Cross-sectional Survey Research Articles

Current Practices for Delivering New Diagnosis Education at Children's Oncology Group Institutions: A Report From the Children's Oncology Group.

The Children's Oncology Group (COG) Nursing Discipline developed expert consensus recommendations and resources to guide the delivery of new diagnosis education across its member institutions. Current new diagnosis education practices across COG member institutions are unknown. To understand current new diagnosis education practices across COG member institutions. We conducted a cross-sectional survey of COG nurses between July and October 2023 to elicit current practices to deliver new diagnosis education to families across COG institutions. Data were collected and managed using REDCap electronic data capture tools. Individual responses from single institutions were averaged as a single institution-level response. Respondents included 146/227 (64.3%) COG institutions across 5 countries. Advanced practice nurses and nurse educators have primary responsibility for new diagnosis education at 28.1% and 26.7% of institutions, respectively. Less than half (42.4%) of institutions have a clearly defined process for delivering new diagnosis patient/family education. Almost all (88.2%) institutions use the COG Family Handbook; 64.7% use the COG New Diagnosis Guide, and 41.9% use the COG KidsCare app to support the delivery of new diagnosis education. More than half (61.5%) of institutions use checklists to facilitate the delivery of new diagnosis education, with 81.6% of large institutions versus 44.1% of small institutions reporting the use of checklists ( P = .004). There is variability in current new diagnosis education practices across COG institutions. These findings highlight opportunities for implementing standardized approaches aligned with expert consensus recommendations for the delivery of new diagnosis education.

The Perceptions of Overweight and Obese Individuals Regarding Weight-Loss Dietary Supplement Advertisements: A Pilot Cross-Sectional Survey

Introduction: The negative health consequences of overweight and obesity underscore the importance of weight loss in mitigating these issues. Weight-loss dietary supplements (DS) are highly sought-after by overweight or obese individuals, with widespread advertisements promoting their use. This study aimed to investigate the perceptions of overweight and obese individuals regarding weight-loss DS advertisements. Methods: Over a six-week period from 5th April to 17th May 2023, an online pilot cross-sectional study was conducted targeting overweight and obese individuals in Malaysia. The study utilized a convenience sampling method to recruit participants. Results: Of the 146 participants, most were female (82.9%), 53.4% were overweight, and 46.6% were obese. Most respondents believed that weight-loss DS advertisements often contained exaggerated, unverified, and misleading information. Nearly 90% acknowledged that exaggerated advertisement claims might influence consumers, and about 85% believed that people are influenced to buy frequently advertised weight-loss DS. Despite these perceptions, about 40% reported purchasing a weight-loss DS after seeing such a product in an advertisement, while less than 50% of those who purchased weight-loss DS sought information from healthcare professionals. Conclusion: The study found that almost 40% of the respondents had purchased a weight-loss DS after seeing such products being advertised. Individuals with higher income, married people, and older respondents appeared more likely to purchase a weight-loss DS. These findings underscore the necessity for stricter regulatory frameworks and comprehensive consumer education initiatives to protect consumers from misleading information and unethical marketing tactics within the weight-loss DS industry. Implementing targeted public health interventions could further safeguard consumers from the risks associated with exaggerated product claims.

Team and Electronic Health Record Features and Burnout Among Family Physicians.

