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Purpose: To investigate whether genetic variations in cytokine genes involved in the pathogenesis of peri-implantitis are associated with the occurrence of peri-implantitis, an issue that remains controversial and may vary according to the population evaluated. Materials and Methods: A cross-sectional analytical study was carried out on 102 Caucasian Portuguese individuals who were divided into two groups: (1) 43 individuals with peri-implantitis and (2) 59 individuals with good peri-implant health. Samples from the buccal mucosa were obtained, and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and PCR for IL-1RN. Results: The IL-1A-889 C/T polymorphism presented with a higher prevalence of the less common allele (T allele) in patients with peri-implantitis (27.9%) than in healthy patients (16.9%), but without statistical significance (P = .060). For the IL-1B+3954 C/T and IL-1RN (variable number of tandem repeats [VNTR]) polymorphisms, analysis revealed that the allele and genotype frequencies did not differ significantly between groups. There was a significant association between a history of periodontitis and peri-implantitis (P = .020). Conclusions: The evaluated genetic polymorphisms had no influence on the occurrence of peri-implantitis in the study population. Further research into genetic variations in different populations is needed to elucidate the role of genetic factors in the onset and progression of peri-implant disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to determine whether a health service system is an independent influencing factor of having pressure injury problems in individuals with chronic spinal cord injury living in three countries Design: This is a cross-sectional study. Methods: Data from the International Spinal Cord Injury Community Survey were analyzed. The pressure injury problems were assessed using the Spinal Cord Injury Secondary Condition Scales (dichotomized to “having problem” and “not having problem”). Health service systems were categorized as an inpatient-oriented spinal cord injury–specialized system and a primary care–oriented system. A directed acyclic graph was applied to create a multivariable logistic regression model to determine the independent influencing factors of pressure injury problems. Results: Of 790 included participants, 277 (35%) had pressure injury problems. Being recruited from countries with inpatient-oriented spinal cord injury–specialized systems (model 1) and visiting rehabilitation medicine/spinal cord injury physicians at least once a year (model 2) is an independent negative correlating factor of pressure injury problems (odds ratio = 0.569 [95% confidence interval = 0.374–0.866] and 0.591 [95% confidence interval = 0.405–0.864], respectively). Conclusions: Spinal cord injury–specialized health service systems might be a protective factor of pressure injury problems in middle-income country contexts. This result suggests the importance of having spinal cord injury–specialized services in middle-income countries to reduce the prevalence of pressure injury problems. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have investigated the role of gender in clinical symptoms, social functioning, and neuropsychological performance in people with first-episode psychosis (FEP). However, the evidence of gender differences for metacognition in subjects with FEP is still limited and controversial. The aim of the present study was to explore gender differences in cognitive insight and cognitive biases in this population. Methods: Cross-sectional study was carried out in a sample of 104 patients with FEP (35 females and 69 males) recruited from mental health services. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive insight with the Beck Cognitive Insight Scale, and cognitive bias by the Cognitive Biases Questionnaire for Psychosis. The assessment also included clinical and sociodemographic characteristics. Results: After controlling for potential confounders (level of education, marital status, and duration of psychotic illness) analysis of covariance revealed that males presented greater self-reflectiveness (p = 0.004) when compared to females. However, no significant differences were found in self-certainty and composite index of the cognitive insight scale, as in the cognitive biases assessed. Conclusions: Gender was an independent influence factor for self-reflectiveness, being better for males. Self-reflectiveness, if shown to be relatively lacking in women, could contribute to the design of more gender-sensitive and effective psychotherapeutic treatments, as being able to self-reflect predicts to better treatment response in psychosis. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the current knowledge and experiences of consumers in Australia on adverse drug reaction (ADR) reporting and their reasons for reporting or not reporting ADRs, with a focus on the use of digital tools for ADR reporting. Methods: A cross-sectional online survey was conducted among adults who had taken medicine in Australia. A structured questionnaire with multiple choice or Likert scale responses with an option for participants to provide free-text responses and pretested for face validity was used. Consumer characteristics, knowledge, and ADR reporting practices were analyzed using descriptive statistics and the chi-square test or Fisher's exact test. Results: A total of 544 survey responses were included in the analysis. The majority of respondents were women (68%), and 22% were aged between 65 and 74 years. Fifty-eight percent (n = 317) of respondents knew that they could report ADRs to either the Therapeutic Goods Administration (TGA), state or territory government health department, or healthcare professionals. Three-quarters (n = 405) of respondents stated that they had experienced an ADR; of these, 36% reported an ADR to either the TGA, state or territory government health department, or healthcare professionals. Among those who reported ADRs, 58% were unaware that they could use digital tools to report ADRs. The main reason for not reporting was that they did not think the ADR was serious enough to report (39%). Conclusion: Over half of consumers knew that they could report ADR; however, improved consumer awareness about using digital tools for ADR reporting and increased ADR reporting is needed. [ABSTRACT FROM AUTHOR]

We aimed to explore attitudes and training experiences of medical students toward gender medicine (GM). A cross-sectional study with convenience sampling was conducted (sample size = 430). To assess predictors of high GM consideration in patient management, a multivariable logistic regression was performed. A total of 82% considered sex and gender important; 61% stated that they would use GM skills in their careers. A total of 76% had never discussed GM with their tutors, with differences between male and female students (p =.002). Predictors of high GM consideration were: age (adjOR = 1.4, 95%CI = 1.1–1.8) and the impression that tutors considered patients' sex and gender during practice (adjOR = 3.9, 95%CI = 2.0–7.6). Thus, participants considered GM important, but some students were unsure whether it could be useful in practice. The strongest predictor of high GM consideration was the tutors' good example during training. It would be advisable to implement the teaching of this topic during both courses and traineeships. [ABSTRACT FROM AUTHOR]

The professional experiences of school nurses who work outside of urban areas are not often described. We used data from a 2019 statewide survey of school nurses to describe differences between the urban and non-urban (urban cluster and rural) school nurse workforce in New Mexico. Non-urban school nurses were twice as likely as urban nurses to provide clinical services to multiple school campuses (P <.001) and more likely to serve both elementary and secondary school settings (P =.002). They were less likely than urban school nurses to be bachelor's prepared, or to have received recent continuing education on diabetes (P <.001), reproductive health (P = 0.02), LGBQ+ and transgender student health (P <.001, for each), and suicide risk assessment and screening (P =.012). Our findings underscore concerns about geographic differences in the school nursing workforce in terms of educational preparation and student access that could potentially limit the school nurse role in advancing child health equity. [ABSTRACT FROM AUTHOR]

Background: Among individuals who use substances, the perceived stigma of substance use harms their quality of life and may be an obstacle to quitting. We explored the effect of the stigma perceived due to substance use on executive functioning. Methods: This cross-sectional study involved 80 individuals who used substances and sought to quit while admitted to a public neuropsychiatric hospital in south Iran in March 2022. Data were collected using the Barkley Executive Function Questionnaire and the Stigma Scale. Statistical analyses were done using SPSS v. 25. Results: The participants' mean age was 36.56 ± 9.37 years, and most (85.0%) were males. Among them, 28 (35%) used narcotics, 7 (8.8%) used stimulants, and 45 (56.3%) used multiple substances. Increased total sigma scores correlated with deficits in self-management to time, self-organization/problem-solving, self-regulation of emotion, self-motivation, self-restraint, and total executive function. Moreover, each stigma dimension had some correlations with executive dysfunction or its subscales. Conclusions: Self-perceived stigma is directly linked with executive dysfunction in individuals who use substances and seek to quit. Since stigma and executive function both play essential roles in addiction treatment success, interventions should be adjusted to reduce self-perceived stigma and executive function deficits among individuals who use substances. [ABSTRACT FROM AUTHOR]

Background: The Individual Care Plan (ICP) for pediatric palliative care translates the general guideline recommendations into a personalized plan for the child. Various documents exist in pediatrics globally, aimed at facilitating anticipatory care or coordinating end-of-life care. The ICP aims both, but user experiences have not been studied post-development. Objective: The overall aim is to enhance knowledge and understanding of the content of the ICP from the perspectives of parents and healthcare professionals (HCPs). Design and method: We conducted a mixed-method study using a convergent parallel design consisting of questionnaires and individual and focus group interviews among parents and HCPs having user experience with the ICP. The questionnaire and interview data were analyzed separately. Quantitative data were descriptively analyzed using mean, ±SD, and median. Qualitative data were thematically analyzed. A narrative approach and joint display were used to describe the results. Results: In total, 27 parents and 161 HCPs participated. Overall, the content of the ICP was seen as important and complete, but changes and additions were called for on language, structure, and content. The chapter on the needs and wishes of child and parents was considered most important. HCPs would like to see this chapter expanded to incorporate more advance care planning outcomes, and parents wished for this chapter to reflect better who their child is. HCPs mentioned missing a chapter for palliative sedation, mainly to guide other HCPs. The ICP was appraised as not user-friendly and might possibly improve by making the ICP available in a secure digital environment. Conclusion: To meet the needs of parents and HCPs considering importance and completeness of the content of the ICP and its user-friendliness, changes are necessary in the content of the ICP, and preferably the ICP should be made digitally available. Although various documents exist globally to facilitate anticipatory care or coordinating end-of-life care, it appears that the combination of describing the values and preferences of the child and parents, along with medical decisions and life-sustaining treatments, makes the ICP a unique and comprehensive care plan. [ABSTRACT FROM AUTHOR]

