Item Questionnaire Research Articles

An intervention framework for the adoption of solar home system technology in rural Vhembe district, South Africa

BackgroundSolar photovoltaic technology is one of the promising renewable energy solutions of the twenty-first century. It successfully provides electricity to industries, homes and even the transport sector. The decreasing prices of solar modules from 2010 have made Solar Home Systems Technology (SHST) increasingly attractive compared to other renewable energy technologies. Paradoxically, in rural communities of South Africa the usage of SHS remains low. Households continue to rely on unclean energy sources such as firewood for cooking and water heating. Previous efforts to electrify rural communities with SHS have failed considerably. Thus, a comprehensive study was conducted in the Vhembe District, encompassing three villages, to explore this issue and develop a contextualised solution using a behavioural change model. A 35-item questionnaire was randomly administered to 310 households to understand the factors that contribute to the low adoption rate of SHS technology. The data gathered were analysed using IBM SPSS Statistics and Amos version 28. Confirmatory factor analysis and hypothesis testing were employed as the principal statistical methods.ResultsA 12-item model with five distinct factors consolidated into a single measurement model was revealed. All standardised factor loadings exceeded 0.7. Composite reliability values (CR) were above 0.8 and higher than MaxR(H) values, indicating the model’s reliability. Among the five factors influencing SHS adoption (perceived behavioural control, attitude, intention, trust, and subjective norms), only trust and attitude significantly impacted the intention to adopt SHS in the district (P < 0.05). Based on these findings, the conceptualised structural model reflected SHS adoption as determined by the integration of the technology’s social, technical and policy factors. Because of this, this should be regarded as a true reflection of the practical and behavioural intentions of local communities. Moreover, in this paper the barriers hindering SHS adoption are explained, emphasising the significance of attitude and trust. Highlights of policy imperatives are included together with a proposal for a contextual framework, and the way of promoting sustainable solutions. Emphasis is placed on the importance of scaling up renewable energy access.ConclusionsThis research provides a compelling academic exploration of the barriers to the adoption of SHS, the influential role of attitudes and trust, policy considerations, a contextual framework, and the need for promoting sustainable solutions and expanding access to renewable energy. The South African government should lead a change in how solar PV is deployed, considering its social impact, associated technical skills and policy support.

Assessing the professional social capital of psychiatrists: development of the Resource Generator for Psychiatrists (RG-Psy)

BackgroundIn the field of psychiatry, the dissemination of clinical innovations greatly depends on the social capital of clinicians. An instrument specifically aimed at measuring their professional social capital therefore needs to be developed.MethodsThis survey was conducted to develop and validate the Resource Generator for Psychiatrists, an 11-item questionnaire measuring the social capital of psychiatrists. The online questionnaire was administered through a link sent by e-mail to all psychiatrists and residents in psychiatry licensed to work in Belgium, after excluding ineligible psychiatrists. A total of 1618 psychiatrists or residents were reached. An exploratory factor analysis was conducted. Internal consistency was assessed using Pearson’s correlation, item-total correlation and Cronbach’s alpha. Test-retest reliability was also measured. Multivariable linear regression analysis assessed the association between the total score of the social capital and psychiatrist demographics.ResultsA total of 196 psychiatrists responded to the survey (response rate: 12.1%). The Resource Generator for Psychiatrists showed a normal distribution with a mean of 23.6 (SD = 15.5), good test-retest reliability (ICC = 0.81) and a good total Cronbach’s alpha (0.74). Exploratory factor analysis revealed two main subtypes in psychiatrists’ social capital: “Resources for the clinician” and “Resources for the professional”, with a Cronbach’s alpha of 0.62 and 0.7 respectively. Clinicians attending institutional seminars (β = 5.52, SE = 2.2, p = .013) and working in multidisciplinary settings, such as hospitals (β = 4.75, SE = 2.06, p = .023) or a mobile team (β = 8.75, SE = 3.52, p = .014) were more likely to have higher social capital.ConclusionPsychiatrists’ access to professional resources can be reliably measured by using an 11-item questionnaire.

