Care Education Research Articles

Do women have a choice when it comes to fetal monitoring? Perceptions of information provided and choice of fetal monitoring in Australia: A national survey

IntroIn Australia, little research has examined how women and people participate in decision-making about types of fetal monitoring, or their perceptions of information provided by caregivers. MethodsA national cross-sectional survey, the ‘Women’s experiences Of Monitoring Baby’ (WOMB) Study, explored women’s experiences of intrapartum fetal monitoring. This study reports on selected results. ResultsThere were 861 responses. Of respondents, 20 % reported receiving enough information about types of fetal monitoring from care providers and childbirth education, 35 % recalled being asked for consent, and 34 % were unaware they had a choice in monitoring. Most women (86 %) obtained information via ‘other’ sources or own reading, and where monitoring was discussed, it was most likely a ‘brief discussion’ with a midwife (43 %).Women who were monitored via wired CTG (35 %) were more likely to report facing barriers to choosing their preferred monitoring type, (p<0.001). Wired CTG was significantly associated with hospital type and primiparity and 70 % indicated they would not choose it again (p<0.001). ConclusionWomen did not know they had a choice in the type of intrapartum monitoring received, and felt they had insufficient information to make informed decisions. While monitoring via intermittent doppler and wireless CTG was preferred, women experienced barriers to receiving these, especially in public hospitals in rural/regional areas and private metropolitan hospitals. Antenatal models of care and childbirth education are underutilised avenues for providing information however, it is incumbent on maternity systems to provide adequate information resources, access to equipment and appropriate models of woman-centred and humane care.

Sustainable Development Goals for Cleft Care.

The sustainable development goals (SDGs) are a blueprint for a better and more sustainable future for all. Understanding these initiatives helps everyone develop insights into critical global issues, including health care management, education, gender equality, and other challenges related to the 17 SDGs. Implementing these goals will contribute to sustainable development for cleft care in the least developed countries. The authors critically reviewed relevant articles on cleft lip and palate from 2014 to 2022. The authors' review utilized the online search tools Springer Nature, PubMed, and Google Scholar, using keywords of "cleft lip and palate," "cleft outreach program," "sustainable cleft care," "sustainable development goals for cleft," and "sustainable outreach program." In addition, the authors investigated the potentially necessary SDGs for sustainable cleft care management.

Large language models in patient education: a scoping review of applications in medicine.

Large Language Models (LLMs) are sophisticated algorithms that analyze and generate vast amounts of textual data, mimicking human communication. Notable LLMs include GPT-4o by Open AI, Claude 3.5 Sonnet by Anthropic, and Gemini by Google. This scoping review aims to synthesize the current applications and potential uses of LLMs in patient education and engagement. Following the PRISMA-ScR checklist and methodologies by Arksey, O'Malley, and Levac, we conducted a scoping review. We searched PubMed in June 2024, using keywords and MeSH terms related to LLMs and patient education. Two authors conducted the initial screening, and discrepancies were resolved by consensus. We employed thematic analysis to address our primary research question. The review identified 201 studies, predominantly from the United States (58.2%). Six themes emerged: generating patient education materials, interpreting medical information, providing lifestyle recommendations, supporting customized medication use, offering perioperative care instructions, and optimizing doctor-patient interaction. LLMs were found to provide accurate responses to patient queries, enhance existing educational materials, and translate medical information into patient-friendly language. However, challenges such as readability, accuracy, and potential biases were noted. LLMs demonstrate significant potential in patient education and engagement by creating accessible educational materials, interpreting complex medical information, and enhancing communication between patients and healthcare providers. Nonetheless, issues related to the accuracy and readability of LLM-generated content, as well as ethical concerns, require further research and development. Future studies should focus on improving LLMs and ensuring content reliability while addressing ethical considerations.

The health of older caregivers in Spain: a matter of age or a matter of care?

