Questionnaire-based Survey Research Articles

Early diagnosis of lupus: A possibilty. A multicentric study from SLE Special Interest Group (SIG) of Indian Rheumatology Association (IRA).

Systemic Lupus Erythematosus (SLE) warrants an early diagnosis and prompt management. Delay in diagnosis can result in repeated flares, permanent damage, and even death. There is a large variability in the time taken to diagnose SLE across the world. We undertook this study to determine the time taken for diagnosis of SLE in India and to identify the factors associated. Patients with SLE diagnosed within the previous 1year as per Systemic Lupus Erythematosus International Collaborating Clinics criteria (SLICC) 2012 criteria were included in a cross-sectional multicentre questionnaire-based survey. Demographic profile, self-reported socioeconomic status as per Kuppuswamy classification of socioeconomic status (version 2022) (SES), and several healthcare related parameters including referral pattern were recorded. Median time taken for diagnosis was used to demarcate early or late diagnosis and associated factors were explored. We included 488 patients with SLE from 10 rheumatology centres. The median time to diagnosis was 6months Interquartile Range (IQR 3,14.7) and within 3months in about one third [150(30.7%)]. Very early diagnosis (<1month) was established in 78(16.0%) patients. The mean SLE Disease Activity Index (SLEDAI) at diagnosis was 10.28+7.24. In univariate analysis, an older age, lower SES, non-southern state of residence and larger family size were significantly associated with late diagnosis. In the multivariate analysis, higher SES (AOR 0.95, 95% CI: 0.92-0.98), multiple organ system involvement at initial presentation (AOR1.75 95%CI: 1.08-2.84) and place of residence in south Indian states (AOR1.92 95%CI: 1.24-2.97) had lesser odds of being associated with late diagnosis. Distance from the closest medical centre/professional did not influence the time to diagnosis. Majority of patients had first consulted a medical graduate (42.5%) or postgraduate doctor (48.2%), and referral to rheumatologist was largely done by postgraduate (65%) doctors. More than half of our patients (61%) self-finance their treatment. Median time to diagnosis of SLE was 6months, 1/3rd being diagnosed within 3months and 78(16.0%) with 1month of symptom onset. Delay in diagnosis was noted in those belonging to lower socioeconomic strata and those with single organ disease. Distance to the health care facility did not influence time to diagnosis.

An Investigation into Building Functional Failures in Akure South Local Government, Ondo State, Nigeria

Functional failures and faults are regular occurrences in buildings and construction industries. The rate of building collapse in Nigeria has increased dramatically over the last decade and shows no signs of abating which has led to massive losses causing loss of physical properties, destruction of movable properties, injury, and loss of life. Beyond this, building collapse always has far-reaching economic, financial, psychological, and sociological implications. This study reported the causes of functional failures of buildings in Akure South Local Government Area, Nigeria. As a result, this study aimed to investigate the causes of functional failures in buildings and their impact on the quality and functionality of a building to build a theoretical framework that can help address the functional failures in buildings. The study utilized a questionnaire-based survey in the Akure South Local Government area. Data was collected from residents occupying the buildings. Information obtained includes the type of building and the current physical condition of the houses they live in, and 90 responses were collected and analyzed. The analysis identified six factors of functional failures in buildings investigated; damp 30%, cracks 50%, poor plumbing 45%, poor electrical wiring 35%, roofing defects 25% and Inadequate maintenance 70% and four causes of building failures; poor construction materials 32.7%, human errors 20.7%, natural disasters 12.4%, and a combination of the three factors 34.2%. Based on the findings, the results showed that the combination of the three factors was the most significant cause of building functional failures in the Akure South LGA, while natural disasters were the least significant cause. To mitigate the functional failures in buildings, it is important to enforce stringent regulations and standards by involving Governmental bodies (architectural Engineers and structural Engineers) to check building drawings and structural analysis report properly and correctly before design approvals, conduct regular inspections and internal audits, to help detect and rectify errors and maintaining standards throughout the construction process in order to enhance the quality, safety, and resilience of buildings, ensuring their functionality and longevity.

