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Resumo Enquadramento: Em tempo de pandemia, as consultas de enfermagem de vigilância da gravidez sofreram alterações, nomeadamente na restrição de acompanhantes. Por esse motivo, é importante a avaliação da satisfação das grávidas com a assistência de enfermagem durante este contexto pandémico. Objetivo: Avaliar a satisfação da grávida com a assistência das enfermeiras obstétricas nas consultas de vigilância da gravidez durante o contexto de pandemia COVID-19. Metodologia: Estudo transversal descritivo de natureza quantitativa, com uma amostra de 196 grávidas. Aplicado a Escala de Satisfação dos Pacientes com a Assistência de Enfermagem (General Practice Nurse Satisfaction Scale - GPNS), constituída pelas dimensões: relacionamento interpessoal e comunicação, confiança, credibilidade e dedicação. Resultados: As grávidas apresentam-se em média mais satisfeitas na dimensão relacionamento interpessoal e comunicação e menos satisfeitas na dimensão dedicação. Conclusão: As grávidas apresentam-se satisfeitas com a assistência de enfermagem percecionando a sua importância. Tal reforça a pertinência das consultas serem realizadas por um Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica.

Abstract Background: Prenatal nursing appointments underwent changes during the COVID-19 pandemic, namely in the restriction of companions. For this reason, it is important to assess pregnant women's satisfaction with nursing care during this period. Objective: To assess pregnant women's satisfaction with nurse midwife-led prenatal appointments during the COVID-19 pandemic. Methodology: A qualitative descriptive cross-sectional study was conducted with a sample of 196 pregnant women. The Portuguese version of the General Practice Nurse Satisfaction Scale (Escala de Satisfação dos Pacientes com a Assistência de Enfermagem) was administered to the sample. The tool consists of the following dimensions: interpersonal relationship and communication, confidence, credibility, and dedication. Results: Pregnant women are, on average, more satisfied in the interpersonal relationship and communication dimension and less satisfied in the dedication dimension. Conclusion: Pregnant women are satisfied with nursing care and acknowledge its importance. This finding reinforces the importance of nurse midwife-led consultations.

Resumen Marco contextual: En tiempos de pandemia, las citas de enfermería para el seguimiento del embarazo cambiaron, sobre todo la restricción de acompañantes. Por esta razón, es importante evaluar la satisfacción de las mujeres embarazadas con los cuidados de enfermería durante este contexto pandémico. Objetivo: Evaluar la satisfacción de las mujeres embarazadas con la atención prestada por las enfermeras obstétricas en las consultas de seguimiento del embarazo durante la pandemia de COVID-19. Metodología: Estudio descriptivo transversal de carácter cuantitativo, con una muestra de 196 mujeres embarazadas. Se aplicó la Escala de Satisfacción de los Pacientes con Asistencia de Enfermería (General Practice Nurse Satisfaction Scale - GPNS), compuesta por las siguientes dimensiones: relaciones interpersonales y comunicación, confianza, credibilidad y dedicación. Resultados: Las mujeres embarazadas están, de media, más satisfechas en la dimensión relaciones interpersonales y comunicación, y menos satisfechas en la dimensión dedicación. Conclusión: Las embarazadas se mostraron satisfechas con los cuidados de enfermería y se dieron cuenta de su importancia. Esto refuerza la pertinencia de que las consultas sean realizadas por una enfermera especializada en Enfermería de Salud Materna y Obstétrica.

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Objetivo: avaliar os fatores clínicos associados ao bem-estar das mulheres durante o trabalho de parto e parto à luz da bioética principialista e da deontologia. Método: estudo transversal com abordagem quantitativa. Participaram 396 puérperas internadas em um hospital municipal do sudoeste da Bahia, e os dados foram coletados no período de janeiro a maio de 2023, após aprovação do comitê de ética em pesquisa. Os dados foram organizados no software Excel e analisados via SPSS v.25. a partir da regressão logística multinomial. Resultados: a maior parte da amostra apresentou bem-estar com assistência em saúde, mulheres que tiveram parto realizado por profissionais não médicos apresentaram mais chances de níveis de bem-estar "adequado". E mulheres que não tiveram a via de parto cesárea apresentaram aumento de chances de bem-estar. Conclusão: é necessário que os profissionais reflitam sobre suas ações, condicionando-as à humanização no parto, em observância aos princípios bioéticos.

