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This paper discusses how the William G. Squires Library conducted a usability study on their LibGuides to identify student design preferences. The results of the study support previous research concerning best practices for LibGuide creation. This paper offers insight into how librarian-centric design hinders student success and provides suggestions for how to best develop a student-centric template design that offers consistency and increased user proficiency across all guides. [ABSTRACT FROM AUTHOR]

Background: Based on participatory research tools and analysis with a gender focus, we aim to identify the knowledge associated with native plants of the Atlantic Forest in one Quilombola community whose territory is juxtaposed with a protected area, in South Brazil. Methods: Through the perception of the residents of the Quilombola community of São Roque, we classified the availability, harvesting intensity, abundance, and importance of fourteen plants native to the Atlantic Forest found in their territory. These fourteen plants were selected after initial interviews with a free listing of plants done with all adults (44 people), followed by plant collection and identification. A participatory workshop was built with the community to collect data through three activities: four-cell tool, environment matrix, and importance matrix. To identify the gender nuances in the knowledge within this community, all activities were separated into two groups based on the gender of the 22 participants (9 women and 13 men) and the researchers. Results: The species Pau-pra-tudo (Picrasma crenata), Quina (Coutarea hexandra), and Cipó-milome (Aristolochia triangularis) were similarly classified as important by both groups, which indicates the cultural and environmental relevance associated with them regardless of gender. The perceptions of other species were expressed differently between the groups, showing the variance of the ecological knowledge and the relationship between the sociocultural contexts of gender and the knowledge manifested. The final part of the workshop was a lecture given by two community experts about herbal medicines based on forest species found in the territory. Conclusions: Based on the multiple forms of results recorded in the workshop, we discuss the demand for inclusion of the traditional community in land management plans of environmental agencies, highlighting how individual characteristics, such as gender, can fill gaps in data about local biodiversity. [ABSTRACT FROM AUTHOR]

Background: Poly-victimization (PV) not only threatens physical and mental health but also causes a range of social problems. Left-behind children in rural areas are more likely to experience PV problems. However, there have been fewer studies on PV among rural children, and even fewer intervention studies. Objective: The difference-in-differences method was employed to analyze the impact of intervention measures, based on the theory of planned behavior, on PV among left-behind children in rural areas. Methods: The study subjects were left-behind children from six middle schools in two cities in southern China, who completed the baseline survey from 2020 to 2021. They were divided into a control group and an intervention group, each consisting of 228 cases, based on their schools. Before and after the intervention, the Self-made victimization-related knowledge, attitude, and practice questionnaire, Poly-victimization scale, and Middle school students' coping style scale were used to evaluate the victimization-related KAP(knowledge, attitude, and practice), victimization occurrence, and coping styles of left-behind children, respectively. Stata 15.0 was used to establish a difference-in-differences regression model to analyze the impact of the intervention measures on poly-victimization and coping styles. Results: Mixed Anova revealed that after the intervention, the KAP scores of the intervention group were significantly higher than those of the control group (p < 0.05). After the intervention, the incidence of child victimization in the intervention group dropped to 9.60% (n = 22), lower than in the baseline survey, with a statistically significant difference (p < 0.01). The incidence of PV among children in the intervention group was lower than that in the control group, with the difference being statistically significant (p < 0.01). The net reduction in the incidence of PV among children was 21.20%. After the intervention, the protection rate for preventing PV among children was 73.33%, and the effect index was 3.75. The intervention improved children's coping styles, problem-solving, and help-seeking, while reducing negative coping styles such as avoidance and venting, with the differences being statistically significant (p < 0.05). Conclusion: Intervention measures based on the theory of planned behavior reduce the occurrence of PV among left-behind children, and the intervention effects on different types of victimization are also different. [ABSTRACT FROM AUTHOR]

Objective: Workplace health promotion (WHP) in Germany is receiving increasing support from health insurance funds. Nevertheless, there is hardly any knowledge on the process of how health outcomes are achieved, especially in nursing. The aim of the study was to find out how and what can be implemented in different care settings and to examine the reactions and interactions of the participants under routine conditions. Methods: Guided by a logic model, a holistic WHP approach was implemented in four acute care hospitals, seven inpatient care facilities and four outpatient care services from April 2021 to October 2022. Data on realized WHP interventions, participant assessment and topics of work design was collected and analyzed descriptively. Results: The realized WHP interventions were adapted depending on the content and context. Mainly short relaxation interventions were delivered or those with an event character were received by participants. The highest participation rate of planned participants was achieved in team building training. Participants predominantly assessed WHP interventions as useful, the quality as (very) good and were generally (very) satisfied with the intervention components. For work design topics, intentions for the design of work organization were mainly documented in action plans. Conclusion: Cooperation with practitioners in research should be continued as a contribution to quality development. This could provide suggestions as to which content adjustments lead to greater acceptance by the target group in a specific context. Trial registration: The project was registered in the German Clinical Trial Register (DRKS00024961, 2021/04/09). [ABSTRACT FROM AUTHOR]

Background: Wild food plants (WFPs) play an important role in the traditional dietary habits of various indigenous communities worldwide, particularly in mountainous regions. To understand the dynamics of food preferences, cross-cultural studies on food plants should be conducted across diverse ethnic groups in a given area. In this context, the current study investigated the use of WFPs by seven different cultural groups in the Kashmir Himalayan Region. In this area, people gather wild plants and their parts for direct consumption, traditional foods, or sale in local markets. Despite this reliance, documentation of the food system, especially concerning WFPs, is notably lacking. Hence, our research aimed to document WFPs, along with associated traditional ecological knowledge, and identify major threats to their long-term sustainability in Division Muzaffarabad. Methods: Through a comprehensive approach involving questionnaires, interviews, focus groups, and market surveys, we gathered data from 321 respondents. PCA was performed to analyze threats and plant use using "factoextra" in R software. Origin Pro was used to create a chord diagram, while R software was used to generate a Polar heat map. Additionally, a Venn diagram was created using Bioinformatics software. Results: The study included 321 informants, of whom 75.38% were men and 24.61% were women. In total, 113 plant taxa from 74 genera and 41 botanical families were reported. Polygonaceae and Rosaceae accounted for the majority (17 species each), followed by Lamiaceae (7 species). Leaves were the most used part as food sources (41.04%), followed by fruits (33.33%). Most of the species are consumed as cooked (46.46%) and as raw snacks (37.80%). A total of 47 plant species were collected and cooked as wild vegetables, followed by 40 species used as fruits. This study is the first to describe the market potential and ecological distribution of WFPs in the study area. Cross-comparison showed that utilization of WFPs varies significantly across the region and communities, including their edible parts and mode of consumption. Jaccard index (JI) value ranged from 5.81 to 25. Furthermore, the current study describes 29 WFPs and 10 traditional food dishes that have rarely been documented in Pakistan's ethnobotanical literature. Climate change, invasive species, expansion of agriculture, and plant diseases are some of the most significant threats to WFPs in the study area. Conclusions: The older age group has more knowledge about WFPs compared to the younger generation, who are not interested in learning about the utilization of WFPs. This lack of interest in information about WFPs among the younger generation can be attributed to their limited access to markets and availability of food plants in the study area. Traditional gathering of food plants has been reduced in younger generations during recent years; therefore, it is crucial to develop effective conservation strategies. These efforts not only safeguard indigenous flora, food knowledge, and cultural heritage, but they also contribute to food security and public health by utilizing local wild foods in the examined area. [ABSTRACT FROM AUTHOR]

Background: This study investigates the effectiveness of a self-developed intelligent monitoring system for home-based knee rehabilitation following total knee arthroplasty (TKA). Methods: In this randomized controlled trial, 120 patients undergoing TKA were divided using random digit allocation. Preoperative and one-month postoperative assessments of knee function, quality of life, and isometric knee extension strength were conducted with the Intelligent Monitoring System. Patients received group-specific rehabilitation instructions pre-discharge and performed exercises for one month. Results: Changes in isometric knee extensor strength on the affected side within one month post-surgery for the brace-monitored rehabilitation group showed a significant decrease three days after surgery compared to one day before surgery. Subsequent measurements taken at postoperative days 5, 7, 14, and 21 indicated a gradual increase in strength, although these increases did not reach statistical significance when compared with previous measurements. One month post-surgery, all groups demonstrated significant improvements in knee joint function and mobility compared to pre-surgery levels. Notably, the brace-monitored group showed statistically significant improvements in 36-Item Short-Form Health Survey (SF-36) scores over the conventional rehabilitation group. Conclusions: The Intelligent Monitoring System provides effective real-time monitoring and guidance for home-based knee rehabilitation post-TKA. It significantly enhances knee joint function, isometric knee extension strength, and quality of life shortly after surgery compared to traditional rehabilitation methods. This system offers a promising approach for improving postoperative recovery in TKA patients. Trial registration: This study was approved by the Medical Ethics Committee of Xiangya Hospital, Central South University (Ethics Approval Number 202209008-2). It was registered with the China Clinical Trial Registry, a primary registry of the World Health Organization's International Clinical Trials Registry Platform (Registration Number ChiCTR2300068852). [ABSTRACT FROM AUTHOR]

