Care Attitudes Research Articles

Knowledge, Attitude and Practice of Intimate Care and Its Association with Vaginal Discharge among Female Students in International Islamic University Malaysia (IIUM) Kuantan, Pahang, Malaysia

Background: Prioritizing cleanliness, especially in intimate areas, is crucial for personal health. Globally, around 10% of women suffer from genital infections, and 75% of them have experienced these infections before and the rate of occurrence is increasing in many developing countries. Many women intend to get screened for vaginal discharge problems, but due to taboos and other factors, they often do not follow through with the process. This cross-sectional study aimed to assess the level of knowledge, attitude and practice (KAP) towards intimate hygiene and the association between knowledge, attitude, and practices on intimate care and vaginal discharge among female students at International Islamic University Malaysia Kuantan (IIUMK). Methods: Two hundred and sixty respondents from different Kulliyyah were given a self-administered questionnaire. The data were analysed using SPSS software. Results: The finding showed that most of the respondents had good knowledge (87.5%) and practice (68.8%), and moderate attitude (53.6%) towards intimate care and its association with vaginal discharge. Conclusion: These findings of the study underscore the importance of targeted health education and awareness programs to further enhance intimate care practices and knowledge, particularly among younger women, married women, and those who are sexually active.

The Effect of Standardized Nursing Terminology Video Education on Intensive Care Unit Nurses’ Knowledge, Perception, Attitude, and Self-Efficacy in Evidence-Based Nursing Practice

Purpose: This study investigated the impact of standardized nursing terminology video education on Intensive Care Unit (ICU) nurses' knowledge, perception, attitude, and self-efficacy in evidence-based practice. Methods: ICU nurses with over 1 year of clinical experience participated in the study, with 26 in the experimental group and 27 in the control group. The experimental group received standardized nursing terminology videos, while the control group received pamphlets. Standardized tools were used to measure outcomes before and after the intervention in both groups. The collected data were analyzed using SPSS 28.0. Differences between the experimental and control groups were analyzed using the <i>x</i><sup>2</sup> test, Fisher's exact test, and Independent t-test. Changes within groups for outcome variables were analyzed using paired t-test and Wilcoxon signed-rank test, while group differences were analyzed using Independent t-test and Mann-Whitney U test. Results: Standardized nursing terminology education significantly improved perception, attitude, and self-efficacy in evidence-based practice among ICU nurses. Knowledge scores increased from 22.77±6.59 to 27.58±3.61 (<i>p</i><.001), perception scores from 24.65±5.78 to 28.54±3.84 (<i>p</i>=.001), attitude scores from 63.46±11.85 to 74.27±9.05 (<i>p</i><.001), and self-efficacy in evidence-based nursing scores from 53.12±10.85 to 58.12±9.51 (<i>p</i>=.007). However, there was no significant difference in knowledge improvement between experimental and control groups. Conclusion: This research provides evidence supporting the necessity of systematic education on standardized nursing language and its application in clinical practice to improve nurses' perceptions, attitudes, and self-efficacy in evidence-based nursing related to standardized nursing terminology.

The Role of Parenting in Cultivating Environmental Attitudes in Early Childhood in Digital Era

In this digital era, parenting plays an important role in shaping environmental awareness and nature-friendly behavior in early childhood. Children at this time are often exposed to technology from an early age, so excessive use can affect children's attitudes and behavior towards the environment. This study aims to identify the role of appropriate parenting on environmental care in the digital era in early childhood. This research uses a qualitative study with a literature review research method by collecting various scientific sources. This research aims to convey information about how the role of parenting can affect children's environmental care attitudes in the digital era. An important finding in this study is that the role of parents in shaping children's character, especially in the digital era, is very important. Parents must understand the characteristics of children in the digital era, apply appropriate parenting patterns and build effective communication with children. The importance of applying democratic and authoritative parenting, in helping children develop positive environmental awareness. Therefore, the importance of early religious and moral values education as an effort to instill environmental awareness in children. Parents' involvement in children's learning, both at home and at school, is a key factor in shaping environmental awareness in early childhood.