Objective: to evaluate the clinical factors associated with women's well-being during labor and delivery in the light of bioethics principlism and deontology. Method: a cross-sectional study with a quantitative approach was conducted. It involved 396 postpartum women admitted to a municipal hospital in the southwest of Bahia. Data were collected from January to May 2023, after approval from the research ethics committee. The data were tabulated using Excel software and analyzed using SPSS v.25 through Multinomial Logistic Regression. Results: majority of the sample exhibited well-being with health care assistance. Women who underwent delivery performed by non-medical professionals showed higher chances of "adequate" levels of well-being. Additionally, women who did not undergo cesarean delivery showed increased chances of well-being. Conclusion: It is necessary for professionals to reflect on their actions, conditioning them to the humanization of childbirth, according to bioethical principles.

Objetivo: evaluar los factores clínicos asociados al bienestar de la mujer durante el trabajo de parto y parto a la luz de la bioética y la deontología principialista. Método: estudio transversal con enfoque cuantitativo. Incluyó 396 puérperas ingresadas en un hospital municipal del suroeste de Bahía. Recolección de datos de enero a mayo de 2023, con aprobación del comité de ética en investigación. Los datos se tabularon en el software Excel y se analizaron mediante SPSS v.25. utilizando regresión logística multinomial. Resultados: la mayoría de las participantes de la muestra presentó bienestar con la atención para la salud; las que tuvieron partos realizados por profesionales no médicos tenían más probabilidades de tener niveles "adecuados" de bienestar; las que no tuvieron parto por cesárea tenían mayores probabilidades de tener bienestar. Conclusión: es necesario que los profesionales reflexionen sobre sus acciones y las adecuen para humanizar el parto, respetando los principios bioéticos.

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BACKGROUND: Virtual simulation experiment is a vital component of higher education digitalization, emerging from the deep integration of specialty disciplines and information technology. Chinese universities have invested heavily in the construction of virtual simulation experiment projects, and the number of projects is considerably large. However, the popularity and effectiveness of these projects are not satisfactory. As an important index to measure the teaching quality, analyzing the influencing factors and mediating effects of learning satisfaction of virtual simulation experiment is an effective entry point to improve the quality and efficiency of virtual simulation experiment teaching and improve the learning effect. METHODS: This study used quantitative research methods. The research sample includes 538 students from various levels of higher education institutions such as Nanjing University, Nantong University, Nanjing Medical University, and Jiangsu University, covering 11 majors. They started to study the virtual simulation experiment course for one academic year in September 2023 and conducted a questionnaire survey at the end of the course. The questionnaire survey involved four aspects, mainly from the student dimension, course dimension, the technical dimension, and the embodied dimension to evaluate the learning satisfaction of the virtual simulation experiment course. The data were analyzed using SPSS and AMOS. RESULTS: According to the results of the structural equation modeling (SEM), all of the student dimension (learning motivation {ß = 0.658,p < 0.001} and task value {ß = 0.339,p < 0.001}), course dimension (course content {ß = 0.275,p < 0.001}, course flexibility {ß = 0.052,p < 0.002}, and course quality {ß = 0.635,p < 0.001}), technical dimension (interface design {ß = 0.445,p < 0.001}, interaction design {ß = 0.151,p < 0.001}, technical adaptability {ß = 0.225,p < 0.001}, and technical reliability y{ß = 0.140,p < 0.001}), and embodied dimension (social presence {ß = 0.270,p < 0.001} and spatial presence {ß = 0.689,p < 0.001}) have positive effects on improving the learning satisfaction of virtual simulation experiments. Meanwhile, the technical dimension exhibited a mediating effect in the influence of embodied dimension on learning satisfaction. CONCLUSIONS: To enhance the learning effectiveness of virtual simulation experiments, we can put forward the strategies from four dimensions including students, course, technical, and embodied to specifically address learning satisfaction. This approach would provide directional guidance for the development of medical virtual simulation experiments.