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and quickly developing research area. The aim of this article was to holistically, thematically and chronologically analyze and synthesize the literature production in this research area and identify the most prolific research entities and research themes. Methods: This article quantitatively and qualitatively analyzed research literature production harvested from the Scopus bibliometric database, using a triangulation of bibliometric and thematic analysis. For this, Excel 2024, Bibliometrix Biblioshiny 4.1 and VOSviewer version 1.6.20 softwares were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and 26 February 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018 exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes (pathophysiology of CLBP and the quantification assessment tools, diagnostics and CLBP treatment, CLBP questionnaires and surveys, quality of life, complementary methods in physiotherapy and psychosocioeconomic aspects), while the chronological analysis revealed three main areas of development: assessment tools, CLBP processing and study methodology. Conclusions: The results of this bibliometric study present a good starting point for further research, providing taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends. This article offers an interdisciplinary view of the current issue of public health. The results of this study provide a basis for the development of both the physiotherapy and epidemiological fields. [ABSTRACT FROM AUTHOR]

Background: Reading problems are the most prevalent type of specific learning disability. Reading problems usually result from phonological deficits; however, it is unclear how much other linguistic abilities are impacted as well. Objective: To study different language parameters and cognitive skills in a group of Egyptian children with reading problems to better understand the difficulties that need to be considered in rehabilitation programs for those children. Methods: A case–control study was conducted on 30 children with reading problems having IQs above 85 and 30 normal control children matched for age and gender (their ages ranged from 7 to 9 years and 11 months). They underwent testing for dyslexia by the Arabic dyslexia assessment test, language evaluation using the Receptive Expressive Arabic Language Scale (REAL scale), and the Stanford-Binet intelligence scale, fifth edition. Results: There were highly significant correlations between the severity of dyslexia and total language scores, most of REAL scale subtests. Also, highly significant correlations were detected between the severity of dyslexia and the total IQ, verbal IQ, and verbal working memory subtests. The linear regression model revealed a highly significant association between dyslexia and expressive language scaled scores, total language scaled scores, and a significant association with expressive vocabulary and understanding oral instructions subtests of REAL scale. Additionally, a highly significant association has been detected between dyslexia and the verbal working memory subtest of the Stanford-Binet test. Correlations between total language scores and intellectual abilities (total IQ, verbal IQ, and non-verbal IQ) revealed highly significant positive results. Conclusion: Deficits in both receptive and expressive language were observed in children with reading problems. Expressive vocabulary, listening comprehension, and verbal working memory subtests are the most affected language and cognitive skills. [ABSTRACT FROM AUTHOR]

Background: Music is the art of combining vocals or instruments to form the beauty of expression. Perception of the sounds includes two types of processing: bottom-up and top-down. Earlier studies have reported that musicians outperformed nonmusicians in the discrimination of frequency, intensity, duration, temporal processing tasks, and working memory. The present study compared musicians' and nonmusicians' differential sensitivity and auditory processing abilities in children and younger adults. Methods: A total of 120 participants in the age range of 9–15 years and 18–25 years were recruited for the study and were further divided into four groups: children musicians, children nonmusicians, young adult musicians, young adult nonmusicians group A, B, C, D, respectively. Each group consisted of 30 participants. Further, all the participants were assessed with Differential sensitivity tests such as DLI, DLF, DDT, GDT, and Dichotic CV. Results: The study revealed a high statistical difference in the DLI, DLF, DDT, GDT, and DCV, indicating that children who learned music had better scores than those who did not. A similar trend was observed for younger adults, wherein musicians scored better than nonmusicians on differential sensitivity and auditory processing abilities. Conclusion: It was observed that younger adults (musicians and nonmusicians) showed no difference in Dichotic CV, which shows that the maturation and auditory ability of the younger adults are stabilized. Hence, the present study infers that intensive musical training influences superior performance in auditory perceptual tasks. [ABSTRACT FROM AUTHOR]

Background: The ethnobotanical analysis of two bordering areas allows for the in-depth understanding of the dynamics of Local Ecological Knowledge, which mirrors the naturalistic, historical, and sociopolitical features of each area. As part of the Interreg Italy-Switzerland B-ICE&Heritage and GEMME projects, this work is an ethnobotanical comparative study of two neighboring Alpine territories: Valmalenco (Italy) and Valposchiavo (Switzerland). Methods: A total of 471 informants were interviewed on different fields of use (medicinal, food, veterinary, etc.). All data were organized in Excel™ spreadsheets. Informant Consensus Factor was calculated for the pathologies reported. Jaccard's similarity indices were calculated to compare the Valmalenco and Valposchiavo areas. Subsequently, another comparison between Valmalenco/Valposchiavo and Italian/Swiss Alpine neighboring areas was carried out. Results: The number of taxa for Valmalenco was 227 (77 families) and 226 in Valposchiavo (65). Out of the 10 most cited species, 7 were mentioned in both. Arnica montana L. was the most cited in Valmalenco, and Sambucus nigra L. in Valposchiavo. The 5 most cited families were the same. Regarding the medicinal and food fields, the similarity indices were fairly low (0.31 and 0.34 for the species; 0.22 and 0.31 for the uses). Concerning the comparison with Italian and Swiss Alps, similarity values were slightly higher with Italy (Valmalenco food species: 0.38 with Italy and 0.26 with Switzerland, medicinal: 0.26 IT and 0.14 SW; Valposchiavo food species: 0.36 with IT and 0.26 with SW, medicinal: 0.21 IT and 0.14 SW). Conclusion: Although Valmalenco and Valposchiavo partly share natural environment, language, history, and culture, they had low similarity indices. They both seemed to have more similarities with Italy than Switzerland, maintaining low values with the surrounding territories too. They showed a common core of Local Ecological Knowledge with several divergent branches possibly due to pivotal historical happenings, as well as more modern external influences. [ABSTRACT FROM AUTHOR]

Background: Due to the significant increase in the prevalence of food-related diseases, the value that physicians place on nutritional advice may have implications for patient treatment. The objective of this study was to evaluate the perception of the importance of nutritional intervention among physicians in the Universidad San Francisco de Quito's (USFQ) healthcare system. Methods: This cross-sectional study employed a telephone survey administered to a subset of all medical doctors (MDs) working in the healthcare system clinics of USFQ between 2021 and 2022. Study participants were recruited through voluntary response sample from a complete list of 253 MD. The single time questionnaire consisted of a 22-item validated survey in which attitudes, self-perceived capacity, and knowledge about nutrition ofmedical doctors were evaluated. Data was analyzed using descriptive statistics, two-sided t test, bivariate associations and linear and logistic regressions. Results: 136 MDs completed the survey yielding a response rate of 54%. Our analysis grouped participants into clinical (CE) and non-clinical specialties, hereafter referred to as surgical MDs. While a higher percentage of physicians in CE are confident in their ability to provide examples of recommended food portions based on national or international guidelines, 1 in 10 do not know how to use and interpret BMI or waist circumference, and around 1 in 3 do not know how many calories there are in one gram of fat, protein, or carbohydrates, and their basic metabolic functions. Almost all survey participants believe MDs can have an impact on the eating behavior of a patient if time is used to discuss the problem, however, almost half of survey participants believe nutrition counseling is not an effective use of time. Conclusion: It is important to explore the perceptions and self-confidence of physicians around nutrition related issues. Our results demonstrated that nearly 1 in 4 surgical MDs do not feel capable of recognizing nutritional risk in patients, which highlights the essentiality of physicians having an updated understanding of basic nutrition principles. Future research should examine how commonly MDs refer patients to nutritionists/dietitians, as well as strategies for improving physician knowledge on basic nutrition concepts. [ABSTRACT FROM AUTHOR]