Background: In Nigeria, the attitudes of community pharmacists toward providing pharmaceutical care (PC) for people with mental illnesses remain unclear. This study aimed to assess the community pharmacists' attitudes and barriers toward providing PC services for clients with mental disorders in Enugu, Nigeria. Methods: A cross-sectional survey was conducted among all eligible community pharmacists in Enugu, Nigeria. The data were obtained using validated self-administered questionnaire adapted from the literature and a sociodemographic form. The data collected were analyzed using descriptive statistics and Chi-square/Fisher's Exact test. P values less than 0.05 were considered significant. Results: A total of 155 community pharmacists took part in the survey, giving a response rate of 95.6%. The findings showed that more than half of the community pharmacists (n = 80, 51.6%) had positive attitudes toward providing PC services for patients with mental illness. Positive attitudes were associated with having a family member with mental illness (p = 0.038) and a good self-rated knowledge of mental illness (p < 0.001). The most frequently reported barriers to PC were patient factors associated with their symptoms (59.4%) and a lack of patient information (52.9%). Conclusion: The attitudes of community pharmacists toward providing PC for patients with mental illness is largely positive but suboptimal. Patient factors related to their symptoms were cited as the major obstacle to providing PC. Therefore, continued education and training and supportive environment are encouraged to improve the situation. [ABSTRACT FROM AUTHOR]

Background: Healthy lifestyle behavior includes appropriate behaviors such as eating habits, physical activity and weight control in order to stay healthy and prevent diseases. The aim of this cross-sectional study is to evaluate healthy lifestyle behaviors, physical activity levels and social media use of dental students. Methods: An online questionnaire including demographic characteristics, International Physical Activity Questionnaire Short Version (IPAQ-S) and Health Promoting Lifestyle Profile (HPLP) was filed by 420 dental students. The data were evaluated statistically. Results: The mean age was 21.6 ± 1.96 years and the majority of the students (71.7%) were living with their families. Obesity and overweight in males and underweight in females were statistically higher. There was no difference between the genders in terms of social media use. The most preferred applications were Instagram (92.7%), YouTube (85%) and Twitter (59.7%). In terms of IPAQ durations and HPLP scores, there was no gender difference. According to the IPAQ classification, while the majority of students (64.3%) were physically low active, 23.1% were physically inactive. As the total HPLP score increased, the total IPAQ score increased. Conclusion: It is concluded that as the university students make up the majority of the young adults, encouraging their health-promoting behaviors is crucial for improving public health. [ABSTRACT FROM AUTHOR]

Background: Organizational readiness for change, defined as the collective preparedness of organization members to enact changes, remains understudied in implementing sepsis survivor transition-in-care protocols. Effective implementation relies on collaboration between hospital and post-acute care informants, including those who are leaders and staff. Therefore, our cross-sectional study compared organizational readiness for change among hospital and post-acute care informants. Methods: We invited informants from 16 hospitals and five affiliated HHC agencies involved in implementing a sepsis survivor transition-in-care protocol to complete a pre-implementation survey, where organizational readiness for change was measured via the Organizational Readiness to Implement Change (ORIC) scale (range 12-60). We also collected their demographic and job area information. Mann-Whitney U-tests and linear regressions, adjusting for leadership status, were used to compare organizational readiness of change between hospital and post-acute care informants. Results: Eighty-four informants, 51 from hospitals and 33 from post-acute care, completed the survey. Hospital and post-acute care informants had a median ORIC score of 52 and 57 respectively. Post-acute care informants had a mean 4.39-unit higher ORIC score compared to hospital informants (p = 0.03). Conclusions: Post-acute care informants had higher organizational readiness of change than hospital informants, potentially attributed to differences in health policies, expertise, organizational structure, and priorities. These findings and potential inferences may inform sepsis survivor transition-in-care protocol implementation. Future research should confirm, expand, and examine underlying factors related to these findings with a larger and more diverse sample. Additional studiesmay assess the predictive validity of ORIC towards implementation success. [ABSTRACT FROM AUTHOR]

Background: Malay herbal medicine (MHM) is a popular medication and supplementation among Malaysian mothers during pregnancy and postpartum. It is expected to improve the baby's health, increase breastmilk production, promote slimming and uterine involution, and improve the mother's general health. Recent increases in reports of heavy metal contamination have raised safety concerns. Objective: This pilot exploratory study employed a comparative cross-sectional design to investigate the types of MHM ingested during pregnancy and postpartum, their possible heavy metal contamination and associated health risks. Method: This study involved 167 healthy postpartum Malay women. Findings: MHM consumption was significantly associated with the mother's number of pregnancies and children (p < 0.05) as well as her pre-pregnancy weight (p < 0.05). Mothers who consume MHM were twice as likely (95% CI 1.077–3.963) to experience threatened abortion. Heavy metals were detected in the three most widely consumed MHM samples. The mean concentration of heavy metals in these samples were 47.44 ± 67.74 μg/kg for As, 25.34 ± 2.48 μg/kg for Cd, 3685.87 ± 5683.36 μg/kg for Cr and 194.33 ± 195.19 μg/kg for Pb. The calculated non-carcinogenic hazard health risks (HQ) and health index (HI) were less than one, suggesting no adverse health impacts under the exposure conditions studied. Conclusion: While the HQ and HI values indicate no immediate health risks, the potential transfer from mother to foetus during pregnancy and from mother to infant during breastfeeding warrants further investigation. Additional studies are essential to confirm our findings and monitor the health of mothers and infants. [ABSTRACT FROM AUTHOR]

Background: There is a lack of literature which assesses both patient and health care provider (HCP) perceptions of barriers and facilitators to diabetes health care in immigrant and refugee populations within the United States. This study uniquely incorporates both cohorts' perceptions on the same topic to assess for congruency and discrepancies in perspectives. Methods: Surveys were deployed to patients with diabetes and HCPs to solicit perceptions of barriers and facilitators to diabetes care, with the intention to determine similarities and differences between cohorts. A literature review was conducted to explore barriers and facilitators to diabetes care in immigrant/refugee populations in the US to aid in development of the survey used in this study, as no validated survey existed. Broad recruitment strategies were used, including snowball sampling. Descriptive statistics were calculated and reported p-values were derived from a chi-squared or Fisher's exact test and used for categorical data and a Wilcoxon rank sum or Kruskal–Wallis rank sum test was used for continuous data. Qualitive analysis was completed using the inductive analysis method. Results: Among 19 immigrant and refugee patients and 35 HCPs, almost all facilitators to diabetes care were endorsed by patients and HCPs as helpful. The highest ranked facilitator among patients and HCPs was having access to health insurance. Patients rated stress, while HCPs rated lack of health insurance as the biggest barriers to diabetes care for immigrants and refugees. Patients and HCPs differed in perspective on who held primary responsibility for diabetes management. Patients wanted more diabetes education and nutrition support, while HCPs thought understanding patients' cultural context/sensitivity, providing more education, and having language/translation services were the most important things HCPs can do to care for patients' diabetes. Conclusions: Immigrant/refugee patients and HCPs largely agree about what factors are most helpful in managing diabetes, with access to health insurance as the greatest facilitator. However, while HCPs identified lack of health insurance as the greatest barrier to care, immigrant and refugee patients cited the role of stress as the greatest challenge in managing their diabetes. There was a striking difference in perception of responsibility for diabetes management, with 89% of patient participants responding that the patient is responsible, while only 17% of HCPs responded that the patient was responsible. Future work should include surveys translated into languages other than English to further elicit the perspective of diabetes care in immigrant/refugee populations. Clinical recommendations based on this study include assessing and supporting patient stressors, assuring patients understand that diabetes management is a partnership, providing culturally tailored diabetes education, and increasing access to health insurance. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic contact restrictions considerably changed maternal visiting contacts during the time in which breastfeeding is initiated. We wanted to know how maternity ward staff and mothers rated the conditions of starting breastfeeding under contact restrictions. Methods: In the Breastfeeding in North Rhine-Westphalia (SINA) study, Germany, 2021/22, chief physicians as well as ward staff from 41 (out of 131) maternity hospitals (82 members of the healthcare sector in total) were surveyed by telephone concerning structural and practical conditions for breastfeeding support before and during the pandemic; 192 (out of 426 eligible) mothers answered an online-questionnaire about their breastfeeding experiences at 2 weeks and 2 months after birth. Results: In almost all of the hospitals, visits were restricted due to the pandemic, with the exception of the primary support person. After more than one year of pandemic experience, the ward staff were convinced that the restrictions were mostly positive for the mothers (97.6%) and for the ward staff themselves (78.0%). A total of 80.5% of the ward staff would maintain the restrictions beyond the pandemic. The mothers themselves mostly rated the restrictions in the hospital as being just right; moreover, many mothers voluntarily maintained the restrictions at home, at least in part. Conclusions: The unprecedented visiting restrictions in hospitals during the pandemic were like an "experiment" born out of necessity. Restricting visiting arrangements may be an underestimated beneficial component for the development of the mother-infant dyad in perinatal breastfeeding care, particularly in healthcare systems where almost all births occur in the maternity hospital. Trial registration: German Clinical Trials Register (DRKS) (DRKS00027975). [ABSTRACT FROM AUTHOR]