In the context of a growing volume of electronic health record (EHR)-based work and post-COVID-19 pandemic staffing pressures, health system leaders need an up-to-date understanding of changes in family physicians' experiences of burnout, determinants of burnout, and how to enhance the family physicians' experience. To evaluate the association of family physicians' perceptions of team structure and EHR experiences with burnout and identify modifiable practice structure factors associated with team and EHR experiences. A serial cross-sectional survey study was conducted from December 1, 2016, to October 24, 2023. Participants included family physicians seeking continuous certification through the American Board of Family Medicine. Yearly prevalence of burnout, perceived team efficiency, perceived EHR proficiency, and perceived EHR time were the outcomes. Multivariable logistic regression models subsequently assessed associations of team- and EHR-related experiences with burnout and the association between practice structure and staffing features in team efficiency and EHR time. The study included 10 315 physicians who answered the subset of questions related to burnout on the American Board of Family Medicine's Continuous Certification Questionnaire between 2017 and 2023. Among the sample, 5584 respondents (54.1%) were male, and the median age was 50 (IQR, 43-58) years. The proportion of physicians reporting burnout ranged from 37.9% in 2017 to a peak of 42.8% in 2022, which did not represent a significant temporal trend (P = .91). Appropriate home EHR use was associated with 0.58 (95% CI, 0.53-0.64; P < .001) times the odds of burnout, while high team efficiency was associated with 0.61 (95% CI, 0.56-0.67; P < .001) times the odds of burnout. Physician collaboration with a registered nurse was associated with greater odds of high team efficiency (odds ratio [OR], 1.35; 95% CI, 1.22-1.50). Collaboration with a physician assistant was associated with greater odds of appropriate home EHR time (OR, 1.13; 95% CI, 1.03-1.24). In this national cross-sectional study of US family physicians, appropriate time spent on the EHR at home and primary care team efficiency were associated with lower odds of burnout. These findings suggest that clinical leaders and policymakers should focus on optimizing primary care team support and family physicians' EHR experiences to enhance the sustainability of primary care practice.

Twenty-year trend in the prevalence of increased cardiometabolic risk, measured by abdominal obesity, among Spanish children and adolescents across body mass index categories.

Identifying children and adolescents with cardiometabolic risk at an early stage is crucial for effective treatment and prevention. From a practical perspective, this could be accomplished by assessing the presence of abdominal obesity, which serves as a surrogate indicator of increased cardiometabolic risk and is easy to measure. However, the assessment of abdominal obesity via waist circumference has not yet become a standard procedure in pediatric healthcare. The present study aimed to analyze the secular trends in increased cardiometabolic risk, as indicated by waist circumference among Spanish children and adolescents. This study included 4861 children and adolescents aged 8 to 16years from two nationwide representative cross-sectional surveys, the EnKid study and the PASOS study, conducted in 1998-2000 and 2019-2020, respectively. Anthropometric variables were measured in both surveys by trained personnel. Three different waist-to-height (WHtR) cutoffs were used to define abdominal obesity as criteria for cardiometabolic risk. BMI categories were defined according to the IOTF and WHO growth charts. Abdominal obesity [waist to height ratio (cm/cm) > 0.49] significantly increased from 40.7 to 56.1% and 93.8 to 97.2% in participants with overweight and obesity, respectively, between 1998-2000 and 2019-2020 (p < 0.05). Logistic regression analysis, adjusted for sex and age, revealed that the odds of being at increased cardiometabolic risk in 2019-2020 was 1.99 (95% CI 1.48-2.67) in participants with overweight in comparison with 1998-2000. The effect size was comparable among the three WHtR criteria for abdominal obesity or the BMI categories according to IOTF and WHO boundaries. The prevalence of Spanish children with increased cardiometabolic risk, identified by abdominal obesity, significantly increased among those with overweight during the last two decades. This finding underlines the need of including the measurement of waist circumference as a standard procedure in pediatric practice.

Synthesizing customer satisfaction and loyalty through contractors’ service quality and brand image

PurposeThe present study developed an integrated model to evaluate the relationship between service quality, brand image, customer satisfaction and customer loyalty in the context of Myanmar’s construction industry.Design/methodology/approachData on the study variables were gathered from a cross-sectional survey of 210 client organizations that own private buildings in Myanmar. A factor analysis-validated structural equation model was developed to assess the research hypotheses and conceptual framework.FindingsThe results supported an integrated model in which brand image partly mediated the effects of service quality on customer satisfaction. Besides, the brand image and customer satisfaction fully mediated the impact of service quality on customer loyalty. Brand image exerted indirect effects on customer loyalty through customer satisfaction. The study further identified the direct effects of service quality on brand image and customer satisfaction, brand image on customer satisfaction and customer satisfaction on customer loyalty.Originality/valueWhile prior studies have explored service quality in the construction industry, no integrated model has been developed to identify the relationship between service quality, brand image, customer satisfaction and customer loyalty in construction project settings. This study filled this critical gap in the literature by offering a unique perspective on the study variables and their interrelationships.