Abstract Introduction Informal care is crucial in Spain’s care system, with a rising number of caregivers aged 75 or older, yet studies on its health effects are lacking. This study aims to determine the differential impact of age and care-related variables on the health of older caregivers. Materials and methods This is a cross-sectional, national study with a sample of 3,870 informal caregivers from the Spanish 2020 Disability, Personal Autonomy and Dependency Survey. We performed a logistic regression where self-reported deterioration in caregiver health due to caregiving was the dependent variable and age (&amp;lt;75 vs. ≥ 75) was the independent variable. Caregivers’ sex, educational level (primary and lower or secondary and higher), income (&amp;lt;1,150 euros per month vs. ≥ 1,150), severe functional limitation of caregivers and care-receptors (yes or no), duration of care (&amp;lt; 8 years vs. ≥ 8 years), and daily hours of care were used as covariates. Results One in 6 caregivers was 75 or older (16,1%). Caregivers’ mean age was 58.4, and care-receptors’ 66.6 years. Women represented 63.0% of caregivers, and 42.8% of care-receptors. Up to 4.6% of caregivers had a severe limitation, and 43.7% of caregivers reported deterioration of their health due to caregiving. A greater perception of deterioration in caregiver health due to caregiving was associated with being 75 years or older (β = 0.34, p = 0.009). Covariates associated with caregivers’ health deterioration were being a woman (β = 0.77, p &amp;lt; 0.001), presence of severe limitation of care receptors (β = 0.58, p &amp;lt; 0.001), and increased daily hours of care (β = 0.01, p = 0.013). Caregivers’ severe limitation, level of education, income and years of care did not show a significant association with perception of health deterioration. Discussion Caregivers older than 75 years in Spain experience a key deterioration in their health associated with caregiving. This vulnerable population must be prioritized in health and social policies. Key messages • One out of 6 caregivers in Spain is aged 75 years or older. Caregiving impacts greatly in their health status. • Older caregivers is a vulnerable population that must be a priority for health and social services.

Anxiety, depression, and poor sleep quality in COVID-19 survivors of the first year of the pandemic

Abstract Background Psychological outcomes after SARS-CoV-2 infection have been reported primarily among patients with post-COVID-19 condition followed at COVID-specific clinics who may not represent the population of COVID-19 survivors. This study compares the frequency, 2 years after infection, of symptoms of anxiety and depression and poor sleep quality between COVID-19 survivors from the first year of the pandemic and comparison groups matched for sex, age, and level of care. Methods Participants are users of the Local Health Unit of Matosinhos (comprising almost all citizens of this municipality) classified according to hospitalization and SARS-CoV-2 infection between March, 2020 and February, 2021 in 4 groups: group#1, hospitalized due to COVID-19 (n = 101); group#2, hospitalized, uninfected (n = 87); group#3, infected, non-hospitalized (n = 252); group#4, uninfected, non-hospitalized (n = 258). They were evaluated between July, 2022 and October, 2023, with the Hospital Anxiety and Depression Scale (HADS-A, anxiety, and HADS-D, depression) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to compute OR and 95%CI adjusted for sex, age, education, marital status, employment, smoking, and level of care of the associations between the study group and clinically significant symptoms of anxiety (HADS-A scores&amp;gt;10), depression (HADS-D scores&amp;gt;10) and poor sleep (PSQI scores&amp;gt;5). Results No significant differences (p &amp;lt; 0.05) were observed for the prevalence of clinically significant symptoms of depression (overall 9.2%) and poor sleep quality (overall 59.8%) between SARS-COV-2 infected participants and comparison groups, but HADS-A scores&amp;gt;10 were more frequent in infected individuals (19.3% vs. 13.6%; OR = 1.92; 95%CI:1.21,3.05). Conclusions Healthcare services should pay special attention to COVID-19 survivors from the first year of the pandemic to identify and treat anxiety symptoms. Funding: FCT UIDB/ 04750/2020 LA/P/0064/2020 PTDC/SAU-EPI/6275/2020 Key messages • COVID-19 survivors from the 1st year of the pandemic present more frequently high levels of anxiety than the general population 2 years after COVID-19. • Specific care for anxiety symptoms are needed for COVID-19 survivors from the 1st year of the pandemic

