BACKGROUND: There is a common concern that range of motion (ROM) is negatively affected by the Latarjet procedure. We hypothesize that the Latarjet procedure results in full recuperation of ROM postoperatively and significantly improved patient reported outcome measures.
METHODS: Patient data were prospectively collected from a randomized controlled trial to analyze outcomes after open Latarjet procedure. Inclusion criteria involved a minimum follow-up of six months and unilateral shoulder instability. Study outcome was assessed by postoperative ROM at six months postoperatively and compared to the preoperative ROM of the ipsilateral shoulder as well as the ROM of the unaffected contralateral shoulder. All ROM measurements were performed utilizing a motion capture system to ensure consistent and reliable measurements.
RESULTS: The study included a total of 84 patients. ROM was measured in external rotation with the shoulder adducted (ER1), external rotation with the shoulder abducted 90 degrees (ER2), internal rotation with the arm abducted 90 degrees (IR2), and active forward elevation (AE). The average difference in ROM between the operated arm vs. the contralateral healthy arm at six months postoperatively was 3.4 degrees in ER1 (p=0.19), 4.2 degrees in ER2 (p=0.086), 2.2 degrees in IR2 (p=0.36), and 2.4 degrees in AE (p=0.045). Sub-analysis of patients with and without sling use revealed no significant difference in ROM between the operated shoulder and contralateral shoulder at six months in either group, with the exception of ER2 in the sling group. In this latter group, ROM was 71 degrees in the operated arm and 79 degrees in the contralateral arm (p=0.0094). Average preoperative pain score was 25.7 (21.4-30.1, 95%CI) vs. 13.0 postoperatively at six months (9.50-16.5, 95%CI) (p <0.00001). Average preoperative SANE instability was 42.9 (38.4-47.3, 95%CI) vs. 86.2 postoperatively at six months (83.6-88.7, 95%CI) (p <0.00001). Average preoperative Rowe score was 38.5 (34.3-42.7, 95%CI) vs. 84.3 at six postoperative months (81.1-87.4, 95%CI) (p<0.00001).
CONCLUSIONS: Latarjet procedure performed for anterior instability utilizing a capsular repair result in complete ROM recovery in ER1, ER2, and IR2 at six months postoperatively, with only a slight discrepancy in active elevation. Sling use after the Latarjet procedure results in no benefit over postoperative recovery without the use of a sling. Sling use negatively affects the ROM in ER2, taking as reference the contralateral arm of the same patient, when compared to patients that did not use a sling postoperatively.

Teaching can be considered as an extremely demanding and stressful occupation and being a language educator brings about its own distinctive challenges. In the wake of COVID-19 pandemic, teachers worldwide experienced fundamental changes in their profession and their lives as a whole. Coping with such an unprecedented situation and responses to it have created new and extra stressful factors for teachers to cope with, including the difficulties created by quick transition from direct teaching to virtual and remote teaching. This study examined EFL teachers\' coping strategies during the Covid-19 virtual education and their association with work engagement and teacher apprehension. A total of 296 language instructors contributed to this study by participating in a survey in January 2021. To determine what coping strategies teachers use in virtual teaching during Covid-19, the researchers adapted the Brief-COPE scale designed and validated by Carver (Int J Behav Med 4:92-100, 1997) to make it appropriate for virtual education. The survey measured 11 coping strategies divided into two broad types, approach and avoidant. For measuring work engagement, the Work and Well-being Survey (UWES) scale designed and validated by Schaufeli and Bakker (Test manual for the Utrecht work engagement scale, vol 3. Utrecht University, The Netherlands, pp. 44-52, 2003. http://www.schaufeli.com) was utilized. To assess teachers\' apprehension, the research employed the Sources of Teachers\' Apprehension Scale (STAS) developed by Ghanizadeh et al. (Asia-Pac Educ Res 1-14, 2020). The result demonstrated that the adapted coping strategies scale enjoys acceptable reliability and validity indices. The results estimated via structural equation modeling (SEM) revealed that EFL teachers\' approach coping strategies positively and significantly predicted work engagement (β = 0.72, t = 10.56). Work engagement was negatively predicted by avoidant coping strategies (β = - 0.29, t = - 3.36). Teacher apprehension was negatively influenced by approach coping strategies (β = - 0.44, t = - 5.57) and positively by avoidant coping strategies (β = 0.43, t = 5.29). The study proposes some practical recommendations for overcoming the Covid-19 related challenges which could further deliver valuable guidance for supporting future training of teachers.

UNASSIGNED: The aim of the present study was to determine the prevalence of paraplegia-related fear in spinal anesthesia among the general population in the central region of Saudi Arabia.
UNASSIGNED: A total of 371 participants were given a pretested, precoded, questionnaire was used to collect data to assess the prevalence of fear of paraplegia in spinal anesthesia. The questionnaire contained questions to assess variables like the extent of fear, causes, gender preponderance, any false information about paraplegia in spinal anesthesia, and complications experienced after receiving spinal anesthesia.
UNASSIGNED: It was noted that 80.1% of the respondents were familiar with the term spinal/regional/epidural anesthesia. Forty one point eight percent of the respondents their reference of knowledge about regional anesthesia was family of friends. Thirteen point nine percent of the responses were paralysis, 8.2% of the responses were feeling of pain during the operation, and 7.9% of the responses were nausea or vomiting.
UNASSIGNED: The present study revealed that the participants exhibited a certain degree of apprehension stemming from their inadequate understanding and awareness regarding spinal anesthesia.

