Item Questionnaire Research Articles

Knowledge, Awareness, and Perceptions Towards Antibiotic Use, Resistance, and Antimicrobial Stewardship Among Final-Year Medical and Pharmacy Students in Saudi Arabia

Background/Objectives: Antibiotic resistance (ABR) is a global crisis leading to increased mortality and economic burden. Antimicrobial stewardship (AMS) promotes responsible antibiotic use and prescribing practices to combat ABR. This study assessed the knowledge, awareness, and perceptions of final-year medical and pharmacy students in Saudi Arabia regarding antibiotic use, ABR, and AMS. Methods: A national cross-sectional survey was conducted from January to April 2024 using a 49-item questionnaire. The survey assessed knowledge of antibiotic use, ABR, and AMS using predefined scoring, while perceptions were evaluated with a 5-point Likert scale. Data were analyzed using descriptive statistics and Chi-square tests to explore associations between independent variables and outcomes. A logistic regression analysis identified factors associated with good knowledge, and results were reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among 197 participants from 26 Saudi universities, pharmacy students comprised 73.1% of the sample. Good knowledge was observed in 44.7% for antibiotic use, 47.7% for ABR, and 52.8% for AMS. However, 28.4% lacked awareness of AMS, and 5.6% were unaware of ABR. Pharmacy students demonstrated significantly higher knowledge and confidence in AMS and antibiotic handling compared to medical students (p < 0.001). Higher knowledge was also associated with the university’s region and prior education on resistance or AMS during college. Conclusions: This study highlights significant gaps in knowledge and awareness of antibiotic use, ABR, and AMS among final-year medical and pharmacy students in Saudi Arabia. The findings emphasize the need for targeted educational strategies, standardized curricula, and enhanced AMS training to better prepare future healthcare professionals to combat ABR effectively.

COVID-19 vaccination attitudes and acceptance among people with serious mental illness.

This study examines attitudes towards COVID-19 vaccination among a diverse cohort of adults with serious mental illness (SMI), participant characteristics that are associated with vaccine acceptance, and barriers to COVID-19 vaccination among this population. A 28-item questionnaire was administered to 185 adults with SMI receiving care at a university-based outpatient psychiatric clinic. Variables included demographics, health behaviors, and vaccination status. Chi-square tests were used for categorical demographic comparisons on binary COVID-19 vaccine status. Female participants were more likely to have received COVID-19 vaccination (77.6%) than male (55.7%) participants. White (73.3%) and Hispanic/Latino (81.8%) participants were more likely to have received vaccination than Black/African American (54.9%) participants. Participants who reported having seen a primary care provider (PCP) within the past two years were more likely to be vaccinated (72.1%) than those who had not (41.7%). Participants who reported having received an influenza vaccine in the past two years were more likely to be vaccinated (80.2%) than those who had not (41.8%). Participants who had not been vaccinated were more likely to report greater concerns about all potential barriers to vaccination, including concerns about side effects, cost, health effects, and distrust of clinicians and governments. The overall vaccination rate of study participants with SMI was similar to that of the general population. Efforts to enhance engagement in primary care may help improve preventative health behaviors in people with SMI.

P0492 Development and Assessment of a Novel Ulcerative Colitis–Specific Quality of Life Questionnaire: A Prospective, Multi-Institutional Study

Abstract Background Interest in the quality of life (QoL) of patients with inflammatory bowel disease (IBD) has recently increased. Althoughmeasurement tools have been devised for IBD in general, there is no specific tool for measuring the QoL of patients with ulcerativecolitis (UC). Therefore, we developed a QoL questionnaire specifically for patients with UC. Methods The Korean Ulcerative Colitis-Specific Questionnaire (K-UCSQ) was developed through item generation,raw-scale construction, focus group meetings, and multi-center field tests. Two hundred patients with UC were recruited for a fieldtest of the K-UCSQ, and subsequent responses to the Inflammatory Bowel Disease Questionnaire (IBDQ) were also obtained. Afterperforming factor analyses to ensure construct validity, the K-UCSQ was finalized as a four-domain, 28-item questionnaire. Subsequentanalyses evaluated the reliability of the K-UCSQ in terms of Cronbach’s alpha, concurrent validity in comparison with thepre-established IBDQ, and predictive validity of the area under the ROC curve (AUC) for clinically relevant QoL outcomes. Results A Cronbach’s alpha of 0.94 showed excellent reliability. Furthermore, correlation analyses demonstrated the concurrent validityof the K-UCSQ in comparison with the IBDQ. The K-UCSQ also showed high validity in predicting the perceived overall health(AUC of 0.812 vs. 0.797 using the IBDQ) and past 2-week QoL (AUC of 0.864 vs. 0.859 using the IBDQ). Conclusion The newly developed K-UCSQ is concise, bathroom problem-emphasizing, and UC-specific, suggesting that it couldbe a valid and reliable UC-specific instrument for QoL measurement.