Background: Determining risk indicators behind dental caries is important for identifying children in need of enhanced dental care. The aim of this register-based study was to investigate the association of family-related risk indicators and dental attendance in the development of dental caries in preschool children. Methods: The data for this study were collected from the medical records of 206 randomly chosen preschool children who lived in the city of Oulu, Finland, during 2014–2020. Data on challenges in family life, missing appointments and utilization of oral health care were collected. Sum functions were formed of risk indicators. Analyses were carried out for three age groups (1- to 2-, 3- to 4- and 5- to 6-year-olds) born between 2014 and 2018. Results: There was a significant association between the number of family-related risk indicators and the prevalence of manifested caries lesions in the age group of 5- to 6-year-olds. All family-related risk indicators and information about health care utilization were associated with dental caries risk. Challenges in a child's family life were present among 20.3% of the 5- to 6-year-olds. In all age groups, the most common challenges in family life were parental exhaustion and problems in the parents' relationship or divorce. Conclusion: Family-related risk indicators and dental attendance should be considered when determining caries risk. The caries risk indicators investigated here are associated with each other. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this cross-sectional study was to investigate if serum levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) and CC chemokine ligand 17 (CCL17) correlate with disease activity in axial spondyloarthritis (axSpA) and peripheral spondyloarthritis (pSpA) patients. Patients and methods: The cross-sectional study was conducted with 80 individuals (48 females, 32 males; mean age: 47.7±11.5 years) between March 2021 and September 2021. Of the participants, 20 were axSpA, 20 were pSpA, and 20 were active rheumatoid arthritis patients, and the remaining 20 were healthy controls. Age, sex, body mass index, disease duration, comorbid diseases, smoking status, medical treatments, C-reactive protein (CRP) level and human leukocyte antigen B27 (HLA-B27) positivity were recorded. Serum GM-CSF and CCL17 levels were analyzed by ELISA. Ankylosing Spondylitis Disease Activity Score with CRP (ASDAS-CRP) was used to evaluate the disease activity of patients with spondyloarthritis. Functional status of spondyloarthritis patients was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI). Results: While the serum GM-CSF levels were similar in the axSpA and pSpA groups, they were significantly higher than the healthy control group (p=0.021 and p=0.009, respectively). There was a significant correlation between GM-CSF levels and ASDAS-CRP (r=0.545, p=0.013) and BASFI (r=0.546, p=0.013) in the axSpA group. In active axSpA patients, the cut-off value for GM-CSF was 15.89 pg/mL (sensitivity 50%, specificity 100%). No differences were detected in serum CCL17 levels among the groups. Conclusion: The results suggest that serum GM-CSF levels may be used as a new marker for the evaluation of disease activity in axSpA, and GM-CSF might be a therapeutic target. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors. BACKGROUND: Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff. METHODS: A cross-sectional, descriptive correlational design was used. The Florida Organization forNursing Leadership enabled distribution of a wellness survey to nurse managers. RESULTS: There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout. CONCLUSIONS: Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers. [ABSTRACT FROM AUTHOR]

Objective To study the frequency of microbiological etiology of respiratory infections in patients with long COVID and their associated clinical and radiological findings. Methods Nasopharyngeal swabs and sputum specimens were collected from 97 patients with respiratory illness stemming from long COVID. The specimens were assessed for their microbiological profile (bacteria and virus) and their association with the overall clinical and radiological picture. Results In total, 23 (24%) patients with long COVID had viral infection (n = 12), bacterial infection (n = 9), or coinfection (n = 2). Microorganisms were detected at significantly higher rates in hospitalized patients, patients with moderate COVID-19, and patients with asthma (P <.05). Tachycardia (65%) was the most common symptom at presentation. A statistically significant number of patients with long COVID who had viral infection presented with cough and myalgia; and a statistically significant number of patients with long COVID who had bacterial infection presented with productive coughing (P <.05). Post-COVID fibrotic changes were found in 61% of cohort patients (31/51). Conclusion A decreasing trend of respiratory pathogens (enveloped viruses and bacteria) was found in long COVID. An analysis including a larger group of viral- or bacterial-infected patients with long COVID is needed to obtain high-level evidence on the presenting symptoms (cough, myalgia) and their association with the underlying comorbidities and severity. [ABSTRACT FROM AUTHOR]

Background and Objectives: Systemic Lupus Erythematosus (SLE) often causes damage to small nerve fibers, leading to distressing painful and autonomic symptoms. Despite this, Small Fiber Neuropathy (SFN) remains an underrecognized complication for SLE patients. In this cross‐sectional study, we aimed to assess SFN in patients with SLE and to explore its correlations with immunologic disease features and clinical manifestations. Methods: We recruited 50 SLE patients (1 male to 12.5 females, aged 20–80 years) reporting painful disturbances. We conducted a comprehensive clinical and neurophysiological evaluation, using Nerve Conduction Studies and Quantitative Sensory Testing. Additionally, we carried out an extensive laboratory assessment of disease‐related serological parameters. We also performed a thorough skin biopsy analysis, investigating somatic and autonomic innervation while detecting complement and inflammatory cell infiltrates within the skin. Results: Out of 50 patients, 19 were diagnosed with SFN, primarily characterized by a non‐length‐dependent distribution; 7 had a mixed neuropathy, with both large and small fiber involvement. Patients with SFN were younger than patients with a mixed neuropathy (p =.0143); furthermore, they were more likely to have a history of hypocomplementemia (p =.0058) and to be treated with cyclosporine A (p =.0053) compared to patients without neuropathy. However, there were no significant differences in painful and autonomic symptoms between patients with and without SFN. Discussion: This study highlights the relevant frequency of SFN with a non‐length‐dependent distribution among SLE patients experiencing painful symptoms. Indeed, SFN emerges as an early manifestation of SLE‐related neuropathy and is closely associated with hypocomplementemia, suggesting a potential pathogenic role of the complement system. Moreover, SFN may be influenced by disease‐modifying therapies. However, the precise role of SFN in shaping painful and autonomic symptoms in patients with SLE remains to be fully elucidated. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To understand and describe attitudes toward general health checkups, breast health knowledge, cultural beliefs, and health-promoting behaviors among Myanmar American immigrant women in the United States. SAMPLE & SETTING: 267 women participated in the study. 10 women were excluded because of missing data, so the total sample size was 257 participants. METHODS & VARIABLES: A descriptive, crosssectional survey design was used to describe and investigate breast health perceptions and behaviors. RESULTS: Nearly 75% of the study sample reported having negative attitudes toward general health checkups and were found to have less accurate breast health knowledge and more fatalistic views about breast cancer. Only 29% of older women adhered to mammogram recommendations. Younger women reported more barriers to mammograms, and older women reported fewer barriers to mammograms. IMPLICATIONS FOR NURSING: This study demonstrated the need for additional research focusing on unique perspectives when investigating breast health practices among Myanmar American immigrant women. The findings highlight the essential need to build a strong partnership with stakeholders to combat breast health disparities and address the complex nature of acculturation. [ABSTRACT FROM AUTHOR]