When do shoppers prefer using QR codes? Empirical evidence from Vietnam

This research aimed to explore the factors influencing the behavioural intention to use over-the-counter (OTC) QR codes for purchasing products in Vietnamese supermarkets. The study included 996 consumers and employed a questionnaire-based survey method to test the hypotheses using partial least squares structural equation modelling (PLS-SEM). Drawing on the theory of reasoned action (TRA) and signalling theory, the findings identified five key factors that positively affected the intention to use OTC QR codes: perceived usefulness of OTC QR codes (e.g., for payment and traceability), attitude, customer satisfaction, and supply chain transparency. Additionally, the perceived usefulness of OTC QR codes positively impacted attitude and customer satisfaction, while its usefulness for traceability enhanced supply chain transparency. The study also identified the moderating influence of personal innovativeness on the relationship between perceived usefulness of OTC QR codes for payment and attitude and customer satisfaction. Furthermore, the moderating role of electronic Word-of-Mouth (e-Word-of-Mouth) in the relationship between customer satisfaction, attitude, and behavioural intention was discovered. This research contributes to the existing literature by expanding our understanding of the perceived usefulness of OTC QR codes and elucidating the various mechanisms through which their both functionalities could encourage consumer adoption in the context of Vietnamese supermarkets.

The lasting legacy of COVID-19 on individual shopping decisions: tracing the evolution of online shopping habits and its stability

ABSTRACT Societies are witnessing a significant increase in online shopping frequency, which has become a viable alternative to in-store shopping, a common aspect of people’s daily trips. Throughout pandemics, consumer behavior changes as a result of factors such as fear of disease, lockdowns, and physical store closures. This research aims to analyze the impact of variables accounting for health concerns and attitudes towards shopping in the increase of e-shopping during the COVID-19 and in the stability of such patterns in the post-pandemic era. A questionnaire-based survey was conducted in Tehran, employing two Binary Logit models to identify significant factors. Results indicated that positive attitudes and benefits and convenience significantly increased online shopping frequency. Additionally, factors such as loyalty, shopping enjoyment, and prior online shopping experience before COVID-19 bolstered the stability of online shopping rates. Also, health concerns, emerged as significant influencers on both the growth and stability of online shopping.

Assessing Saudi women’s awareness about human papillomavirus (HPV) and their susceptibility to receive the vaccine

ABSTRACT Cervical cancer is a significant health concern for women worldwide, with human papillomavirus (HPV) being the primary cause. This study aimed to assess Saudi women’s awareness and knowledge of HPV, determine their information sources, and evaluate their intention to receive the HPV vaccine. A questionnaire-based survey was conducted among 654 Saudi females aged 18 to 60 years from January to May 2023. The results revealed that 60.85% of the participants had heard about HPV, but only 8.25% had received the HPV vaccination. Despite the low vaccination rate, 71.11% of the respondents expressed willingness to receive the vaccine. Educational level was the significant predictor of the vaccine awareness and acceptance. The internet and social media were the most prevalent sources of information about HPV. The study highlights the need for additional education about HPV-related diseases and vaccination among Saudi women. Although there is a high level of HPV vaccine acceptance, the lack of knowledge suggests that targeted educational interventions are necessary to increase awareness and promote vaccination uptake. These findings can inform public health strategies to reduce the burden of cervical cancer in Saudi Arabia through improved HPV vaccination coverage and education.

Assessment of the public knowledge, attitudes, and perceptions of Nigerians regarding preparedness for future pandemics