The Effectiveness of Mindfulness Integrated Cognitive Behavioral Therapy on Negative Emotions and Cognitive Regulation of Emotions in Patients with Multiple Sclerosis: A Clinical Trial Study

Introduction: Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system. Patients with MS suffer from problems such as negative emotions and poor emotion regulation. The present study investigated the effectiveness of mindfulness integrated cognitive behavioral therapy (MICBT) on negative emotions and emotion regulation in patients with MS. Methods: This research was a semi-experimental study using a pre-test-post-test with a control group. A total of 52 patients with MS referring to Shafa Hospital in Kerman city, were selected by the convenience sampling method in 2023 and were randomly divided into two experimental (26 people) and control (26 people) groups. Patients completed the questionnaire of depression, anxiety and stress scale-21 items (DASS-21) and cognitive emotion regulation questionnaire of Garnefski in the pre-test and post-test. The data were analyzed in the descriptive section using independent t-test and chi-square tests, and in the inferential section using multivariate analysis of covariance, using SPSS-24 software. Results: The results of covariance analysis showed that there was a significant difference between the groups in depression, stress, anxiety, positive and negative emotional strategies in the post-test (P< 0/001). Comparison of mean values showed that in the MICBT group, depression (14/46), stress (16/85) and anxiety (11/38) and negative emotion regulation strategies (M=35/38) decreased, while positive emotion regulation strategies (M=75/35) increased significantly. Conclusion: MICBT is suggested as an effective method in reducing depression, stress, anxiety and improving cognitive regulation of emotions in patients with MS.

N09 Italian translation and validation of the Spiritual Needs Questionnaire - Extended Version in Inflammatory Bowel Disease: preliminary results

Abstract Background Addressing the existential and spiritual needs of patients with Inflammatory Bowel Disease (IBD) is crucial for holistic patient care. However, limited research has been conducted on spiritual well-being among IBD patients [1,2]. This study focused on translating and validating the Spiritual Needs Questionnaire - Extended Version (SpNQ-EV – Figure 1), a 32-item 4-point Likert scale questionnaire with 3 open-ended questions, for Italian patients with IBD. Methods The study employed a rigorous 6-step translation and validation process, including forward- and back-translation, expert review, and both quantitative and qualitative validation (Figure 2) already adopted in previous studies [3]. Face and content (quantitative) validation involved a panel of 10 experts in nursing, psychology, and gastroenterology, and IBD patients who evaluated its clarity, relevance, and comprehensiveness. The qualitative validation, aims at confirming item- and scale-validity and ensuring user-friendly administration. Is adopting the Thinking Out Loud (TOL) technique (think-aloud method) asking 20 participants to verbalize their thoughts while completing the questionnaire to capture real-time insights into their understanding, interpretation, and potential challenges with questionnaire’s items. Results The face validation process showed that experts and patients rated the questionnaire items as clear and easily understandable with a rate between 0.9 and 1.0 in every single item and an overall rate of 0.93, excluding the need for items reformulation. For content validity, the Scale Content Validity Index (S-CVI) was calculated at 0.96, while the Item Content Validity Index (I-CVI) was in a range between 0.9 and 1.0 in every item, indicating excellent relevance and coverage of the spiritual needs constructs. The qualitative validation, conducted so far with the participation of 4 out of 20 patients, confirmed the understanding and correct interpretation of the individual items and of the whole questionnaire, ruling out potential challenges in completing the questionnaire. Conclusion The Italian version of the SpNQ-EV is a valid tool for assessing the spiritual needs of Italian IBD patients, as confirmed by both face and content validation. This validated questionnaire can facilitate the integration of spiritual care into clinical practice, enabling healthcare professionals to better address holistic well-being. A pilot study adopting the TOL technique is confirming the clarity and cultural relevance of the translated questionnaire. The finalized Italian version will be subsequently administered to IBD patients in a larger pilot study [4] to assess its reliability. Further research will explore its application in other European languages and settings.