An update on the concept and importance of health literacy in young people

Abstract The burden of non-communicable diseases is a growing public health crisis that requires immediate action. As health literacy (HL) has been strongly linked with health behaviours and health outcomes, it has many potential implications for health care and health education. Although recent research has emphasised the importance of developing HL early in life, much of the research has focused on understanding and improving HL in adult populations. As young people socialise in different contexts and are exposed to different health-related situations, they require different HL competencies. As part of a wider project, this study aims to gather the perceptions of international academics and community-based practitioners on the concept and importance of HL in and for young people. Specifically, the study aims to (i) explore current understandings of the concept of HL in young people; (ii) examine the importance of HL for young people; (iii) identify those at risk of having low levels of HL; and (iv) determine the specific health behaviours that young people are currently struggling with. A stakeholder mapping exercise was used to recruit academic and community-based practitioners to take part in a one-to-one interview (n = 29). Reflexive thematic analysis was used to analyse the data. The preliminary findings suggest that HL is a very broad yet individualised concept that is critical to develop at an early age given the difficulty young people face in adopting healthy behaviours in their social and physical environment. Furthermore, the participants highlighted that minority groups, such as members of the travelling community and refugees, and those from low socioeconomic populations, are at greatest risk of low HL. Finally, the health issues that appeared to be of most concern in young people were vaping, social media use and poor mental health. These findings can be used to inform appropriate interventions and policies to target the HL of young people. Key messages • Health literacy is a very, yet individualised, concept that is critical to develop given the difficulty young people face in adopting healthy behaviours in their social and physical environment. • Minority groups, such as members of the travelling community, refugees, and those from low socioeconomic populations are at greatest risk of low levels of health literacy.

The association between the mental health disorders, substance abuse, and tobacco use with head & neck cancer stage at diagnosis.

Mental health disorders, substance abuse, and tobacco use are prevalent in the US population. However, the association between these conditions and head and neck cancer (HNC) stage is poorly understood. This research aims to uncover the relationship between pre-existing mental health disorders, substance abuse, and tobacco use and HNC stage at diagnosis in patients receiving care in an integrated, public safety-net healthcare system. This study was a secondary data analysis of linked hospital tumor registries and electronic health record (EHR) data. The study's primary independent variables were the comorbidities of mental health disorders, substance abuse, and tobacco use. The dependent variable was HNC stage at diagnosis, operationalized as early stage (i.e., stages I, II, and III) and advanced stage (stage IV, IVA, IVB, or IVC). The analysis included multivariable logistic regression adjusted for covariates of demographic variables, tumor anato RESULTS: The study population consisted of 357 patients with median age of 59years, and was primarily male (77%), diverse (Black or African American 41%; Hispanic 22%), and from neighborhoods with low income (median average annual household income $39,785). Patients with a history of mental health disorders with or without tobacco use had significantly lower odds of advanced stage HNC at diagnosis (adjusted OR = 0.35, 95% Confidence Interval [CI]: 0.17-0.72.) while patients with a history of substance abuse with or without tobacco use had significantly higher odds of advanced stage HNC at diagnosis (adjusted OR 1.41, 95% CI: 1.01-1.98) than patients with no history of mental health disorders, substance abuse, or tobacco use. The relationship between HNC stage at diagnosis and the comorbidities of mental health disorders, substance abuse, or tobacco differs depending on the type and co-occurrence of these comorbidities. These findings demonstrate the need for innovative care delivery models and education initiatives tailored to meet the needs of patients with mental health disorders, substance abuse, and tobacco use that facilitate early detection of HNC.