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BACKGROUND: Satisfaction and happiness are two widely studied topics in current literature. Human beings need to find happiness. However, for many authors, satisfaction is a prerequisite for happiness. Satisfaction, in turn, can be approached from different perspectives, such as job satisfaction, health satisfaction, and social life satisfaction. This research analyses the relationship between these variables and their influence on proactive social behaviour. METHODS: The present study utilised the European Social Survey, an academic survey conducted across Europe in its round 10, carried out between 2022 and 2023, with a database of 25,311 valid responses. Structural equation modelling analysis conduct using PLS-SEM with the Smart PLS software. RESULTS: The results demonstrate a direct and significant relationship between overall satisfaction and happiness and between happiness and prosocial behaviour. Similarly, a solid indirect relationship exists between satisfaction and prosocial behaviour in society. Furthermore, job satisfaction is among the variables influencing overall satisfaction and happiness. However, it is not the most important, with satisfaction with social life being the most influential on satisfaction. CONCLUSIONS AND IMPLICATIONS: Happiness is one of the main variables that influence people's lives. As we have observed, this happiness has a direct and solid relationship with the individual's level of satisfaction, with job satisfaction and satisfaction with social life being the most influential in this relationship between satisfaction and happiness. Therefore, these conclusions must be understood by both workers and employers and public administrations. Additionally, the relationship between happiness and prosocial behaviour is an interesting topic that the governments of countries and regions in Europe should consider.

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Research highlights the positive impact of social connectedness on subjective well-being. In this paper, we test a model in which an identity-based mechanism links a structural form of connectedness (significant social ties) with two psychological well-being outcomes, life satisfaction and self-esteem. Using data from the LIVES Longitudinal Lausanne Youth Study (LIVES-LOLYS, N = 422), a longitudinal mediation path model tests direct and indirect effects, via the strength of social identification, of the number of significant social ties in two life domains (friends and family) on life satisfaction and self-esteem. Results showed positive associations between the number of significant ties and social identification in the concordant domain, empirically linking the structural and subjective forms of social connectedness. Moreover, our model displays significant indirect effects in the friend domain, but not in the family domain. Having more friends as significant social ties predicted higher social identification with friends, and this was longitudinally associated with higher life satisfaction and self-esteem. Findings show a new mechanism linking structural and subjective forms of social connectedness, unpacking their concerted impact in protecting well-being. The differences between the friend and family domains are discussed in the framework of both life-course and social identity perspectives.

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Background: Self-care and empowerment promotion in patients with heart failure (HF) is essential for improving their prognosis, but there is limited information concerning the patients' depth of knowledge about this pathology as well as patient satisfaction within heart failure units (HFUs). Our objective was to assess both aspects in a cohort of patients regularly followed-up HFUs. Methods: A multicenter, observational study was conducted with consecutive patients followed in 14 HFUs between June and November 2023. It was based on a cross-sectional survey comprising 23 questions related to demographics, knowledge/self-care, and the subjective assessment of perceived quality and satisfaction in HFUs. Results: 281 patients were included (36.7% women, 74.7% aged over 65 years). 48% had hospitalizations for HF or sought emergency department services within the preceding year. The mean correct responses related to knowledge were 9.7 ± 2.3 (80.7% of the total), and 53 patients (18.9%) answered all knowledge questions correctly. 211 (79.6%) could identify potential HF decompensation with abrupt weight gain, and 196 (74.2%) recognized at least three additional signs of worsening HF. 266 patients (98.2%) were likely or very likely to recommend HFUs, and 194 (89.8%) positively appreciated the experience at the day hospital. Conclusions: Patients followed up in HFUs showed adequate but improvable knowledge and capacity for self-care, with a high level of satisfaction.