N41 eHealth management in Inflammatory Bowel Disease: a survey of the views of people with IBD and their healthcare professionals: preliminary results from a questionnaire survey

Abstract Background In a previous qualitative study, interviews were conducted with people with inflammatory bowel disease (IBD) using NHS services and healthcare professionals (HCPs1). Themes arising from the findings of this research included “Human matters” and “Accessibility matters”. Participants described generally accepting eHealth solutions, but some concerns were expressed about accessibility and challenges to effective eHealth. This study aimed to gain a broader understanding of the themes identified. Methods A 32-item online questionnaire was developed with items relating to demographic characteristics, level of agreement with statements based on the themes identified in the previous study, experiences of using eHealth, and opinions on the future use of eHealth in IBD care. People with IBD and their HCPS were invited to participate via professional networks, patient groups, and charities. The online survey was available between June and October 2024. Descriptive statistics were used to summarise the data. Results Two hundred and thirty respondents completed the survey; 103 (45%) reported being healthcare professionals (HCPs), and 127 (55%) participants had IBD. HCP respondents reported to be medical doctors (n=17, 17%), nurses (n=73, 71%), dietitians (n=5, 5%), surgeons (n=2, 2%), pharmacists (n=4, 4%), an Advanced Clinical Practitioner (n=1, 1%), and psychologist (n=1, 1%). Participants with IBD reported a diagnosis of Ulcerative Colitis (n=52, 41%), Crohn’s Disease (n=57, 45%) or IBD of unknown origin (n=18, 14%). Only 5 (4%) participants with IBD and 5 (5%) HCPs reported not using eHealth to support condition management. Most HCPs (n=97, 86%) and participants with IBD (n=116, 91%) reported valuing in-person care, with 94 (91%) HCPs emphasising its relevance for eHealth effectiveness. 45 (32%) HCPs and 33 (36%) participants with IBD reported technology in the NHS supports IBD care effectively. However, some participants (n=75, 37%) responded "yes" or "not sure" when asked if there were negative impacts of eHealth on IBD management. Conclusion Preliminary results of this study indicate that people with IBD and HCPs value eHealth and face-to-face contact. Some participants expressed that the use of eHealth could negatively impact their experience during healthcare delivery. Further data analysis, including free text responses in the survey, aims to explore further participants’ views on e-health to manage IBD.

P0157 Preoperative emotional dysfunction is associated with postoperative morbidity in Crohn’s disease patients

Abstract Background Anxiety has been found to be associated with postoperative morbidity in patients with Crohn’s disease. The impact of preoperative emotional dysfunction was analyzed in the present prospective observational study. Methods Consecutive patients undergoing bowel resection for Crohn’s disease were asked to fill out the IBDQ-32 questionnaire. The 32-item Inflammatory Bowel Disease Questionnaire (IBDQ-32) is the most frequently used instrument to capture disease- specific quality of life. One of 4 domains scores the emotional function. The domain consists of 12 items. All items use 7-point Likert-type scales for capturing symptom- related experiences over the previous 2 weeks, with 1 indicating the highest symptom frequency/severity and 7 indicating the lowest symptom frequency/severity. For emotional function, scores between 12 and 84 can be calculated, higher score indicating better quality of life. Results 112 patients underwent bowel resection (90 ileocolic resections, 11 colorectal resections, 5 both ileocolic and colorectal resections and 6 small bowel resections. Postoperative complications occurred in 26 patients (23%), postoperative ileus in 10 (9%), wound complications in 9 (8%) and intraabdominal septic complications in 5 (4.5%). Patients who developed postoperative complications revealed significantly decreased emotional scoring (40.3 vs. 48.3, p=0.009). Also, patients with postoperative ileus (38.2 vs. 47.1, p=0.049), wound complications (35.1 vs. 47.4, p=0.009) and intraabdominal septic complications (40.8 vs. 46.6, p=0.35) demonstrated higher grade of emotional dysfunction preoperatively. Preoperative abscess, severe preoperative anemia and preoperative weight loss were all significantly associated with an impaired preoperative emotional functioning. Conclusion Preoperative emotional dysfunction was associated with an increased risk of postoperative morbidity. However, severe disease complications (abscess, anemia,weight loss) led also to more emotional suffering preoperatively.