Hand hygiene, knowledge and training motivational drives: findings from a survey in a university hospital

This study assessed healthcare workers’ (HCWs) knowledge and adherence to hand hygiene principles in a large Italian university hospital, focusing on identifying knowledge gaps and evaluating training effectiveness. A specifically designed 17-item questionnaire, based on the World Health Organization (WHO) Hand Hygiene Knowledge Questionnaire, was used to measure theoretical knowledge, the role of training, and the impact of experience. The survey had an 8% participation rate (542 responses from a total of 6,749 HCWs), with higher responses among nurses and doctors. Results showed moderate knowledge of hand hygiene protocols, averaging 74%, but revealed gaps in comprehension, particularly in the correct use of hand rub and post-contact sanitation. Logistic regression analysis identified significant predictors of knowledge and adherence, with professional characteristics such as professional qualifications and length of service influencing outcomes (p &amp;lt; 0.05). The findings confirm the strong correlation between hand hygiene knowledge and compliance in reducing healthcare-associated infections (HAIs). Continuous education and customized interventions, including targeted training and feedback, are essential for targeting weak points and improving adherence. These insights emphasize the importance of ongoing training and monitoring to enhance hand hygiene practices, promote a culture of patient safety, and, as a consequence, reduce the incidence of HAIs.

Validity and reliability of the Turkish version of the Düsseldorf orthorexia scale (TR-DOS) and the prevalence of orthorexia nervosa among Turkish university students

ABSTRACT Orthorexia Nervosa (ON) is characterized by an excessive preoccupation with healthy foods accompanied by the avoidance of self-declared unhealthy options, yet it remains unrecognized in major diagnostic guidelines. The Düsseldorf Orthorexia Scale (DOS), a 10-item self-report questionnaire using a four-point Likert scale, assesses the obsession with healthy eating. This study evaluates the reliability and validity of the TR-DOS in the Turkish context and estimates the prevalence of ON among university students. Several studies have shown that translating the DOS into various linguistic groups may exhibit different models of DOS scores. However, the psychometric properties and model fit of the DOS have not yet been investigated in Turkish-speaking populations; to address this gap, we assessed the psychometric properties of a Turkish translation of DOS (TR-DOS) in a sample of 425 university students in Türkiye. The TR-DOS revealed a 7.3% ON prevalence and a 9.0% risk of development. Weak positive associations were observed between TR-DOS total scores and BMI (r = 0.152, p = .002). Exploratory Factor Analysis confirmed the validity of TR-DOS (KMO = 0.867) with satisfactory reliability (Cronbach’s alpha = 0.854). Confirmatory Factor Analysis indicated an acceptable fit for the TR-DOS model (χ2/df = 3.127, RMSEA = 0.071, SRMR = 0.046, IFI = 0.955, CFI = 0.955, GFI = 0.956, TLI = 0.932). Moderate positive correlations were found between TR-DOS and eating disorder measures (EAT-26: r = 0.428, p < .001; EDE-Q-13: r = 0.430, p < .001). The findings demonstrated that the TR-DOS is both culturally appropriate and psychometrically adequate for Turkish university students. It is a reliable and valid instrument for assessing obsessive healthy eating behaviors in this population.

Clarifying the Actual Situation of Old-Old Adults with Unknown Health Conditions and Those Indifferent to Health Using the National Health Insurance Database (KDB) System

Background/Objectives: This study aimed to investigate the actual situation of individuals with unknown health conditions (UHCs) and those indifferent to health (IH) among old-old adults (OOAs) aged 75 years and above using the National Health Insurance Database (KDB) system. Methods: A total of 102 individuals with no history of medical examinations were selected from the KDB system in a city in Japan. Data were collected through home visit interviews and blood pressure monitors distributed by public health nurses (PHNs) from Community Comprehensive Support Centers (CCSCs). The collected data included personal attributes, health concern levels, and responses to a 15-item OOA questionnaire. Semi-structured interviews were conducted with seven PHNs. The control group consisted of 76 users of the “Kayoinoba” service (Kayoinoba users: KUs). Results: Of the 83 individuals who could be interviewed, 50 (49.0%) were classified as UHCs and 11 (10.8%) were classified as IH, including 5 from the low health concern group and 6 who refused to participate. In the word cloud generated from the PHNs’ interviews, the words and phrases “community welfare commissioner”, “community development”, “blood pressure monitor”, “troublesome”, “suspicious”, and “young” were highlighted. In the comparison of health assessments between UHCs and KUs, “body weight loss” and “cognitive function” were more prevalent among KUs, and “smoking” and “social participation” were more prevalent among UHCs. Conclusions: The home visit activities of CCSCs utilizing the KDB system may contribute to an understanding of the actual situation of UHCs, including IHs, among OOAs. UHCs (including patients with IH status) had a higher proportion of risk factors related to smoking and lower social participation than KUs.