Maternal education and antenatal attendance in Georgia: A cohort study

Abstract Background Antenatal care (ANC) and maternal education are important determinants for maternal and newborn health outcomes. Understanding the impact of maternal education on ANC is crucial. Purpose To examine the association between maternal education and ANC attendance. Methods A retrospective cohort study utilized nationwide electronic medical birth registry data (2020-2022) in Georgia. the study includes pregnant women and their newborns. A randomized sample was selected, and extracted variables included maternal age, parity, body mass index, education, year of delivery, gestational age, infant sex, Apgar score, birth weight, delivery type, and newborn status. Statistical analysis via IBM SPSS v23 involved chi-square, t-tests, and logistic regression. Results The sample size contains 4976 mothers after excluding cases with missing data (n = 25). The mean maternal age was 30.5 years (SD = 5.4), with a mean BMI of 28.0(SD = 4.8), and the mean gestational week was 38.4(SD = 2.0), with a mean birth weight of 3263.0 (SD = 568.0) grams. Highly educated women had more than 3 times higher odds (OR = 3.636,95%CI:2.575-5.134) of having at least one ANC visit compared to those with Unknown education. primiparous women had significantly higher odds of having at least one ANC visit compared to Multiparous women, OR = 1.519, (95%CI:1.081-2.135). The chi-square test showed significant difference between ANC visits and the number of liveborn/stillborn (χ² = 53.026, p &amp;lt; .001). Moreover, there was a significant association between birth weight categories and ANC visits (χ² = 167.095, p &amp;lt; .001). Conclusions Our study emphasizes the role of education in improving access to ANC among women with low education levels. We can increase ANC visits and improve maternal and newborn health outcomes by focusing educational efforts on pregnant women. Additionally, focusing on high-risk populations, and using tailored interventions can further improve ANC attendance along with maternal and neonatal health. Key messages • Boosting ANC access and improving maternal and neonatal health by tailored community programs. • Conservative communities and underrepresented communities require additional resources to promote tailored healthcare. and extra effort in education about ANC.

Attitudes, fears and experiences of medical scientists towards using AI tools in their work routine

Abstract Background Artificial intelligence (AI) has experienced an explosive growth in the healthcare sector and the scientific field. Large Language Models (LLMs) are investigated as potential tool to be used in medical treatment, by e.g. producing doctor’s reports, supporting personalized medicine or educating patients. However, limitations are broadly discussed addressing patient safety and ethical concerns due to false and misleading content. Therefore, LLMs face criticism among users not only towards their integration in the patient-provider-interaction, but also in its use in medical research and health care education. In the ongoing EXPOLS (Exploring the Potential of LLMs in Statistical Consulting) study, we address the question ‘What are the attitudes, fears and experiences regarding the integration of AI tools in the clinical/scientific work routine?’ Methods We implemented an online survey that will be accessible in 07/2024. All employees at the University and Medical Center Freiburg will be asked to participate in the survey via online media. We expect a sample size of n = 600-1,200. The survey combines published measurements (e.g. TRI 2.0, result expectation measure), as well as a self-designed instrument with 15 items aiming to measure fears and attitudes towards AI. Latter was developed within a multidisciplinary team making use of ChatGPT as item generator. We will investigate its psychometric properties using exploratory factor analysis and describe distribution characteristics. Results At the time of the conference, the project will be completed and both psychometric insights and content-related results will be reported. The results could have important public health implications, since attitudes towards AI will steer its integration in the medical and clinical routine. Conclusions The EXPOLS study makes a current inventory among medical scientists in Freiburg following a modern approach in instrument development by including ChatGPT as collegial advisor. Key messages • This study explores attitudes, fears and experiences towards the integration of AI tools in the work routine from medical and scientific staff at the University of Freiburg. • The findings might be crucial in determining the integration of AI based tools in the medical and clinical work routine.

Targeted initiatives to tackle health inequalities, integrating the Leeds Health and Care Workforce