P0534 School-related challenges in paediatric Inflammatory Bowel Diseases and the role of patient associations: results from a national survey of over 350 italian paediatric patients

Abstract Background In patients with IBD quality of life (QoL) is a fundamental long-term therapeutic target1. Given the significant role that school plays in the daily lives of paediatric patients, understanding its impact on their QoL is crucial2. The present study aimed to evaluate patients’ perspectives on their relationship with school, with the goal of identifying areas for practical improvement. Methods An anonymized survey was distributed (02/2020-11/2024) to all paediatric IBD patients and families registered with the Italian patient association AMICI. Data collected included disease type, sex and school grade (primary, secondary school, college), along with disease awareness and responses to a 20-item questionnaire evaluating various aspects of the school experience (Table 1). Questions included binary (yes/no) or ternary (often/sometimes/never) response options. Results A total of 362 patients (54% females; median age 16 years, IQR 13-18) responded to the survey, with the majority attending secondary school or college (326/362, 90%). Most respondents reported being aware of their disease (327/362, 90%; 38% with Crohn’s disease, 48% with ulcerative colitis) and its chronic nature (311/362, 86% - Table 2). While a significant proportion (269/362, 74%) expressed a positive attitude towards school and had disclosed their condition to at least 1 person within the school environment (286/362, 79%), several challenges were identified. In terms of empathy, only 25% (91/362) and 23% (84/362) felt to be often understood by teachers and peers, respectively. Toilet access was problematic, with just 48% (172/362) reporting unrestricted access and 62% (225/362) expressing fear of using school bathrooms (Table 1). Additionally, 25% (91/362) reported being teased due to their condition, while 22% (80/362) experienced direct aggression and/or physical/verbal bullying. Almost half (172/362, 48%) attended school despite feeling unwell to avoid criticism, with a minority having access to a support teacher (54/362, 15%) or opportunities to catch up on missed lessons (191/362, 53%). To address these issues, patients’ suggestions were training programs to educate teachers/peers (108/362, 29%) and practical improvements in restroom access/organization and absences management (51/362, 14%). Conclusion Despite existing awareness campaigns, national/international initiatives to educate school staff/peers and foster understanding should be implemented to ensure a more inclusive school environment, improving paediatric IBD QoL. Patient associations can play a pivotal role by identifying patients daily needs and facilitating collaboration between healthcare providers, educators and policymakers to develop tailored programs addressing emergent challenges.

Screening of primary aldosteronism and pheochromocytoma among patients with hypertension: an Italian nationwide survey.

The delayed or missed diagnosis of secondary hypertension contributes to the poor blood pressure control worldwide. This study aimed to assess the diagnostic approach to primary aldosteronism (PA) and pheochromocytoma (PHEO) among Italian centers associated to European and Italian Societies of Hypertension. Between July and December 2023, a 10-items questionnaire was administered to experts from 82 centers of 14 Italian regions and to cardiologists from the ARCA (Associazioni Regionali Cardiologi Ambulatoriali) Piemonte. Results were stratified for geographical area, specialty, and center category (excellence vs. non-excellence centers). Each center diagnosed an average of 2 cases of PA and 0.2 cases of PHEO annually, with higher figures in excellence centers. PA screening is performed mainly in patients with resistant hypertension (73.2%) or hypertension and spontaneous hypokalemia (84.1%), while only 17.1% and 35.4% of centers screen patients with grade 2-3 hypertension. Screening rate is lower for cardiologists compared to other specialists. The main barriers to wider testing were challenges in interpreting the aldosterone/renin ratio under interfering medications and switching to non-interfering drugs. Clinical scores to predict the likelihood of PA and the definition of Standard Operating Procedures were identified as potential tools to boost screening rates. Testing for PHEO was mostly conducted in patients with typical symptoms (75.6%) and/or hypertensive crisis (74.4%). Only 37.8% of centers screened all patients with adrenal incidentaloma. This study highlights significant gaps in the screening and diagnosis of PA and PHEO across Italian centers and underscores the need for widespread and standardized diagnostic protocols.