IntroductionPandemics are global health crises that have caused millions of deaths, enormous socio-economic disruptions, and considerable public and global health security consequences. This study assessed Nigerians’ knowledge, attitudes, and perceptions regarding preparedness for the next pandemics.MethodsA cross-sectional questionnaire-based national survey was conducted among 1276 respondents in Nigeria to determine public knowledge, attitudes, and perceptions of preparedness for future pandemics. Descriptive and inferential statistics were used for analyses.ResultsOf the 1276 respondents to this survey, > 50% had not heard of the Spanish flu and Zika disease. Approximately half (594) of the respondents did not consider antimicrobial resistance a possible cause of future pandemics. Over an average proportion of respondents reported unsatisfactory knowledge (655, 51.3%) and poor perceptions (695, 54.5%) about pandemic preparedness. The respondents’ good knowledge and satisfactory attitudes toward pandemic preparedness decreased with age. The respondents' education, age, and state of residence were significantly associated with good knowledge, satisfactory attitudes, and positive perceptions of pandemic preparedness with respondents with tertiary education levels being at least two times more likely to have these positive outcomes.ConclusionThis study revealed serious gaps in Nigerians’ knowledge, attitudes, and perceptions of their readiness for upcoming pandemics. To protect Nigerians’ health, emphasis should be placed on these issues by all stakeholders, including the government.

Work-related boredom, felt deprivation and employee dissatisfaction: is being closer to the leader a bane?

PurposeJob dissatisfaction is a prevalent, yet understudied phenomenon. This study aims to examine the determinants of job dissatisfaction among information technology (IT) professionals. Based on the relative deprivation theory and the social exchange theory, this study examines the complex linkage between work-related boredom, felt deprivation, leader–member exchange and job dissatisfaction.Design/methodology/approachThe questionnaire-based survey data were collected from IT professionals working in Bangalore, India. Regression with process macro was used for data analysis.FindingsThis study found the predictors of job dissatisfaction and felt deprivation. It also found the path through which work-related boredom impacts job dissatisfaction (through felt deprivation). Furthermore, it found that the direct effect of boredom on felt deprivation is greater for employees in close relationships with the leader.Research limitations/implicationsJob dissatisfaction is one of the critical factors that has several adverse consequences for individuals and the organization. This study provides the antecedents, explains the path and suggests a boundary condition leading to job dissatisfaction. It further highlights the adverse consequences of work-related boredom on felt deprivation for employees having strong leader–member exchange relationships.Originality/valueThis study contributes to the literature on job dissatisfaction, boredom, felt deprivation and leader–member exchange in the IT sector in an emerging economy. To the best of the author’s knowledge, this is one of the early studies that explain the mechanism and the conditions leading to felt deprivation and job dissatisfaction.

Needs Assessment for a Leadership Course in Saudi Medical Schools: The Student Perspective.

Leaders in healthcare no longer need to hold formal management positions; instead, leadership is perceived to be the responsibility of all healthcare professionals. Despite changes in curricula and teaching design, however, this review of the content taught in medical colleges in Saudi Arabia reveals a lack of leadership and a failure to equip young graduates to compete on the global stage. Medical students need leadership skills for patient care, cooperation, and navigating the complex healthcare system. Clinical management skills in hospitals require these talents also. The complexity of healthcare and the impact healthcare executives have on people's lives highlight the importance of these skills. Thus, healthcare practitioners must develop non-technical skills like proactivity, motivation, and change management to lead across professional boundaries and negotiate the increasingly complex healthcare landscape. This cross-sectional study combines a quantitative approach with a self-administered questionnaire-based survey. The sampling procedure is a non-probability convenience technique, adapted for 700 male and female undergraduate medical students from four medical colleges. Of the students, 75.46% had minimal leadership experience and 22.69% had some leadership experience; 3.02% of 464 students considered themselves highly experienced in leadership. As the needs assessment and other relevant factors show, leadership should be introduced as a skilled subject. There will always be a growing demand for competent medical graduates, who are capable of becoming future leaders. Although elementary leadership concepts remain fundamentally the same, curricular development must focus on the needs of society and stakeholders.

Sleep quality and perceived stress levels in Chinese patients with minor recurrent aphthous stomatitis: a cross-sectional questionnaire-based survey