Abstract Deprivation and poor health are significant challenges in Leeds, with the poverty gap growing in parts of the city. The Leeds One Workforce approach to narrowing inequalities (NI) was co-designed in 2021 building on the innovative partnership approach already visible in the city. Its phased approach has seen interventions put in place to boost the opportunities for people from marginalised communities to develop their skills and remove barriers to careers in health and care and has global relevance for other localities experiencing high deprivation. The overall NI approach is supported by a long-term and wide-reaching evaluation plan which mobilises our partner organisations and intends to amplify best practice in getting people into careers and supporting this group to develop within the health and care workforce. We will present findings from embedded evaluations of initiatives across the city, and individual case studies, from those who have accessed NI interventions in Leeds. These will explore the relationships and contributions of partnership organisations and presence of any unexpected barriers or facilitators to these interventions. Linking with third-sector organisations and creating accessible pre-employment opportunities to develop core working skills is a vital part of the Leeds approach to recruiting people from priority wards. Additionally, supporting people into careers in health and care which suit their values, interests and personal circumstances, in addition to employing organisations with flexibility and openness towards their employees at their core is a strong factor in recruiting and retaining from areas of deprivation. Partnership working is essential to tackling health inequalities in places of high deprivation to address individual and systemic barriers to securing employment, ensure the best chance of success for community outreach programmes, and maximise efficiencies by combining the efforts of local organisations. Key messages • Leeds, UK is transforming approaches to narrowing health inequalities through partnership working across health and social care education and employment. • Current and future best practice will be explored to demonstrate transferable NI approaches.

Real-world evaluation of a lipid transformation project in primary care settings

Abstract Background The National Health Service England Long-Term Plan (2019) highlights the need to optimise lipid management to reduce cardiovascular disease (CVD) risk. A collaborative project was funded between a local health service and an industry partner to review current practice and improve outcomes in a UK region through introduction of lipid management pathways, primary care education and patient-focused reviews to optimise lipid-lowering therapies among high-risk patient groups. Purpose The project aimed to increase prescribing of CVD risk reduction therapies such as high-intensity statins (HIST), escalation of therapy to achieve lipid-lowering treatment targets, to improve clinician knowledge and confidence in lipid management and provide benefits for local populations in reducing CVD risk. Methods Systematic patient searches across six Primary Care Networks (PCNs) prioritised high-risk patients for review. Community of Practice sessions were held to facilitate shared learning and problem-solving. A pragmatic, real-world evaluation was conducted to explore the impact of the new pathways and tools on prescribing outcomes and optimisation of lipid-lowering therapies. To examine the changes in HIST prescriptions, a statistical analysis of open-source prescribing data was undertaken between baseline (December 2021) and follow-up (December 2022) on over 39,000 eligible patient records. Qualitative interviews with clinicians from all participating PCNs and a thematic analysis of emerging themes was conducted in 2023. Results A paired sample t-test demonstrated a significant increase in the percentage of HIST prescribed, of the total number of statins prescribed, across the six PCNs between baseline and follow-up t(5) = -3.38, p = 0.01. Table 1 illustrates the changes at individual PCN level. Four of the six PCNs reached the National Institute for Health and Care Excellence minimum threshold of 65% target for HIST prescribing in statin prescriptions and three of these PCNs exceeded the optimal target of 75% HIST. An additional 600 patients were prescribed Ezetimibe (as therapy escalation or for statin intolerance). Through qualitative data, clinicians reported development of new skills and knowledge, leading to increased confidence in optimising lipid management with medication and lifestyle interventions. Conclusion The lipid transformation project demonstrated significant improvements in prescribing of lipid-lowering therapies and improved clinician competence in lipid management pathways and guidance. This has enabled sustainable improvements in lipid management and cardiovascular disease reduction in local populations.

COVID-19 drives medical education reform to promote "healthy China 2030" action plan.

In June 2019, the Chinese government proposed the Healthy China Action Plan (2019-2030) development strategy, which focuses on disease prevention and health promotion. It is expected that by 2030, the national health literacy level will be significantly improved, premature mortality caused by major chronic diseases will be significantly reduced, the average healthy life expectancy will be greatly improved, and the main health indicators of residents will enter the ranks of high-income countries. Unfortunately, at the end of 2019, COVID-19 began to break out in Wuhan, China, which had a huge impact on China's economy and people's health. A series of problems in China's health care and medical education were exposed in the prevention and treatment of the epidemic. How to reform medical education and build a medical talent training system with Chinese characteristics is the key to achieving China's Health 2030 strategy. This article will explore the direction of medical education reform in China under the background of the "Healthy China 2030" strategy and the post pandemic era.