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Introduction: The technological revolution has narrowed the information gap between physician and patient. This has led to an evolution in medicine from paternalistic to patient-centric, with health care systems now prioritizing patient experience to achieve higher satisfaction scores. Therefore, it is imperative to start early in educating trainees on how to best address the holistic needs of the patient while also delivering high-quality care. Methods: We implemented a 1-hour workshop that was repeated weekly over 8 weeks to capture all internal medicine residents in our program. During the workshop, we reviewed the historical evolution of patient care from paternalistic to patient-centered, presented the Hospital Consumer Assessment of Healthcare Providers and Systems survey questions, and discussed evidence-based strategies for physicians to improve their patients' experience utilizing four case-based scenarios. Results: Over the 8-week period, a total of 195 residents participated in the workshop. One hundred thirty-nine residents (71%) completed the pre- and postsession survey. Results demonstrated significant knowledge improvement (p < .001) in all of the topics discussed. Additionally, the majority of residents felt the workshop would be useful in their clinical practice and found the clinical scenarios useful. Discussion: Given the evolution towards patient-centered care, it is important to take a proactive approach in providing residents with the tools to best address their patients' needs. Early understanding of patient satisfaction surveys and the impacts they have on hospital metrics can help trainees in their careers as practicing physicians.

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INTRODUCTION: Job satisfaction is an attitudinal variable representing the extent to which people like or dislike their jobs. It is a critical factor influencing healthcare quality, patient outcomes, and overall well-being in medical professionals. This study aimed to determine Job Satisfaction among medical doctors in Nepal. METHODS: A descriptive cross-sectional study was conducted among medical doctors of Nepal between June 2023 and August 2023 after obtaining ethical approval from the Ethical Review Board of Nepal Health Research Council. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. RESULTS: Among 380 participants, 63 (16.58%) (12.84-20.32 at 95% Confidence Interval) expressed satisfaction. The number of satisfied participants above 40 years were 10 (16%) and less than 40 years were 53 (84%). Out of 63, 46 (73.02%) were male and 17 (26.98%) were females. CONCLUSIONS: Job satisfaction among doctors practicing in Nepal was found to be lower than the studies conducted in similar settings.

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Budesonide Rectal Foam (BF) was introduced in 2017 and changed in November 2022 upon request, addressing the challenges encountered with liquid rectal formulations indicated for ulcerative colitis (UC). This formulation is an important agent in the treatment of rectal to sigmoid colon lesions in moderate UC. As the characteristics of the formulation of the rectal formulation are thought to influence patient satisfaction, a survey was conducted on the formulation and patient satisfaction among patients who used BF before and after the change. The survey spanned from January 2023 to May 2023. As the primary endpoint, the same patients were evaluated on the Visual Analogue Scale (VAS) for patient satisfaction. Significant variations in formulation usability and patient satisfaction were observed in 20 eligible patients before and after the change (p<0.05). Patient satisfaction with the formulation was strongly correlated with formulation usability, ease of pushing the head, and ease of insertion (r>0.7). The change in packaging was thought to improve the usability of the formulation and patient satisfaction. The formulation's usability and ease of insertion had a clear influence on satisfaction with the rectal formulation.

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BACKGROUND: Work-family conflict among physicians has many adverse consequences, like reduced work engagement and impaired well-being. However, relatively little research has been conducted on the impact of work-family conflict on specific pathways of physician well-being. The aim of this study was to determine the relationship between work-family conflict and employee well-being among physicians and to explore the mediating role of job satisfaction and work engagement in this relationship. METHODS: Using data from a cross-sectional survey of 2,480 physicians in Jilin Province, China, partial least squares structural equation modeling (PLS-SEM) was applied in this study to examine the direct and indirect effects of work-family conflict on employee well-being and to assess the mediating roles of job satisfaction and work engagement therein. RESULTS: The employee well-being score of physicians in Jilin Province was 5.16 ± 1.20. The univariate analysis results indicated significant disparities in employee well-being scores across different age groups, marital statuses, and professional titles. Work-family conflict was significantly negatively associated with employee well-being, while job satisfaction and work engagement were significantly positively associated with employee well-being. In addition, job satisfaction and work engagement were found to mediate the association between work-family conflict and employee well-being, and work engagement was considered to mediate the association between job satisfaction and employee well-being. CONCLUSIONS: Our study confirms that work-family conflict negatively affects physicians' employee well-being. Moreover, our investigation revealed that the association between work-family conflict and employee well-being is influenced by both job satisfaction and work engagement and that work engagement plays a mediating role in the link between job satisfaction and employee well-being. Therefore, we propose that hospital administrators should rationally allocate organizational resources and develop manageable schedules to enhance physicians' employee well-being.