WHAT IS KNOWN ON THE SUBJECT?: Involuntary detention is a legislative power that allows people to be taken against their will for a mandatory mental health assessment and is known to be a restrictive and traumatizing process for patients. While there is some literature examining police/ambulance and mental health worker co-response models, the conclusions are mixed as to whether they reduce rates of involuntary detentions in mentally ill people. The Police, Ambulance, Clinician Early Response (PACER) model is an example of a tri-response mental health crisis response team whose role is to respond and assess people thought to be experiencing a mental health crisis. There is little literature to determine whether PACER tri-response model reduces incidents of involuntary detention when compared with standard police and/or ambulance responses. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes the outcomes of patients assessed by a PACER team, compared with patients who were assessed by police or ambulance. It demonstrates that PACER may reduce unnecessary involuntary detentions through expert mental health assessment for patients coming to emergency services for assistance. It is one of only two published studies examining a tri-response model. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results of this study may support health and policing policymakers to implement PACER models as a means of reducing involuntary detentions, reducing demand for emergency departments, reducing time spent by emergency services responding to people experiencing mental health crisis and improving outcomes for people with mental illness.
UNASSIGNED: BACKGROUND: Involuntary detention is a common method of enforcing mental health assessment and treatment; however, it is associated with poor patient outcomes and high emergency service and hospital demand.
OBJECTIVE: To examine the association between (1) Police, Ambulance, Clinician, Early Response (PACER) model, (2) police or (3) ambulance response and rates of involuntary detention of mentally ill people.
METHODS: A retrospective observational study using routine administrative data in an Australian City, over a 12-month period (2019-2020).
RESULTS: Over a 12-month period, 8577 people received crisis mental health intervention in the study setting. We observed an 18% increase in the relative risk of being involuntarily detained by police, and a 640% increase in the relative risk of being detained by ambulance. The PACER team detained 10% of their total presentations, as compared with 12% by police and 74% by ambulance. Involuntary detentions enacted by PACER were more likely to convert to a post-detention hospitalization (72%), when compared with police (27%) and ambulance (17%).
CONCLUSIONS: PACER was associated with lower rates of involuntary detention and higher rates of post-detention hospitalization when compared to police and ambulance response.
CONCLUSIONS: PACER cohort experience more positive outcomes than with police or ambulance cohorts.

OBJECTIVE: We aimed to develop a consensus-based rehabilitation guideline specifically designed to reduce apprehension following arthroscopic Bankart repair after traumatic anterior shoulder dislocation. DESIGN: Delphi-based consensus. METHOD: A comprehensive list of interventions for potential inclusion in a postoperative rehabilitation guideline was developed. American and European physiotherapists and orthopedic surgeons were invited to participate in a Delphi panel, engaging in 3 survey rounds. The health professionals were surveyed about their level of agreement on both initially listed and newly suggested interventions. Consensus was established when a \"critical-to-include\" rating was given in ≥70% of all responses. Ten former patients were consulted to identify the intervention during standard care rehabilitation that had the most impact on reducing postoperative apprehension following ABR. Any interventions not initially listed in the first round were added to the second survey round of the Delphi process. RESULTS: Forty-four health professionals reached consensus on a set of 27 interventions for managing apprehension after arthroscopic Bankart repair. New interventions included gradual exposure to shoulder positions eliciting apprehension, training in anterior stability-provoking positions, and education addressing the impact of psychosocial factors. Former patients identified specific interventions that were effective in reducing postoperative apprehension following ABR. These interventions encompassed medicine ball throws, active-assisted wall slides, and kinetic chain exercises in anterior stability-provoking positions. CONCLUSION: Our Delphi process informed expert recommendations for various interventions aimed at addressing apprehension associated with ABR. The recommendations were the foundation for developing a rehabilitation guideline (REGUIDE). The REGUIDE integrates principles from cognitive-behavioral therapy to improve rehabilitation and mitigate apprehension. J Orthop Sports Phys Ther 2024;54(5):1-13. Epub 20 March 2024. doi:10.2519/jospt.2024.12106.

UNASSIGNED: Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads.
UNASSIGNED: Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability. Patients completed the supine moving apprehension test and the Western Ontario Shoulder Instability index before and 6 months after surgical stabilization of their shoulder. The presence of anterior apprehension was also documented post-operatively.
UNASSIGNED: The supine moving apprehension test demonstrated good test-retest reliability (intraclass correlation coefficient = 0.74-0.84). Patients performed 18-30 repetitions less than healthy individuals during the supine moving apprehension test (P < 0.01). A strong correlation was found between supine moving apprehension test scores and Western Ontario Shoulder Instability post-operatively (r = -0.74, P ≤ 0.01). Supine moving apprehension test scores significantly improved among patients following surgery (P < 0.01). Patients with a negative apprehension test post-operatively performed the supine moving apprehension test significantly better than patients with a positive apprehension test (P < 0.01).
UNASSIGNED: The supine moving apprehension test is reliable and valid among patients with anterior shoulder dislocation and may serve to assess patients\' ability to control shoulder anterior instability loads.