Complex medical terminology utilized in clinical documentation can present barriers to patients understanding their medical findings. We aimed to generate easy-to-understand summaries of clinical radiology reports using large language models (LLMs) and evaluate their safety and quality. Eight board-certified physician reviewers evaluated 1982 LLM-generated radiology report summaries (computed tomography, magnetic resonance imaging, ultrasound, and x-ray) for safety and quality, using predefined rating criteria and the corresponding original radiology reports for reference. Physician reviewers determined 99.2% (1967 out of 1982) of the LLM-generated summaries to be safe. The reviewers scored the quality of the LLM-generated summaries from "5—Very Good" to "1—Very Poor," respectively, as follows: 80.6%, 11.1%, 5.7%, 1.7%, and 0.9%. Safety varied significantly across imaging modality (P =.002). Large language models can be used to generate safe and high-quality summaries of clinical radiology reports. Further investigation is warranted to determine the impact of LLM-generated summaries on patient perception of understanding, knowledge of their medical conditions, and overall experience. [ABSTRACT FROM AUTHOR]

Background/Objectives: Premature birth can lead to socio-emotional, behavioural and executive problems that impact quality of life and school performance in the long term. The aim of this pilot study was to evaluate the feasibility and efficacy of a 12-week computerised training called Vis-à-vis to enhance these competencies in a cohort of very preterm (VPT) children aged 6 to 9. Methods: This pilot randomised controlled trial included 45 children born before 32 gestational weeks. Socio-emotional, behavioural and executive competencies were evaluated at three time points using computerised tasks, neuropsychological tests and questionnaires. Results: Among the eligible VPT children, 20% (n = 45) accepted to be part of the study, and 40% (n = 18) dropped out. Finally, 60% (n = 27) of the enrolled participants completed the study. Results showed a significant improvement in emotion knowledge and recognition immediately after the completion of the training. Conclusions: Overall, our results indicate that the implementation of this type of computerised training is feasible, but the overall compliance is unsatisfactory given the high dropout rate. Nevertheless, the positive effect of the training on emotion recognition encourages further exploration of these kinds of interventions to prevent adverse consequences in children born too soon. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) and Feeding or Eating Disorders (FEDs) often coexist during adolescence with reciprocal influences on their clinical picture. The present study aimed to identify differences and similarities in the clinical presentation of young patients with both conditions compared to those with the two non-comorbid disorders. Methods: We consecutively recruited forty-five female patients aged between 11 and 18 at our third-level hospital and subdivided them into three groups (NSSI: n = 15; FED: n = 15; NSSI + FED: n = 15). Patients underwent a full clinical assessment. Results: Based on our results, the NSSI + FED group was characterized by higher rates of binging/purging behaviors, greater prevalence of Cyclothymic Disorder, and a more severe clinical presentation compared to the non-comorbid groups. Moreover, higher levels of suicidal ideation were found in the NSSI + FED group. Pharmacological treatment patterns also differed, with SSRI being prescribed more frequently to NSSI + FED patients while mood stabilizers were prescribed more frequently to NSSI ones. A Principal Component Analysis identified four main dimensions: "Body Image" impairment was more pronounced in NSSI + FED patients, indicating negative attitudes towards their own body; "Metacognition" deficits were higher in NSSI than FED. Conclusions: The present study underscores distinctive clinical features in patients with comorbid NSSI and FED, emphasizing the urgent need for tailored intervention strategies focusing on specific symptom domains. [ABSTRACT FROM AUTHOR]

Background: The term "sharenting" describes the increasingly popular habit of parents to share photos, videos, or other information regarding their children on their social profiles, through online platforms. It is highly likely that many parents are posting content about their underage children online with little knowledge of the risks associated with this practice. This study aims to investigate whether variables such as parents' age, gender, marital status, occupation and educational level influence the practice of sharing child-related content and the degree of awareness. Methods: We performed a pilot cross-sectional study, based on an anonymous questionnaire. The questionnaire was administered to parents of underage children attending the pediatric outpatient clinic of the Umberto I Hospital, Sapienza University, in Rome, Italy, by researchers, through the google forms platform; qualitative variables were generated on excel sheets and a statistical analysis was performed on SPSS Ibm-statistics using the chi-square test. Results: Two hundred twenty-eight parents of children under 18 years of age completed the questionnaire (82% mothers, 18% fathers); 98% of the respondents used social media and 75% of them published their children's related content online. Thirty-one percent of the compilers started their practice of sharenting in the first 6 months of life of their child. Our analysis showed that compared to parents who do not post online, parents who usually post online their children are significantly more likely to be partial employees or unemployed (p = 0,002), with lower educational level (p = 0,05), younger (less than 35 years of age (p = 0,01)) and have a higher number of followers (p < 0,001). Finally, 93% of the compilers were not aware of the current legislation and of the risks related to the practice of sharenting. Conclusions: Pediatricians, healthcare assistants and preventive healthcare professionals should play a central role in alerting parents and families to the risks of sharenting; the results of our study could draw their attention to the increasing practice of sharenting and make healthcare professionals active part in the protection of children. [ABSTRACT FROM AUTHOR]

Introduction: Possessing ethical intelligence and cognitive flexibility can play a significant role in the acceptable performance of nurses. Furthermore, respecting the privacy of patients should always be a primary ethical principle that nurses focus on. This study aimed to investigate the ethical intelligence and cognitive flexibility of nurses and their role in predicting the level of patients' privacy observance. Also, determining the overall status of patient privacy protection and its two domains, namely human dignity domain and maintaining personal privacy, were specific objectives of this study. Methods: This cross-sectional descriptive-analytical study was conducted in 2022. A sample of 340 nurses and 1067 patients from teaching hospitals affiliated with Shiraz University of Medical Sciences in southern Iran were selected. Standard questionnaires of ethical intelligence and cognitive flexibility were used for nurses, and a privacy observance questionnaire was used for patients. Data were analyzed using t-tests, ANOVA, Pearson correlation coefficient, and multiple linear regression with the SPSS23 software. Results: The mean score of ethical intelligence and cognitive flexibility for nurses was 98.33 ± 18.06 (out of 200) and 74.56 ± 16.76 (out of 140), respectively. The mean score of patients' privacy observance was 79.74 ± 14.53 (out of 150). The results of multiple linear regression showed that the dimensions of perseverance and assertiveness towards rights (β = 0.540, p < 0.001), action based on principles, values, and beliefs (β = 0.454, p < 0.001), responsibility towards personal decisions (β = 0.410, p < 0.001), accepting responsibility for serving others (β = 0.393, p < 0.001), ability to forgive one's mistakes (β = 0.301, p = 0.001), ability to forgive others' mistakes (β = 0.287, p = 0.002), honesty (β = 0.275, p = 0.004), acknowledgment of mistakes and failures (β = 0.263, p = 0.005), commitment to promises (β = 0.242, p = 0.005), and interest in others (β = 0.237, p = 0.01) from the dimensions of ethical intelligence, as well as the dimensions of perceived control (β = 0.580, p < 0.001), perception of multiple solutions (β = 0.511, p < 0.001), and perception of justifications (β = 0.373, p < 0.001) from the dimensions of cognitive flexibility had a positive and significant effect on the level of patients' privacy observance. Conclusion: Ethical intelligence and cognitive flexibility of nurses and the level of patient privacy protection were estimated to be at a moderate level. Also, the level of ethical intelligence and cognitive flexibility of nurses played a predictive role in the level of patients' privacy observance. It is suggested that hospital managers and policymakers enhance nurses' ethical intelligence and cognitive flexibility through educational, welfare, managerial, motivational, and job-related programs, thereby improving the status of patient privacy protection. [ABSTRACT FROM AUTHOR]

Background: Early childhood educators play a critical role in promoting physical activity and reducing sedentary time in childcare centres. However, early childhood educators receive limited specialised pre- and in-service learning opportunities relating to these behaviours and may lack the capacity to effectively engage children in healthy movement behaviours. This study aimed to examine the efficacy of an e-Learning course on increasing early childhood educators' physical activity and sedentary behaviour-related capacities. Methods: A two-group parallel randomized controlled trial was conducted with early childhood educators in Canada (Mage = 41.78, 97% female). Participants randomized to the intervention group were asked to complete a physical activity and sedentary behaviour e-Learning course within a 4-week period. Participants randomized to the waitlist control condition were assigned to a waitlist to receive the intervention after the testing period. Participants reported on their self-efficacy, knowledge, intentions, and perceived behavioural control relating to physical activity and sedentary behaviours at baseline, post-intervention, and 3 months follow-up. Linear mixed effects models were estimated to determine difference in changes in outcomes from baseline to post-intervention, and follow-up. Results: A total of 209 early childhood educators participated in the study (intervention n = 98; control n = 111). The TEACH e-Learning course was found to be efficacious at improving all of the examined outcomes, with standardized effect sizes ranging from d = 0.58 to d = 0.65 for self-efficacy outcomes, d = 0.66 to d = 1.20 for knowledge outcomes, d = 0.50 to d = 0.65 for intention outcomes, and d = 0.33 to d = 0.69 for perceived behavioural control outcomes post-intervention. The intervention effects were sustained at follow-up for all outcomes apart from perceived behavioural control to limit screen time. Additionally, the magnitude of the effect for knowledge outcomes decreased at follow-up, with standardized effect sizes ranging from d = 0.49 to d = 0.67. Conclusions: The e-Learning course was highly successful at improving early childhood educators' capacity pertaining to physical activity and sedentary behaviours. Providing training content through e-Learning may be an efficacious approach to providing continual professional learning opportunities relating to physical activity and sedentary time to early childhood educators on a large scale. [ABSTRACT FROM AUTHOR]