Biomedical researchers' perspectives on the reproducibility of research.

We conducted an international cross-sectional survey of biomedical researchers' perspectives on the reproducibility of research. This study builds on a widely cited 2016 survey on reproducibility and provides a biomedical-specific and contemporary perspective on reproducibility. To sample the community, we randomly selected 400 journals indexed in MEDLINE, from which we extracted the author names and emails from all articles published between October 1, 2020 and October 1, 2021. We invited participants to complete an anonymous online survey which collected basic demographic information, perceptions about a reproducibility crisis, perceived causes of irreproducibility of research results, experience conducting reproducibility studies, and knowledge of funding and training for research on reproducibility. A total of 1,924 participants accessed our survey, of which 1,630 provided useable responses (response rate 7% of 23,234). Key findings include that 72% of participants agreed there was a reproducibility crisis in biomedicine, with 27% of participants indicating the crisis was "significant." The leading perceived cause of irreproducibility was a "pressure to publish" with 62% of participants indicating it "always" or "very often" contributes. About half of the participants (54%) had run a replication of their own previously published study while slightly more (57%) had run a replication of another researcher's study. Just 16% of participants indicated their institution had established procedures to enhance the reproducibility of biomedical research and 67% felt their institution valued new research over replication studies. Participants also reported few opportunities to obtain funding to attempt to reproduce a study and 83% perceived it would be harder to do so than to get funding to do a novel study. Our results may be used to guide training and interventions to improve research reproducibility and to monitor rates of reproducibility over time. The findings are also relevant to policy makers and academic leadership looking to create incentives and research cultures that support reproducibility and value research quality.

Treating the perimenopause in the UK armed forces: a mixed methods review exploring the confidence of general practitioners.

Access to high-quality perimenopause (PMP) care for UK Armed Forces (UKAF) personnel is crucial, given the increasing proportion of women aged 40-55. However, due to the lack of exposure of General Practitioners (GP) to the PMP in Defence Primary Health Care (DPHC), there are concerns about the confidence in PMP management, particularly in prescribing hormone replacement therapy (HRT). To assess the confidence of GPs working in DPHC in the management of the PMP. This study employed a mixed methods approach and included all GPs (Uniformed and Civilian) working in DPHC. A cross-sectional survey gathered quantitative data on demographics, views on perimenopause care, and self-rated confidence levels in managing the perimenopause among Defence GPs. Semi-structured interviews of purposefully sampled respondents was thematically analysed to explore this further. There were 164 responses from 542 Defence GPs (response rate 30.3%). The majority of respondents expressed confidence in managing the perimenopause but reported lower confidence levels in prescribing HRT for younger women and initiating testosterone. Factors influencing confidence included recent perimenopause continuing professional development (CPD), GP gender, and exposure to perimenopause cases. Semi-structured interviews provided deeper insights into GP characteristics, CPD, and awareness of the PMP. Women's health hubs providing PMP care and experiential education were strongly supported. While the study identified gaps in confidence among Defence GPs, particularly in certain aspects of perimenopause management, similar to those found in NHS GPs. CPD and case exposure were important predictors of confidence, with strong support for regional women's health hubs to optimise PMP care. Further research is warranted to explore strategies for bridging confidence gaps and improving perimenopause care delivery within the UKAF context.