Determinant Factors of Entrepreneurial Culture in University Students: An Analysis from the Theory of Planned Behavior at a Peruvian University

This study analyzed the influence of attitude toward innovation and creativity, entrepreneurial self-efficacy, and institutional support in the consolidation of an entrepreneurial culture among Peruvian university students, using the Theory of Planned Behavior (TPB) as the theoretical framework. Data were collected from 948 students through a validated 29-item questionnaire, and the data analysis was conducted using the PLS-SEM method. The results showed that both attitude toward innovation and entrepreneurial self-efficacy have a significant positive impact on entrepreneurial culture, and entrepreneurial self-efficacy acted as a partial mediator in this relationship. However, external resources and institutional support were not significant mediators between entrepreneurial intention and entrepreneurial culture. This study expands the understanding of TPB in the Peruvian context, highlighting the importance of fostering self-efficacy and an innovative attitude in students to strengthen entrepreneurial culture in universities. Educational institutions should consider these key factors when designing programs that promote entrepreneurship.

Association Between the Two-Year Trajectories of Dental Anxiety and the Changes in the Oral Health-Related Quality of Life in Parents of FinnBrain Birth Cohort Study

Objectives: We evaluated associations between changes in dental anxiety and oral health-related quality of life (OHRQoL) in parents of the FinnBrain Birth Cohort Study. Methods: Two-year dental anxiety trajectories measured with Modified Dental Anxiety Scale from gestational weeks (gw) 14 and 34, and 3 and 24 months after birth were used. OHRQoL was measured with the Oral Health Impact Profile 14-item questionnaire at gw34 and 4 years. Changes in the OHRQoL sum and dimension scores according to dental anxiety trajectories were analyzed with the Jonckheere–Terpstra test separately for mothers (n = 998) and fathers (n = 513). Results: Overall, OHRQoL decreased in all dental anxiety trajectory groups except the High decreasing group in mothers, and in the Stable high group in fathers. The decline in the overall OHRQoL was greatest in the Stable high trajectory group for both parents. In fathers, OHRQoL increased considerably but not statistically significantly in the High decreasing trajectory group. The changes in OHRQoL dimensions Psychological discomfort and Handicap differed according to dental anxiety trajectories for both of mothers and fathers, and also for the dimension Psychological disability for mothers. Conclusions: These findings highlight the need for targeted interventions in treating high dental anxiety and in preventing the increase in dental anxiety to improve oral health outcomes such as OHRQoL.

Knowledge and utilization of manual therapy in the management of knee osteoarthritis by physical therapists in Saudi Arabia: a cross-sectional study

BackgroundThe knowledge and utilization of manual therapy in treating knee osteoarthritis (OA) may help explain the effective utilization of manual therapy for managing knee OA. Little is known about the knowledge and utilization of manual therapy in the management of knee OA by physical therapists (PTs) in Saudi Arabia. The present study aimed to evaluate the knowledge and utilization of manual therapy by PTs in Saudi Arabia via a survey method.MethodsA cross-sectional study design was used. PTs working in various hospitals in Saudi Arabia participated. A 29-item questionnaire was developed based on previous studies. One hundred ninety-seven participants returned the completed questionnaire (response rate, 78.8%). Descriptive statistics were utilized to summarize and present the study participants’ characteristics and responses.ResultsApproximately one-third (35.2%) of the participants did not receive any formal manual therapy training, whereas the others received formal manual therapy training in undergraduate (23.8%) or postgraduate (40.9%) studies. Only approximately one-third of the participants (29.9%) were qualified as certified manual therapy practitioners. Most participants (57%) reported using manual therapy according to the patient’s condition. Most of the participants cited several treatment goals for manual therapy, including pain reduction (84.8%), improved range of motion (77.2%), increased mobility (58.2%), and improved function (55.4%).ConclusionsPTs in Saudi Arabia showed a positive attitude toward using manual therapy for treating knee OA. However, they suggested combining exercise and manual therapy as the best treatment option for knee OA.Trial registrationNot applicable.