Background: As one of the world's biodiversity hotspots, Indonesia contains over 25,000 plant species, including unconventional food plants (UFPs). These plants are integral to the dietary practices of rural communities, providing essential nutrients often overlooked in modern diets. However, the use of UFP is declining, with both their dietary and cultural values being undermined. In rural West Java, this decline in UFP biodiversity coincides with public health challenges related to malnutrition. This study aims to document the diversity of UFPs used by local communities in rural West Java, assess their nutritional value, and explore their consumption practices. Methods: Data were collected using mixed methods, including interviews with 20 key informants and food frequency questionnaire administered to 107 women in three villages in the area. The nutritional compositions of documented UFPs were obtained from literature and analysis. Bivariate correlation was used to analyze the relationships between UFP consumption frequency and potential correlates. Results: The study documented 52 species of UFPs from 29 families, many of which are rich in nutritional value. About half of respondents (56%) consumed UFPs moderately (2–3 times a week). UFP consumption frequency had a strong correlation (r = 0.70) with associated knowledge (r = 0.70, p < 0.01) and a weak correlation with age (r = 0.240, p = 0.015), livestock possession (r = 0.260, p = 0.008), and family size (r = − 0.220, p = 0.02). Motivations for UFP consumption included availability as free food (33%), medicinal value (26%), nostalgic value (23%), and preferred taste (18%). Most respondents (92%) agreed that consumption has declined compared to the past, with perceived reduced availability and lack of knowledge cited as the primary reasons for the declining trend. Conclusions: UFP use is common in the study area, where local communities value these plants for their critical roles in diet, medicine, and culture. Given their significant potential to meet dietary needs, educating and raising awareness about UFPs can enhance their consumption and contribute to food and nutrition security. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that Chinese Clinicians and nurses have positive attitudes toward ACP, but no local tools exist to assess their need for ACP knowledge and skills training. resulting in their inability to initiate ACP conversations as well as poor end-of-life care for patients. Therefore, this study aims to assess the needs of Chinese Clinicians and nurses for ACP knowledge and skills training and assess the validity and reliability of a questionnaire on the Training Needs for Advance Care Planning (TNACP) scale. Methods: From October to November 2021, 170 clinicians and nurses were pre-surveyed using a preliminary draft of the questionnaire. The responses were screened using item analysis, Cronbach's alpha coefficient, and the intraclass correlation coefficient (ICC) to describe the internal consistency and stability of the questionnaire. The Content validity index (CVI), Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to test the validity of the questionnaire. Results: After independent samples t-test analysis, Except for the entry "A2", the critical ratio between the two groups of the remaining 23 items was statistically significant (p < 0.05). Based on the above screening methods, the "A2" item was deleted, and the final number of questionnaire items was 23. The I-CVI was 0.79–1.00, and the S-CVI/Ave was 0.90. Three common factors were extracted—the cumulative contribution rate was 69.969%, and the factor loading of all items was 0.506–0.843 (all > 0.40). The results of confirmatory factor analysis showed that the Training Needs for Advance Care Planning (TNACP) scale model fit well(X2/df = 2.504, RMSEA = 0.092, GFI = 0.809, AGFI = 0.745, CFI = 0.931, IFI = 0.932, TLI = 0.916); the Cronbach's α = 0.888 for the total questionnaire, and the three dimensions of Cronbach's α were 0.729 to 0.959; and the ICC for the overall scores between the test-retest evaluations was 0.884 (p < 0.001). Conclusions: The TNACP scale has good reliability and validity and can be used to assess Chinese Clinicians and nurses' training needs for implementing ACP. [ABSTRACT FROM AUTHOR]

Providing patients with accurate and organized information about colonoscopy, while reducing anxiety, is critical to the procedure's success. This study evaluated the impact of an immersive 360° virtual reality (VR)-based educational intervention for first-time adult colonoscopy patients regarding anxiety, attitudes, knowledge, compliance with bowel preparation, and bowel cleanliness. A quasi-experimental design with a non-equivalent control group and non-synchronized pretest–post-test clinical trial was conducted with 40 patients in the experimental group and 40 in the control group. The 360° VR intervention included two sessions: precautions before colonoscopy and the colonoscopy process. The control group received education through individual verbal explanations with written materials. The findings indicated that the VR intervention significantly improved patients' colonoscopy-related anxiety, attitudes, adherence to bowel preparation instructions, and bowel cleanliness. Utilizing 360° VR as an educational tool has the potential to enhance the effectiveness of educational programs by providing realistic information and engaging patients. These findings suggest that 360° VR has the capacity to enhance screening rates and clinical outcomes by reducing negative perceptions associated with colonoscopy. Furthermore, the application of this method can extend to diverse diagnostic testing-related nursing situations in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: Due to the type and nature of hospitalized psychiatric patients, nurses encounter many ambiguous and complex clinical situations that require intuitive decision-making. The present study was conducted to determine the use of intuition and its barriers and facilitators among psychiatric nurses. Methods: This study adopts a descriptive cross-sectional design and employs 123 nurses using convenience sampling in 2022. Demographic characteristics, the use of intuition in clinical practice, and the barriers and facilitators of intuition in clinical practice questionnaires were used for data collection. Results: The results of this study showed that the mean (SD) of intuitive decision-making among psychiatric nurses was 58 (13.07) out of a range from 25-125. The use of intuition had a statistically significant correlation with age and work experience in the psychiatry ward. The use of intuitive decision-making has a statistically significant difference in gender, work shift, and education level. The biggest barrier to the use of intuitive decision-making among psychiatric nurses was "The limitations of nursing role which restrict the use of intuition in the clinical setting". The most common facilitator in the use of intuition among psychiatric nurses was "having experience and clinical knowledge leads to the use of intuition in patient care". Conclusion: Given the low level of the use of intuition and the important role of intuitive decision-making in the quality of nursing care, nursing managers should provide some strategies for reducing the barriers to the use of intuition among nurses. [ABSTRACT FROM AUTHOR]

Objective: There is little research available regarding the instructional practices of librarians who support students completing knowledge synthesis projects. This study addresses this research gap by identifying the topics taught, approaches, and resources that academic health sciences librarians employ when teaching students how to conduct comprehensive searches for knowledge synthesis projects in group settings. Methods: This study applies an exploratory-descriptive design using online survey data collection. The final survey instrument included 31 open, closed, and frequency-style questions. Results: The survey received responses from 114 participants, 74 of whom met the target population. Some key results include shared motivations to teach in groups, including student learning and curriculum requirements, as well as popular types of instruction such as single session seminars, and teaching techniques, such as lectures and live demos. Conclusion: This research demonstrates the scope and coverage of librarian-led training in the knowledge synthesis research landscape. Although searching related topics such as Boolean logic were the most frequent, librarians report teaching throughout the review process like methods and reporting. Live demos and lectures were the most reported approaches to teaching, whereas gamification or student-driven learning were used rarely. Our results suggest that librarian's application of formal pedagogical approaches while teaching knowledge synthesis may be under-utilized, as most respondents did not report using any formal instructional framework. [ABSTRACT FROM AUTHOR]