The critical role of education in shaping nurses' attitudes and intentions towards neonatal palliative care: A network analysis

BackgroundNeonatal palliative care is an essential component of comprehensive neonatal care; however, its implementation remains challenging worldwide, particularly in low- and middle-income countries due to limited resources, cultural barriers, and lack of training. ObjectivesThe aim of this study was to investigate the structural characteristics of neonatal nurses' attitudes towards neonatal palliative care and their intention to provide such care using network analysis to identify key influencing factors and interrelationships. DesignA multi-center cross-sectional study. SettingThe setting was 92 hospitals across 28 provinces in mainland China. ParticipantsA convenience sampling method was employed to recruit 893 neonatal nurses from October 2023 to February 2024. MethodsThe web-based survey included a sociodemographic questionnaire, the simplified Chinese version of the Neonatal Palliative Care Attitude Scale (NiPCAS), and a single question gauging participants' intention to provide neonatal palliative care. Network analysis techniques were used to examine the structural characteristics of the attitude network. ResultsA total of 767 valid questionnaires were received. The estimated network comprised 26 nodes representing individual NiPCAS items, with 150 non-zero edges out of a possible 325 connections. In-service education experience emerged as the most central and influential node, demonstrating the highest centrality (strength = 2.511; bridge strength = 3.144) and predictability (R2 = 0.475). This was followed by the ideal palliative care environment and staff support for palliative care. On average, 29.3 % of each item's variance could be accounted for by surrounding items. The strongest associations with the intention to provide neonatal palliative care were observed with beliefs about the necessity of palliative care in neonatal nurse education (edge weight = 0.29). ConclusionsThe findings highlight the pivotal role of in-service education experience in shaping nurses' attitudes towards neonatal palliative care, suggesting that educational interventions may significantly influence overall attitudinal structures. The strong associations between the intention to provide neonatal palliative care, and beliefs about the necessity of palliative care in neonatal nurse education, further reinforce the critical role of education in fostering positive attitudes and intentions. The significance of organizational and resource-related factors suggests that efforts to improve neonatal palliative care should focus on enhancing staff support and creating supportive work environments.

Comparison of the Short Time Effect of an Oral Hygiene Education in Four Sessions via Quantitative Light-Induced Fluorescence Technology Versus Disclosing Agents in Children: A Randomized, Crossover Clinical Trial.

The aim of this study is to compare the effectiveness of Qscan plus™ (AIOBIO, Seoul, Korea) based on quantitative light-induced fluorescence (QLF) technology and disclosing agents in oral health programs in children. A randomized crossover study was conducted for Korean children aged 6-11 years. Fifty-eight participants (29 to use Qscan plus™ first and 29 to use the disclosing agent first) were enrolled in this study. The participants were randomly divided into two groups. One group was assigned to brush with Qscan plus™, while the other group brushed with disclosed plaque visualization. One month later, the groups switched procedures. A total of 39 participants were analyzed, excluding those lost during the trial. There was no adverse event during the trial. The patient hygiene performance (PHP) index was used to assess oral hygiene status, and questionnaires about oral health behavior and attitude were completed. The data were analyzed using repeated-measure analysis of variance, with a significance level of p < 0.05. The PHP score decreased significantly on post-brushing and follow-up compared to baseline in both methods (p < 0.001), but there was no significant difference between the two methods. After oral hygiene education, participants' brushing time increased, and their oral care attitudes improved. More participants preferred the Qscan device to the disclosed plaque visualization because it is more easily noticeable. The Qscan device has a similar educational effect as disclosing agents, and can be used as a supplementary tool to encourage children in oral hygiene education.

