) or hypoxaemia (oxygen saturation <90% for >2 consecutive minutes). The co-primary outcome was 30-day adverse postoperative events (including complications, readmission, and mortality). Analyses were adjusted for a priori defined confounders. RESULTS: Among 364,429 included patients, 57,550 (15.8%) experienced intraoperative complications and 55,168 (15.1%) experienced adverse postoperative events. Care by female compared with male anaesthesia providers was associated with lower risk of intraoperative complications (adjusted odds ratio [aOR] 0.95, 95% confidence interval [CI] 0.94-0.97, P<0.001), which was magnified among non-trainees (aOR 0.84, 95% CI 0.82-0.87, P-for-interaction<0.001). Anaesthesia provider sex was not associated with the composite of adverse postoperative events (aOR 1.00, 95% CI 0.98-1.02, P=0.88). CONCLUSIONS: Care by a female anaesthesia provider was associated with a lower risk of intraoperative complications, which was magnified among non-trainees. Future studies should investigate underlying mechanisms.

Health science students' preparedness for climate change: a scoping review on knowledge, attitudes, and practices.

INTRODUCTION: Climate change (CC) is a global public health issue, and the role of health professionals in addressing its impact is crucial. However, to what extent health professionals are prepared to deal with CC-related health problems is unclear. We aimed to evaluate the knowledge, attitudes, and practices of health students about the CC. METHODS: We conducted a scoping review through systematic searches in PubMed, Scopus, Web of Science, Proquest, and EBSCO. We included original scientific research with no language or time restrictions. Two authors independently reviewed and decided on the eligibility of the studies, then performed data extraction. RESULTS: 21 studies were included, with a total of 9205 undergraduate nursing, medical, pharmacy, and public health students mainly. Most health science students (> 75%) recognized human activities as the main cause of CC. However, they perceived a lack of knowledge on how to address CC. Moreover, we found inadequate coverage or limited development of CC in related curricula that may contribute to incomplete learning or low confidence in the theoretical and practical concepts of students. CONCLUSION: The findings of our scoping review suggest that while health sciences students possess a general understanding of CC, there is a significant gap in their knowledge regarding its specific health impacts. To address this gap, there is a need for targeted education and training for future health care professionals that emphasizes the health effects of CC.

Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements.

Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.

Social representations of breastfeeding in health science students: A first step to strengthening their training.

AIM: This study aims to describe the social representations of breastfeeding among Mexican health science students. BACKGROUND: Breastfeeding is a complex phenomenon involving biological, affective and sociocultural aspects. Its definition includes diverse beliefs, attitudes, traditions and myths. Being aware of the connections between biological and sociocultural concepts in the social representations of breastfeeding in health science students may facilitate our comprehension of their attitudes/behaviors towards breastfeeding. DESIGN: A qualitative study was carried out based on the structuralist approach of the social representations theory. METHODS: Data were collected with free-listing questionnaires with breastfeeding as an inducer word among a random sample of nutrition, medical and nursing undergraduate students (n=124). The analyses used were similitude/meanings of words, prototypical and categorical analyses. RESULTS: The findings suggest that the structure of the social representation is composed of breastfeeding essentials (baby, mother, & milk), affective (attachment, love & link), biological (nutrition, breasts, & health) and sociocultural elements (taboo, responsibility, & economic). Only instrumental elements are found in the nucleus, whereas biological, affective and sociocultural elements are observed in the peripheries. Moreover, emerging thematic categories such as the "affective bond" and "feeding" introduced additional dimensions, thereby emphasizing the complexity and richness of the social representation of breastfeeding in the context of health science students. CONCLUSIONS: The structure of the social representation of breastfeeding among some Mexican undergraduate health science students focuses on the instrumental aspects, emphasizing essential elements. However, they downplay more scientifically oriented elements specific to their academic training. These findings, when extrapolated to different contexts, present an opportunity that could assist the development of tailored and culturally adapted educational strategies to strengthen breastfeeding training for health students. This approach can significantly contribute to enhancing breastfeeding promotion in society by addressing practical, scientific and language-inclusive aspects in the training of health professionals.

Exploring the determinants of student midwives' wellbeing during their studies: A qualitative study.

