Background Work engagement is important for employee well-being and work performance. However, no intervention study has investigated the effect of an eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). Objective The aim of the study was to examine the effects of a newly developed smartphone-based stress management program (ABC Stress Management) on improving work engagement among hospital nurses in Vietnam, an LMIC. Methods Full-time registered nurses (n=949) were randomly assigned to one of 2 intervention groups or a control group. The intervention groups were a 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills), provided in either free-choice (program A) or fixed order (program B). Work engagement was assessed at baseline and 3-month and 7-month follow-ups in each of the 3 groups. Results The scores of work engagement in both intervention groups improved from baseline to 3-month follow-up, and then decreased at the 7-month follow-up, while the score steadily increased from baseline to 7-month follow-up in the control group. Program B showed a significant intervention effect on improving work engagement at the 3-month follow-up (P=.049) with a small effect size (Cohen d= 0.16; 95% CI 0.001 to 0.43]). Program A showed nonsignificant trend (d=0.13; 95% CI –0.014 to 0.41; P=.07) toward improved engagement at 3 months. Neither program achieved effectiveness at the 7-month follow-up. Conclusions The study demonstrated that a fixed order (program B) delivery of a smartphone-based stress management program was effective in improving work engagement in nurses in Vietnam. However, the effect was small and only temporary. Further improvement of this program is required to achieve a greater effect size and more sustained, longer lasting impact on work engagement. Trial Registration University Hospital Medical Information Network Clinical Trials Registry UMIN000033139; tinyurl.com/55gxo253 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2018-025138

The purpose of this study was to evaluate the impact of changes to a patient's prandial status, metabolic status (rest vs. exercise), and peripheral blood flow (via caffeine or warming) on the uptake of 99m Tc-sestamibi in breast tissue. Methods: A total of 154 subjects participated in 1 of 4 study groups that evaluated the effects of 4 types of intervention on the uptake of 99m Tc-sestamibi in breast tissue (effect of fasting, light exercise, caffeine, and peripheral warming). Molecular breast imaging was performed before and after each intervention. Count density was assessed in counts/cm 2 /MBq from the mediolateral oblique view in all studies. Results: Uptake of 99m Tc-sestamibi in breast tissue increased by approximately 25% from 6.6 counts/cm 2 /MBq in the fed state to 8.3 counts/cm 2 /MBq with fasting. Peripheral warming also resulted in an approximately 20% increase in count density from 9.1 to 10.9 counts/cm 2 /MBq. Conversely, exercise caused a 35% drop in count density relative to the resting state. Uptake did not seem to be influenced by caffeine and did not correlate with a patient's height, weight, or breast thickness. There was only a weak correlation between breast activity and body surface area. Conclusion: The combined effects of fasting and warming resulted in an approximately 50% increased uptake of 99m Tc-sestamibi in breast tissue relative to that observed in a reference group to whom no preparatory instructions had been given. Optimal patient preparation before administration of 99m Tc-sestamibi should permit a corresponding reduction in either acquisition time or required dose of 99m Tc-sestamibi.Key Words: 99m Tc-sestamibi; breast; fasting; exercise J Nucl Med Technol 2015; 43:13-20 DOI: 10.2967/jnmt.114.150128 Nucl ear medicine breast imaging techniques, including both single-photon and positron emission technologies, have been evaluated for several diagnostic indications because of their ability to detect mammographically occult disease (1-5). We have reported on the use of molecular breast imaging (MBI), performed with 99m Tc-sestamibi and a dual-head cadmium zinc telluride g camera, for screening of women with mammographically dense breasts (6,7). In the most recent trial (7), supplemental screening with MBI in women with dense breasts improved the breast cancer detection rate from 3.2 per 1,000 with mammography alone to 12 per 1,000 with the combination of MBI and mammography (P , 0.001).A key consideration in the acceptance of MBI for screening use is the need to reduce the associated radiation dose of this procedure. Early studies with nuclear breast imaging technologies, including scintimammography (8) and breast-specific g imaging (1), used administered activities of 99m Tc-sestamibi in the range of 925-1,110 MBq (25-30 mCi), which result in effective doses to the body of 6.8-8.1 mSv (9) and were considered too high for screening (10). By comparison, the effective dose from digital mammography is 0.5 mSv and that from current mammography combined with digital breast tomosy...

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The present study investigated the internal consistency reliability, construct validity, and item response characteristics of a newly developed Vietnamese version of the Kessler 6 (K6) scale among hospital nurses in Hanoi, Vietnam. The K6 was translated into the Vietnamese language following a standard procedure. A survey was conducted of nurses in a large general hospital in Hanoi, Vietnam, using a questionnaire including the Vietnamese K6, other scales (DASS21, health-related QOL, self-rated health, and psychosocial work environment), and questions about demographic variables. Internal consistency reliability (Cronbach's alpha coefficient) was calculated. A confirmatory factor analysis was conducted. Eleven hypotheses were tested (as Pearson's correlations with the K6) to assess the scale's construct validity. Item response theory (IRT) analysis was conducted to identify the item response characteristics. The Cronbach's alpha coefficient was 0.864. The explanatory and confirmatory factor analyses indicated a one-factor structure. Most hypotheses tested for construct validity were supported. IRT analysis indicated that response categories were located in order according to severity. K6 provided reliable information regarding higher levels of psychological distress. The findings suggest that the Vietnamese version of the K6 is a reliable and valid instrument to measure psychological distress among hospital nurses in Vietnam.