Introduction: Nurses with intelligence and moral reasoning can perform well and be effective in their relationships with colleagues, patients, and companions. The clinical competence of nurses is the primary concern of healthcare systems. The present study aimed to assess the relationship between moral intelligence, moral reasoning, and clinical competence of nurses. Material & Methods: This descriptive-analytical correlational study was conducted on 110 nurses who were selected via convenience sampling in the teaching hospitals of Ilam in 2022. Data collection tools were demographic characteristics form, Link and Keel's moral intelligence, the Nursing Clinical Competence Questionnaire by Liu et al., and the Nursing Dilemma Test by Chrisham. Data were analyzed in SPSS software (version 16) using the Pearson correlation coefficient. The level of statistical significance was 0.05. Results: The majority of subjects were women (54.5%) with a bachelor's degree in nursing (87.3%), official employment (61.8%), with a work experience of 1-5 years (50%), and mean age of 30.98±5.83 years. The mean scores of moral intelligence, moral reasoning, and clinical competence were reported as 157.59±26.60, 36.51±16.17, and 136.65±46.08, respectively. There was a direct and significant correlation between moral intelligence and clinical competence (r=0.517; P=0.001), moral intelligence and moral reasoning (r=0.444; P=0.001), as well as moral reasoning and clinical competence (r=0.802; P=0.001). Discussion & Conclusion: Considering the direct and significant relationship between the variables, it is recommended that nurses' awareness of moral intelligence, moral reasoning, and clinical competency be raised through clinical training courses. [ABSTRACT FROM AUTHOR]

The 22q11.2 deletion syndrome (DS) can have a significant impact on functionality. The purpose was to describe 22q11.2DS children with functioning from a biopsychosocial perspective, focusing on the impact of children's health condition from domains of the International Classification of Functioning, Disability, and Health (ICF). Methods: A descriptive, cross-sectional case series study with seven 22q11.2DS children. A questionnaire with an ICF checklist for 22q11.2DS was completed using a structured interview. The Wechsler Abbreviated Scale of Intelligence (WASI) was used to determine the Intelligence Quotient (IQ). Results: Seven participants from 7 to 12 years old, presented some level of IQ impairment. It was observed that 22q11.2DS children experience significant intellectual, cognitive, and speech impairments across ICF Body Function domains. Impairments related to nose and pharynx were found in only one patient. The most relevant categories considered limitations in the Activity and Participation components pertained to producing nonverbal messages, communication, handling stress, and social interaction. Family, health professionals, and acquaintances were perceived as facilitators in the component Environmental Factors. Conclusion: The sample has its functioning affected by aspects that go beyond impairments in body structure and function. The organization of information from the perspective of the ICF is a different approach that helps clinical reasoning. [ABSTRACT FROM AUTHOR]

Background: Supportive care and dental treatment for older adults are crucial in addressing the global emergency of population aging, requiring specialized healthcare services and knowledge-based practices. Methods: This cross-sectional content analysis study was conducted on 150 general dentists in Kerman in 2021. The participants were selected using cluster sampling. The data were collected using a questionnaire with four sections assessing the participants' demographic characteristics, knowledge, attitudes, and performance. The data were analyzed with SPSS-26 software using the t-test, ANOVA, and linear regression analysis. Results: The dentists' mean age was 36.10 ± 7.60 years. The mean knowledge score of the participants was 5.29 ± 1.49 (out of 9). The mean attitude score was 59.42 ± 11.6 (out of 85), and the mean performance score was 24.13 ± 4.96 (out of a maximum of 35). The data showed a positive relationship between the dentists' knowledge, attitudes, and performance. However, the participants' gender had no significant correlation with their knowledge, attitudes, or performance. It was also shown that 50% of dentists had adequate experience treating elderly patients with complex medical problems. Conclusions: The participants had an adequate level of knowledge and performance and a positive attitude toward dental care for older adults. Health officials and administrators need to organize and hold effective training and refresher courses on geriatric dentistry to promote dentists' knowledge and performance. Trial registration: Ethics code IR.KMU.REC.1401.007. [ABSTRACT FROM AUTHOR]

Objectives: Traumatic dental injury occurs during sports competitions, training, and practice and can be prevented by the use of mouthguards. For this reason, this study aimed to evaluate the knowledge and attitudes of sports science faculty students, physical education teachers, and athletes about mouthguards. Methods: Five hundred thirty-two participants were reached via social media. In the questionnaire consisting of 20 questions, questions about the sociodemographic characteristics of the participants were asked in part 1, and questions about their level of knowledge and attitudes about the mouthguards were asked in part 2. Descriptive statistical analysis and a chi-square test were used to evaluate the data. Results: The number of people who think that mouthguards protect the athlete from traumatic dental injury is 381 (71.6%). The number of people who think that mouthguards affect the performance of the athlete is positively 228 (42.9%). To protect against traumatic dental injury, 51.48% of the participants preferred the custom-made; 39.3% of them preferred the boil-bite; 33.22% of them preferred the standard/stock type mouth guard; and 22.96% of them preferred the helmet, and 18.26% of them preferred the face mask. Conclusions: The knowledge and attitude of sports science faculty students, physical education teachers, and athletes are low about mouthguards. Since these people who are engaged in sports have a high exposure to traumatic dental injuries, education should be given to increase their awareness about mouthguards. [ABSTRACT FROM AUTHOR]

Background: Ionizing radiation has become increasingly utilized in medical practice. Consequently, healthcare workers must be aware of radiation hazards and apply the necessary countermeasures to reduce occupational exposure. This study assessed the awareness of radiation hazards and knowledge of radiation protection measures among radiologists and non-radiologists. These findings may improve the application of various safety measures during medical interventions involving radiation. Methods: We conducted a cross-sectional questionnaire-based study among 200 medical personnel, including consultant surgeons, physicians, radiologists, nurses, and radiographers, across five hospitals in Jordan between November 2022 and February 2023. The questionnaire collected data on demographic characteristics, awareness of radiation hazards, and knowledge of radioprotective techniques. Results: Overall, the knowledge of radiation protection and awareness of radiation hazards among the participants were poor (51.55% and 37.17%, respectively). No significant difference was detected between the medical disciplines in terms of the level of knowledge of radiation protection; however, radiographers were significantly more aware of radiation hazards. Conclusions: According to our findings, medical personnel generally have poor awareness of radiation hazards and radiation protection protocols. However, this understanding can be enhanced through periodic in-service training and regular monitoring of occupational radiation exposure by health professionals. [ABSTRACT FROM AUTHOR]

Background/purpose: Oral cancer, including malignancies of the tongue, lips, floor of the mouth, cheek mucosa, gums, palate, and oropharynx, is life-threatening. Early diagnosis and appropriate treatment are crucial for long-term survival. Dentists frequently encounter oral cancers due to the nature of their work. This study aimed to evaluate the knowledge and experience of dentists in Turkey regarding oral cancers. Materials and methods: A total of 361 participants were included in the study, and survey questions were sent via email. The survey consisted of 16 questions measuring demographic data and knowledge about oral cancerous lesions. Participants were grouped based on their specialization and knowledge level, and differences in responses among groups were examined. Results: Only 21.3% of the participants felt they had sufficient knowledge and experience about oral cancerous lesions. Overall, the correct answer rates indicated a moderate level of knowledge and experience. When grouped by specialization, oral surgeons had the highest accuracy in their responses (p < 0.05). Conclusion: Dentists are the professional group that most frequently encounters clinically oral cancerous lesions. Therefore, it is critically important for them to be knowledgeable and experienced to reduce morbidity and mortality through early diagnosis. This study evaluated the knowledge status of dentists in Turkey regarding oral cancer and highlighted the need for improved education. [ABSTRACT FROM AUTHOR]

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30–59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice, in conjunction with optimum care quality, improves patients' clinical outcomes. However, its implementation in daily clinical practice continues to present difficulties. The aim of this study was to identify the strategies applied by Advanced Practice Nurses (APNs) to foster adherence to clinical practice guideline recommendations. Methods: An exploratory qualitative study was conducted with six focus groups at three public hospitals belonging to the Balearic Islands Health Care Service (Spain). The study participants were 32 ward nurses and 5 advanced practice nurses working routinely with inpatients at these hospitals. The study was conducted from November 2020 to January 2021, using thematic analysis, based on the COREQ checklist. Results: Four major themes related to the facilitation process were identified either by RNs and APNs: the context of the project, APN contribution to nursing team management, healthcare provision on the ward, and the acquisition and application of knowledge. Conclusions: The APNs adapted their actions to the characteristics and needs of the local context, employing strategies aimed at improving teamwork, healthcare, and knowledge management. Each of these contributions enhanced the sustainability of the changes made. [ABSTRACT FROM AUTHOR]