PROBLEM: Student wellbeing is a global concern in the aftermath of the COVID pandemic. Students in healthcare often are exposed to academic, clinical, and psychosocial factors of stress, in particularly student midwives, as they are exposed to other people's intimate life experiences. The aim of this study was to identify factors which help and hinder student midwives in their studies. BACKGROUND: Midwifery students in the Netherlands must complete 35-50 % of their bachelor's degree with placements in community and hospital-based maternity care. METHODS: An exploratory qualitative study was conducted, using the Job-Demands-Resources model. Data were collected through semi-structured individual and group interviews with Bachelor student midwives from the Netherlands. FINDINGS: During coursework students found the high workload and lack of recovery time demanding. During placements, their sense of being constantly assessed, having to be available on call and being away from home were experienced as demands. The relationships with teachers as supportive. Support from their placement supervisors and peers were also resourceful if available and positive. In other cases, peer pressure and grand expectations from supervisors were demanding. Personal demands were setting ambitious standards and feeling alone during their placements, and personal resources were positive attitude towards to becoming a midwife. DISCUSSION: The academic programme for student midwives seemed highly demanding, with a stark difference between the learning environment in the faculty coursework and in the placements. Positive support from placement supervisors in a culture that values learning and development, can contribute to student midwives' socialization into midwifery.

Dependence of Successful Airway Management in Neonatal Simulation Manikins on the Type of Supraglottic Airway Device and Providers' Backgrounds.

Supraglottic airway devices such as laryngeal masks and i-gels are useful for airway management. The i-gel is a relatively new device that replaces the air-inflated cuff of the laryngeal mask with a gel-filled cuff. It remains unclear which device is more effective for neonatal resuscitation. We aimed to evaluate the dependence of successful airway management in neonatal simulators on the device type and providers' backgrounds. Ninety-one healthcare providers performed four attempts at airway management using a laryngeal mask and i-gel in two types of neonatal manikins. The dependence of successful insertions within 16.7 s (75th percentile of all successful insertions) on the device type and providers' specialty, years of healthcare service, and completion of the neonatal resuscitation training course was assessed. Successful insertion (p = 0.001) and insertion time (p = 0.003) were associated with using the i-gel vs. laryngeal mask. The providers' backgrounds were not associated with the outcome. Using the i-gel was associated with more successful airway management than laryngeal masks using neonatal manikins. Considering the limited effect of the provider's specialty and experience, using the i-gel as the first-choice device in neonatal resuscitation may be advantageous. Prospective studies are warranted to compare these devices in the clinical setting.

Qualidade de sono e saúde mental de universitários da área da saúde durante a covid-19 / Sleep quality and mental health of university students in healthcare during COVID-19 / Calidad del sueño y salud mental de estudiantes universitarios en el ámbito salud durante el covid-19

Em universitários, comprometimentos na qualidade de sono e na saúde mental estão relacionados com maior disfunção diurna e menor desempenho acadêmico. O contexto causado pela covid-19 prejudicou a qualidade de sono e a saúde mental de diversos grupos populacionais. Entretanto, mais estudos são necessários para avaliar essas variáveis em estudantes universitários matriculados em diferentes cursos da área da saúde durante a referida pandemia. Com esta pesquisa, objetivou-se avaliar a qualidade de sono e saúde mental de estudantes universitários da área da saúde durante a pandemia da covid-19, bem como investigar possíveis correlações entre os referidos aspectos nessa população. Trata-se de estudo transversal que empregou um formulário eletrônico contendo tanto perguntas para caracterização da amostra quanto questionários específicos. O índice de qualidade de sono de Pittsburgh (PSQI) foi empregado para avaliar a qualidade de sono. Já o questionário de saúde geral (QSG-12) e a escala hospitalar de ansiedade e depressão (HAD) para avaliar, respectivamente, o bem-estar psicológico e ansiedade e depressão. 324 estudantes da área da saúde participaram deste estudo. Entre eles, 87.3% apresentaram uma qualidade de sono pobre (≥ 5), 74.1% apresentaram prejuízo na saúde mental e 73.7% apresentaram quadro de ansiedade possível ou provável. Além disso, evidenciou-se correlação moderada positiva entre os valores do PSQI, do QSG-12 e da escala HAD. Nesse contexto, estudos são necessários para investigar opções terapêuticas capazes de atenuar esses impactos.