Socio-Economic Aspect of a Person’s Image Representation in the Khakass Proverbial Picture of the World

Purpose. The article describes Khakass proverbs and sayings that represent the socio-economic relations of a person in society. Currently, many issues relating to the description of a person’s image through paremic expressions in the Khakass language have not yet received proper coverage, which determines the relevance of this study.Results. The authors have come to the conclusion that the socio-economic aspect is widely represented in Khakass proverbs and sayings. It is realized in the images of people, relatives, children, friends, enemies, masters, guests, neighbors, as well as men and women. The image of the people affirms the norms and rules of collectivism and peaceful coexistence in society. Children, parents and relatives are the main components of family relationships and always come to the aid of each other. The host is distinguished by his hospitality, and the guest, in turn, does not abuse this. As a rule, neighbors are endowed with such qualities as kindness and responsiveness. Based on the analyzed linguistic material, a man is endowed with a higher proportion of stereotypical characteristics: strength, stamina, strength of character, etc. And a woman appears as a kind, gentle and strong person.Conclusion. Economic relations reflect the ideas about a person’s financial condition, their work activity and the commodity-money sphere. The key to a person’s success in the Khakass society is adherence to the principles of col-lectivism, mutual assistance, tolerance, perseverance, education of the younger generation and caring attitude towards each other.

Prosocial Behavior of College Students: A Self-determination Perspective

Students’ prosocial behavior refers to self-determination motivation with the aim of helping others and a caring attitude. The purpose of this research study is to explore the role of college students’ prosocial behavior in terms of self-determination. The age of college students is in the early adulthood category. The research approach in this study is to use a qualitative approach with literature study techniques. The result of this study is that the role of students’ prosocial behavior in terms of self-determination is the existence of students’ autonomous interest and motivation to behave prosocially in real terms. Autonomous prosocial motivation is manifested as the regulation of prosocial behavior determined by the individual himself, the interest and pleasure to help others without coercion from others. However, individuals who are motivated to be prosocial because they want to avoid guilt and shame may cause individuals to experience more negative emotions. This study implies that the role of autonomous motivation as part of self-determination theory becomes strong evidence in individuals achieving desired goals, and specifically also evidence of individuals performing highly prosocial behavior. Keywords: college students, prosocial behavior, self-determination

Compassion fatigue and palliative care in neonatal nurses.

Neonatal intensive care units (NICUs) emerge as one of the areas where palliative care is most needed. This study was conducted to examine the attitudes and compassion fatigue levels of NICUs nurses working in Şanlıurfa, where the fertility rate and infant mortality are highest in Turkey, toward palliative care. This study was conducted in descriptive type. The research was carried out with 204 (85%) nurses who agreed to participate in the research between October 2022 and February 2023, out of 240 neonatal intensive care nurses working in the NICU of 2 training and research hospitals and a university hospital in Şanlıurfa. The data of the study were collected using an Introductory Information Form, the Neonatal Palliative Care Attitude Scale, and the Compassion Fatigue Short Scale. Nurses; compassion fatigue scale mean score was 61.46 ± 26.64, palliative care scale mean score was 3.13 ± 0.74 for organization subdimension, 2.85 ± 0.73 for resources subdimension, and 3.08 ± 0.89 for clinician subdimension. In the results of the study, 8 barriers (parents do not participate in decisions, there is not enough staff, lack of time to spend with the family, lack of policies/rules in institutions for palliative care, lack of education and communication, society's beliefs, nurses' personal attitudes toward death, and lack of appreciation of past experiences with palliative care) and 6 facilitators (Nurses' ability to express their perceptions, views and beliefs about palliative care, to participate and support palliative care, to inform parents, to provide counseling, adequate physical conditions) for palliative care were determined. While it was determined that nurses had a slightly below moderate level of compassion fatigue and a close attitude toward organization and resources toward palliative care, it was determined that ethical conflict toward palliative care was high in clinical subdimension scores. It is recommended that all nurses working in the NICU obtain certificates, improvements in resources such as personnel and equipment, improvements in the shift work system and development of policies/rules in institutions for palliative care.

Knowledge, Attitude, and Practice (KAP) and Perceptions of DFU and Foot Care among Doctors of Various Specialties in Western Maharashtra, India

Knowledge, Attitude, and Practice (KAP) and Perceptions of DFU and Foot Care among Doctors of Various Specialties in Western Maharashtra, India

Implementing and Evaluating a Pilot Interprofessional Training Program to Engage Health Care Teams in Cost of Care Conversations.