This study examines the convergence between traditional and scientific knowledge regarding the use of fire and its potential to trigger wildfires, with possible impacts on ecosystems and human well-being. The research encompasses three distinct natural regions of Ecuador: the coast, the highlands, and the Amazon. Data on traditional fire use were collected through semi-structured interviews with 791 members from five local communities. These data were compared with climatic variables (rainfall (mm), relative humidity (%), wind speed (km/h), and wind direction) to understand the climatic conditions conducive to wildfires and their relationship with human perceptions. Furthermore, the severity of fires over the past 4 years (2019–2022) was assessed using remote sensing methods, employing the Normalized Burn Ratio (NBR) and the difference between pre-fire and post-fire conditions (NBR Pre-fire–NBR Post-fire). The results revealed a significant alignment between traditional knowledge, climatic data, and many fires, which were of low severity, suggesting potential benefits for ecosystems. These findings not only enable the identification of optimal techniques and timing for traditional burns but also contribute to human well-being by maintaining a harmonious balance between communities and their environment. Additionally, they provide valuable insights for the development of more inclusive and effective integrated fire management strategies in these natural areas of Ecuador. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a chronic neurodegenerative disease that affects the central nervous system, primarily the motor nervous system, and occurs most often in older adults. A large number of studies have shown that high intelligence leads to an increased risk of PD. However, whether there is a causal relationship between intelligence on PD has not yet been reported. Methods: In this study, Mendelian randomization (MR) analysis was performed with intelligence (ebi-a-GCST006250) and fluid intelligence score (ukb-b-5238) as exposure factors and PD (ieu-b-7) as an outcome, which the datasets were mined from the IEU OpenGWAS database. MR analysis was performed through 3 methods [MR Egger, weighted median, inverse variance weighted (IVW)], of which IVW was the primary method. In addition, the reliability of the results of the MR analysis was assessed via the heterogeneity test, the horizontal polytropy test, and Leave-One-Out (LOO). Finally, based on gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, the genes corresponding to intelligence and fluid intelligence score related to SNPs were enriched for functional features and pathways. Results: The results of MR analysis suggested that elevated intelligence indicators can increase the risk of PD [p = 0.015, Odd Ratio (OR) = 1.316]. Meanwhile, fluid intelligence score was causally associated with the PD (p = 0.035), which was a risk factor (OR = 1.142). The reliability of the results of MR analysis was demonstrated by sensitivity analysis. Finally, the results of GO enrichment analysis for 87 genes corresponding to intelligence related SNPs mainly included regulation of synapse organization, developmental cell growth, etc. These genes were enriched in the synaptic vessel cycle, polycomb expressive complex in KEGG. Similarly, 44 genes corresponding to SNPs associated with fluid intelligence score were used for enrichment analysis. Based on the GO database, these genes were mainly enriched in regulation of developmental growth, negative regulation of neuron projection development, etc. In KEGG, 44 genes corresponding to SNPs associated with fluid intelligence score were enriched in signaling pathways including Alzheimer's disease, the cellular senescence, etc. Conclusion: The causal relationships between intelligence and fluid intelligence scores, and PD were demonstrated through MR analysis, providing an important reference and evidence for the study of PD. [ABSTRACT FROM AUTHOR]

Background: The lack of trust between patients and physicians has a variety of negative consequences. There are several theories concerning how interpersonal trust is built, and different studies have investigated trust between patients and physicians that have identified single factors as contributors to trust. However, all possible contributors to a trusting patient-physician relationship remain unclear. This review synthesizes current knowledge regarding patient-physician trust and integrates contributors to trust into a model. Methods: A systematic search was conducted using the databases MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and Eric (Ovid). We ran simultaneous searches for a combination of the phrases: patient-physician relationship (or synonyms) and trust or psychological safety. Six-hundred and twenty-five abstracts were identified and screened using pre-defined criteria and later underwent full-text article screening. We identified contributors to trust in the eligible articles and critically assessed whether they were modifiable. Results: Forty-five articles were included in the review. Patient-centered factors that contributed modifiable promoters of trust included psychological factors, levels of health education and literacy, and the social environment. Physician-centered factors that added to a trusting patient-physician relationship included competence, communication, interest in the patient, caring, the provisioning of health education, and professionalism. The patient-physician alliance, time spent together, and shared decision-making also contributed to trusting relationships between patients and physicians. External contributors included institutional factors, how payments are made, and additional healthcare services. Discussion: Our model summarized modifiable contributors to a trusting patient-physician relationship. We found that providing sufficient time during patient-physician encounters, ensuring continuity of care, and fostering health education are promising starting points for improving trust between patients and physicians. Future research should evaluate the effectiveness of interventions that address multiple modifiable contributors to a trusting patient-physician relationship. [ABSTRACT FROM AUTHOR]

(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute's guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability—physical, psychological, and social—in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Assessment of wild edible vegetables (WEVs) from the ethnobotanical approach is a significant key to understanding indigenous knowledge systems. The available literature has revealed a tremendous decline in knowledge of WEVs over the last few decades. The main purpose of this study was to document and analyse the traditional knowledge of WEVs among the two major ethnic groups of Mizoram regarding their use and the diversity associated with the importance of traditional medicines. Secondly, a market survey will be conducted to determine the status of available WEVs. Methods: This study conducted an ethnobotanical survey among 72 informants through semi-structured interviews and questionnaires besides direct field observations. The documented data were quantitatively analysed using various ethnobotanical indices, including Informant's consensus factor (ICF), Fidelity level value (Fl), and Direct matrix ranking (DMR). A marketing survey was conducted in the Bara Bazar, Mizoram's most prominent local market. A total of 38 vendor informants were interviewed to observe and collect the price of commonly sold WEVs. Results: A total of 70 WEVs, distributed in 58 genera under 36 families, were documented and identified. Of these, 33 WEVs were of medicinal importance. Leafy vegetables were documented as the most frequently consumed parts (55.71%). The majority (44.29%) of the plants documented were consumed in fried form. The highest level of agreement among informants for food used categories was observed for plants combined with dry fish (ICF = 1). The Informant's consensus factor (ICF) of disease categories ranges from 0.75 to 1, with the highest being reported for convulsion (ICF = 1), sleep inducer (ICF = 1), and antiseptic (ICF = 1). Picria fel-terrae was the most preferred plant for hypertension treatment (100% FL). Direct matrix ranking (DMR) indicated that Dysoxylum excelsum was highly utilized by the inhabitant for multipurpose species (DMR = 64). Jaccard similarity index (JI) between the two ethnic groups was revealed at 1.26. Forty-seven WEVs were found to be commercialized in the Bara Bazar market, Aizawl, with a price range from 0.1 to 2.4 USD. Ensete superbum was reported as near threatened per the IUCN Red List of Threatened Species. Conclusion: This work highlighted the importance and rich diversity of WEVs in Mizoram, which are presently used among different age groups for food and medicine. Informants have good knowledge of WEVs, which was shared to a great extent among the inhabitants; this legacy of traditional culture must be conserved. This study further suggests a priority setting for conserving multipurpose WEVs in human-inhabited sites, investigating the recorded species' nutritional properties and pharmacological activities. [ABSTRACT FROM AUTHOR]

Background: Reproductive health emergencies, such as postpartum hemorrhage, contribute significantly to maternal and neonatal morbidity and mortality in Uganda due to knowledge and skills gaps. Medical interns, intern midwives, and nurses are crucial as frontline healthcare workers in responding to these emergencies. Our proposed hands-on strategy involves comprehensive simulation-based training (SBT) to equip these healthcare workers with the essential knowledge to manage common reproductive health emergencies and procedures in the country. Objectives: The study aimed to assess the effectiveness of comprehensive SBT in improving the knowledge of interns and fifth-year medical students on reproductive health emergencies and procedures at Gulu University and its Teaching Hospitals in Uganda. Design: A before-and-after study. Methods: A 4-day SBT was conducted for fifth-year medical students and interns (nurses, midwives, and doctors) at Gulu University Teaching Hospitals, focusing on reproductive health emergencies. Pre- and post-tests with 40 multiple-choice questions were used to evaluate knowledge enhancement, the scores were summarized as medians and interquartile ranges. Paired sample t -tests was used to test the difference in pre- and post-test scores. Independent sample t -tests compared median post-test results between interns and students, with a p -value <0.05 considered significant. Results: A total of 153 participants were enrolled, the majority being males (78.4%, n = 120) and medical students (73.9%, n = 113). Among the 40 interns, 55% (n = 22) were doctors, 30% (n = 12) were midwives, and 15% (n = 6) were nurses. The study participants showed an increase in knowledge, with median post-test scores higher than pre-test scores for all participants [63% (interquartile ranges, IQR: 57–71%) versus 49% (42–54%), with a median difference of 14% (8–23%), p < 0.001]. Conclusion: The SBT effectively imparts key knowledge competencies to the interns and fifth-year medical students. We recommend that SBT be included as part of the course units that students should take and for continuous medical education for qualified healthcare workers in resource-limited settings. [ABSTRACT FROM AUTHOR]