In university students, sleep quality and mental health impairments are related to greater daytime dysfunction and lower academic performance. COVID-19 has harmed the quality of sleep and mental health of several population groups. However, more studies are needed to evaluate the quality of sleep and mental health of university students enrolled in health courses during the COVID-19 pandemic. To evaluate the quality of sleep and mental health of university students in healthcare during the COVID-19 pandemic and to investigate possible correlations between the aforementioned aspects in this population. An electronic form containing questions to characterize its sample and other specific questionnaires were used in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality and the General Health Questionnaire (QSG-12) and the Hospital Anxiety and Depression Scale (HAD) were used to evaluate psychological well-being, anxiety, and depression, respectively. Overall, 324 health students participated in this study. Of these, 87.3% of students had poor sleep quality (≥ 5), 74.1% had impaired mental health, and 73.7% had possible or probable anxiety. Furthermore, the PSQI, QSG-12, and HAD scale values showed a moderately positive correlation. During the COVID-19 pandemic, university students in healthcare experienced significant losses in their sleep quality and mental health. In this context, studies must investigate therapeutic options to mitigate these impacts.

Las alteraciones en la calidad del sueño y la salud mental de estudiantes universitarios se relacionan con una mayor disfunción diurna y menor rendimiento académico. El contexto provocado por el covid-19 ha perjudicado la calidad del sueño y la salud mental de varios grupos de la población. Sin embargo, se necesitan más estudios para evaluar la calidad del sueño y la salud mental de estudiantes universitarios matriculados en diferentes carreras de salud durante la pandemia del covid-19. El objetivo de este estudio fue evaluar la calidad del sueño y la salud mental de estudiantes universitarios en el campo de la salud durante la pandemia del covid-19, así como investigar posibles correlaciones entre los aspectos antes mencionados en esta población. Se trata de un estudio transversal que utilizó un formulario electrónico que contenía preguntas para caracterizar la muestra y cuestionarios específicos. Se utilizó el Índice de Calidad del Sueño de Pittsburg (PSQI) para evaluar la calidad del sueño. El Cuestionario de Salud General (CSG-12) y la Escala Hospitalaria de Ansiedad y Depresión (HADS) se utilizaron para evaluar, respectivamente, el bienestar psicológico y la ansiedad y depresión. En este estudio participaron 324 estudiantes del campo de la salud. De estos, el 87,3% de los estudiantes tenía mala calidad del sueño (≥ 5), el 74,1% presentaban problemas de salud mental y el 73,7% tenía posible o probable ansiedad. Además, hubo una correlación positiva moderada entre los valores de las escalas PSQI, CSG-12 y HADS. Durante la pandemia del covid-19, los estudiantes universitarios del campo de la salud experimentaron pérdidas significativas en su calidad de sueño y salud mental. En este contexto, son necesarios estudios que investiguen opciones terapéuticas capaces de mitigar estos impactos.

The development and introduction of entrustable professional activities at 2 community-based chiropractic student preceptorship sites in the United States.

OBJECTIVE: Entrustable professional activities (EPAs) have seen widespread adoption in medical education and other health professions education. EPAs aim to provide a bridge between competency-based education and clinical practice by translating competencies into fundamental profession-specific tasks associated with clinical practice. Despite the extensive use of EPAs in health professions education, EPAs have yet to be introduced into chiropractic education. The purpose of this paper is to describe the development and introduction of EPAs as part of 2 community-based chiropractic student preceptorship education programs in the United States. METHODS: EPAs were developed and introduced at 2 community-based chiropractic preceptorship sites in 5 distinct steps: (1) differentiating EPAs from competencies, learning objectives, and knowledge, skills, and attitudes; (2) identifying EPAs; (3) mapping EPAs to competencies and necessary experience, knowledge, and skills; (4) designing EPA assessment strategies; and (5) implementing the use of EPAs. RESULTS: A total of 13 individual EPAs were developed and mapped to Council on Chiropractic Education meta-competency outcomes and underlying experience, knowledge, and skills. Three assessment tools were created to evaluate student entrustability for EPAs and enhance student self-assessment. The EPAs and assessment tools were integrated into chiropractic student preceptorships at each site. CONCLUSION: This paper describes the development and introduction of EPAs at 2 community-based chiropractic preceptorship sites. Future research is needed to develop and standardize EPA use and assessment, and to evaluate outcomes associated with EPA use.