Exploring Implementation of Reasonable Adjustments in Hospitals for People With Intellectual Disability: Using a Realist Lens.

To explore the factors influencing the implementation of reasonable adjustments in hospitals for people with intellectual disability: using a realist lens. A qualitative study using a realist lens. Data collection involved one focus group interview and three semi-structured interviews with healthcare professionals working in hospital or community settings in September 2023. Data were analysed using qualitative content analysis and findings were mapped to the Context and Implementation of Complex Interventions (CICI) framework across the dimension's context, implementation and setting. Healthcare professionals support the provision of reasonable adjustments in acute hospitals as a person-centred approach to caring for people with intellectual disability. While reasonable adjustments are evident in practice, they are mostly individual-level cases with little evidence of strategic system-level implementation. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework. Context factors spanned the domains of epidemiological (e.g., ageing population), socio-cultural (e.g., historical healthcare), political (e.g., lack of integrated care pathways) and ethical (e.g., provision of person-centred care). Implementation factors spanned the domains of strategies (e.g., leadership strategies), agents (e.g., liaison and advocacy roles) and outcomes (e.g., individual-level reasonable adjustments). The setting for the complex intervention was the acute hospital. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. A radical change is needed where implementation of reasonable adjustments in acute hospitals are broadened beyond isolated individual-level cases to system-level healthcare. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting in complex interventions such as reasonable adjustments and sets foundation for further implementation research in this area. Reasonable adjustments at the system-level within acute hospitals would promote person-centred care and help address the inequities and health disparities experienced by people with intellectual disability. This research uses a realist lens to explore the factors influencing the implementation of reasonable adjustments in acute hospitals for people with intellectual disability. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework across the dimensions of context (domains epidemiological, socio-cultural, political and ethical), implementation (domains strategies, agents and outcomes) and setting. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting of complex interventions such as reasonable adjustments and sets a foundation for further implementation research in this area. This research adhered to the Equator research reporting guideline: standards for reporting qualitative research. A parent of a child with intellectual disability was involved in the conduct of this research, specifically in the design, data collection and preparation of the manuscript.

Feasibility and Acceptability of a Palliative Care Intervention Among Older or Adults with Advanced CKD and their Caregivers.

In non-nephrology settings, specialty Palliative Care (PC) improves decision-making, patient's quality of life (QoL), advance care planning (ACP), and certain indicators of the quality of end-of-life (EoL) care. This pilot RCT explored the feasibility and acceptability of a PC intervention, CKD-EDU, for older adults ≥75 years with eGFR ≤25 ml/min and their caregivers. Participants randomized to the control group received standard nephrology care and routine kidney therapy (KT) education, while those randomized to CKD-EDU received a decision aid and met with a PC clinician up to three times to discuss KT decisions and EoL planning. Patients were assessed at baseline, 4-6, 12-14, and 24-26 weeks. Main outcomes included intervention feasibility and acceptability, decision-conflict, and patient QoL. The mediating effects of reduced decision conflict on improved QOL were explored, as were the effects of CKD-EDU on ACP, EoL treatment intensity and 6-month-hospitalization. Statistical analyses encompassed descriptive analyses, adjusted repeated-measure-models, mediation analyses and logistic-regression models. Among the 127 eligible patients screened, 58 (44%) consented: 30 were randomized to CKD-EUD and 28 to the control arm. All patients completed baseline assessments, and 89% completed at least one intervention session (n=26/29), underscoring intervention adherence and feasibility. Similarly, assessments completion rates at 4 (83%, n=45/54) ), 12 (93%, n=42/45), and 24 (95%, n=40/42) weeks were high. The intervention received over 85% acceptability ratings for all questions. Patients exposed to CKD-EDU exhibited significant improvement in decisional conflict scale scores (P = 0.003) at 4-6 weeks and improvements in QoL at 24-26 weeks (P=0.02). Exploratory analyses were not statistically significant in this pilot, but all effect sizes were in the predicted direction. This study demonstrates the feasibility and acceptability of CKD-EDU. A larger scale trial is warranted to assess its effectiveness in improving key outcomes important to patients and families.