The effects of individual and team resilience on psychological health and team performance: a multi-level approach

AbstractThe challenges that individuals and teams face in complex and unstable environments can negatively affect individuals’ psychological health and team performance. In such contexts, resilience becomes an essential resource for both teams and individuals. It is therefore important to develop a comprehensive approach of resilience at work. The aim of this study is to examine the concurrent and differential effects of individual and team resilience, at both the within-group and between-group levels, on team performance and psychological health (i.e., operationalised as stress and subjective well-being). A cross-sectional survey of 530 employees nested within 68 teams was conducted. Multilevel Structural Equation Modelling analyses indicated that both individual resilience and team resilience at the within-group level were related to psychological health and team performance. Individual resilience was more strongly related to psychological health than to team performance, while the opposite was the case for team resilience. At the between-group level, individual resilience was related to psychological health, while team resilience was related to team performance. These findings suggest that resilience comprises of several components that are equally important but in different ways. Having resilient individuals in a team matters more for psychological health and ensuring that teams sustain a resilient group dynamic is more important for team performance.

Gout Flare Burden in the United States: A Multiyear Cross-Sectional Survey Study.

The objective of this study was to assess the burden of gout flares and examine associated patient characteristics and outcomes in a sample of US adults. Data were collected via an online survey of US adults ≥18 years using a random stratified sampling framework. Participants with gout completed questions about treatments, serum urate (SU) levels, severity, satisfaction with control, and gout flares. All participants completed the Veterans RAND 12-Item Health Survey, the Generalized Anxiety Disorder 7-Item Scale, and the Patient Health Questionnaire 9-Item Scale. Data were summarized using descriptive statistics. Multivariable-adjusted logistic regression analyses examined factors predictive of reporting gout flares to a physician. A total of 933 participants met the study criteria for having gout. Those with gout tended to be older (58.3 [SD 13.3] years vs 45.4 [SD 16.1] years; P < 0.001), male (76.3% vs 46.9%; P < 0.001), White (80.5% vs 76.8%; P = 0.01), and married or living with their partner (58.9% vs 52.8%; P < 0.001) compared with those without gout (n = 30,146). The total gout flare burden for those with gout was 6.6 gout flares per year. Nearly 72% of gout flares were either not reported to physicians or pretreated or prevented. Characteristics of those who were less likely to report gout flares included being younger, being less educated, having a lower Charlson Comorbidity Index score, not being diagnosed with gout by their doctor, and not taking a urate-lowering therapy. This study confirmed that gout flares are common in US adults with gout and found that gout flares are underreported. Reliance on clinical documentation of physician-reported gout flares is insufficient to assess the true patient burden of gout.

Relationships Among eHealth Literacy, Physical Literacy, and Physical Activity in Chinese University Students: Cross-Sectional Study.

eHealth literacy is critical for evaluating abilities in locating, accessing, and applying digital health information to enhance one's understanding, skills, and attitudes toward a healthy lifestyle. Prior research indicates that enhancing eHealth literacy can improve health behaviors such as physical activity (PA). Physical literacy (PL) refers to the ability to develop sustainable PA habits, taking into account various aspects of an individual. Notably, university students have shown a decline in PA and possess low PL levels. However, the connection between eHealth literacy and PL in this demographic has not been extensively studied, and it remains uncertain whether PA acts as a mediator between eHealth literacy and PL. This study examines the extent to which PA mediates the link between eHealth literacy and PL in Chinese university students and explores gender differences in these variables. In February 2022, a cross-sectional survey was administered to 1210 students across 3 universities in China. The instruments used were the Perceived PL Instrument, the International Physical Activity Questionnaire, and the Chinese version of the eHealth Literacy Scale. Correlations between eHealth literacy, PA, and PL were analyzed using Pearson product-moment correlation and multiple linear regression, while mediation models helped elucidate the interactions among the 3 variables. The response rate for the study was 92.9% (1124/1210). In the mediation analysis, eHealth literacy showed a significant direct effect on PL, with a coefficient of 0.78 (β .75, SE 0.02; P<.001). Moderate to vigorous physical activity (MVPA) accounted for 2.16% of the total effect, suggesting that MVPA partially mediates the relationship between eHealth literacy and PL. Additionally, male students outperformed female students in terms of MVPA (t636=4.94; P<.001) and PL (t636=3.18; P<.001), but no significant differences were found in eHealth literacy (t636=1.23; P=.22). The findings indicate that MVPA serves as a mediator in the link between eHealth literacy and PL among university students. Students with low eHealth literacy or limited PA are less likely to be physically literate. Thus, eHealth literacy plays a crucial role in enhancing PL and PA, especially when interventions targeting PL are implemented. Our results also suggest a need for targeted health education interventions aimed at improving MVPA and PL among female students, while also recognizing that eHealth literacy is comparable across genders at universities.