Mental health variables affecting Quality of Life (QOL) among healthcare workers during the COVID-19 pandemic in Jazan City, Saudi Arabia.

Health workers directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing mental health symptoms. The study aimed to assess the quality of life (QoL) of healthcare workers at Prince Mohammed bin Nasser Tertiary Hospital in Jazan during the COVID-19 pandemic, with a focus on the relationship between QoL and stress, anxiety, and depression. Pandemic. This was a cross-sectional study conducted among healthcare workers at Prince Mohammed bin Nasser Hospital in the Jazan. The study included a sample of 352 healthcare workers. Data was collected through a self-administered questionnaire pertaining to sociodemographic characteristics and the 21-item Depression Anxiety Stress Scale questionnaire, SF-36, for QoL. Descriptive statistics, frequencies, and percentages were used. A chi-squared test was performed to compare categorical data. A one-way ANOVA was performed to compare the effect of disorder variables on QoL. Multiple linear regression analyses were carried out to discern the differences between the different groups of participants in QoL measures. Our results showed a poor QoL among those with a chronic disease (p = 0.002), who worked in the COVID-19 department (p = 0.030) and those who experienced the death of relatives or friends due to COVID-19 (p = 0.003). Healthcare workers, particularly those with chronic diseases or who had lost relatives to COVID-19, exhibited significantly lower QoL levels, especially those working directly in COVID-19 departments.

Integrating virtual reality to enhance remote teaching of anatomy during unprecedented times.

The COVID-19 pandemic necessitated a global paradigm shift in the teaching of human anatomy. Most institutions successfully transitioned from traditional in-person teaching methods, to various distance-learning strategies. Since virtual reality (VR) offers immersive three-dimensional (3D) experiences, this study investigated students' experiences regarding the capacity of VR to support distance-learning of anatomy. Using the VR application, 3D Organon Virtual Reality Anatomy, anatomy instructors pre-recorded learning content as 360-degree videos with live voice-over and integrated it into the teaching material of the MBBS first-year abdomen, pelvis, and perineum-structure and function course. A 19-item 5-point Likert scale questionnaire, comprising of two major categories, "VR experience in anatomy lessons" and "VR in anatomy lessons vs. traditional cadaveric dissection" was disseminated. Post-evaluation analysis revealed a response rate of 63.5%. Almost 70% of students agreed that VR was instrumental in solidifying their theoretical understanding and improved spatial awareness with better retention of anatomical relationships. Approximately 50% wanted to continue using VR even if instruction becomes onsite. Though 72% of participants agree that VR addressed the session learning objectives only 24% agree that it is similar or better than cadaveric dissection, thus preferring cadaveric dissection to VR. Only 12.1% agree that VR is more beneficial to cadaveric dissection. Our exploration into the integration of VR technology in anatomy teaching has revealed promising opportunities. While VR can augment traditional teaching methods in unprecedented times such as war, floods or global pandemic, it should not replace hands-on cadaveric learning entirely, but rather complement existing approaches.

Standardized List Evaluating Apnea (SLEAP): A Comprehensive Survey to Define the Quality of Life in OSA.

To develop and validate a patient-reported outcome measure (PROM) to evaluate the quality of life (QoL) among patients with obstructive sleep apnea (OSA). A prospective cohort study. Tertiary referral center. We developed a 15-item English questionnaire that was administered to 176 adults with OSA and 22 adult controls without symptoms of OSA in a tertiary sleep surgery clinic between June 2021 and December 2021. The internal consistency and test-retest reliability were measured using the Cronbach's α and the intraclass correlation coefficient, respectively. The 2-sample Wilcoxon rank-sum (Mann-Whitney) test was applied to compare the 2 groups. Convergent validity of the test scores of the questionnaire was compared to previously validated outcome measures and objective sleep study outcomes using the Spearman correlation coefficient. Of the 198 respondents (176 cases and 22 controls); 71% were men and 29% were women. The internal consistency was excellent with the α of .92 (lower 95% confidence limit of 0.90). All the test-retest correlations were positive, significant, and strong ranging from 0.50 to 0.90. The differences between cases and controls were statistically significant for all the items and for the total score. The total score of the questionnaire with the Epworth Sleepiness Scale and objective OSA measures was moderate to strong. The new tool provides a validated PROM to evaluate the QoL among OSA patients specifically, with excellent internal consistency, reasonable test-retest reliability, discriminant validity, and construct validity. Level 4.