Background: Association between liver cirrhosis (LC) and glucose intolerance has been known since long. Many studies in the past have attempted to explore the correlation of glucose metabolism disorders (GMD) with the severity of LC with mixed results (some favouring i.e. higher prevalence of GMD in more severe LC; others negating). This study was conducted to shed further light on the significance of this association. Objective: This study has been carried out with the aim of studying the correlation between GMD and the severity of LC, as determined by the Child-Turcotte-Pughe (CTP) score. Methods: 100 patients with LC admitted in medical wards were studied and tested with fasting plasma glucose (FPG), 2 h post-75 g oral glucose load plasma glucose (PPG), glycosylated haemoglobin (HbA1c) and fasting plasma insulin. They were categorized based on the severity of LC into CTP A, B or C class and then patients belonging to different classes were compared for the presence of GMD and insulin resistance (IR). Conclusion: Out of 100 patients, 6, 21 and 73 were respectively found as falling under CTP class A, B and C of LC. The frequency of diabetes mellitus (DM) was found to progressively increase with worsening grade of cirrhosis (17%-A, 24%-B and 27%-C), however this was not significant (p value 0.82). The p values for IR, GMD (pre-diabetes or DM), pre-diabetes (pre-DM) were 0.629, 0.382 and 0.189 respectively. To conclude, development of GMD and IR may be independent of the severity of LC. However more studies may be required to further study this association. [ABSTRACT FROM AUTHOR]

Objective: To analyse the influence of the COVID‐19 pandemic and the perception of self‐efficacy on the health professionals of the Spanish out‐of‐hospital emergency services. Design: Observational, cross‐sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February–30 April, 2021). Methods: The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self‐efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self‐efficacy on mental health. Results: The means of the sample for stress, anxiety, depression and self‐efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self‐efficacy. Self‐efficacy had a direct effect on the mental health for working in patient care. Conclusions: Healthcare workers showed moderate stress, severe anxiety, mild depression and good self‐efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self‐efficacy is a determining factor of mental health in the direct care modality. Implications: The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out‐of‐hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self‐efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. Reporting Method: We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros ‐ ASISA Foundation (Spain). Patient or Public Contribution: 'No patient or public involvement'. [ABSTRACT FROM AUTHOR]

Purpose: To explore student and tutor perspectives on the learning efficacy of virtual, compared to in-person, problem-based tutorial (PBT) in occupational therapy, physiotherapy, and speech-language pathology health professional programs. Materials and Methods: This was a quality improvement study using a cross sectional survey at a single institution. Separate student and tutor surveys were disseminated online. Students received the survey at two timepoints, tutors received the survey at one timepoint. Descriptive statistics summarized quantitative survey questions. Chi-squared or Fischer's Exact analyses explored differences between in-person and virtual PBT. Exploratory analyses determined if associations amongst programs and/or between cohorts existed on variables of interest. Open-ended survey questions were analyzed using content analysis. Results: A total of 241 students and 85 tutors completed the survey. Results demonstrate most students and tutors were satisfied with the use of virtual tutorials (77%; 89% respectively) and felt that they were effective in exploring content within the PBT course. However, students in the most recent cohort rated virtual tutorials more highly (p = 0.01). Conclusions: Virtual modes of PBT were successful in achieving course objectives and led to high satisfaction in users. Health professional programs can use this information when designing virtual problem-based tutorial courses in the post-pandemic era. IMPLICATIONS FOR REHABILITATION: Problem-based learning (PBL) involves the active engagement of students in self-directed learning where learning gaps are identified, and information is retrieved and critically appraised to apply clinical reasoning to healthcare decisions. Traditionally, the PBL process has been implemented in-person through the use of small group tutorial with six to eight students and a tutor, however, the COVID-19 pandemic led to a quick transition to virtual tutorials. This study found that virtual modes of conducting PBL tutorial were successful in achieving course objectives and both students and tutors were satisfied with using virtual means to achieve course objectives in three professional rehabilitation programs (Occupational Therapy, Physiotherapy, Speech Language Pathology). Health professional programs in rehabilitation can use this information when designing courses using PBL processes in the future, and clinicians can use this information when considering the use of virtual means for care and for collaboration between professionals in various healthcare settings. [ABSTRACT FROM AUTHOR]

Importance: Individuals with sickle cell disease (SCD) are at heightened risk of poor neurocognitive and academic outcomes. The relationship between fine motor skills and academic outcomes is not well understood. Objective: To compare the fine motor skills of individuals with SCD with normative expectations, test whether demographic and medical factors are associated with fine motor performance, and determine the impact of fine motor performance on academic performance. Design: Cross-sectional. Setting: St. Jude Children's Research Hospital. Participants: Individuals with SCD (N = 376; ages 8–24 yr). Outcomes and Measures: Fine motor outcomes included visual–motor integration, manual dexterity, and graphomotor speed. Academic outcomes included math fluency and word reading. Demographic and medical variables were obtained via medical records and interviews. Results: Compared with normative expectations, the performance of individuals with SCD on all fine motor measures was lower than expected. Male sex, lower socioeconomic status, and lower oxygen saturation was associated with slower graphomotor speed. Lower socioeconomic status and older age were associated with lower visual–motor integration scores. Performance on all fine motor measures was positively associated with math fluency and word reading. Conclusions and Relevance: Individuals with SCD exhibited poorer than expected fine motor skills across multiple motor domains, and these deficits were associated with poorer academic outcomes. Early referral to intervention services for fine motor skills may facilitate improved academic outcomes for individuals with SCD. Plain-Language Summary: This study had three objectives: (1) Compare the fine motor skills of people with sickle cell disease (SCD) with normative expectations, (2) test whether demographic and medical factors are associated with fine motor performance, and (3) determine the impact of fine motor performance on academic performance. We found that SCD is a risk factor for lower than expected fine motor performance across multiple fine motor domains and that these deficits also affect functional academic skills. The study found that sickle cell disease is a risk factor for lower than expected fine motor performance across multiple domains and that these deficits also affect functional academic skills. [ABSTRACT FROM AUTHOR]

Background: Keratinocyte carcinoma (KC) is a common malignancy characterized by a high recurrence rate and considerable psychological distress. The incidence of KC is increasing in China, raising concerns about its psychological consequences and adverse effects on quality of life. Demographic and clinical factors are thought to influence mental health outcomes in these patients. Nonetheless, data on the prevalence of anxiety in Chinese patients with KC and the factors associated with this anxiety are notably lacking. Therefore, a comprehensive investigation into the anxiety of patients with KC is imperative. Objective: This study aimed to investigate the prevalence of anxiety in patients with KC, a disease that can significantly affect a patient's appearance and overall quality of life. Understanding the level of anxiety in this population is critical to developing targeted interventions, improving treatment outcomes, supporting mental health, and improving patient care practices. Methods: This cross-sectional study was conducted at China's largest dermatology hospital from November 2017 to September 2022. A consecutive sampling method was used to recruit participants. Anxiety status was surveyed by the Self-rating Anxiety Scale (SAS). Explanatory variables were surveyed by demographic data questionnaires. Non-parametric test and Chi-square test analyses were used to compare the differences between groups. Multiple linear regression analysis was performed to identify factors associated with anxiety. Results: A total of 192 patients with KC were included. The median score of SAS was 35 (IQR 16.25). The prevalence of anxiety in patients with KC was 20.8%. Females (p = 0.008), under 60 years old (p = 0.011), living in rural (p = 0.010) or urban areas (p = 0.029), having fewer than three children (p = 0.016), with a history of skin diseases (p < 0.001), with a history of long-term oral medication (p = 0.001), and experiencing pain or itching (p = 0.001) had SAS scores that were significantly higher than their counterparts. Conclusion: This study showed that the prevalence of anxiety was very high among Chinese patients with KC, especially among women, young patients, rural residents, patients with fewer than three children, and individuals with a history of skin disease, long-term oral medications, or symptoms of pain or itching. Targeted psychological interventions for these specific populations should be implemented to effectively alleviate anxiety and improve quality of life in these at-risk groups. [ABSTRACT FROM AUTHOR]