Long-term physical and mental health outcomes of Ebola Virus Disease survivors in Kenema District, Sierra Leone: A cross-sectional survey.

The 2013-2016 Ebola Virus Disease (EVD) epidemic in West Africa was the deadliest in history, with over 28,000 cases. Numerous physical and mental health symptoms have been reported in EVD survivors, although there is limited prior research on how the health of survivors compares to the general population. We conducted a survey of EVD survivors in Kenema District, Sierra Leone and a population-based sample of community members who lived in EVD-affected areas but were not diagnosed with EVD, and compared resulting data about self-reported symptoms, duration, and severity between EVD survivors and community members through multivariate regression models. This study found that more than six years after the epidemic, survivors were significantly more likely to experience both physical and mental health symptoms than community members, with respective adjusted incidence rate ratios (IRRs) of 2.65 (95% CI, 2.28-3.09), p < 0.001, and 11.95 (95% CI, 6.58-21.71), p < 0.001. The most highly reported physical health symptoms experienced by EVD survivors were joint pain (75.5%), headaches (67.3%), and vision problems (44.5%), and the most prevalent psychological symptoms were spells of terror and panic (25.5%) and difficulty falling asleep or staying asleep (20.0%). EVD survivors were significantly more likely than community members to report the symptoms as lasting for a longer period, a median of 6.0 (3.0-7.0) years, and with higher severity. The results indicated that six years after the epidemic, EVD survivors in Kenema District, Sierra Leone are experiencing worse physical and mental health than their peers. These findings of the long-term, debilitating health issues following EVD infection should be considered when designing and implementing future epidemic responses.

Emotional management and clinical communication among nursing students: a single institution experience

BackgroundThe development of emotional and clinical communication is crucial for being a nurse. The aim of this study is to evaluate the influencing factors of emotional management and clinical communication competencies among nursing students, to inform strategies for enhancing the management and nursing care practices.MethodsThis study was a cross-sectional survey. The study period was from December 1 to December 31, 2022, during which nursing students were the population of the survey. The assessments of the emotional management and clinical communication competencies of the nursing students were conducted using the validated Emotion Management Ability Questionnaire and the Clinical Communication Ability Scale, respectively.ResultsA total of 356 nursing students were investigated in this study. The nursing students had moderate ability of emotional management and clinical communication. The emotional management ability was correlated with the clinical communication ability of nursing students (all p&amp;lt;0.05). The results of multivariate regression analysis indicated that gender, educational level and home place were the independent influencing factors on the emotional management ability in the nursing students (all p&amp;lt;0.05). Family structure, internship time and personality were the independent influencing factors for the clinical communication ability among the nursing students (all p&amp;lt;0.05).ConclusionsThe competencies in emotional management and clinical communication among clinical nursing students warrant enhancement. It is imperative to implement tailored educational and training programs to optimize the development and performance of nursing students in their clinical training.

Clinical Characteristics and Treatment of Patients Diagnosed with Pulmonary Arterial Hypertension: A Real-World Study in the USA, Europe and Japan.