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Introduction: The design of Pediatric Intensive Care Unit (PICU) rooms significantly impacts patient care and satisfaction. The aims were first, to describe the current physical space across PICUs in the USA, and second, to identify what proportion of PICUs are compliant with current guidelines. Methods: A descriptive cross-sectional survey was conducted, targeting division chiefs and medical directors of PICUs nationwide. The survey collected data on unit type, construction and renovation dates, room sizes, and available amenities. According to the Guidelines for Design and Construction of Hospitals, PICU rooms are recommended to be single rooms, at least 200 sq ft, have a window and a private bathroom. Data were anonymized and reported as median and interquartile ranges or frequencies and percentages. Results: Thirty units responded. Among the respondents, 26 had general PICUs, 9 had cardiac ICUs, and 3 had intermediate care units, with some units containing multiple types of ICUs. The median annual admissions were 1,125, with a median occupancy rate of 78%. Twenty-three percent of units had at least one double room, and 3% had triple or quadruple rooms. The median room size was 265 sq ft (IQR 230; 304), the smallest room size was 220 sq ft (IQR 179; 275), and the largest single room size was 312 sq ft (IQR 273; 330). Thirty-seven percent of units had bathrooms in every room, while 80% had windows in every room. Additionally, 46% of units had dialysis capabilities in every room, and 7% had negative pressure capabilities in every room. The median building year was 2008 (IQR 2001;2014), with 36% of units having undergone at least one renovation. Larger rooms were associated with more recent build dates (p = 0.01). Only 30% of the PICUs met the guidelines for physical space. These compliant units were built at a median of 4 years ago (IQR 1; 8). Conclusion: This study highlights the variability in PICU room design and amenities across healthcare facilities. Many units still fall short of meeting the guidelines for room size, windows, and private bathrooms. Future research should investigate the relationship between room characteristics and patient outcomes to inform better design practices, with a goal of improving patient experiences and clinical outcomes.

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BACKGROUND: The purpose of this project was to measure satisfaction with virtual comprehensive geriatric assessments (CGA) among older Veterans (OVs). METHODS: The CGA involved five different healthcare providers and four one-hour VA Video Connect (VVC) calls. Using specific enrollment criteria, OVs were recruited in four cohorts separated by time. After completing the CGA, participants were asked to complete a 10-statement telephone questionnaire. Before analyses, responses to each statement were dichotomized as Agree (Agree/Strongly agree) or Do not Agree (Neutral/Disagree/Strongly Disagree). Descriptive statistics and Binomial generalized linear models (GLMs) were used to analyze the data. RESULTS: All 269 enrolled OVs completed all components of the CGA. This included 79, 57, 61, and 72 Veterans in cohorts 1 to 4, respectively. Their average age was 76.0 ± 5.9 years, and they were predominately white (82%), male (94%), and residents of rural settings (64%). Of the 236 (88%) OVs who completed the telephone survey, 57% indicated they were comfortable using VVC and 57% expressed willingness to use VVC again; 44% felt that VVC was easier than going to in-person visits. The OVs in Cohort 1 were more likely to agree with these statements than those in the remaining cohorts, especially Cohorts 2 and 4. Differences in demographics partially explained some of these findings. The majority (89% or higher) of survey participants agreed with the remaining seven survey statements indicating they were satisfied with the CGA program. CONCLUSION: OVs were very satisfied with their participation in a program of CGA, although not necessarily the mode of delivery. The percentage of participants who indicated discomfort using VVC for the CGA visits appeared to increase with time. Further work is needed to determine which OVs would be the best candidates to use VVC to complete all or part of a CGA.