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BACKGROUND: While absenteeism refers to not attending work, presenteeism is defined as not being present at work. These two conditions, which negatively affect employee health, can be indicators of work efficiency, work peace, work safety and work engagement. OBJECTIVE: Several factors were evaluated in this study concerning absenteeism and presenteeism among factory workers. METHODS: This cross-sectional study was conducted among workers in a factory operating in a heavy industry in southern Turkey in 2021. A survey consisting of 57 questions was applied to 152 factory workers by face-to-face interview method. The participants' behaviour over the last month was evaluated regarding absenteeism and presenteeism. RESULTS: It was reported that 24 (15.8%) of all employees were absent from work in the last month (absenteeism), excluding holidays and sick leave, and that 20 (13.2%) employees engaged in presenteeism, working when they should not have been at the workplace. There was a high absenteeism rate among employees who had an acute illness and were dissatisfied with their jobs. Several factors have been associated with presenteeism, including poor economic conditions, family health problems, previous unemployment, working overtime, job dissatisfaction, poor relationships with colleagues and difficulty finding a replacement, acute illness, sleep problems and fatigue. CONCLUSIONS: To increase the productivity and commitment of employees, it may be useful to identify the reasons for absenteeism and present behaviours, to facilitate effective interpersonal communication skills by examining the organisational climate of employees, and to regulate workload based on a comprehensive assessment of the health status of employees. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) is a life-changing event that often results in chronic physical damage and challenges in maintaining a good quality of life as it affects every aspect of life. These situations require adjustment, increasing vulnerability to psychological disorders. The objective of this study was to evaluate the impact of SCI on psychological morbidity in individuals with subacute and chronic SCI. The present investigation was designed to determine the presence and extent of psychological complications following SCI. We used two reliable questionnaires and validated psychological assessments to study depression (BDI) and anxiety (STAI), a broad range of factors derived from SCI that may be predictors of certain psychological problems. The psychological assessment revealed alterations in depression and anxiety, although the data do not exceed those of previous investigations. No clear predisposing factors leading to certain psychological pathologies were found. In addition, individuals in the subacute and chronic stages differed in their scores. In individuals with SCI, identifying predictors of psychological problems is difficult, but premature assessment of mental state is essential. This early diagnosis of possible problems or changes at the mental level is fundamental and necessary to avoid possible alterations at the cognitive level and, of course, more serious mental complications. [ABSTRACT FROM AUTHOR]

Background: Lateral and medial elbow tendinopathies are common soft tissue disorders affecting 1–3% of the general population, causing significant pain and functional impairment in the elbow and upper limb. While often associated with overuse and repetitive strain, their exact etiology, including potential associations with prior injuries in adjacent joints, remains unclear. This preliminary study aims to explore the distribution of lateral and medial elbow tendinopathies and investigate the occurrence of previous lesions in adjacent joints among diagnosed individuals, providing foundational insights for future research. Methods: A multicenter cross-sectional observational study was conducted involving 90 subjects diagnosed with lateral and/or medial elbow tendinopathy. The data collection occurred during the initial consultations, including demographic information, clinical assessments, and history of prior injuries in adjacent joints. Results: Among the sample, 44.4% reported prior injuries to adjacent joints in the affected upper limb, with 45.6% of these injuries identified as musculotendinous in nature. The analysis also showed that the type of elbow tendinopathy was significantly associated with sex (p = 0.01) and occupational origin (p = 0.022). Conclusions: While a notable percentage of the subjects reported prior musculoskeletal injuries in the same limb, the study's geographic limitations and reliance on self-reported data introduce potential recall bias. These preliminary findings suggest a possible relationship between prior adjacent joint injuries and elbow tendinopathy. Further research with larger sample sizes and more rigorous study design is needed to confirm these observations and explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

The highest prevalence of cardiovascular risk factors has been associated with obesity, sedentary lifestyle, and elevated blood pressure due to high workload and work stress. This study aimed to analyze the cardiometabolic risk and lifestyles among the health sciences university academics and campus administrators at a private university in Spain. A cross-sectional study was conducted during the 2018–2019 academic year by the Nursing Department, using a self-administered questionnaire and face-to-face assessments of anthropometric variables related to cardiovascular risk in university personnel. The variables measured included sociodemographics, cardiovascular risk history, comorbidities, toxic habits, Mediterranean diet adherence, physical exercise, psychosocial stress, and physical, anthropometric, and analytical data. Cardiovascular risk was categorized into relative (<40 years), absolute, and vascular age (>40 years). Among the 101 participants, 61.4% were women, with a mean age of 41.3 years ± 9 years. The smoking prevalence was 21.8% (68.2% women), 27.7% were sedentary, and 51.0% adhered to the Mediterranean diet, with higher adherence among the academics. Emotional risk was present in 32.7% of the participants. A prior diagnosis of hypertension was significantly more frequent in the men (15.4%) compared to the women (3.2%). The blood pressure measurements were mostly optimal across both genders and professional groups, but the proportion of hypertension grade 1 was significantly higher among the academics (10%) compared to the administrators (4.5%) and among the men (11.1%) compared to the women (5.9%). The absolute cardiovascular risk among the university employees was generally low, but the men exhibited a more moderate risk compared to the women. It is necessary for the university to promote health within its community, with the Nursing Department playing a key role in health promotion and research. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is the gold standard in infant nutrition. Successful breastfeeding depends on many factors, including the help of medical personnel in teaching breastfeeding, the need for professional work, and breastfeeding-friendly places in public spaces. The main goal was to identify various barriers among mothers to breastfeeding. Methods: This study used a quantitative descriptive research design. We recruited 419 mothers aged at least 18 years old through social media. Results were analysed using Pearson's chi-squared and Fisher's tests of independence for pairs of dependent and independent variables. Results: Most often, women gave birth at the age of 25–30, had one or two children, and attended higher education. Almost half of them lived in a large city and gave birth to a child by caesarean section. A total of 83.1% of mothers planned to breastfeed, but not all of them were able to do so for various reasons. One-third of them felt sorry for themselves that they had to change their feeding method. The majority of mothers did not receive sufficient help in the hospital in terms of learning how to breastfeed (61%), did not use the help of a lactation consultant (67%), and answered that there was no lactation consultant in their place of residence (65%). Only 43.2% of mothers returned to work without ceasing breastfeeding. A total of 42% of mothers experienced feelings of embarrassment when breastfeeding in a public place. The most frequently indicated barrier to breastfeeding in a public place was the lack of a suitable location where a woman would feel comfortable, calm, and intimate. Conclusion: There are various barriers towards breastfeeding: too few lactation consultants, problems with breastfeeding when the mother wants to return to work, and unfriendly places for breastfeeding in public spaces. Efforts must be made to support mothers in breastfeeding. [ABSTRACT FROM AUTHOR]

Men who have sex with men are at an increased risk of acquiring sexually transmitted infections, and although behavioral and contextual interventions have improved, infections continue to spread. Therefore, a new focus on recent trends in sexual health in this population is needed. The aim of this study was to describe the relationship between sociodemographic and behavioral characteristics according to Grindr usage patterns, the prevalence of sexually transmitted infections (STIs), and attitudes toward HIV testing. In January 2020, a cross-sectional study was conducted using a sample of 881 men who have sex with men (MSM) who completed an online questionnaire. We evaluated their Grindr use patterns (moderate or intensive) and explored the associations of these with sociodemographic behavioral characteristics, STIs, and attitudes toward HIV testing. Of 881 participants in total, 587 (66.6%) were intensive Grindr users. Compared to moderate users, these participants reported significantly higher numbers of casual sexual partners (76.2% vs. 23.8%; p < 0.001), were more likely to participate in Chemsex (77.3% vs. 22.7%: p = 0.031), and had a higher self-reported number of STIs (69.9% vs. 30.1; p = 0.046). They also demonstrated better attitudes toward HIV testing (69.7% vs. 30.3%; p = 0.045) and perceived themselves to be at moderate risk of HIV (71.2% vs. 28.8%: p = 0.048). Moreover, intensive Grindr users were 1.36 times more likely than moderate users to test positive for STIs (95%CI = 1.15–1.91; p = 0.048). With some limitations, age, sexual partners, intensive Grindr users, and PrEP uses were associated with the risk of STIs in the sample of Spanish Grindr users studied. As Grindr users are vulnerable to sociodemographic and behavioral factors that determine STIs and HIV infection, mainly among intensive users, it is necessary to highlight the importance of new trends such as online dating apps, PrEP use, substance use in sex, and Chemsex, and these need to be incorporated into online public health strategies. [ABSTRACT FROM AUTHOR]

Background: Preparing healthcare systems for emergencies is crucial to maintaining healthcare quality. Nursing homes (NHs) require tailored emergency plans. This article aims to develop a typology of French private NHs and study their early COVID-19 responses and mortality outcomes. Methods: We conducted a cross-sectional survey among NHs of a French network consisting of 290 facilities during the first wave of the COVID-19 pandemic. A Hierarchical Clustering on Principal Components (HCPC) was conducted to develop the typology of the NHs. Association tests were used to analyze the relationships between the typology, prevention and control measures, COVID-19 mortality, and the satisfaction of hospitalization requests. Results: The 290 NHs vary in size, services, and location characteristics. The HCPC identified three clusters: large urban NHs with low levels of primary care (Cluster 1), small rural NHs (Cluster 2), and medium urban NHs with high levels of primary care (Cluster 3). The COVID-19 outcomes and response measures differed by cluster, with Clusters 1 and 2 experiencing higher mortality rates. Nearly all the NHs implemented preventive measures, but the timing and extent varied. Conclusions: This typology could help in better preparing NHs for future health emergencies, allowing for targeted resource allocation and tailored adaptations. It underscores the importance of primary care territorial structuring in managing health crises. [ABSTRACT FROM AUTHOR]