Assessment of Dentists Attitudes, Knowledge, Practices, and Challenges in Utilizing Rubber Dams for Restorative and Endodontic Procedures: An Online Questionnaire Survey

Rubber dams are essential for dental procedures, ensuring isolation, patient safety, and better work efficiency for dentists. However, their use is often limited by challenges such as difficulty in application, time constraints, and inadequate training. This study aimed to assess the attitudes, knowledge, practices, and challenges to rubber dam use during among dentists in Tripoli, Libya. A cross-sectional online survey involving 165 dentists was conducted using a validated 26-item questionnaire. Data were analyzed using chi-square tests, with significance set at p &lt;0.05. Results showed that 67.9% of dentists had access to rubber dams, but only 64.8% used them. Lack of training during undergraduate studies was reported by 61.2%, and 42.4% identified inadequate training as the main barrier. Significant association were found between rubber dam use and gender, place of work, prior training, and years of practice. Although dentists expressed positive attitudes toward rubber dam use, barriers such as insufficient training, radiographic procedures, and time constraints hindered regular application. Enhanced training programs could improve acceptance rates.

Impact of physical activity on quality of life in patients with epilepsy in a developing country: A cross-sectional, survey-based study

RationalePatients with epilepsy face different barriers based on ignorance and fear of themselves and others while exercising, this situation complicates attempts at exercise and promotes discrimination against patients. Physical activity has been associated with favorable results in the health of this population and can be used as a non-pharmacological treatment seeking to increase the health and improve living conditions of patients. Our study aims to explore how physical activity impacts quality-of-life perception in these patients. MethodsWe performed a cross-sectional, survey-based study conducted at the outpatient Epilepsy Clinic in the National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”. Patients between 17 and 65 years of age and with an established diagnosis of epilepsy were considered for participation. A 31-item questionnaire was administered to all participants face-to-face or by telephone. The questions included in the survey were selected from the Global Physical Activity Questionnaire and the Quality of Life in Epilepsy Inventory to assess the level of exercise and perceived quality of life of participants. Descriptive and inferential Mann-Whitney U test statistical analysis was done using IBM SPSS Statistics 23.0 software. ResultsParticipants' mean age was 35.69 ± 11.93 years, 45 % were male and 55 % female. Significant differences were found in the domain of perceived quality of life in the self-reported physically active participants (p = 0.0256; 95 % IC: 1.00–15.22), with a mean score of 75.78 ± 16.64 in the active group vs. 67.66 ± 15.86 in the sedentary group. In those who complied with the exercise recommendations according to the WHO, there was significant evidence of improvement in the general quality of life (p = 0.0032; 95 % IC:4.9–23.9), with a mean score of 75.22 ± 15.92 in the active group vs. 60.76 ± 17.836 in the sedentary group. ConclusionsPhysical activity is associated with a significant impact on how patients with epilepsy perceive their quality of life. In addition, it improves memory and concentration in the tasks they perform in their daily lives.

Knowledge, risk perceptions and practices regarding rodents and their associated pathogens: environmental consultants in Chile