This study evaluated the impact of Financial and Insurance Navigation Assistance-Training - a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology-oncology clinic. A pre-post study design was used to evaluate the impact of Financial and Insurance Navigation Assistance-Training on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected via surveys administered at baseline/pretraining, immediate post-training, and 12-month post-training. Most health care team members (n= 21) reported improvement in their knowledge of available financial (66.7%) and legal resources (86.7%) and ability to address social needs (93.3%), financial needs (93.3%), and facilitate CoC conversations with patients and caregivers (66.7%). Improvements in attitudes and behaviors toward engaging in CoC conversations, screenings, and referrals were relatively improved as a result of the training. However, there was a lower positive rate for actual behaviors around routine screening and initiating discussions on out-of-pocket costs, suggesting a need to address barriers. Study findings highlight the importance of interprofessional education in helping health care teams address social determinants of health through effective CoC conversations.

Knowledge, Attitudes and Confidence in Providing Dementia Care to Older Adults Among Nurses Practicing in Hanoi, Vietnam: A Cross-Sectional Study.

Nurses' competencies are crucial in providing effective dementia care in healthcare settings for older people. Understanding nurses' current knowledge, attitudes and confidence in this area is essential for developing education programmes for healthcare professionals to improve patient care. The purpose of this study was to assess the knowledge, attitudes and confidence related to providing dementia care among nurses practicing in geriatric hospital wards and nursing homes in Hanoi, Vietnam. A total of 269 out of 313 (response rate was 86%) full-time nurses working at six geriatric wards in hospitals and nursing homes in Hanoi were surveyed using three self-administered questionnaires: the Dementia Knowledge Assessment Scale (DKAS), Dementia Attitude Scale (DAS) and the Confidence in Dementia Scale (CODE). Multiple regression models were constructed to identify factors associated with dementia care knowledge, attitudes and confidence. The overall mean scores of nurse's knowledge, attitudes and confidence were 28.1 ± 8.0, 102.1 ± 13.4 and 28.3 ± 6.4, respectively. A positive correlation was reported between the knowledge and attitude scores and between the attitudes and confidence scores. Greater seniority (β: 0.29; 95% CI: 0.03-0.56) and having learned information through colleagues or experts (β: 3.02; 95% CI: 0.88-5.16) were associated with better dementia knowledge. A higher level of dementia training desirability was associated with increased knowledge (β: 0.74; 95% CI: 0.28-1.20) and favourable attitudes (β: 0.94; 95% CI: 0.15-1.74), whereas frequent exposure to dementia cases was associated with higher confidence (β: 3.56; 95% CI: 1.39-5.73) and more favourable attitudes (β: 3.96; 95% CI: 0.27-7.66). Our study highlights deficits in knowledge, low levels of social comfort in nurses' attitudes towards people with dementia and a lack of confidence in providing effective care among nurses practicing in healthcare settings for older adults in Hanoi, Vietnam. With the ageing of the population and with increasing numbers of persons living with dementia, our findings suggest the importance of improving the training of nurses to specifically address these deficits. Multidisciplinary consultation meetings need to be encouraged in the healthcare workplace setting as well as ensuring the presence of qualified counsellors for care teams working with older adults in non-hospital settings. Training about non-cognitive symptoms of dementia and demonstrating effective verbal and non-verbal communication skills is critical and should be integrated into nurse's educational training.

Managing Postembolization Syndrome Through a Machine Learning-Based Clinical Decision Support System: A Randomized Controlled Trial.