Background: In northwestern Pakistan, Lotkuh is a high-altitude terrain nestled within the eastern Hindu Kush region. Enclaved by towering peaks and harboring a unique culture, the region mirrors the geographical and cultural diversity of Pakistan. In this geographically isolated region, a treasure trove of ethnobotanical knowledge unfolds through generations of interaction between the inhabitants and indigenous plants, resulting in a profound understanding of the plant uses in nutritional, medicinal, cultural, and ritual contexts. Thus, the study seeks to gather, analyze, and document the indigenous knowledge of plant utilization of the distinct tribal culture. Methods: Through semi-structured questionnaires, inventory interviews, and participatory workshops, data were collected by engaging a cohort of 120 local respondents. The collected data were then classified into nine distinct use categories, following which quantitative indices were calculated. Results: The research identified a total of 150 plant species spanning across 59 different families and categorized them into 9 distinct usage groups. Among these, Astragalus oihorensis, Astragalus owirensis, Cicer nuristanicum, Geranium parmiricum, and Rochelia chitralensis stand out as novel species with distinctive applications. Notably, medicinal use garnered 600 reports, while animal feed, veterinary applications, human consumption, and toxicity recorded 500, 450, 425, and 104 reports, respectively. Informant consensus was high ranging between 0.8 and 0.9 with most agreement on human food and animal feed category. Platanus orientalis and Juglans regia, with RFC 0.91, were the most cited. The Family Importance Value (FIV) of Juglandaceae and Platanaceae, each with an FIV of 0.91, and Capparidaceae with an FIV of 0.83 indicate the intricate role the families play. Conclusions: In this study, we explore 150 ethnobotanical species, uncovering novel entries within ethnobotanical literature. Among these, several species showcase unique uses previously undocumented in Pakistani literature. Our research sheds light on the intricate interaction between plants and the distinct cultural landscape of the Lotkuh region. [ABSTRACT FROM AUTHOR]

Background: As a result of demographic change, chronic and oncological diseases are gaining importance in the context of public health. Palliative care plays a crucial role in maintaining the quality of life of those affected. International guidelines demand access to palliative care not only for the elderly but also for younger people who face severe illnesses. It can be assumed that palliative care will become increasingly important for them. In order to develop public health strategies which are able to promote palliative care, it is important to assess the knowledge of, and attitude towards, palliative care as found among members of the general public and its specific target groups. In particular, little is known about young adults' knowledge and perceptions of palliative care. Objectives and design: This work aimed to assess the understanding and viewpoints regarding palliative care among the general population and among young adults aged 18 to 24. We therefore conducted a systematic review, which, for this target population, could be seen as a novel approach. Methods: Exclusion and inclusion criteria were developed using the PICOS process. Literature was researched within MEDLINE (via PubMed), Google Scholar and Web of Science. A search string was developed and refined for all three databases. Grey literature was included. Duplicates were excluded using Mendeley. The literature was independently screened by two researchers. Narrative synthesis was used to answer the main research question. Results: For the general public, palliative care is still associated with death and dying and comforting sick people towards the end of their lives. Multiple social determinants are linked to better knowledge of palliative care: higher education, higher income, female gender, having relatives that received palliative care, and permanent employment. The population's knowledge of palliative care structures increases, the longer such structures have been established within a country. Young adults are familiar with the term palliative care, yet their understanding lacks nuance. They associate palliative care with death and dying and perceive palliative care to be a medical discipline primarily for the elderly. Nevertheless, young adults demand participation within the planning of interventions to destigmatize palliative care. Conclusions: The general public still lacks a detailed understanding of palliative care. Palliative care faces stigma at multiple levels, which creates barriers for those who set out to implement it. However, addressing young adults as a crucial peer group can help break down barriers and promote access to palliative care. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes. Methods: Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention. Results: In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ² = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ² = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ² = 7.59, p = .006). Conclusion: A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future. [ABSTRACT FROM AUTHOR]

Ensuring diagnostic performance of artificial intelligence (AI) before introduction into clinical practice is essential. Growing numbers of studies using AI for digital pathology have been reported over recent years. The aim of this work is to examine the diagnostic accuracy of AI in digital pathology images for any disease. This systematic review and meta-analysis included diagnostic accuracy studies using any type of AI applied to whole slide images (WSIs) for any disease. The reference standard was diagnosis by histopathological assessment and/or immunohistochemistry. Searches were conducted in PubMed, EMBASE and CENTRAL in June 2022. Risk of bias and concerns of applicability were assessed using the QUADAS-2 tool. Data extraction was conducted by two investigators and meta-analysis was performed using a bivariate random effects model, with additional subgroup analyses also performed. Of 2976 identified studies, 100 were included in the review and 48 in the meta-analysis. Studies were from a range of countries, including over 152,000 whole slide images (WSIs), representing many diseases. These studies reported a mean sensitivity of 96.3% (CI 94.1–97.7) and mean specificity of 93.3% (CI 90.5–95.4). There was heterogeneity in study design and 99% of studies identified for inclusion had at least one area at high or unclear risk of bias or applicability concerns. Details on selection of cases, division of model development and validation data and raw performance data were frequently ambiguous or missing. AI is reported as having high diagnostic accuracy in the reported areas but requires more rigorous evaluation of its performance. [ABSTRACT FROM AUTHOR]

Background: Neurogenic dysphagia is one of the most dangerous consequences of stroke leading to pulmonary infections and even death in stroke survivors. Aim: Evaluate the effect of implementing swallowing training exercises on neurogenic dysphagia among acute stroke patients. Design: A quasi-experimental research design. Setting: This study was conducted at Neurological Intensive Care Units of Tanta Main University Hospital which affiliated to Ministry of Higher Education and Scientific Research. Subjects: A purposive sampling of 60 patients with acute stroke aged from 21 to 60 years old, both sexes. Tools: Four tools were used in this study Tool I: Acute Stroke Patients' Assessment: It included three parts as the following: Part (1): Patients' demographic characteristics, Part (2): Patients' medical data, and Part (3): Patients' swallowing reflexes examination, Tool II: Functional Oral Intake Scale (FOIS), Tool (III): The 8-Point Penetration-Aspiration Scale (PAS), and Tool (IV): Dysphagia Observational Checklist. Results: The study finding revealed a highly statistically significant difference was observed among control & study group at 5th day of admission with (p= 0.000) post application of the swallowing training exercises regarding penetrationaspiration scale. Conclusions: Neurogenic dysphagia is a common problem notified among acute stroke patients that need special intervention to improve patients' status and decreased its complications. Recommendation: Manual log book about care of dysphagia and stroke patients should be available to nurses at Neurological Intensive Care Units as a teaching guide for patients with neurogenic dysphagia and Continues health education programs for patients and relatives to increase practices and knowledge on swallowing exercises. [ABSTRACT FROM AUTHOR]

Deep learning approaches for clinical predictions based on magnetic resonance imaging data have shown great promise as a translational technology for diagnosis and prognosis in neurological disorders, but its clinical impact has been limited. This is partially attributed to the opaqueness of deep learning models, causing insufficient understanding of what underlies their decisions. To overcome this, we trained convolutional neural networks on structural brain scans to differentiate dementia patients from healthy controls, and applied layerwise relevance propagation to procure individual-level explanations of the model predictions. Through extensive validations we demonstrate that deviations recognized by the model corroborate existing knowledge of structural brain aberrations in dementia. By employing the explainable dementia classifier in a longitudinal dataset of patients with mild cognitive impairment, we show that the spatially rich explanations complement the model prediction when forecasting transition to dementia and help characterize the biological manifestation of disease in the individual brain. Overall, our work exemplifies the clinical potential of explainable artificial intelligence in precision medicine. [ABSTRACT FROM AUTHOR]