Computerized exams use in enhancing the credibility of the education system

This paper aims to identify the role of computerized exams in enhancing the credibility of the education system from Al-Zaytoonah University of Jordan students’ perspectives. The research methodology uses descriptive survey research. The research also includes designing a 28-item questionnaire as a research instrument distributed over three areas and an interview form used to conduct interviews with 53 students included in the research population. The findings indicate that computerized exams have high trust and credibility among university students and receive high acceptance and preference. The results indicate statistically significant differences at a level of less than 0.05 for the overall variables depending on the gender variable in favor of males with a t-value of 4.01 and a significance level of 0.00. The article concludes by supporting the expansion of computerized exams especially those that show the results immediately in assessing students’ academic performance and achievement as it provides a sense of confidence in the integrity and transparency of the test and enhances the credibility of the educational system. Another recommendation is developing modern and more effective software and computerized exam methods capable of measuring the largest possible number of skills and knowledge to encourage students and teachers to move toward this type of test.

Sociodemographic factors associated with dental students knowledge and attitudes regarding disinfection as a control measure to reduce the spread of COVID-19

Despite maintaining a lower mortality rate and greater control of victims infected by COVID-19, the world’s population and science are still confronted with this coronavirus. Therefore, the aim was to assess the association between sociodemographic factors and the level of knowledge and attitudes of dental students regarding disinfection as a control measure to reduce the spread of COVID-19. This cross-sectional study evaluated 503 dental students from the capital city and one Peruvian province between February and June 2022. A validated 13-item questionnaire was used. A Poisson regression model with robust variance was used to evaluate the influence of the variables sex, age, year of study, marital status, place of origin, death of a family member due to COVID-19, and history of COVID-19, with the level of knowledge and attitudes of the dental students, considering a significance level of p < 0.05. Of the total participants, 14.3% showed sufficient knowledge, and 89.3% showed positive attitudes regarding disinfection as a control measure to reduce the spread of COVID-19. Furthermore, those from the capital city were 52% less likely to have sufficient knowledge regarding disinfection as a control measure to reduce the spread of COVID-19, compared to those from the province (APR = 0.48; 95% CI: 0.31–0.75). Moreover, none of the variables considered in this study were significantly associated with attitudes toward this topic (p > 0.05). A minority of dental students presented sufficient knowledge, while the majority presented positive attitudes regarding disinfection as a control measure to reduce the spread of COVID-19. In addition, being from the capital city was a limiting factor for sufficient knowledge. The variables sex, age, year of study, marital status, place of origin, death of a family member due to COVID-19, and history of COVID-19 were not influential factors for positive attitudes on this topic.

Knowledge, attitudes, and use of the Mediterranean diet in practice among dietitians in the United Arab Emirates: a cross-sectional study

Dietitians are uniquely positioned to promote the Mediterranean Diet (MedDiet), a diet recognized for its health benefits and sustainability. This study aimed to assess the knowledge and attitudes regarding the MedDiet among dietitians in the United Arab Emirates (UAE), and to examine the frequency and correlates of using this diet in clinical practice. Practicing dietitians (n = 220) completed a 44-item web-based questionnaire, verified for face, content and construct validity, as well as internal and parallel form reliability. Total scores were computed as sum of items for knowledge and attitudes. The mean knowledge score was 6.48 ± 1.85 out of 10, with gaps related to MedDiet’s benefits and nutrient composition. Despite positive attitudes, many dietitians did not agree that it is easy to encourage patients to decrease red meat (68%) and increase fruits/vegetables intake (70%). In clinical practice, 35% of dietitians rarely/never used the MedDiet. Dietitians were more likely to recommend the MedDiet if they had a Mediterranean country of origin (p = 0.037), higher knowledge (p = 0.022) and attitude (p = 0.013) scores, and acquired information about the MedDiet through university education (p = < 0.001) or conferences/seminars/workshops (p = 0.002). Using the findings of this study, evidence-based interventions can be developed to support the role of dietitians in promoting adherence to the MedDiet.

Sleep Preferences and Chronotype Traits Impact on Academic Performance Among University Students