This study aimed to describe the clinical characteristics of patients with pulmonary arterial hypertension, treatment received, and factors predicting initial or earlier combination therapy. The Adelphi Real World Pulmonary Arterial Hypertension (PAH) Disease Specific Programme™ is a cross-sectional survey with retrospective data collection conducted in the USA, Europe (France, Germany, Italy, Spain, and the UK), and Japan from March to August 2022. Physicians reported patient characteristics, treatment history, and reasons for treatment selection. Descriptive statistics were grouped by country and World Health Organization functional classification. A multivariable Cox regression analysis investigated factors predicting initial or earlier combination therapy use. Data for 1173 patients was provided by 293 physicians. Patients' mean (standard deviation) age was 58.7 (13.8) years and 54.6% were female. Overall, 91.2% of patients were receiving, or had previously received, PAH-specific treatment. About three-quarters of the cohort were still taking the initial treatment strategy: for this group, 54% were prescribed monotherapy and 32% combination therapy; 15% of patients received supportive therapy alone. The proportion of patients receiving PAH-specific treatment was lowest in the USA (82.0%) and highest in France (94.6%). The proportion of patients receiving PAH on combination therapy was lowest in the USA (23.8%) and highest in Germany (36.5%). Treatment was prescribed for PAH in 87.6%, 89.8%, 89.3%, and 75.0% of patients who were functional classI, II, III, and IV, respectively, and combination therapy usage was more likely for those with more advanced functional class. Higher risk status, care by a pulmonologist, Japanese residence, more complete assessments, and hospitalization in the past 12months were statistically associated with decreased time to combination therapy for PAH. Older age was statistically associated with increased time to combination therapy. In this real-world, geographically diverse sample, monotherapy treatment was common, even among patients with advanced disease.

Long-term outcomes and quality of life in congenital diaphragmatic hernia survivors treated with extracorporeal life support: A cross-sectional survey.

Few reports have shown Quality-of-Life long-term outcomes in children with congenital diaphragmatic hernia (CDH) who received extracorporeal membrane oxygenation (ECMO) support. We reviewed the short- and long-term outcomes in CDH patients that were supported with ECMO during their neonatal treatment. Telephone interviews of parents of CDH children were performed. The Functional Status Scale (FSS) and the Paediatric Quality of Life Inventory (PedQL, Version 4.0) were completed with the parents. All children with a CDH and supported with ECMO from 2010 to 2023 were included in the study. Twenty children were identified, with two having two ECMO runs. Birth weight was 3.2 kg (median). ECMO support lasted for (median) 13.6 days (range 3.8 to 39). Twelve patients were alive at the time of the survey. The age (median) at time of the interview was 6.3 years (range 1 to 12). The FSS score showed no impairment (FSS score 6) in any domain in eight patients. Two patients had a score of 7, and two patients had a score of 8 and 9, respectively. The PedQL showed a median score 84.5, with a physical health summary score of 92.5 and a psychosocial health summary score of 78.7. The cardiac specific PedQL inventory score was 77. ECMO support for CDH patients is associated with functional and Quality of Life outcomes that are similar to that in other PICU discharge populations. Denying ECMO support to CDH patients on the basis of predicted poor long-term outcomes does not appear to be justified.

An international, cross-sectional survey of preprint attitudes among biomedical researchers

Background Preprints are scientific manuscripts that are made available on open-access servers but are not yet peer-reviewed. Although preprints are becoming more prevalent, uptake is not optimal. Understanding researchers’ opinions and attitudes toward preprints is valuable to optimize their use. Understanding knowledge gaps and researchers’ attitudes toward preprinting can assist stakeholders, such as journals, funding agencies, and universities, to use preprints more effectively. Here, we aimed to collect perceptions and behaviours regarding preprints across an international sample of biomedical researchers. Methods Corresponding authors of articles published in biomedical research journals were identified from a random sample of journals from the MEDLINE database. Their names and email addresses were extracted to invite them to our anonymous, cross-sectional survey, which asked participants questions about their knowledge, attitudes, and opinions regarding preprinting. Results The survey was completed by 730 respondents providing a response rate of 3.20% and demonstrated a wide range of attitudes and opinions about preprints with authors from various disciplines and career stages worldwide. Most respondents were familiar with the concept of preprints but most had not previously posted one. The lead author of the project and journal policy had the greatest impact on decisions to post a preprint, whereas employers/research institutes had the least impact. Supporting open science practices was the highest ranked incentive, while increasing authors’ visibility was the highest ranked motivation for publishing preprints. Conclusions Although many biomedical researchers recognize the benefits of preprints, there is still hesitation among others to engage in this practice. This may be due to the general lack of peer review of preprints and little enthusiasm from external organizations such as journals, funding agencies, and universities. Future work is needed to determine optimal ways to improve researchers’ attitudes through modifications to current preprint systems and policies.