ABSTRACT Objectives This cross-sectional study aimed to evaluate sleep quality and perceived stress levels in Chinese patients with active minor recurrent aphthous stomatitis (MiRAS) lesions, as well as to investigate the potential relationship between sleep quality and perceived stress levels and the risk of MiRAS episodes. Methods The study population consisted of individuals recruited from a Chinese cohort who underwent medical and oral examinations from March 2022 to August 2023. All participants completed a set of uniform anonymous questionnaires, which included sociodemographic characteristics, clinical information, the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI) and the Perceived Stress Scale (PSS-14). Statistical analysis was conducted using the independent sample t test, Mann-Whitney U test, Pearson’s chi-square test and Pearson’s correlation analysis. After adjusting for potential confounders (age, gender, marital status, and education level), multivariate logistic regression analyses were performed to assess the associations of sleep quality and perceived stress levels with the risk of MiRAS episodes. Additionally, restricted cubic spline curves were constructed to visualize these correlations. Results A total of 329 eligible volunteers participated in the study, comprising 122 Chinese MiRAS patients and 207 healthy controls without MiRAS. Compared to healthy participants, MiRAS patients exhibited significantly higher PSQI and ISI scores (p = 0.000). However, no statistically significant difference was observed between the two groups regarding PSS-14 scores or its two subscales (p > 0.05). Multiple regression analysis indicated that lower sleep quality was significantly associated with an increased risk of MiRAS episodes (p = 0.000), whereas no statistically significant relationship was found between perceived stress levels and the risk of MiRAS episodes (p > 0.05). Conclusion Maintaining a regular bedtime and improving sleep quality may contribute to reducing the incidence and recurrence of MiRAS, while psychological intervention may be ineffective for MiRAS patients.

Study concerning methods for managing used engine oil. Analysis of a questionnaire-based survey

Abstract This paper focuses on methods of managing used engine oil by presenting an analysis of the results of a survey based on a questionnaire designed by the authors, which aims to illustrate the real, objective situation of the management of used engine oil generated by vehicles powered by internal combustion engines. The answers are analyzed for each question separately and both conclusions and implementable objectives that could improve the current situation are highlighted. In order to facilitate the understanding of the current framework, general aspects regarding the management of used engine oil are also presented, with an emphasis on the legislative perspective.

Update on the Obstetric Anesthesia Practice in Flanders/Belgium: A 10-year follow-up survey and review

Background: With 75% of women receiving neuraxial anesthesia for labor and cesarean section (CS) in Flanders, Belgium, obstetric anesthesia is an essential part of perinatal care. Despite advancements in obstetric anesthesia and guidelines being updated regularly, past surveys have shown great variability among hospitals. Objective: This investigation aims to observe current obstetric anesthesia practices, compare them with previous surveys, and assess adherence to guidelines among anesthesiologists. Methods: An online questionnaire-based survey, approved by the KU Leuven Ethics Committee, was conducted focusing on three main topics: analgesia during labor, anesthesia for CS, and postoperative analgesia after CS. The survey, consisting of 127 questions, was distributed via email to the heads of anesthesia departments in 57 Flemish hospitals providing obstetric anesthesia care. Responses were anonymously analyzed. Results: For labor analgesia initiation, a conventional epidural with administration of ropivacaine 0.2% (+- sufentanil) remains the most widespread used technique, although Combined-Spinal Epidural (CSE) has gained significant popularity. Patient-controlled epidural analgesia (PCEA) in combination with continuous epidural infusion (CEI) is the preferred maintenance method, however programmed-intermittent bolus (PIEB) has found its way into standard practice. CSs are mostly done by performing CSE or single shot spinal, using hyperbaric bupivacaine 0.5% with sufentanil. Spinal-induced hypotension is treated with a combination of left lateral tilt, fluid administration and vasopressor administration, usually as a bolus. Post-CS pain is mainly treated by a combination of oral/ parenteral analgesics and neuraxial analgesia (PCEA +- CEI), with only a minority choosing regional techniques such as wound infiltration, transverse abdominal plane blocks, quadratus lumborum blocks, etc. Conclusion: Compared to previous surveys, the Flemish anesthesiologists adhere well to the latest guidelines and gold standards in obstetric anesthesia, consistently modernizing their practices. Nevertheless, with the continual introduction of novel techniques and methods, it is imperative for practitioners to maintain efforts in pursuing ongoing innovation.

Multi-institutional questionnaire-based survey on online adaptive radiotherapy performed using commercial systems in Japan in 2023.