Due to irregular daytime routines, chronotype changes, side jobs and exam periods after the COVID-19 pandemic, university students are trying to find new balances in their everyday life. The aim of the present study is to analyze the impact of daytime chronotype and hour preferences for the circadian rhythm on academic achievement among university students, considering their sleep habits and class frequencies in daytime and nighttime classes. Furthermore, this study aimed to analyze the differences in chronotype preferences with regard to age, sex, and academic schedule students are attending. A sample of 87 university second-year Psychology and Management students attending the academic year 2021/2022 after the governmental relief measures of the COVID-19 pandemic completed a 13-item questionnaire on sleep habits and preferences. Further variables encompassed sleep behaviors, such as age, sex, daytime and nighttime classes, as well as academic achievement. The results of the study showed that university students had a higher preference for the morningness type. Additionally, chronotype traits explained 30% (values from regression analysis) of academic achievement but did not directly impact academic results. The sleep-wake cycle diverged among age groups because the youngest participants (19–21 years old) and older participants (35–44 years old) reported higher academic scores during the first semester and the full academic year. No significant differences were identified with respect to sex. There is a lack of literature explaining the effect of sleep hours on academic achievement among students after stay-at-home rules during the COVID-19 pandemic. Thus, it is imperative to understand the difficulties students face with regard to their studying hours, working shifts, and daytime or nighttime classes to create a sustainable university system that attends to students’ needs and necessities.

Validation of Spatial Orientation Screening questionnaire for use in memory clinic patients.

Spatial orientation is required for independent mobility in society. Deficits in spatial orientation can be an early symptom of Alzheimer's disease and other dementias, and there is a need for brief assessment tools to identify impairments. The aim of this study was to evaluate the construct and known-group validity of our newly developed Spatial Orientation Screening (SOS) questionnaire. We included 132 patients with subjective cognitive decline (n = 16), mild cognitive impairment (n = 32), or all-cause dementia (n = 84) from a memory clinic and a reference group of cognitively unimpaired older adults (n = 108). The patients and their next-of-kin answered the self- and proxy-rated versions of the 4-item SOS (0-8 points) and the 10-item Questionnaire of Everyday Navigational Ability (QuENA, 0-30 points). The patients also performed the Floor Maze Test (FMT) for performance-based spatial abilities. Mean ages (SD) of the patient and reference groups were 68.6 (±7.6) years and 73.7 (±6.7) years, respectively. Construct validity between self-rated versions of the SOS and QuENA was satisfactory with rs = 0.66, between the proxy-rated versions rs = 0.61, and between the proxy-reported SOS and FMT rs = 0.49 (all p < 0.001). Known-group validity was also acceptable, with significantly higher median (IQR) SOS self-reported scores in patients 1.0 (2.0) compared to the reference group 0.2 (0.5) points, (p < 0.001). Informants reported more severe impairments compared to the patients' self-reports on both SOS and QuENA (both p < 0.001). The SOS had satisfactory validity for use as a screening instrument for assessment of spatial orientation in memory clinic patients.

Cardiomeds, an mHealth App for Self-Management to Support Swiss Patients With Heart Failure: 2-Stage Mixed Methods Usability Study.

Mobile health apps have shown promising results in improving self-management of several chronic diseases in patients. We have developed a mobile health app (Cardiomeds) dedicated to patients with heart failure (HF). This app includes an interactive medication list; daily self-monitoring of symptoms, weight, blood pressure, and heart rate; and educational information on HF delivered through various formats. This study aimed to perform a mixed methods usability study of Cardiomeds. Smartphone users with HF were recruited from the HF outpatient clinic at the University Hospital of Geneva. The usability test was conducted in 2 stages, with modifications made to the app after the first stage to address major usability issues. Each stage required 10 participants to perform 14 tasks, such as entering vital signs, entering a new medication and time of intake, or finding information about HF. Each task was timed, sessions were recorded, and all data were anonymized. After completing the tasks, patients completed the System Usability Scale 10-item questionnaire and answered 5 open questions about their perceptions of Cardiomeds. Twenty patients with HF, 75% (15/20) of whom were men, with a mean age of 55 years, were included in this study. The average time to complete all 14 tasks was 18 (SD 5.7) minutes. Manual medication entry was the most time-consuming task, taking an average of 154.40 (SD 68.08) seconds in the first stage, 103.10 (SD 42.76) seconds in the second stage, and 128 (SD 63) seconds overall. The mean overall success rate was 77% (SD 0.23%) for the first stage and 94% (SD 0.07%) for the second stage. A total of 30% (3/10) of participants in the first stage completed all tasks without any help compared with 50% (5/10) of participants during the second stage. The average System Usability Scale score was 80% (SD 17%), showing a slight increase from 79% (SD 16%) in the first stage to 80% (SD 28%) in the second stage, which qualifies the app as "good" in terms of usability. Between the 2 stages, part of the app interface was redesigned to address the key issues identified in the first stage. Despite these improvements, problems related to guidance were frequent and comprised 36% (8/22) of the problems in the first stage and 40% (6/15) in the second stage. In response to open questions, 85% (17/20) of the participants responded that they would like to use the app when it became available. The usability test indicated that Cardiomeds is a suitable and user-friendly app for patients with HF. The app will be further tested in a randomized clinical trial (2022-00731) after acute HF hospitalization to assess its impact on patients' knowledge about HF, self-care, and quality of life.