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PURPOSE: The current study performed a post-occupancy evaluation on a new cancer infusion center with pod-like layout and compared results to a pre-occupancy evaluation to investigate the impact of different cancer infusion center designs on staff efficiency and patient and staff satisfaction. BACKGROUND: The new cancer infusion center opened in October 2020 and replaced two previously existing infusion centers, in the same healthcare system. METHODS: The study used a similar mixed-method approach as the pre-occupancy research, which included staff shadowing, medication delivery shadowing, and staff and patient questionnaires. RESULTS: The new infusion center improved staff efficiencies by reducing nurse travel time compared to pre-occupancy infusion centers. Results also showed an increase in satisfaction with different aspects of the new infusion center including patient privacy, by both patients and nurses. The pod design allowed for better audio and visual privacy for patients, provided a higher amount of worksurface and availability of workstations, reduced noise levels, and enhanced nurse concentration at workstations. Findings indicated that nurses who had prior experience working in the pre-occupancy infusion centers expressed significantly lower levels of satisfaction in the new infusion center, especially in the ability to connect with nurses in other pods. CONCLUSIONS: Although the new pod design had limitations in terms of collaborative opportunities across pods, it showed to provide a more efficient work environment for the staff and increase staff and patient satisfactions. The results also highlight the importance of effective change management strategies when nurses transition to a new work environment.

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The evaluation of outdoor green spaces is influenced by diverse sensory perceptions. Traffic noise and thermal conditions significantly impact greenway-walking satisfaction; their optimization is vital for improving user experience and encouraging outdoor engagement. The study examines a typical Beijing greenway during autumn, focusing on strategies to enhance the walking experience under the combined effects of noise and thermal environments through mobile measurements and surveys. The results show that: 1) The interplay between noise and thermal factors varies depending on the walking state. Upon arrival, an increase in noise significantly worsens thermal comfort; higher sound levels intensify warm thermal sensations, though this effect is not consciously perceived. Upon departure, the effect of noise on thermal perception is not obvious. In both walking states, thermal sensation significantly affects subjective noise perception, yet the trends of influence differ. Subjective noise loudness increases as thermal comfort worsens, showing significant correlation only upon departure. 2) During autumn greenway walks, acoustic factors exert a greater impact on Overall Environmental Satisfaction (OES), with subjective noise loudness being more influential than noise level, followed by air temperature (Ta). Greater noise decreases OES, while OES increases initially with Ta and then decreases. The integrated effects of noise-thermal factors on OES show significant changes. 3) To enhance the autumn greenway-walking experience, the advised parameters are A-weighted Sound Level (ASL) ≤ 59.12 dBA and 15.17 °C ≤ Ta ≤ 18.75 °C. Finally, three design strategies are proposed: reducing subjective noise loudness, differentiating design based on walking status and balancing acoustic-thermal perceptual preferences.

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Introduction Antenatal education is one of the ways to increase a woman's knowledge about pregnancy and childbirth, which could improve self-efficacy during labor, making the expecting mothers well-prepared for labor and nursing. One of the ways for its delivery could be via well-structured antenatal classes. Such classes are part of many countries' healthcare systems and have proven to decline maternal anxiety, shorten labor, increase partner involvement, and overall improve labor experience. However, at the same time, such classes can augment more interventions in labor, induction of labor, and epidural usage. Despite the heterogeneous results of their effect, the high demands of antenatal education among pregnant women can justify its incorporation into antenatal care. By allowing the women to identify labor correctly and preventing admission in false labor, shortening the labor, and teaching women non-pharmacologic ways to manage labor pains, it can reduce the patient and fiscal burden on the already overwhelmed maternity units of Pakistan, hence proving to be an inexpensive health promotion tool. Methods This cross-sectional study was conducted in the Department of Obstetrics and Gynecology of Aga Khan University Hospital Karachi, Pakistan, between December 2020 and June 2021. All pregnant women, aged 18 to 45 years, between gestational ages of 37 to 42 weeks, with singleton, cephalic pregnancy, booked during the first or second trimester, and who attended at least one antenatal class, were invited to participate. Women who had any contraindication to vaginal delivery, whose labor was induced, or who suffered from medical, psychological, or obstetric comorbidities were excused. The participants were observed for labor outcomes in terms of stage of labor on arrival, use of epidural analgesia, mode of delivery, and childbirth experience, using a validated research tool, known as the Questionnaire for Assessing the Childbirth Experience (QACE) to identify women with a positive or negative childbirth experience. A higher score representing on the questionnaire represented a more negative birth experience. A score of less than 19 was considered a positive birth experience. Data was analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, Version 19. Results The mean QACE score was reported as 18.2±3.00, reflecting that on average the mothers had a positive childbirth experience. Modes of delivery revealed 57.6% of the women delivering spontaneously, with 60.4% of them arriving in the labor room in active labor. Demand for labor analgesia in the form of epidural was 64%. Majorly the participants attended only one antenatal class, with 66.91% of women reporting a positive childbirth experience. Conclusion Antenatal education classes are a low-input, high-yielding resource that can be used to empower mothers with pertinent information and support for a pleasant childbirth experience while simultaneously taking the edge off the overburdened maternity wards of low resources, in densely populated countries like Pakistan. Hence it is the need of the hour to devise plans to invest in these classes to make them available to the masses.