Although transarterial chemoembolization has improved as an interventional method for hepatocellular carcinoma, subsequent postembolization syndrome is a threat to the patients' quality of life. This study aimed to evaluate the effectiveness of a clinical decision support system in postembolization syndrome management across nurses and patient outcomes. This study is a randomized controlled trial. We included 40 RNs and 51 hospitalized patients in the study. For nurses in the experimental group, a clinical decision support system and a handbook were provided for 6 weeks, and for nurses in the control group, only a handbook was provided. Notably, the experimental group exhibited statistically significant improvements in patient-centered caring attitude, pain management barrier identification, and comfort care competence after clinical decision support system implementation. Moreover, patients' symptom interference during the experimental period significantly decreased compared with before the intervention. This study offers insights into the potential of clinical decision support system in refining nursing practices and nurturing patient well-being, presenting prospects for advancing patient-centered care and nursing competence. The clinical decision support system contents, encompassing postembolization syndrome risk prediction and care recommendations, should underscore its role in fostering a patient-centered care attitude and bolster nurses' comfort care competence.

Effectiveness of End-of-Life Care Debriefing for Intensive Care Unit Nurses

Purpose : This study aimed to determine the effectiveness of end-of-life care debriefing as an intervention to reduce moral distress among intensive care unit (ICU) nurses after end-of-life care. Methods : This quasiexperimental study included 104 nurses (46 in the control group and 58 in the intervention group) working in three medical ICUs and two surgical ICUs. The data collection period was from September 1, 2017, to January 31, 2018, and end-of-life care debriefing in the intervention group was implemented over three months. Debriefings were conducted in groups or individually, with eight people participating in three or more debriefings. Comparisons of end-of-life care stress, end-of-life care attitudes, and wellness between the two groups were performed using an ANCOVA. Satisfaction with the debriefing was analyzed using descriptive statistics. Results : End-of-life care stress and wellness did not differ between the groups, but there was a significant difference in end-of-life care attitudes. Overall, 50% of the participants were satisfied with the debriefing. Conclusion : Based on the finding that end-of-life care debriefing has a positive impact on ICU nurses’ attitudes toward end-of-life care, it can be used as an effective measure to reduce nurses’ moral distress. An institutional debriefing system should be established and operationalized.

Implications Of The Implementation Of Clinical Authority On Improving The Quality Of Nursing Services

Literature studies indicate that implementing clinical authority can enhance the quality of nursing care. However, many hospitals still have not fully applied clinical authority aligned with nurses' career paths. This research explores the impact of clinical authority on nurses' performance, both directly and indirectly, through situational leadership in Hospital X. Using a mixed-method approach with a parallel concurrent triangulation model, the study collected quantitative data via questionnaires from 300 nurses using total sampling. Descriptive crosstab analysis revealed no significant differences in perceptions of clinical authority, performance, and situational leadership based on individual characteristics. Structural Equation Modeling showed that clinical authority positively and significantly affects nurse performance. Qualitative data were gathered through focus group discussions with 13 nurses and semi-structured interviews with senior nursing managers. Thematic analysis identified six key themes: positive impacts on performance, the role of situational leadership styles, strategies to optimize nursing services, encountered obstacles, competitive challenges, and motivation to enhance care. The qualitative findings indicated that clinical authority fosters nurses' responsibility, adherence to standards, mutual trust, teamwork, and improved communication and caring attitudes. The corroboration of quantitative and qualitative analyses demonstrated alignment, confirming that clinical authority significantly influences nurse performance. To improve nursing care quality, hospitals are encouraged to implement structured career paths for nurses, ensuring that clinical authority is supported at every level

"Another tool for the sexual health toolkit": U.S. health care provider knowledge and attitudes about doxycycline post-exposure prophylaxis (doxy-PEP) to prevent bacterial sexually transmitted infections among men who have sex with men.