Background & Objective: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound with the findings during a cesarean section (C/S) of pregnant women with a history of previous C/S. Materials & Methods: This cross-sectional study was performed on 40 pregnant women referred to Izadi Obstetrics and Gynecology Hospital in Qom. All the women underwent transvaginal ultrasound followed by C/S within a maximum of one week later. Also, an expert gynecologist classified LUS thickness into four grades in the operation room. Results: The mean age of women was 31.58 ± 4.56 years, and the mean thickness of the LUS was 2.17 ± 0.51 cm. Moreover, 57.5% of the women have graded I of LUS based on intraoperative findings. Results indicated that the mean thickness of the LUS measured by ultrasound significantly differed between the three grades detected by the gynecologist (P=0.04). However, there were no significant differences between maternal age, gestational age, parity, and time of last C/S among women with different LUS grades (P=0.05). Transvaginal ultrasound could be helpful in evaluating the risk of scar dehiscence and uterine rupture among women with LUS grades I and II with a history of previous C/S. Conclusion: Transvaginal Ultrasonography, Lower Uterine Segment Thickness, Cesarean Section. [ABSTRACT FROM AUTHOR]

Background Early detection of obesity-promoting dietary behavior patterns improves the identification of at-risk families and the implementation of interventions. This is accomplished through the use of the Child Eating Behavior Questionnaire (CEBQ). No study has been conducted using the CEBQ in children followed in Essonne's Maternal–Infant Protection (PMI) centers. We investigated, in a cross-sectional design, the differences in children's eating behavior with PMI follow-up according to their weight status. Methods A questionnaire addressed to parents was collected in PMI centers. Multiple hierarchical regression analysis was used to investigate the predictability of the child's CEBQ on body mass index (BMI). Results From January to April 2022, 850 children were selected, from which 500 (aged 1–6 years) were included, and of whom 10.6% were obese. There was a significant positive association between 'Food Responsiveness', 'Enjoyment of Food' and BMI. In contrast, there was a significant negative association between 'Satiety Responsiveness', 'Slowness in Eating' and BMI. Besides, 'Food approach' and 'food avoidance' behaviors were positively and negatively related to BMI z-scores, respectively. Conclusion Due to significant differences in children's eating behavior according to their weight, it is needed to raise awareness among parents about their impact on them. [ABSTRACT FROM AUTHOR]

Background Earthquakes disproportionately affect women and exacerbate gender and social inequalities. This study aims to investigate the psychological impact of the earthquake in Türkiye on women and the associated factors. Methods This is a survey-based study. We collected data from 498 women residing in cities most affected by the earthquake. Results Participants' mean age was 27.72 ± 5.4. Over 78% of the participants lost at least one family member, and 43.7% lost at least one child due to the earthquake. The mean average of Brief Symptom Inventory (BSI) scores was 100.8 (SD = 8.37), and the Global Severity Index was 1.9 (SD = 0.16). Regression analysis showed that higher education levels predicted poor outcomes across most BSI dimensions. Losing a family member and shelter and injury status were also predictors for several mental health outcomes of the BSI subscales. Conclusions Earthquakes significantly impact women's well-being and may have a broader impact on the whole family. There is an urgent need to provide psycho-social interventions in the response and recovery phases of the crisis to meet the affected women's needs. This includes providing basic needs with attention to women-specific needs, restoring social networks, addressing gender-based violence and providing gender-sensitive specialized interventions for those who need further support. [ABSTRACT FROM AUTHOR]

Background The health and environmental benefits of legume consumption are reflected in dietary guidelines worldwide. However, legume intake fails to meet recommendations. Dietitians' legume counseling practices can impact consumption patterns. This cross-sectional study assessed Israeli dietitians' knowledge, attitudes, perceptions and practices regarding legume counseling and identified pertinent barriers and facilitators. Methods An electronic survey among Israeli dietitians (n  = 309) was performed. Multivariable logistic regression assessed associations between recommending legumes with participants' socio-demographic and professional characteristics, knowledge, perceptions, attitudes toward legume counseling and personal legume intake. Results Almost half (47.4%) of the participants recommended that 76% or more of their patients increase legume intake. Factors that were associated with recommending legumes were perceptions of fewer barriers to consumption [adjusted OR (aOR) 1.92 (95% CI 1.24–2.96)] and positive attitudes toward legume counseling pertaining to its importance [aOR 1.95 (95% CI 1.12–3.4)]. Negatively associated factors were a low level of personal legume consumption [aOR 0.38 (95% CI 0.15–0.94)] and working in hospitals [aOR 0.43 (95% CI 0.19–0.98)]. Conclusions Israeli dietitians' recommendations for legume consumption were well below current guidelines. These findings indicate the need for a tailored intervention for nutrition professionals to increase the frequency of legume counseling and overall consumption. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the most common chronic childhood disease. The recommended age for the first dental visit (FDV) is 1 year, yet a minority of children visit before the age of 3 years. Aim: The aim of the study was to estimate the patterns of and predictors for dental visits among a sample of children. Design: Parents of children between the ages of 6 months and 18 years, who attended the paediatric dentistry clinics and the well‐baby clinics, were recruited. A validated questionnaire was used to collect data. Logistic regression was utilized to assess the predictors of ever visiting a dentist. Results: The mean age at FDV was 5.8 ± 2.1 years. Parents' belief of not needing to see a dentist was the most common barrier to visiting a dentist (33%). Among the reasons for FDV, caries and pain were the most common (45% and 20%, respectively). Predictors of ever visiting a dentist were children who are not an only child and children of parents who visited a dentist themselves. Conclusion: Children visited the dentist at an age older than that recommended, and the reasons for FDV were mainly caries and its consequences. [ABSTRACT FROM AUTHOR]

Diabetes is increasing significantly in the world especially among low- and middle-income countries including Algeria where it is ranked second in term of morbidity. This study was conducted aiming to evaluate the level of knowledge and lifestyle practice among Algerian university students. A national online cross-sectional survey was conducted between 14 November 2022 and 11 February 2023. 417 students answered the questionnaire. Demographically, females (82%), singles (86.1%), students aged between 20 and 30 years old (62.2%) and those living in urban areas (86.8%) were the most represented. More than half were students of bachelor level (52.3%) and were mainly studying in Natural and Life Sciences (37.2%) and Humanities (29.5%) faculties, and 10.6% of them declared living with diabetes. Overall, an average percentage of 75.1% correct responses was obtained and 54.6% of the respondents have shown a high level of knowledge. If age, the field of study and paternal education were associated with a high level of knowledge, being a Health Sciences student (OR: 10.175, CI 95%: 2.985–34.677) and being diabetic (OR: 10.486, CI95%: 3.424–32.12) were highly significant factors (p < 0.01). Regarding lifestyle practice, a moderate level of good practice of 54.2% was obtained and the level of knowledge was the only associated factor. These results described that some gaps of knowledge were observed especially among certain categories including students without formal education in Health, and Natural and Life Sciences. Results of this study could be helpful to the health program deciders in their campaigns of prevention against this silent disease. [ABSTRACT FROM AUTHOR]

