Development and psychometric testing of an instrument to compare career choice influences and perceptions of nursing among healthcare students

Background: With the availability of more healthcare courses and an increased intake of nursing students, education institutions are facing challenges to attract school leavers to enter nursing courses. The comparison of career choice influences and perception of nursing among healthcare students can provide information for recruitment strategies. An instrument to compare the influences of healthcare career choice is lacking. The purpose of this study is to develop and evaluate the psychometric properties of an instrument to compare the influences of healthcare career choice with perceptions of nursing as a career choice. Methods: The study was conducted in two phases. In phase one, two sets of scales with parallel items that measure the influences of healthcare career choice and perceptions of nursing as a career choice were developed through an earlier qualitative study, literature review, and expert validation. Phase two involved testing the construct validity, concurrent validity and reliability with a convenience sample of 283 first year healthcare students who were recruited at two education institutions in Singapore. Results: An exploratory factor analysis revealed 35-parallel items in a six-factor solution (personal interest, prior healthcare exposure, self-efficacy, perceived nature of work, job prospects, and social influences) that explained 59 and 64% of the variance for healthcare career choice and nursing as a career choice respectively. A high correlation (r = 0.76, p \u3c 0.001) was obtained with an existing tool, confirming the concurrent validity. The internal consistency was sufficient with Cronbach’s alpha of 0.93 for healthcare career choice and 0.94 for nursing as a career choice. The test-retest reliability was acceptable with an Intraclass Correlation Coefficient of 0.63 for healthcare career choice and 0.60 for nursing as a career choice. Conclusions: The instrument provides opportunities for understanding the differences between influences of healthcare career choice and perceptions of nursing as a career choice. This comparative understanding of career choice influences can guide educator and policy-makers on nursing recruitmen

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Pes Anserine Syndrome and Bursitis in a Stroke Patient without Prior Knee Pathology: Diagnostic and Treatment-Learning Points

Snapping pes anserinus is a cause of extraarticular medial knee snapping. It results from the translation of the semitendinosis or gracilis tendon during active knee flexion and extension. A 60-year-old female with left medullary infarct and no prior left knee pathology presented with left painful knee snap on walking 3 years after the stroke onset. Clinical examination detected a medial knee snap on the left knee extension. Dynamic ultrasound identified the semitendinosis tendon causing the knee snap. Magnetic resonance imaging of the left knee excluded intraarticular causes of knee snap and confirms soft-tissue edema and bursitis near the pes anserine. The patient was treated with local anesthetic injection and physical therapy with immediate pain relief. This case describes pes anserine syndrome in a stroke patient without prior knee pathology. Poststroke gait deviation can possibly cause repetitive excessive knee loading, leading to secondary musculoskeletal complications such as snapping pes anserinus

Hip fractures: A review of predictors affecting Functional Independence Measure, ambulation and rehabilitation length of stay during inpatient rehabilitation in Singapore General Hospital

Introduction: Osteoporotic hip fractures receiving surgery are common and early rehabilitation is needed in the acute hospital setting. In Singapore, many receive rehabilitation after hip surgery in a tertiary hospital, and various clinical variables may be predictors of functional outcomes. Methods: We retrospectively reviewed 68 patients who went through inpatient rehabilitation in Singapore General Hospital. The primary outcomes of this study were to identify predictors which affect Functional Independence Measure (FIM) efficiency and motor FIM gain at discharge. The secondary outcomes include predictors affecting ambulation distance at discharge and rehabilitation length of stay (RLOS). Results: Age, dementia and days from fracture to surgery are important predictors of FIM efficiency; age and FIM efficiency are important predictors of ambulation distance; and type of fracture is an important predictor of RLOS. Patients of age <75 (OR 2.419, p =0.002), absence of dementia (OR 2.570, p =0.045) and those who received surgery <3 days from fracture onset (OR 2.529, p =0.036) achieved greater FIM efficiency. Younger patients of age <75 (OR 23.177, p =0.030) and those with FIM efficiency of more than 7 points per week (OR 38.963, p =0.05) achieved greater ambulation distance at discharge. Type of hip fracture is an important predictor for RLOS, with neck of femur fracture patients having shorter RLOS (OR 7.186, p =0.005). Conclusion: Age, dementia, days from fracture to surgery and type of hip fractures are important predictors of early functional outcomes in inpatient rehabilitation setting

Delinquency and self esteem.

This study examines the various factors that affect the self esteem and juvenile behaviour among the male youths of today. It includes a study on the self as a mediating factor of the relationships between these factors and juvenile delinquency