How students experience the learning process is of great importance because it affects the enthusiasm they feel during this process. Although many studies have been conducted on apprehension, anxiety, and burnout in both teachers and students, few focus on the relationship between these three variables. To this end, the three variables in this review study are first defined. Then, the relationship between EFL learners\' apprehension and their anxiety and burnout is discussed. It seems that the more apprehensive and anxious one feels, the more likely they feel burned out. Finally, the implications of this study and suggestions for further studies are presented.

OBJECTIVE: Despite previous research identifying anxiety as a risk factor for problematic smartphone use among students, the mediating and moderating mechanisms underlying the relationship between the two aforementioned variables are poorly understood. This study aims to explore the relationship between anxiety and problematic smartphone use among first-year junior high school students, together with the mediating effects of school adjustment and the moderating effects of physical activity on the mentioned relationship.
METHODS: This study was conducted using a Web-based self-report questionnaire survey with data collected from 445 first-year junior high school students in Jinan City, Shandong Province. Mediation and moderation analyses were performed using the PROCESS macro in SPSS.
RESULTS: The results showed that anxiety predicted problematic smartphone use not only directly but also indirectly via school adjustment. School adjustment played a partial mediating role in the relationship between anxiety and problematic smartphone use. Physical activity also played a moderating role in the relationship between anxiety and school adjustment.
CONCLUSIONS: school adjustment and physical activity may be important variables in the relationship between anxiety and problematic smartphone use.

UNASSIGNED: Dental graduates undergo stress owing to factors such as academic pressure and job uncertainty. Additionally, a lack of guidance with regard to clinical entrepreneurship is a cause of great concern. This study aimed to assess the aspirations and apprehensions of dental interns and to determine the availability of career guidance among them.
UNASSIGNED: A cross-sectional online survey was conducted using a self-designed electronic questionnaire. A total of 480 dental interns from both public and private dental institutions in the state of Kerala were included in this study. The stratified random sampling method was adopted, and the population proportion ratio was used to collect the samples. Data were analysed using the Chi-square test, Student\'s t-test, analysis of variance and multivariate linear regression.
UNASSIGNED: The majority of the interns were females (87.5%); 75% of the participants had graduated from private institutions and 44% resided in rural areas. The apprehension score was high among interns from private institutions and those who belonged to a higher socioeconomic stratum (P < 0.05). However, the level was low among those who expressed strong aspirations (r = -0.213) and satisfaction (r = -0.329).
UNASSIGNED: The determinants for apprehension exhibited substantial disparities among the private and public educational sectors. Although the scenario of students who approached dentistry was similar, their plans for the future differed based on gender, sector and socioeconomic status. The lack of effective career guidance from institutions might impact the advancement of dentistry in future.

OBJECTIVE: The purpose of this study was to investigate the outcomes of conservative treatment for recurrent shoulder dislocation without subjective apprehension, despite the presence of a Bankart lesion or glenoid defect.
METHODS: A retrospective analysis was performed for 92 patients with recurrent shoulder dislocation treated with conservative treatment due to negative apprehension between 2009 and 2018. The failure of the conservative treatment was defined as a dislocation or subluxation episode or subjective feeling of instability based on a positive apprehension. The Kaplan-Meier method was used to estimate failure rates over time, and a receiver operating characteristic (ROC) curve was constructed to determine a cut-off value for a glenoid defect. The clinical outcomes were compared between patients who completed conservative treatment without recurrence of instability (Group A) and those who failed and subsequently underwent surgical treatment (Group B) using shoulder functional scores and sports/recreation activity level.
RESULTS: This retrospective study included 61 of 92 eligible patients with recurrent shoulder dislocation. Among the 61 patients, conservative treatment failed in 46 (75.4%) over the 2-year study period. The cut-off value for a glenoid defect was 14.4%. The association between glenoid defect size (≥ 14.4% or as a continuous variable) and survival was statistically significant (p = 0.039 and p < 0.001, respectively). The mean glenoid defect size in Group B increased from 14.6 ± 3.0% to 17.3 ± 3.1% (p < 0.001), and clinical outcomes for Group A were inferior to those for Group B at the 24-month follow-up.
CONCLUSIONS: Conservative treatment for recurrent shoulder dislocation in patients without subjective apprehension showed a high failure rate during the study period, especially if the glenoid defect was ≥ 14.4% in size. Despite clinical improvement in patients who completed conservative treatment without recurrence, functional outcome scores and sport/recreation activity levels were better in the patients who underwent arthroscopic Bankart repair. Therefore, for recurrent anterior shoulder instability, even without subjective apprehension, surgical treatment is warranted over conservative treatment.
METHODS: Level IV.