BackgroundRodents play essential ecological roles but are also significant reservoirs of zoonotic pathogens, posing risks to humans. Individuals with frequent occupational contact with rodents face an elevated risk of exposure to rodent-borne diseases. This study examines the knowledge, risk perceptions, and practices of Chilean environmental consultants (ECs) concerning rodents and rodent-borne diseases.MethodsA 32-item questionnaire, which focused primarily on biologists, veterinarians, and environmental engineers, was administered. The questionnaire included closed, open-ended, and semi-open-ended questions. Data analyses, performed using R software, involved calculating frequencies and proportions for questions related to knowledge of rodents and rodent-borne diseases, rodent management and handling, biosafety procedures, and training. Additionally, generalized linear models (GLMs) were used to assess knowledge of rodent hosts and diseases, whereas correspondence analysis was used to examine associations between EC characteristics (undergraduate fields of study and years of experience) and responses regarding risk perception and the importance of zoonotic disease training.ResultsCompleted questionnaires were received from 206 ECs. Although the ECs demonstrated a strong awareness of hantavirus cardiopulmonary syndrome, identifying it as a significant rodent-borne threat, knowledge gaps were evident regarding the specific role of certain rodent reservoir species and other rodent-borne diseases in Chile. For example, leptospirosis was well recognized, particularly among veterinarians, whereas emerging zoonoses such as scrub typhus was rarely mentioned. The study also revealed the frequent use of live trapping and direct handling of rodents, resulting in injuries to 32% of the respondents. Despite the widespread use of personal protective equipment, key elements such as respiratory protection and disposable suits were underutilized, and inadequate cleaning practices for traps were reported. Nevertheless, ECs expressed a willingness to participate in zoonotic disease training, underscoring the need for further education.ConclusionsThis study highlights the critical need for ongoing education for ECs on rodent reservoirs, diseases, and biosafety measures to enhance their safety and reduce the risk of zoonotic infections. The findings offer valuable insights for developing strategies aimed at improving awareness and strengthening biosafety practices within this occupational group.

Exploring the transformational leadership capacities of nurse supervisors in Saudi Arabia

The COVID-19 pandemic posed a major challenge for healthcare systems worldwide. This study examined how hospital nurse supervisors in Saudi Arabia applied transformational leadership (TL) skills during the pandemic, as perceived by staff nurses. It also identified effective strategies and challenges nurse supervisors encountered during crises. Conducted across hospitals in Saudi Arabia, this quantitative cross-sectional study included 916 staff nurses. Data was collected from January to April 2023 through a 19-item survey questionnaire on TL. The six aspects of TL (Charisma, Social, Vision, Transactional, Delegation, and Execution) were consistently observed among nurse supervisors, with an average score of 2.99±1.014. All paired domains, except Charisma, showed strong positive correlations, indicating solid relationships within each pair. Identified best practices of nurse supervisors included shared goals, supervision, mentorship, and incentives. However, challenges included a sudden increase in patient numbers, limited resources, and nurses' concerns about health and safety. These findings can guide policymakers in developing leadership programs to strengthen nurses' leadership skills, particularly in crisis situations.

Linguistic Competence Among Egyptian vs. Saudi EFL Majors in Light of Utilizing Artificial Intelligence Technology

This study aimed at probing Egyptian and Saudi English as a Foreign Language (EFL) majors' perceptions of the impact of AI technology on enhancing linguistic competence and predicting the level of linguistic competence development due to the utilisation of AI. The descriptive survey method was used to accomplish the purpose of the study. A 27-item questionnaire was developed to collect the study data from the participants, totalling 523 EFL majors: 256 Egyptian EFL majors at the Faculty of Education at Al-Azhar University, Egypt and 267 EFL majors at Prince Sattam bin Abdulaziz University, Saudi Arabia. The results of the statistical analysis demonstrated that AI technology is perceived positively by the EFL majors in both contexts. However, the Egyptian students showed higher positive perceptions than their Saudi counterparts. More importantly, the simple regression analysis has shown a statistically significant positive correlation between the EFL majors' perceptions and their linguistic competence. The study recommends enhancing the EFL majors' proficiency in using AI tools for developing language skills.

Asthma knowledge assessment of primary healthcare physicians in Iraq

Objective: The aim of the study was to assess knowledge among primary healthcare (PHC) physicians about asthma in Iraq. Methods: A retrospective study was conducted in Iraq. Data were collected from 400 physicians who completed the electronic asthma training course for four weeks starting in March 2023. This study used aconvenience sampling technique via email from participating physicians. A 15-item questionnaire based on the National Asthma Guideline for Primary Care Physicians was used to assess their knowledge about asthma. The Mann–Whitney test was used to compare knowledge scores based on gender, prior training in chronic respiratory disorders, and a personal history of bronchial asthma. The Kruskal–Wallis test was used to compare knowledge scores depending on the specialty and years of practice as a PHC doctor. Results: The mean age of the participating doctors was 32.5 years, 67.9% were female, and 32.1% were male. Overall, the participants’ knowledge score was poor at less than 70%. The Mann–Whitney test revealed no significant difference in the knowledge scores of the participating physicians depending on their gender, previous asthma training, or personal history of bronchial asthma. A significant difference was found when comparing the knowledge scores of participating physicians depending on their specialty and duration of practice as a PHC doctor. Conclusion: This study showed that PHC physicians’ knowledge about asthma based on the recommended national guidelines of Iraq was poor. Further research is required to examine the parameters associated with improving both understanding of asthma and compliance with the guidelines.