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Background and Objectives: Self-employment is a vital alternative to waged employment for older workers. Recent research has shown that employment transitions frequently occur when individuals approach retirement. However, evidence of how older people's health changes when they switch between self and waged employment is lacking, particularly outside Western contexts. To address this research gap, we explored the health impact of employment transitions for the older working population in China by hukou (urban or rural household registration status), region, and education. Research Design and Methods: We employed fixed effect models to examine the impact of employment transitions on cognitive, mental, and physical health and life satisfaction drawing on data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (N = 4,606). Given China's unique context, we analyzed the results of agricultural and nonagricultural work separately. Results: Individuals transitioning into or remaining in self-employment had lower self-rated health and life satisfaction than those remaining in waged employment. There was no significant difference in cognitive functioning or depressive symptoms. Additionally, those who transitioned from self-employment into waged employment rated their health worse than those who remained in waged employment. The health impacts were more apparent for agricultural than nonagricultural self-employment, particularly for older workers living in urban regions with rural hukou and lower education levels. Discussion and Implications: Most older Chinese transitioning into or staying self-employed are or were pushed into self-employment due to their low human capital and socioeconomic status, which affects their subsequent health. Pension reform and policies supporting older adults to stay in the workforce could help close the economic and health gaps between rural and urban older adults.

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Aim: The study aimed to translate the OHIP-EDENT into Hindi and assess its validity and reliability. Methods: The study included 150 participants whose demographic information was collected using the Modified Kuppuswamy Socio-economic Scale. The Oral Health Impact Profile in Edentulous (OHIP-EDENT) was translated into Hindi using the standard forward-backward method. Test-retest reliability was assessed using the Intra-class Correlation Coefficient (ICC) and internal consistency using Cronbach's alpha. The Kaiser-Meyer-Olkin (KMO) test and Bartlett's test of sphericity coefficient were used to conduct Exploratory Factor Analysis (EFA) and confirm the Construct validity. To establish Convergent validity, the relationship between the global question and the OHIP-EDENT-H subscale scores was observed. Results: The data was analyzed with a confidence level of 95 %, and statistical significance was interpreted as a p-value of less than 0.05. The Cronbach's alpha score for OHIP-EDENT-H was 1.00, indicating high internal consistency. The corrected item-total correlations ranged from 0.665 to 0.923, and the total ICC score was 0.763, demonstrating good reliability. The subscales' intra-class correlation coefficient values ranged from 0.968 to 0.997, indicating high reliability. However, items 4, 6, 13, 17, 18, and 19 had factor loadings below the acceptable threshold of 0.40 in the factor analysis. Additionally, the total and subscale scores of the OHIP-EDENT-H showed significant correlations with global question, with correlation coefficients ranging from 0.665 to 0.923. Conclusion: The Hindi version of OHIP-EDENT is a reliable and valid tool for evaluating the OHRQoL of Hindi-speaking edentulous individuals.