Background/aim: The most commonly prescribed anti-seizures medications (ASMs) for the treatment of epilepsy are currently topiramate, zonisamide, lacosamide, carbamazepine and levetiracetam. The objective of this study was to examine the correlation between preoperative, intraoperative, and postoperative metabolic acidosis and the use of ASMs prior to craniotomy operations. Materials and methods: This retrospective cross-sectional study evaluated patients who underwent intracranial surgery with craniotomy under general anaesthesia between May 2020 and April 2023 and used ASMs. The patients were classified into four groups based on the pharmacological mechanisms of action of the ASMs administered before intracranial surgery (Group-I, zonisamide or topiramate; Group-II, lacosamide; Group-III, carbamazepine; Group-IV, levetiracetam). Metabolic acidosis severity was defined based on base excess (BE) levels: mild (-3 to -5), moderate (-5 to -10), and severe (below − 10). The study investigated the correlation between ASMs and the severity of metabolic acidosis in preoperative, intraoperative, and postoperative blood gas measurements. Results: Out of 35 patients, 24 patients underwent intracranial surgery and 11 patients underwent epilepsy surgery. There were statistically significant differences in the severity of metabolic acidosis between preoperative (p < 0.001), intraoperative (p < 0.001) and postoperative (p = 0.01) groups. The preoperative mean BE of group-I was − 4.7, which was statistically lower than that of group-III (p = 0.01) and group-IV (p < 0.001). Intraoperatively and postoperatively, group-I had a mean BE of -7.5 and − 3.2, respectively, which was statistically lower than that of groups II (p = 0.007; p = 0.04), III (p = 0.002; p = 0.03), and IV (p < 0.001; p = 0.009). There was no statistically significant difference in BE between groups II, III and IV at all three time points. Group I had the lowest BE at all three time points. Intraoperative bicarbonate was administered to all patients in group I, whereas no intraoperative bicarbonate was required in the other groups. In group I, 50% of patients required postoperative intensive care. Conclusion: The use of ASMs in patients undergoing surgery is important in terms of mortality and morbidity. Topirimat and zonisamide are ASMs that can cause preoperative, intraoperative and postoperative metabolic acidosis. Patients receiving topirimat or zonisamide are particularly susceptible to metabolic acidosis. Special care should be taken in the management of anaesthesia in patients receiving these drugs, and monitoring of the perioperative metabolic status is essential. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is the most common movement disorder and the second most common neurodegenerative disease. The aim of our study was to compare gray–white matter changes (GWC) between Parkinson's disease (PD) patients and age-matched healthy control group as well as comparing GWC between different stages of PD (early and complicated). Our study was prospective cross-sectional case–control observational study with analytic component conducted on twenty patients and ten controls without any signs or symptoms of PD or any history of PD in first-degree relatives. All patients and controls were tested for history taking with stress on resting tremors, rigidity, gait abnormalities, postural instability and any symptoms of cognitive impairment, clinical examination including general examination and neurological examination. Also diffusion tensor imaging (DTI) with fiber tracking (tractography) and susceptibility-weighted MR imaging were performed for all cases. Results: As regards DTI and evaluation of fractional anisotropy (FA) and mean diffusivity (MD) values between PD cases and healthy controls, the cases group showed significant decrease in FA values at substantia nigra on both sides and left cingulum as well as significant increase in MD values at substantia nigra on both sides and corpus callosum. Also, there are significant decrease in FA values at substantia nigra on both sides and significant increase in MD values at substantia nigra on both sides and right cingulum in late parkinsonism when compared to early parkinsonism. A cutoff FA value of 0.945 at right substantia nigra and cutoff FA value of 0.585 at left substantia nigra showed significant AUC that could differentiate between cases and controls. Also cutoff MD value of 0.791 at right substantia nigra and cutoff MD value of 0.813 at left substantia nigra showed significant AUC that could differentiate between cases and controls. Conclusions: Diffusion tensor imaging showed valuable role in evaluation of gray–white matter changes in Parkinson's disease. Also, it helps to assess degree of gray–white matter changes when comparing late parkinsonism to early parkinsonism through evaluation of FA and MD values at corpus callosum, substania nigra, and cingulum. [ABSTRACT FROM AUTHOR]

Aims: To investigate the level of adoption of evidence‐based family engagement and support during end‐of‐life cancer care and subsequent bereavement and its contextual facilitators and barriers from health professionals' perspectives, and to explore differences between professional groups. Design: Contextual analysis using an online cross‐sectional survey. Methods: This study was conducted in four Swiss hospitals and three home care oncology and palliative care services. Non‐parametric testing was used to investigate the level of adoption and differences between nurses, physicians, occupational‐ and physiotherapists and psychosocial professionals (chaplains, onco‐psychologists and social workers). The STROBE checklist for cross‐sectional studies was followed. Results: The majority of the 111 participating health professionals were nurses. Adoption was statistically significantly higher during end‐of‐life care than bereavement, with nurses and physicians reporting higher levels than the other professional groups. Guidance on end‐of‐life family care was available in about half of the cases, in contrast to a quarter for bereavement care. Self‐perceived knowledge, skills and attitudes were moderate to high, with nurses and physicians reporting higher levels than others, except for general skills in working with families. Organisational structures were experienced as rather supportive, with the psychosocial group appraising the organisational context as significantly less conducive to fully implementing end‐of‐life and bereavement care than others, particularly during the end‐of‐life phase. Conclusion: Evidence‐based family engagement and support were better adopted during end‐of‐life care than bereavement. Overall, nurses and physicians felt better enabled to care for families compared to other professional groups. Patient or Public Contribution: No patient or public contribution. Protocol registration: https://osf.io/j4kfh. Implications for the profession and/or patient care: Implementation and quality improvement efforts should focus particularly on the bereavement phase and be tailored to professional groups. Impact: The findings show that evidence‐based family engagement and support practices during end‐of‐life were rather well adopted in contrast to subsequent bereavement care, with nurses and physicians better enabled than other professionals to provide care. A better understanding of health professionals' contributions and roles in family care is important to build interprofessional capacity for evidence‐based end‐of‐life and bereavement support. Reporting Method: The STROBE checklist for reports of cross‐sectional studies was followed (von Elm et al., 2007). [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the perspectives, preferences, and clinical experiences regarding using electronic apex locator and apex locator integrated instrumentation of dentists and endodontists. Methods: A web-based questionnaire consisting of 3 parts and 23 closed-ended questions to achieve the objective of the study was carried out in ethical conditions between August and October 2023. The first part of survey included demographic information, while the second part was about evaluating electronic apex locator usage. In the last part, only participants' use of apex locator-integrated instrumentation was evaluated. Data were analyzed at a significance level of p < 0.05. Results: A total of 297 clinicians, including 59 endodontists and 34 endodontic residents/Ph.D. students participated in the questionnaire. Endodontists and endodontic residents/Ph.D. students perform statistically significantly more root canal treatments per week on average (p = 0.001). For the working length determination method (multiple option question), 78.5% of participants use an electronic apex locator and 39.7% apex locator-integrated engines. However, the preference rate for electronic apex determination technique was generally 95.6%, with the full rate confirmation of endodontists and endodontic residents/Ph.D. students (100%). A total of 21 endodontists out of 59 prefer apex locator integrated engine-driven instrumentation. Although many of these specialized clinicians use this technique, they stated that they measure electronic working length passively for confirmation of the working length before (90.5%) and after the preparation (66.7%). Conclusions: Dentists, as well as endodontists, are skeptical about apex locator-integrated engine-driven instrumentation. Using this technique as a supporter rather than a primary way for preparation within safe limits may give safer results in terms of treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Eating disorders are complex illnesses with serious long-term consequences. They are linked to negative outcomes such as miscarriage, low birth weight, and other obstetric and postpartum difficulties. Our study in Muscat, Oman, examines the eating habits of pregnant women who consult primary care physicians. In this study, our aim is to identify key sociodemographic factors linked with eating disorders in Oman. Method: We used the Eating Disorder Examination Questionnaire to assess the potential for the presence of eating disorders. Chi-Square and Fisher's Exact tests were used to analyze relationships between improper eating behavior and independent variables. Results: The study showed that 1.6% of participants had a potential diagnosis of an eating disorder, with the most common inappropriate behavior being binge eating at a prevalence of 18.8%. A pre-gestational low Body Mass Index (BMI) was associated with a higher prevalence of binge eating during pregnancy. Additionally, we found that pregnant women who were working were more prone to self-induced vomiting. High BMI before pregnancy was significantly associated with various inappropriate eating behaviors, such as restraint behavior (p = 0.000), shape concern (p = 0.000), weight concern (p = 0.040), eating (p = 0.045), laxative use (p = 0.020), and excessive exercise (p = 0.043). Conclusion: The study reveals a high prevalence of eating disorders in pregnancy. Less educated women exhibit higher laxative use, while working women show more instances of binge eating and self-induced vomiting. These findings emphasize the critical need to prioritize targeted interventions and support for vulnerable pregnant women. [ABSTRACT FROM AUTHOR]

Background: The use of herbal medicine has a long history in Sudan and is widely practiced among the general population. However, there is a lack of studies examining the prevalence, patterns, and predictors of herbal medicine usage in Sudan. Thus, this study was conducted to bridge this gap. Methods: This descriptive cross-sectional study was conducted between January and February 2021. It included Sudanese adults residing in Omdurman, Sudan, using systematic and simple random sampling methods. Data were collected using a structured, adapted questionnaire comprising: the socio-demographic characteristics and the knowledge of herbal medicine and its usage. Moreover, it investigated the commonly used herbal remedies and the participants' sources of information and procurement of such products. Additionally, we examined the correlation between socio-demographic factors, cultural beliefs, and the use of herbal medicine. Data were analyzed using SPSS, and categorical data were presented as frequencies and percentages. Associations were assessed using chi-square, Fisher's exact tests, and binary logistic regression (p < 0.05). Results: This study included 381 participants, of which 48.1% were females and 31.4% were aged 20-30. The majority of participants were aware of the practice of herbal medicine and the prevalence of its usage was 85.9%. Peppermint, acacia, hibiscus, ginger, and fenugreek were the most commonly used remedies. Chi-square and Fisher's exact testing revealed that the participants' gender and beliefs in the safety and effectiveness of herbal medicines were significantly associated with herbal medicine usage (p < 0.05). Binary logistic regression analysis showed that only the perception of herbal medicine's safety was an independent predictor of its usage (p-value 0.038). Conclusion: This study reported a very high prevalence of herbal medicine usage, highlighting the acceptability of Sudanese adults towards herbal medicine usage. This prompts further studies to explore their safety, efficacy, and the possibility of their integration into mainstream healthcare practices and policies. [ABSTRACT FROM AUTHOR]