Effect of flipped classroom method on the reflection ability in nursing students in the professional ethics course; Solomon four-group design

Background and purposeThe purpose of reflection in the learning process is to create meaningful and deep learning. Considering the importance of emphasizing active and student-centered methods in learning and the necessity of learners’ participation in the education process, the present study was conducted to investigate the effect of flipped classroom teaching method on the amount of reflection ability in nursing students and the course of professional ethics.Study methodThe current study is a quasi-experimental study using Solomon’s four-group method. The statistical population included all nursing students who were taking the professional ethics course at Kermanshah University of Medical Sciences. The study tool was a 26-item questionnaire with acceptable validity and reliability. The sample size was 80 nursing students by simple random method and divided into four groups, which included: 1- experimental group 1 2- experimental group 2 3- control group 1, and control 2. The collected data were used by SPSS software and using descriptive statistics methods and two-way analysis of variance and analysis of covariance analysis.FindingsThe findings showed that the four investigated groups do not have statistically significant differences in terms of gender composition (p = 0.599). There was no significant difference between the control and experimental groups in terms of all 5 reflection components in the pre-test. A significant difference was observed between the amount of reflection of the experimental and control groups.ConclusionConsidering that there are controversial issues in the course of professional ethics, this method can be effective in the field of deep learning of students.

Unveiling Gender Dynamics in Career Decision-making: Insights from students of University of Technology and Applied Sciences, (UTAS) Sultanate of Oman

This study explores gender differences in career decision-making among students at the University of Technology and Applied Sciences (UTAS) in the Sultanate of Oman. A sample of 380 students, selected using stratified random sampling from a total student population of 35,037, participated in the study with 179 responses received, reflecting a response rate of 47.1%. The sample was proportionally distributed based on the number of students enrolled at each campus, ensuring representation from all university branches, including Muscat (13,000 students), Nizwa (4,697 students), Salalah (3,528 students), Ibra (3,267 students), Ibri (2,682 students), Shinas (3,202 students), and Musannah (4,661 students). Data was collected through a structured 40-item questionnaire, which included seven subscales: educational, on-the-job training, university, financial, personality, social, industrial (focused on Tourism, manufacturing, and technology), and governmental factors. Participants rated items on a five-point Likert scale. Independent samples t-tests and factor analysis were used to analyze the data. Factor analysis was conducted to identify underlying factors influencing career choice. The factor analysis revealed eight key factors influencing career choices: University factors, Government initiatives in the manufacturing sector, Monetary benefits, Personality traits, Technology sector opportunities, Academic performance, Tourism opportunities, and Student involvement. Independent samples t-tests revealed significant gender differences in perceptions related to career guidance and counseling services, career placement services, personal interests in career decisions, and on-the-job training opportunities, with female students generally expressing more positive views than male students. These findings underline the importance of enhancing career counseling and placement services, increasing on-the-job training opportunities, and integrating personal interests into career counselling to support gender-inclusive career development.

Public perceptions and attitudes of drive-through pharmacy services: Insights from a cross-sectional survey in Saudi Arabia.