In this study, we aimed to conduct a survey on the current clinical practice of, staffing for, commissioning of, and staff training for online adaptive radiotherapy (oART) in the institutions that installed commercial oART systems in Japan, and to share the information with institutions that will implement oART systems in future. A web-based questionnaire, containing 107 questions, was distributed to nine institutions in Japan. Data were collected from November to December 2023. Three institutions each with the MRIdian (ViewRay, Oakwood Village, OH, USA), Unity (Elekta AB, Stockholm, Sweden), and Ethos (Varian Medical Systems, Palo Alto, CA, USA) systems completed the questionnaire. One institution (MRIdian) had not performed oART by the response deadline. Each institution had installed only one oART system. Hypofractionation, and moderate hypofractionation or conventional fractionation were employed in the MRIdian/Unity and Ethos systems, respectively. The elapsed time for the oART process was faster with the Ethos than with the other systems. All institutions added additional staff for oART. Commissioning periods differed among the oART systems owing to provision of beam data from the vendors. Chambers used during commissioning measurements differed among the institutions. Institutional training was provided by all nine institutions. To the best of our knowledge, this was the first survey about oART performed using commercial systems in Japan. We believe that this study will provide useful information to institutions that installed, are installing, or are planning to install oART systems.

Assessment of obstructive airway disease in the multicenter SWORD survey India.

The study aimed to assess the control of asthma and the severity of chronic obstructive pulmonary disease (COPD) and evaluate the adequacy of treatment in patients presenting to the outpatient department (OPD) across India. The secondary aim was to assess the risk factors associated with poorly controlled asthma and severe COPD. This is the analysis of Phase IV of the multicenter questionnaire-based point prevalence SWORD survey, conducted in May 2018, and designed to capture details on disease control and treatment as per the global initiative for asthma and the global initiative for chronic obstructive lung disease guidelines. Of the 5,311 respiratory disease patients presenting to the OPD, there were 1,419 and 412 patients with asthma and COPD, respectively, across 290 sites in India. There were 1,022 (72%) patients having well-controlled asthma, 293 (20.6%) patients with partly controlled asthma, and 104 (7.4%) patients with poorly controlled asthma. Of the 412 patients with COPD, there were 307 (74.5%) in A, 54 (13.1%) in B, and 51 (12.4%) in the E category. In spite of poor control or severe disease, 34.8% of asthmatic and 25.7% of patients in the B and E categories of COPD were not using any medicine. Risk factors for partly and poorly controlled asthma included rain wetting (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.02-2.47) and gastroesophageal reflux disease (AOR: 1.50, 95%CI: 1.08-2.10). This study identifies a gap in the treatment of both poorly controlled asthma and severe COPD. A substantial number of patients had poorly controlled asthma and severe COPD, and many were either not taking treatment or taking it inappropriately.

Oral health-related quality of life in the Myanmar population: The first national oral health survey 2016 - 2017.

To describe the oral health-related quality of life (OHRQoL) and its potential influencing factors within the Myanmar population. Data were from the first national oral health survey, involving 3,513 participants aged 15-18 years, 35-44 years, and 60-74 years from 21 selected townships in Myanmar. Self-administered questionnaire-based surveys, conducted from December 2016 to January 2017, included socio-demographics, behavioral factors, self-reported oral conditions (number of teeth present, teeth and gingival conditions), and inquiries regarding OHRQoL (a set of 12 questions with 5 response options) using the recommended questions from WHO Oral Health Surveys. The most prevalent oral health issues were difficulties in chewing (32.2%) and biting foods (30.8%). In bivariate analysis, older individuals, rural residents, and participants with higher educational levels were associated with OHRQoL. In multiple regression analysis, self-reported number of teeth, teeth and gingival conditions were strong predictors of OHRQoL in all age groups. Self-rated oral health conditions predicted quality of life due to oral problems. The development of national oral health policies and strategies is imperative to facilitate early detection of oral health problems and promote the awareness of oral health importance.