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In the past decade, the concept of dyadic coping as a buffer against stress in romantic relationships has received much attention in Western countries, but it has rarely been studied in non-Western countries and among parents with school-aged children. The aim of the present study was to investigate the moderating effect of dyadic coping on the link between financial strain and marital satisfaction, as well as the mediating effect of marital satisfaction on the relationship between financial strain and quality of life. There were 751 heterosexual couples whose eldest child aged 7-12 years in West Java, Indonesia (mean age husband = 37.53 SD = 5.09; mean age wife = 34.42 SD = 4.85) fulfilled the paper and pencil questionnaires in the study. The moderated mediated model illustrated that (1) greater levels of dyadic coping weakened the negative association between financial strain and marital satisfaction for husbands and for wives (2) for both husbands and wives, there were no mediation effect (3) for both husbands and wives, financial strain was negatively associated with quality of life; and marital satisfaction was positively associated with quality of life. We discuss both the theoretical and practical implications of these findings.

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Background: There is substantial evidence on the associations between a positive nurse practice environment and improved nurse and patient outcomes, as well as the factors that mediate these associations, in high-income countries and in hospital settings. The knowledge gaps in African and primary health care settings motivated this empirical study. Objective: The objective of this study was to examine the impact of the dimensions of the nurse practice environment, specifically human resource management, foundations for nursing care, and participation in clinic affairs, on job outcomes and standards of care. Design: A cross-sectional study was conducted between November 2021 and June 2022. Setting: 180 primary health care clinics in two South African provinces of Gauteng and North West. Participants: 665 nurses of all categories. Methods: A causal model was developed with pathways between the nurse practice environment dimensions and the outcomes of job satisfaction, intention to leave, and standards of care. A set of standardised instruments was used to measure the study variables. Using structural equation modelling, workload and professional support were tested as potential mediators between the nurse practice environment and the outcome variables. Results: The nurses scored the domain of foundations for nursing care 71.2 out of 100 on average, indicating high agreement, while the mean scores for nurses' participation in clinic affairs and human resources management were lower at 68.0 and 61.7 respectively. Although nurses expressed moderate satisfaction with professional support (67.7), they were less satisfied with their workload (52.2). The mean score of overall job satisfaction was moderate (58.9), with 53.8 % of the nurses reporting that they intended leaving the clinic where they were working. Thirty-six percent intended leaving the nursing profession, indicating low intention to stay. The final mediation model was judged to fit the data adequately based on goodness-of-fit indices, confirming that workload and professional support had a mediating role between the nurse practice environment dimensions of interest and both nurses' job outcomes and standards of care. Conclusions: We have highlighted the value of supportive practice environments, effective workload management, and enhanced professional support in improving nurses' job outcomes and satisfaction with standards of care. Improving nurses' practice environments at primary health care level may have a wide-ranging impact on the performance of the health system. Therefore, primary health care facility managers should ensure that workload is distributed equitably, professional support for nurses is enhanced, and the overall work environment is improved.

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PURPOSE: This study investigated symptoms of anxiety and depression, feelings of loneliness, and life satisfaction among low-to-middle income Peruvian adolescents during 2 years of remote schooling due to the COVID-19 lockdown. METHODS: We used a four-wave longitudinal observational approach. Data were collected in April 2020, October 2020, June 2021, and November 2021 in Perú. A total of 2,392 adolescents (ages 10-15; 57% female) participated in the study. We described longitudinal changes in symptoms of anxiety and depression, feelings of loneliness, and life satisfaction across the four time points and investigated sex and school grade differences. RESULTS: Symptoms of anxiety, depression, and loneliness increased, and life satisfaction decreased over the course of 2 years of remote education. The rate of change was different for each outcome of well-being. We found robust sex differences for all outcomes. In addition, we found school grade differences for anxiety and depression. DISCUSSION: The mental health and well-being of Peruvian adolescents, particularly female adolescents, declined during 2 years of remote education, despite loosening of other pandemic restrictions. Depression appears to have the earliest impacts, with anxiety levels showing even some improvement for male adolescents. School grade differences in levels of anxiety and depression for seventh and eighth graders in 2020 and 2021 provide initial evidence to disentangle pandemic from developmental effects.