Doxycycline post-exposure prophylaxis (doxy-PEP) reduces chlamydia, gonorrhea, and syphilis infections among men who have sex with men (MSM) and transwomen (TW). Perspectives of health care providers (HCPs) regarding doxy-PEP can inform implementation efforts. From August 2022 to January 2023, HCPs were recruited from 13 cities with high sexually transmitted infection (STI) rates for semi-structured, in-depth interviews about their awareness of and attitudes towards doxy-PEP for STI prevention. HCPs were purposively sampled to include people with experience prescribing PrEP and provision of care to MSM. Interviews were conducted virtually via Zoom. Transcripts and debrief reports were analyzed using a directed content analysis approach to explore knowledge, attitudes, and beliefs about doxy-PEP. Among 30 HCPs, almost half (47%) were between 31-40 years of age, 53% identified as male, and 47% reported their sexual orientation as gay or queer. Half (53%) of participants practiced in the South, 43% had >100 MSM in their clinic panel, and 17% had previously prescribed doxy-PEP. We identified four overarching themes: 1) HCPs expressed positive attitudes towards doxy-PEP; 2) antimicrobial resistance concerns limit enthusiasm for some HCPs; 3) additional data about the long-term safety of doxy-PEP would improve their confidence; and 4) development of guidelines would facilitate the prescription of doxy-PEP, including eligibility, dosing instructions, and treatment management. HCPs were motivated to prescribe doxy-PEP with almost 20% already having prescribed it. Guidelines and data about long-term safety, especially antimicrobial resistance, would facilitate introduction of doxy-PEP into clinical practice.

The Implementation of the Spirit of National Defense and Students Caring Attitude Through Extracurricular Scouting Activities

The objectives of this research include: 1) To find out the general description of the implementation of the spirit of state defense of students at SMK Negeri 1 Pangkep. 2) To find out the general description of the caring attitude of students at SMK Negeri 1 Pangkep. 3) To find out and analyze the implementation of the spirit of state defense and the caring attitude of students through extracurricular scouting activities at SMK Negeri 1 Pangkep. The type of research chosen is qualitative narrative using the case study method. This research was conducted at SMK Negeri 1 Pangkep, South Sulawesi Province. in the third week of May 2024 to the fourth week of July 2024. Data collection techniques in this study through observation, interviews and documentation. The results showed that the implementation of the spirit of state defense with its indicators was well implemented, namely (1) love of the homeland, (2) Awareness of the Nation and State, (3) Belief in the State Ideology Pancasila, (4) Willing to Sacrifice for the Nation and State, not yet optimal (5) Have the Ability to Defend the Country. Then the implementation of the social care attitude of students at SMK Negeri 1 Pangkep is included in the category that has been well implemented through indicators: (1) honesty, (2) compassion, (3) humility, (4) friendliness, (5) kindness, and (6) always helping others. And in general, the relationship between the spirit of state defense, caring attitudes and extracurricular activities of students at SMKN 1 Pangkep through indicators, namely (1) discipline, (2) independence is still not optimal, (3) having noble character and noble character, (4) having the spirit of Pancasila, being loyal and obedient to the Republic of Indonesia, still needs to be improved (5) attitude of togetherness, (6) paying attention to common interests, (7) polite behavior, (8) respect for others, (9) cooperation attitude, and (10) sense of belonging.

Skills and competences of sexuality educators. Evidences from a qualitative research in Italy

Abstract Background The scientific literature recognizes the strategic role of educators in sexuality education projects in schools. If, however, there is often a discussion about the most effective professional figure (teachers, school experts or external experts), there is a little attention to the skills and competences that an educator should possess and to which he or she must be trained. Adopting a Comprehensive Sexuality Education (CSE) approach, which is evaluated as the most effective, it is necessary to consider a skill set for educators that should not be limited to the knowledge in the area of sexual health promotion and risk prevention. Methods In order to build evidence-based competencies and skills, a qualitative study was conducted. A total of 72 educators involved in school-based CSE interventions in 4 Italian Regions, in 24 middle and secondary schools (68 classes), during 2 consecutive school years were enrolled. Before, during, and after the activities in the classrooms, qualitative feedback was collected, through reflective journals written by educators themselves. These data were analyzed through a qualitative approach, according to the principles of empirical phenomenology. Results The phenomenological evidences confirm the need to overcome the conception of educator as instructor equipped only with knowledge in the field of sexual health. It is considered fundamental to possess and develop pedagogical competences and skills, such as: caring attitude, teaching skills, theoretical awareness, capacity to manage the unexpected. Moreover, educators reported the necessity of an initial and continuous training on these dimensions considered as the most challenging. Conclusions The research confirms the complexity of the competency profile of CSE educators. Therefore, their professional development should include tailored designed multi-disciplinary training programs, with particular attention to the pedagogical dimension. Key messages • Comprehensive sexuality education requires an adequate professional figure intended not as an instructor aimed only at risk prevention and health promotion, but as a real caring educator. • Pedagogical skills and competences should be included in the training processes for sex educator, through adequate activities.