Profile of Students and Their Study Strategies – A Diagnosis of the Strengths and Weaknesses of a Student Group in Relation to the Use of Study Strategies

In our study, we aim to define the profile of a group of students enrolled in the first year of an online undergraduate programme. Our sample consists of 166 students of both genders, with an average age of 42 years. We used a 35-item questionnaire as a data collection instrument, which enabled us to analyse the behaviour of these students. Statistical analysis of the questionnaire indicates a high level of internal consistency. The responses reveal strong confidence in their learning, realistic goal setting, self-awareness, and careful time management, with students planning tasks and study time in advance when preparing for assessments. The less positive aspect identified is the difficulty of studying with others or in groups. In summary, by developing and implementing study strategies tailored to the online context, students can maximise their learning, engagement, and academic success, as well as further develop their strategies for self-regulated learning.

Free Will, Work Motivation and Optimism

This study investigated the relationship between beliefs in free will, work motivation, and optimism in a sample of 54 employed adults. A 45-item questionnaire, which included the Free Will subscale of the FAD-Plus, the Work Extrinsic and Intrinsic Motivation Scale (WEIMS), and the Optimism and Pessimism Scale (OPS-C), was used to determine whether belief in free will is linked to higher levels of motivation and a more optimistic outlook. The results indicated a moderate, positive correlation between free will beliefs and work motivation (r = 0.2815, p &lt; 0.05), indicating that individuals who perceive themselves as autonomous and in control of their actions tend to be more motivated in their work. However, the relationship between free will beliefs and optimism were weak and non-significant (r = 0.1745, p = 0.206944), suggesting that free will may not directly impact an individuals optimism.

The Association Between Periconceptual Maternal Dietary Patterns and Miscarriage Risk in Women With Recurrent Miscarriages: A Multicentre Cohort Study.

To examine the association between periconceptual maternal diet and miscarriage risk among women with recurrent miscarriages. Prospective multicentre cohort study (Tommy's Net). Three university hospital research centres in the United Kingdom. 1035 women with a baseline history of two or more miscarriages. We analysed baseline dietary data from a 10-item Food Frequency Questionnaire (FFQ). For individual food category analyses, we used multivariable Poisson regression following adjustment for maternal confounders and paternal dietary patterns. For whole diet analyses, ordinal principal component analysis (PCA) was used to identify common dietary patterns. Results were presented as relative risks (RR) with 95% confidence intervals (CI) and accompanying p-values. Miscarriage rate, defined as the rate of spontaneous pregnancy loss (< 24 weeks of gestation) relative to the total number of pregnancies (miscarriages and live births). High consumption of fruit and nuts (almonds and walnuts) was associated with lower miscarriage risk (fruit 226/662 (34.1%) vs. 38/77 (49.4%), RR 0.66, 95% CI 0.51 to 0.85, p = 0.001; nuts 47/152 (30.9%) vs. 220/613 (35.9%), RR 0.73, 95% CI 0.54 to 0.98, p = 0.039). High red meat intake was associated with a possible increase in miscarriage risk (6/12 (50.0%) vs. 165/469 (35.2%), RR 1.86, 95% CI 1.10 to 3.16, p = 0.022). The association with miscarriage risk was unclear for other food groups, including fresh vegetables, white meat, fish, dairy, eggs, soya and chocolate, due to imprecise point estimates. Through PCA, we identified three data-derived dietary patterns. Yet, no distinct relationship emerged between these dietary patterns and miscarriage risk. A maternal diet rich in fresh fruits and nuts is associated with a lower miscarriage risk among women with a history of recurrent miscarriage. Tommy's Net (ISRCTN17732518) https://www.isrctn.com/ISRCTN17732518. Analysis plan (OSF zp7cs) https://osf.io/zp7cs.