Resilience to future floods through flood memory approach: An example from West Bengal, India

Managing flood situations is a combination of structural, non-structural, and socio-ecological approaches, where the latest includes an operative involvement from the local community, based on their experiences in past flood episodes. The instances of considering this indigenous knowledge and perception while planning for the flood mitigational framework in India are neither very popular a practice nor they are frequently exemplified - but while looking at the case studies from all over the world, this could be a powerful tool for gauging flood scenarios and the living with it. This paper aims to inspect the ways and approaches through which a local community memorizes the fury of floods, how this information can be put in a quantitative way, and can be realistically functioning for coping with future flood consequences. Focusing on the flood memory approach for community resilience, we present the findings of archival research, site-specific folklores and mythological stories (cultural), social methods, verbal methods, exploration of flood markers (structural), and campaigns and exhibitions (educational). A digital questionnaire-based survey was conducted in the most flood-suffering wards of the Kolkata Municipal Corporation area in West Bengal, and upon receiving the reactions, a Flood History Volatility Scale (FHVS) has been devised to test how the strength of an individual's flood memory varies due to some controlling factors. Based on the results obtained from memory work and perceiving the importance of community knowledge during the survey, a comprehensive flood risk management approach has been proposed for flood risk reduction and developing community resilience.

Exploring Varicella Vaccine Coverage and Influencing Factors in Rural and Pastoral Children of Qinghai Province: A Cross-Sectional Catch-Up Vaccination Study

&amp;lt;i&amp;gt;Background: &amp;lt;/i&amp;gt;Varicella is a respiratory infectious disease caused by varicella-zoster virus (VZV) infection. Varicella vaccine has been shown to be highly effective in preventing varicella disease, however it is not included in Qinghai Province’s local immunization planning program and must be paid for by families. Its use in local areas is options instead of compulsory, so high coverage is difficult to guarantee. Starting in October 2021, one dose of live attenuated varicella vaccine was recommended at lest for 3-17-year-old children in Qinghai. In 2022, it was conducted that an investigation of varicella vaccine coverage and factors influencing coverage among children in rural rural and pastoral areas to determine the impact of this VarV catch-up policy. &amp;lt;i&amp;gt;Objective: &amp;lt;/i&amp;gt; To explore varicella vaccine coverage and factors influencing caverage among 3-17-year-old children in rural and pastoral areas of Qinghai province. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; A stratified cluster sampling method was used to select children aged 3-17 years from kindergartens and primary /secondary schools in rural and pastoral areas of Qinghai province for a questionnaire-based survey of their guardians. Coverage levels of one and two doses of VarV (VarV&amp;lt;sub&amp;gt;1&amp;lt;/sub&amp;gt; and VarV&amp;lt;sub&amp;gt;2&amp;lt;/sub&amp;gt;) before and after a catch-up vaccination activity initiated in October 2021, and identified factors influenceing VarV&amp;lt;sub&amp;gt;1&amp;lt;/sub&amp;gt; coverage. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; VarV&amp;lt;sub&amp;gt;1&amp;lt;/sub&amp;gt; and VarV&amp;lt;sub&amp;gt;2 &amp;lt;/sub&amp;gt;coverage levels after the catch-up activity were 79.06% (676/855) and 43.79% (363/829), respectively, and increased by 34.38 and 24.13 percentage points compared with before the catch-up activity. Multivariate logistic regression showed that VarV&amp;lt;sub&amp;gt;1 &amp;lt;/sub&amp;gt;coverage was higher in rural areas than in pastoral areas (OR=4.63, 95%&amp;lt;I&amp;gt;CI&amp;lt;/I&amp;gt;: 2.91-7.39), and higher among children whose guardians scored 4-6 or 7-10 points on knowledge about varicella and VarV than among children whose guardians scored 0-3 points (OR=8.61, 95%&amp;lt;I&amp;gt;CI&amp;lt;/I&amp;gt;: 4.73-15.69, OR=2.86, 95%&amp;lt;I&amp;gt;CI&amp;lt;/I&amp;gt;: 1.69-4.84). the main reasons for non-vaccination were guardians’ lack of understanding of VarV (48.6%, 87 children), guardians’ unawarness of the need for VarV vaccination (43.6%, 78 children), and unavailability of VarV at vaccination centers (31.3%, 56 children). &amp;lt;i&amp;gt;Conclusions: &amp;lt;/i&amp;gt;The catch-up activity significantly increased VarV coverage among children in the surveyed areas. It should been strengthened that health education on knowledge about varicella and VarV among guardians of children in Qinghai, especially in pastoral areas, to promote VarV vaccination of age-eligible children.