Purpose: The use of nutrients and food supplements is increasing worldwide. Nutrients and food supplements frequently used in the surgical period may cause complications and side effects. This study was conducted to determine the level of knowledge about sixty-one nutrients and food supplements among doctors and nurses working in surgical clinics. Design: A multicentre descriptive, quantitative, cross-sectional study. Methods: The study was conducted between 15 February and 31 May 2022 with a total of 410 participants, including 143 doctors and 267 nurses, working in the surgical clinics of 8 hospitals, including public, university and private hospitals, within the borders of one province in Turkey. Data were collected face-to-face using a questionnaire developed by the researchers, which included descriptive characteristics of the doctors and nurses and questions about sixty-one nutrients and food supplements. Results: The median overall success score of the doctors and nurses participating in the study regarding the use of nutrients and food supplements was 3.20 out of 100 points, the median success score of complications and side effects of nutrients and food supplements in the surgical period was 7.06 out of 33 points, the median success score for discontinuation of nutrients and food supplements prior to surgery was 0.21 out of 16 points, and the median success score for drug interactions of nutrients and food supplements was 1.70 out of 51 points. In addition, it was found that the overall success scores of doctors and nurses regarding nutrients and food supplements increased statistically significantly with increasing age and working years. The total success score of doctors and nurses who received training in nutrients and food supplements was statistically significantly higher than that of doctors and nurses who did not receive training. Conclusion: In conclusion, it was found that the level of knowledge of nutrients and food supplements among doctors and nurses working in surgical clinics was less than half or even close to zero. Therefore, it is recommended that training on nutrients and food supplements should be included in the undergraduate and postgraduate education of doctors and nurses in order to prevent complications, side effects, drug interactions and patient safety related to the use of nutrients and food supplements in the surgical period. [ABSTRACT FROM AUTHOR]

Background: In the context of healthcare, satisfaction is the attainment of adequate or acceptable treatment and serves as both a benchmark for quality and the ultimate objective of providing care. In neonatal care facilities, parent satisfaction is a key measure of the quality of the services offered to the newborns and aids in improving healthcare delivery. This is the first systematic review aiming to address critical knowledge gaps regarding factors influencing parental satisfaction with neonatal intensive care unit services, and determine pooled prevalence in Ethiopia. Methods: After comprehensive systematic search for full texts in the English language through an electronic web-based search strategy from databases of PubMed, CINAHL, Embase, African Journals Online, PsycINFO, and Google Scholar, included a total of 8 articles. Checklists from the Joanna Briggs Institute were used to assess the studies' quality of methodology. STATA version 14 software for windows was used for all statistical analyses and meta-analysis was done using a random-effects method. Subgroup and sensitivity analyses were performed to clarify the source of heterogeneity. Results: Pooled national level of parents' satisfaction with neonatal intensive unit service was 57.87% (95% CI (49.99, 65.75%)). Age of respondents and availability of chair were significantly associated with parents' satisfaction with neonatal intensive unit service. Conclusions and recommendation: In our review we found that nearly half of parents expressed dissatisfaction with neonatal intensive unit service, which is high. Age of respondents and availability of chair in neonatal intensive unit waiting area were significantly associated with neonatal intensive unit service. Efforts to enhance parental satisfaction with neonatal intensive unit services are crucial, given that nearly half of parents reported dissatisfaction. Necessary infrastructure should be fulfilled to increase parental satisfaction with neonatal intensive unit service. (PROSPERO) International prospective register of systematic reviews: CRD42023483474 [ABSTRACT FROM AUTHOR]

An important cause of stunting is limited consumption of complementary foods, in terms of both quantities and nutrients. Although existing studies show a positive association between fathers' engagement and children's diet, programmes designed to improve complementary feeding practices often only target mothers. In response to this, maternal behaviour change communication (BCC), paternal BCC and food voucher programmes were designed and implemented in Ethiopia using a clustered randomized controlled trial design. The paternal BCC programme included gender‐equal messages to increase fathers' participation in childcare, household labour and decision making. The research reported in this paper is an examination of the BCC programmes, characterizing the behavioural, normative and control beliefs of both mothers and fathers in BCC households compared to those in control households. In this study, a total of 40 participants were included, with 13 mother–father pairs in the BCC + food voucher group, and seven pairs in the control group. Each participant was interviewed separately. We found that BCC mothers showed more gender‐equal tendencies than the control mothers despite being more rural in location. By contrast, the beliefs of BCC and control fathers were similar overall, suggesting men are more resistant to gender‐equal BCC. More work is needed to develop and test effective methods for changing fathers' beliefs and practices. Key messages: Mothers in behaviour change communication (BCC) group mothers held more gender‐equal beliefs than control mothers, while BCC and control fathers shared similar views, suggesting a male resistance to gender equality.Mothers found fathers' involvement in childcare socially acceptable but often perceived them as inexperienced, which limited their participation.Control mothers' traditional view on household chores maintained the conventional labour division, influencing fathers' involvement.Fathers typically resisted maternal control of resources; however, they agreed that the more knowledgeable should lead decision‐making. BCC mothers showed greater confidence in making household decisions as effectively as fathers. [ABSTRACT FROM AUTHOR]

Background: The incorporation of shared decision making (SDM) is a central part of empowerment processes, as it facilitates greater activation on the part of patients, increasing the likelihood of them gaining control over their healthcare and developing skills to solve their health problems. Despite these benefits, there are still difficulties in the implementation of SDM among healthcare professionals due to internal and external factors related to the context and health systems. Aim: To explore primary care professionals (PCPs)' perceptions of the SDM model, based on their preconceptions and experience in clinical practice. Methods: A framework analysis was conducted on qualitative data derived from a virtual community practice forum, within a cluster-randomized clinical trial developed in the e-MPODERA project. Results: The most important points in the opinions of the PCPs were: exploring the patients' values, preferences and expectations, providing them with and checking their understanding of up-to-date and evidence-based health information. The analysis revealed three themes: determinants of the implementation process of SDM, lack of consistency and dilemmas and benefits of PCP active listening, motivation and positive expectations of SDM. Discussion: In our initial analysis, we examined the connections between the categories of the TDC model and its application in the primary care context. The categories related to the model reflect the theoretical understanding of professionals, while those related to perceptions of its application and use show certain discrepancies. These discrepancies could indicate a lack of understanding of the model and its real-world implications or insufficient commitment on the part of professionals or the organization to ensure its effective implementation. Conclusions: Specific targeted training that addresses knowledge, attitudes and practice may resolve the aforementioned findings. [ABSTRACT FROM AUTHOR]

The use of donated expressed breast milk (DBM) is encouraged in South Africa, with donor milk banks and legislated policies and programmes available in hospitals serving populations with a high HIV prevalence. Concerns over poor attitudes amongst mothers towards DBM seem to persist. A cross-sectional mixed-methods approach was used in a cohort of mothers of neonates in a regional hospital. Between April 2021 and January 2022, survey data on knowledge, awareness and attitudes towards DBM was collected. Qualitative data from open-ended questions were thematically analysed. Comparative analysis using independent sample t-tests and logistic regression to determine differences in variables and to understand associations related to knowledge was conducted. A total of 163 mothers with a mean (SD) age of 27.1 ± 6.3 years were included; 49.7% of mothers had post-high-school qualifications, 82.8% were unemployed and 87.0% received social security. Some 64.4% had inadequate knowledge of DBM. Awareness of DBM had the strongest association with better knowledge concerning DBM and AdjOR (25.25 95% CI 10.60–68.40; p < 0.001). Negative attitudes towards DBM were largely driven by a lack of knowledge regarding human immunodeficiency virus (HIV) screening of donor mothers and fears of HIV transmission when using DBM. Lack of awareness concerning DBM was associated with poor knowledge of DBM, which may drive poor uptake of this critical nutritional source for at-risk neonates. Implementing targeted awareness programmes on DBM, which begin in the antenatal period and specifically address HIV screening of donor mothers, could address the poor uptake of DBM. [ABSTRACT FROM AUTHOR]

Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care. [ABSTRACT FROM AUTHOR]

Purpose: The study investigated the relationships between key variables, including the level of parenting knowledge, acculturative stress, depression, and the strengths and difficulties associated with their children's emotions and behavior, among North Korean refugee mothers who faced the challenging task of adapting to Korean society while raising their children. Methods: A descriptive study design was used. Data were collected from 130 North Korean refugee mothers between September and November 2023. Results: The participants had very limited parenting knowledge, and 82.3% of them scored 21 or higher on the depression scale used in community epidemiological studies. Higher levels of parenting knowledge and lower levels of depression were associated with lower levels of acculturative stress. Moreover, higher levels of depression were associated with more emotional and behavioral difficulties in children. Maternal depression, age, and employment status were identified as factors that influenced emotional and behavioral problems in preschool-aged children. Conclusion: These findings underscore the importance of providing parent education and mental health support programs for North Korean refugee families in order to improve parents' parenting skills and emotional well-being. [ABSTRACT FROM AUTHOR]