French Version of the User Mobile Application Rating Scale: Adaptation and Validation Study.

Managing noncommunicable diseases effectively requires continuous coordination and monitoring, often facilitated by eHealth technologies like mobile health (mHealth) apps. The end-user version of the Mobile Application Rating Scale is a valuable tool for assessing the quality of mHealth apps from the user perspective. However, the absence of a French version restricts its use in French-speaking countries, where the evaluation and regulation of mHealth apps are still lacking, despite the increasing number of apps and their strong relevance in health care. This study aims to translate and culturally adapt a French version of the user Mobile Application Rating Scale (uMARS-F) and to test its overall and internal reliability. Cross-cultural adaptation and translation followed the universalist approach. The uMARS-F was evaluated as part through a cohort study using the French mHealth app "MonSherpa" (Qare). Participants were French-speaking adults with Apple or Android phones, excluding those with difficulty understanding French, prior app use, or physical limitations. They assessed the app using the uMARS-F twice (T1 and T2) 1 week apart. Scores for each section and overall were assessed for normal distribution using the Shapiro-Wilk test and presented as mean (SD), and potential floor or ceiling effects were calculated accordingly. Overall reliability was evaluated using intraclass correlation coefficients and internal reliability using Cronbach α. Concordance between the 3 subscales (objective quality, subjective quality, and perceived impact), 4 sections, and 26 items at T1 and T2 was evaluated using the paired t test (2-tailed) and Pearson correlation. In total, 167 participants assessed the app at both T1 and T2 (100% compliance). Among them, 49.7% (n=83) were female, and 50.3% (n=84) were male, with a mean age of 43 (SD 16) years. The uMARS-F intraclass correlation coefficients were excellent for objective quality (0.959), excellent for subjective quality (0.993), and moderate for perceived impact (0.624). Cronbach α was good for objective quality (0.881), acceptable for subjective quality (0.701), and excellent for perceived impact (0.936). The paired t tests (2-tailed) demonstrated similar scores between the 2 assessments (P>.05), and the Pearson correlation coefficient indicated high consistency in each subscale, section, and item (r>0.76 and P<.001). The reliability and validity of the measures were similar to those found in the original English version as well as in the Spanish, Japanese, Italian, Greek, and Turkish versions that have already been translated and validated. The uMARS-F is a valid tool for end users to assess the quality of mHealth apps in French-speaking countries. The uMARS-F used in combination with the French version of the Mobile Application Rating Scale could enable health care professionals and public health authorities to identify reliable, high-quality, and valid apps for patients and should be part of French health care education programs.

Improving Diabetes Education and Metabolic Control in Children Using Social Robots: A Randomized Trial

Robot engagement in healthcare has the potential to alleviate medical personnel workload while improving efficiency in managing various health conditions. This study evaluates the impact of robot-assisted education on knowledge acquisition and metabolic control in children with Type 1 Diabetes Mellitus (T1DM) compared to traditional education methods. A randomized controlled trial was conducted at the pediatric diabetes clinic of the University of Tabuk Medical Center, Saudi Arabia. Thirty children aged 5–15 years with T1DM were randomly divided into two groups: the robot education (intervention) group and the control education group. Both groups participated in six weekly one-hour educational sessions, with the intervention group interacting with a Pepper robot assistant and the control group receiving education from a qualified diabetes educator nurse. Knowledge was assessed using a 12-item questionnaire before and after the intervention, while metabolic control was evaluated through weekly mean home blood glucose measurements and HbA1c levels before and three months post intervention. The intervention group demonstrated a significantly greater improvement in knowledge scores compared to the control group (p &lt; 0.05). Weekly mean blood glucose levels were consistently lower in the intervention group throughout the study period (p &lt; 0.05 for all samples). Both groups showed a reduction in HbA1c levels after three months, with the intervention group exhibiting a greater mean decrease. The engagement of the Pepper robot in T1DM education for children resulted in improved knowledge acquisition and better metabolic control compared to traditional education methods. This approach may establish a foundation for “learning by interacting with robots” in long-term diabetes management. Further research with larger sample sizes and longer follow-up periods is warranted to confirm these findings and explore the long-term benefits of robot-assisted education in pediatric diabetes care.