The impact of a child’s inborn error of metabolism: the parents’ perspectives on restrictions, discrimination, family planning, and emergency management

BackgroundTo investigate the impact of children’s inborn error of metabolism (IEMs) on the children’s and their parents’ lives from the parents’ perspective. We focused on disease-related restrictions in various issues of daily life, experienced discrimination, parental family planning, and management of metabolic emergencies.MethodsWe conducted a questionnaire-based survey with 108 parents of 119 children with IEM who attended a metabolic outpatient clinic. The children were categorized into 4 cohorts, based on increasing disease severity (cohort 1: IEMs with lowest severity, cohort 4: IEMs with highest severity), and compared by using Tobit regressions.ResultsThe severity of the child’s IEM was associated with an increase in the intensity of perceived restrictions from the parents’ perspective for themselves and their children in all aspects of life: in general, in contact with friends, in the pursuit of hobbies, in childcare/school/occupation, and due to emotional stress. The highest intensity of restrictions in all cohorts was found for the parents themselves in contact with friends (compared to cohort 1: cohort 2: c. 3.556, p = 0.002; cohort 3: c. 4.159, p = 0.003; cohort 4: c. 7.224, p < 0.001). Parents of 8% of children reported that their children were discriminated against because of IEM, with the highest proportion of affected children (43%) in cohort 4. Parental family planning decisions were influenced in 34% of parents, with fear of recurrence being a predominant aspect. Of the parents of children diagnosed with IEMs associated with metabolic emergencies, 68% stated that they felt well or very well prepared for the occurrence of a metabolic emergency, and 100% of parents were able to name the necessary action steps from memory. Nevertheless, 58% stated that they experienced an occurring emergency as rather or very stressful.ConclusionsFrom the parents’ perspective, the intensity of restrictions increased with the severity of the child’s IEM. The study shows the high impact of IEM on parents of children with IEM and the daily challenges they face. These findings emphasize the importance of comprehensive support for parents of children with IEM.

Mosquito nuisance and control in the UK in 2022 – A questionnaire-based survey of local authorities

Mosquito nuisance and control in the UK in 2022 – A questionnaire-based survey of local authorities

Perception and Attitude of Dental Students Towards Geriatric Care: A Questionnaire-Based Survey

Perception and Attitude of Dental Students Towards Geriatric Care: A Questionnaire-Based Survey

The effect of total quality management practices on supply chain performance in the automobile industry

The Pakistan Industrial Technical Assistance Center (PITAC) and Pre-Start of Sales Quality Clinic (PSQC), which are all government-run organizations, failed to fulfill their responsibilities in modernizing the Pakistani automobile manufacturing industry. The automobile industry in Pakistan is one of the most significant industrial sectors, contributing approximately 3% of the country’s GDP and PKR 50 billion. Previously, scholars have discussed the use of TQM practices in different contexts, but this topic has been investigated less in the automobile industry. Furthermore, there are gaps in the literature regarding the relationships among top management commitment, customer focus, supplier quality management, human resource management and supply chain performance (SCP). The current study was designed to measure the impact of total quality management practices (TQMPs) on SCP of the automobile industry in Pakistan. Quantitative research was conducted, and a survey-based questionnaire was administered using a random sampling technique. Data from 155 senior managers representing the outlets of the automobile industry in Pakistan were analyzed using Smart PLS 4. Top management, customer focus, supplier quality, and human resource management are significant antecedents of SCP in Pakistan's automobile industry. This research addressed gaps in the supply chain literature and contributed significantly to the body of knowledge. We recommend that policymakers and practitioners implement practices to advance the SCP of the automobile industry in Pakistan. The study has novelty as unexplored area in literature was discussed by its findings. Policy and managerial implications of this research are significant to contribute to literature. The limitations of this research are discussed to provide significant insight for future directions.