Background: Cleft lip and palate are congenital craniofacial anomalies that significantly impact individuals and their families, both medically and psychosocially. The Qatari population has unique characteristics that are suggestive of a high prevalence of congenital anomalies: high consanguinity rate, large family size, advanced paternal age and high prevalence of certain genetic disorders. The lack of existing data concerning the epidemiology of cleft lip and/or palate in Qatar warrants a descriptive study addressing this topic. Methods: A retrospective nationwide hospital-based cross-sectional study conducted to determine the prevalence of orofacial clefts in Qatar from 2016 to 2021. Data were extracted from the corporation's Cerner database and electronic health records. Information concerning the cleft's characteristics, type, affected side, patient's gender, presence of associated syndromes, nationality, and maternal age were collected. Results: Out of the 147,727 live births, 148 had an orofacial cleft. The prevalence of cleft lip and/or palate was determined to be 1 per 1000 livebirths (95% CI: 0.85, 1.18). The prevalence of cleft lip was 0.18 (95% CI: 0.12, 0.27), cleft palate 0.39 (95% CI: 0.30, 0.51), and cleft lip and palate 0.43 (95% CI: 0.33, 0.55). Qataris had a prevalence of CL 0.25, CP 0.40, and CLP 0.56, compared to 0.16, 0.39, 0.39 for non-Qataris (p-value 0.186). Unilateral clefts predominated over bilateral (74.4% and 25.6%, respectively). Among the unilateral cases, 70.2% occurred on the left side. Most cases were isolated clefts, with only 10.2% having associated syndromes. Conclusions: The prevalence of orofacial clefts in Qatar is consistent with the globally reported prevalence. Most cases were unilateral and on the left side. Associated syndromes were infrequent and more common with cleft palate alone. Intriguing patterns were revealed between Qatari nationals and non-Qatari residents, with specific subtypes of orofacial clefts showing higher prevalence among nationals. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the incidence and severity of depression in patients with retinitis pigmentosa (RP). Materials and Methods: The Beck Depression Inventory (BDI) was administered to 74 patients with RP and 60 healthy controls. Biomicroscopic anterior segment and fundus examination, visual field, optical coherence tomography, and full-field electroretinography tests were performed in all cases. Variables were evaluated with bivariate, multiple linear, and ordinal logistic regression analyses. Results: The RP group included 40 (54%) male and 34 (46%) female patients, while the control group included 23 (38%) male and 37 (62%) female subjects. The patient group had a mean age of 39.20±12.4 years, median best corrected visual acuity (BCVA) of 0.10 decimal (1.0 logarithm of the minimum angle of resolution [logMAR]; range, 1.3-0.7 logMAR), and median visual field mean deviation (MD) score of -28.00 decibels (dB) (range, -1.00 to -34.00 dB). The median BDI score was statistically significantly higher in the patient group (19 points) than in the control group (12 points) (p<0.001). Moderate to severe depression (BDI ≥20) was detected in 61% of patients, while this rate was 25% in healthy controls. BCVA and visual field MD values were identified as predictors of depression score and severity level. The patients' age and gender did not affect total depression score or severity. Conclusion: The prevalence and severity of depression were found to be higher in RP patients than in healthy controls. There was a significant relationship between the patient's functional vision tests and the frequency and severity of depression. Depression reduces the reliability of visual function tests and impairs patients' quality of life. Therefore, assessing mental health as well as functional tests is important in patients with RP. [ABSTRACT FROM AUTHOR]

Background: Despite the global acceptance of palliative sedation, China's engagement in this field remains comparatively restricted. There exists a scarcity of information regarding the attitudes and experiences of hospice nurses concerning palliative sedation. Objectives: This survey aimed at investigating the attitudes of Chinese hospice nurses toward palliative sedation, as well as their practices in palliative sedation. Design: A cross-sectional descriptive study. Setting/Subjects: In 2023, the survey on palliative sedation was introduced during the opening ceremony of the largest National Symposium on New Advances in Hospice Nursing in China. Subsequently, the study questionnaire was disseminated through email to a cohort of 806 hospice nurses attending the conference. Measurements/Results: The statistical analysis was based on 641 valid responses. Among them, 508 had no experience with palliative sedation, while only 133 had such experience. Around 92.5% of hospice nurses with experience in palliative sedation agreed with the physician's instructions to begin palliative sedation. Nurses were present at the start of sedation in nearly all cases (97.0%), and most doctors (79.7%) and family members (82.0%) were also present. However, 8.3% of them perceived that there was no difference between palliative sedation and euthanasia. Furthermore, 13.5% of participants believed that the purpose of palliative sedation was to hasten death. Conclusions: Hospice nurses play a crucial role in the process of palliative sedation, yet they also face significant challenges. It suggests that there is an urgent need in China for the development of consensus or guidelines for palliative sedation to clarify the roles of team members, including hospice nurses. [ABSTRACT FROM AUTHOR]

Introduction: Child abuse and neglect is a widespread and pressing issue, with serious and long-term adverse effects on children's physical and psychological health. Pediatricians play a crucial role in detecting and addressing cases; however, studies have shown challenges in reporting cases encountered in clinical practice. This study aims to examine pediatricians' attitudes towards reporting cases of child abuse and neglect encountered in their clinical practices, as well as the factors influencing these attitudes. Materials and Methods: A descriptive cross-sectional study was conducted among pediatricians in Istanbul. Data collected included sociodemographic characteristics, knowledge and formal training about child neglect and abuse, attitudes about dealing with it, experience, and reporting behavior. The data was collected through a self-administered online questionnaire. The study provides insights into the current awareness and response of Istanbul's pediatricians towards child neglect and abuse. The data were analyzed using SPSS 22, employing descriptive and comparative statistics such as frequency, mean, standard deviation, and correlation tests. Ethical approval was obtained from the Istanbul Medipol University Ethics Committee. The study was conducted in accordance with the Declaration of Helsinki and online consent was obtained from the participants. Results: The study involved 126 pediatricians. Results showed that pediatricians had generally positive attitudes toward reporting child neglect and abuse. Gender and marital status did not significantly influence attitudes, but pediatricians who were parents scored higher on reporting Responsibility. Additionally, it was shown that those with more professional experience had a higher reporting responsibility score. Structured training on child abuse and neglect has been shown to increase pediatricians' reporting responsibility scores and exhibit less anxious attitudes. Conclusion: This study highlights pediatricians' positive attitudes toward reporting child abuse and neglect and identifies influencing factors such as training, professional experience, and collaboration. It emphasizes the importance of addressing challenges like awareness of reporting procedures and concerns about negative consequences. Comprehensive training, clear reporting protocols, and multidisciplinary collaboration are essential for increasing reporting rates and improving the detection of child abuse and neglect. The study contributes to enhancing child protection systems in Turkey by providing insights into pediatricians' attitudes toward reporting child abuse and neglect. [ABSTRACT FROM AUTHOR]

Background: Women with diminished ovarian reserve (DOR) have fewer eggs than would be expected at their age. It is estimated that 10% of women seeking fertility treatment are diagnosed with DOR. However, the success rate of medically assisted reproduction (MAR) is significantly lower in women with DOR, thus many seek additional approaches. Aim: To explore the health needs of women with DOR, treatment options and experience of treatment including traditional complementary integrative medicine (TCIM). Methods: Anyone with a diagnosis of DOR, living in Australia or New Zealand, aged over 18 were invited to complete an online survey distributed via fertility support networks and social media platforms from April to December 2021. Results: Data from 67 respondents were included. The main aspects of health that were impacted by DOR were fertility (91.0%) and mental health (52.2%). The main treatment recommended was MAR with most women either currently using MAR (38.8%) or having previously used MAR (37.3%). TCIM was widely used with 88.1% of women utilising supplements, 74.6% consulting with TCIM practitioners, and 65.7% adopting self‐care practices. The main reasons for using TCIM were to improve fertility or support pregnancy, and to support general health and well‐being. Conclusions: Women with DOR have additional health needs apart from infertility, most notably mental health support. The main form of treatment utilised is MAR, despite DOR being challenging for fertility clinicians. TCIM was widely used, and respondents perceived benefits related to improving fertility, supporting pregnancy, or improving well‐being through use of acupuncture, meditation, naturopathy, massage, yoga. [ABSTRACT FROM AUTHOR]