Lyme disease in UK primary care: a knowledge, attitude and practice survey.

Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding general practitioner (GP) experience with diagnosis and treatment. This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England. Online KAP survey on Lyme disease for UK based practising GPs. An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK based research networks, professional societies and via social media. 191 complete responses were analysed (England n=130, Scotland n=61). The Scotland-based respondent group had more relevant consultations in the previous 3 years. Respondents from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for Lyme disease and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with Lyme disease by both respondent groups for the former and England-based respondents for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses. Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based respondents' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.

Formal and Composition Stability of Ekaterinburg Historical Center

Preserving the city structural elements of architectural and urban planning culture, is currently the most important task. It is necessary to achieve a sustainable development, preserve historical heritage and cultivate a careful attitude towards the culture of the Russian Federation. It is important to take into account the morphological integrity of the historically developed urban environment, which is considered through the prism of formal compositional stability. The article presents the analysis of the architectural and urban development to identify the most stable structural elements of Yekaterinburg. Systematic and historical approaches are the methodology of the study, which allows to consistently analyze the extensive material using urban planning and retrospective analysis.The article proposes periodic formation and development of the structural elements of the historical center from the beginning of the city formation to the present, including six periods: pre-reform, post-reform, pre-war period, war and post-war period, developed socialism and perestroika, postSoviet period. Structural elements of the historical center are reconstructed, reflecting the evolution of the formal and composition aspect of the city in each period of its historical development. Lost and most stable structural elements of the city are identified and can be protected as heritage.

Navigating Burnout: Exploring Pharmacists’ Attitudes toward Patient Care

Abstract Background The study aimed to investigate the link between pharmacists’ burnout levels and their attitudes toward patient care, crucial for addressing burnout’s impact on service quality and fostering positive patient interactions. Methods The study utilized the Shirom-Melamed Burnout Questionnaire (SMBQ) to assess burnout levels among 442 community pharmacists. Additionally, the five-point Likert Scale of General Attitudes and Beliefs of Pharmacists about their Work with Patients (SOSUF), developed by the authors, was employed to measure pharmacists’ cognitive, affective, and behavioral attitudes toward patient care. Statistical analyses involved correlation and regression procedures. Results Moderate burnout levels among pharmacists observed (mean SMBQ score: 4.18 ± 0.96, range: 1.45 to 6.55), alongside generally positive attitudes toward patient care (mean SOSUF score: 3.44 ± 0.37). Regression analysis revealed a moderate positive correlation between burnout and attitudes toward patient care (R = 0.336, R Square = 0.113, Adjusted R Square = 0.111, p &amp;lt; .001). Burnout impacted pharmacists’ attitudes, notably in perceptions of patients not appreciating their efforts (r = -0.317, p &amp;lt; 0.001), finding patient interactions challenging (r = -0.409, p &amp;lt; 0.001), and disregarding their advice (r = -0.333, p &amp;lt; 0.001). Conclusions Despite generally positive attitudes toward patient care, burnout moderately correlates with negativity, notably impacting perceptions of patient appreciation, interaction challenges, and adherence to advice. Addressing burnout is crucial for maintaining positive patient care attitudes and ensuring quality service delivery. Key messages • Burnout impacts pharmacists’ patient care attitudes, emphasizing the need for intervention to enhance healthcare delivery. • Implementing strategies to reduce burnout among pharmacists can improve patient care outcomes.