Environmental Health Attitudes, Practices, and Educational Preferences: A National Survey of Reproductive-Aged Women in Canada

Prenatal exposures to environmental toxicants can adversely affect fetal and child development and lead to increased risk of chronic disease. While regulatory action is essential to reduce sources of environmental toxicants, prenatal care presents an opportunity to educate, mobilize, and support prospective parents to reduce exposures to such hazards. As the first phase of an interdisciplinary research collaboration to inform the development of prenatal environmental health education strategy in Canada, we surveyed reproductive-aged female individuals. The online survey (July–September 2021) yielded a nationally representative sample of 1914 reproductive-aged females living in Canada. The questionnaire topics addressed the respondents’ knowledge and perceptions of environmental health risks, preventive actions and related facilitators and barriers, information sources and preferences, reproductive history, and demographics. The analysis included bivariate and multivariate techniques. Our results suggest broad awareness among reproductive-aged females that exposure to toxicants can be harmful, and that reducing prenatal exposures can benefit child health. However, fewer than half of respondents felt that they had enough knowledge to take protective measures. Despite high levels of preference for prenatal care as an ideal context for learning about environmental health risks and protective measures, fewer than one in four respondents had ever discussed environmental health concerns with a healthcare provider. Our findings reveal a knowledge–action gap and a corresponding opportunity to improve environmental health education and advocacy in prenatal care in the Canadian context.

Hand-Washing Habits in a Sample of Spanish Soft Contact Lens Wearers.

Contact lens (CL) wear is a safe method for the correction of refractive errors. However, rare, severe ocular complications may occur which may lead to visual loss. As most of these complications are related to poor patient compliance with care and maintenance instructions, resulting in the contamination of hands, CLs and accessories, it was the purpose of this study to assess hand-washing habits in a sample of Spanish soft CL wearers. Hand hygiene was explored through a self-reported online survey and via an in-office practical demonstration in a subset of those users answering the survey. A total of 198 surveys were analyzed, and 18 CL users participated in the practical demonstration. Overall, hand-washing habits were not adequate, with 35 (17.8%) and 103 (52.2%) participants reporting not always washing their hands prior to CL or storage case manipulation, respectively. While 161 (81.3%) participants dried their hands after washing, 132 of these (82.1%) used non-disposable cloth towels. Participants receiving specific hand-washing information from their practitioners (141, or 71.1%) had better hand hygiene (p < 0.05). During the practical demonstration, 13 (72.2%) participants used water and soap to wash their hands, but only 3 (16.7%) displayed correct hand washing routines. Complete patient education, as well as practical reminders at all follow-up visits, are essential to ensure better hand hygiene in order to reduce the probability of ocular complications and to guarantee safe and satisfactory CL use.

Working With Traumatised Children During Traumatic Times: Residential Child Care Educators' Compassion Fatigue and Work Engagement

Working With Traumatised Children During Traumatic Times: Residential Child Care Educators' Compassion Fatigue and Work Engagement

Study the Level of Patients’ Service Satisfaction of Luang Prabang Provincial Hospital

The purpose of this research was to study the level of patients’ service satisfaction of Luang Prabang provincial hospital and comparison of patients’ service satisfaction classified by personal information of Luang Prabang provincial hospital. The samples of this study were 385 patients and their relatives who received services at the Luang Prabang provincial hospital. The research were using the questionnaire as a tool to collect data. Data were analyzed by using mean, standard deviation, T-test, F-test (One-way ANOVA). Finding indicated that the overall opinion on service satisfaction was at a median level patient in Luang Prabang provincial hospital. The respondent with different personal demographic data by sex, status, age, education, occupation, income, and types of patient care; were no different in service satisfaction; but the respondent with different personal demographic data by who services at each unit were different in service satisfaction.