Disease-related fatalities in Saudi Arabia (SA) are on the rise, with 28% of all deaths attributed to cardiovascular diseases, followed by cancer, diabetes, and chronic respiratory disorders. In response to this issue, pharmacy dispensing practices have been significantly altered. One such innovative approach is the drive-through pharmacy service. This study aimed to assess the public perceptions and attitudes of drive-through pharmacy services living in Riyadh, SA. A cross-sectional, web-based study was conducted between October 2023 and December 2023 among adults living in Riyadh, SA to assess their perceptions and attitudes toward drive-through dispensing practice. A 19-item questionnaire, divided into 4 sections, was used to achieve the objectives. The first section focused on demographics and personal information. The second section included 3 questions about awareness, the population most benefited, and support. The final section assessed attitudes (5 items) of individuals toward drive-through pharmacy services. A response rate of 79.6% (n = 398) was achieved. A significantly high percentage of respondents, 86.2% (n = 343), reported being aware of drive-through pharmacy. Furthermore, 73.1% of them indicated that drive-through service benefits all populations, with 66.1% (n = 263) actually using the drive-through pharmacy service. In addition, 68.1% (n = 271) of individuals had positive perceptions. Positive perceptions were found to be higher among young adults aged 26 to 35 years compared with other age groups (P = .0001), among married individuals compared with unmarried individuals and others (P = .0001), as well as among housewives (P = .030). The results of the Student t test showed that males had a higher mean overall perception of drive-through pharmacy services (9.33) than females (9.26). Similarly, the analysis of variance analysis showed that individuals aged ≥46 years had a higher perception score (12.53) than other age groups. Furthermore, individuals with children had a lower perception (8.94) compared with those without children, indicating a statistically significant difference in mean perceptions of drive-through pharmacy based on gender (P = .002), age (P = .006), employment (P = .081), and presence of children (P = .001). Most respondents were aware of the drive-through pharmacy services and agreed that they would benefit the nation's entire population. The majority of individuals also supported the expansion of drive-through pharmacy services.

Microbiota awareness levels of medical students: the case of Trakya university

BackgroundHuman microbiota is noteworthy for its ability to encode a much greater variety and quantity of proteins than human cells. Despite its dynamic and complex nature, it has been associated with healthy living for over a century. The knowledge and attitudes of healthcare professionals, especially physicians, influence the use of pro-prebiotic interventions to modulate the microbiota. This study aimed to examine the awareness of medical students about the microbiota and the factors influencing their awareness.MethodsThe study was conducted between May 15 and August 15, 2023, with the participation of 235 medical students. The students were administered a 13-item questionnaire and the Microbiota Awareness Scale (MAS). The questionnaire and scale were administered face-to-face, and the results were statistically analyzed.ResultsThe students’ MAS total mean score was 70.34 ± 8.15. The MAS scores of medical students in the 4th, 5th, and 6th grades who underwent clinical training, those who conducted research on microbiota independently, those who had previously used prebiotics/probiotics, and those who rated themselves highly on microbiota knowledge were statistically higher.ConclusionsThe study revealed that students’ awareness of the microbiota increased with advancing years of medical education, reaching a high level by the time of graduation. To enable future physicians to effectively communicate this knowledge to the public and incorporate it into clinical practice, it is crucial to provide comprehensive education on microbiota, probiotics, and prebiotics during medical training. Additionally, promoting scientific research and organizing activities in these areas are essential for fostering deeper understanding and practical application.

Relevance of Language Learning Evangelism and Education in the Spread of Christianity in Nigeria

This study explores the significance of language learning evangelism and education in the dissemination of Christianity in Nigeria. With over 500 indigenous languages, Nigeria presents unique linguistic and cultural challenges for evangelism. This paper examines how language proficiency enhances effective communication of Christian teachings, fosters community engagement, and promotes cultural sensitivity. By analyzing existing literature, conducting surveys, and observing evangelistic practices in diverse communities, the research highlights the positive correlation between language learning and the successful spread of Christianity. The aim of this study was to investigate the relevance of language learning education in the spread and growth of Christianity in Nigeria. The sampled group consisted of 540 mainline Christian churches, Pentecostal/Neo-Pentecostal Movement and Christian religious leaders. The methodology adopted in this study is, survey research design. The population of the study consisted of 540 respondents comprising 313 Mainline Christian Church Members, 192 Pentecostal/Neo-Pentecostal Movement Members and 35 Christian Religious Leaders, from which 230 respondents was determined using YARO YAMENT formula and was sampled through stratified random sampling technique. A 30 item questionnaire was used in collecting data constructed, validated and its reliability of 0.84 determined by using CRONBACH alpha formula. The data collected were analyzed using mean and standard deviation to answer the research questions; whereas the null hypothesis was tested with ANOVA. The study found that, language learning education is a necessary requirement for cross cultural evangelism as well as successful penetration of Christianity to all the ethnic groups available in Nigeria and the study found that the 15 factors identified, were relevance of language learning education and has immensely contributed to the growth and spread of Christianity in Nigeria. It was recommended that language is the life of every human group in the universe. Recommendations include integrating language education in evangelistic programs to enhance outreach efforts. More so, there was a positive relationship between the spread and growth of Christianity and language learning education in Nigeria.