Insulin Injection Technique and Related Complications in Patients With Diabetes in a Northwest City of China.

Appropriate insulin injection technique can help to enhance positive clinical outcomes in insulin-treated patients. This cross-sectional survey was undertaken to assess the present state of injection technique practices of patients administering insulin and the incidence of local complications associated with insulin injection. This cross-sectional study was conducted at 11 tertiary hospitals in Xi'an City. A total of 1370 patients with diabetes were enroled in the survey. Each patient was asked questions on the Injection Technique questionnaire, demonstrated insulin injection on an injection training pad and had their injection sites inspected by a nurse. About 98% of participants were type 2 diabetic patients. The 5 mm length needles were used by 640 (46.71%) patients. Around 1286 participants reused pen needles. Only one-third of patients rotate the injection sites. Around 901 patients had ecchymosis at injection sites, 43 participants suffered rash and or pruritus and 661 patients had lipohypertrophy. About 2.99% of patients reported having infection at the injection sites. Most patients (72.55%) occasionally felt pain when injecting insulin. The results of the multivariable logistict analysis showed that gender (male), needle length, priming the pen before injections and correct site rotation were negatively associated with the incidence of injection site ecchymosis. Lower incidence of lipohypertrophy was associated with needle length 4 mm, needle length 6 mm, single use of pen needles, priming the pen before injections and correct site rotation. Higher incidence of injection site infection was related to not disinfecting injection sites before each injection. Despite some improvements detected in some aspects of patients' insulin injection practice in recent years, a large gap still exists between insulin injection guidelines and patients' actual injection behaviour. Injection-related complications at injection sites are still considerably common among our study population. Patients' education regarding insulin injection technique should be conducted repeatedly and regularly to make sure patients' compliance to injection guidelines.

Awareness of environmental carcinogens and cancer risk among Jordanians

BackgroundIn light of the existing body of scientific data, many substances are now recognized or reasonably assumed to be human carcinogens. Public knowledge about modifiable environmental carcinogens is regarded as a crucial first step in primary prevention. This study aimed to assess Jordanians' awareness of some of the recognized environmental human carcinogens and general cancer information.MethodsThis study was conducted using a cross-sectional descriptive survey based on a questionnaire completed by Jordanian participants aged 18 or above. The questions consisted of the following sections: socio-demographic characteristics, questions about the prevalent and non-prevalent cancer types in Jordan and general causes of cancer, closed-ended questions to evaluate knowledge about environmental carcinogens as well as factors that influence the development of cancer, source of knowledge about carcinogens and interest in learning about human carcinogens, and the best way for prevention of cancer.ResultsA total of 579 questionnaires were completed. Among respondents, 55.6% (n = 322) had a knowledge score ≥ 8 indicating good knowledge. However, low awareness was demonstrated regarding cancer-causing substances such as wood dust, Nitrosamines, Aflatoxins, Formaldehyde, Naphthalene, Asbestos, Benzene, and Arsenic. A significant portion of the participants failed to categorize infectious pathogens linked to cancer as variables that either cause cancer or raise the risk of developing cancer.ConclusionThis study demonstrated a good level of awareness regarding some environmental carcinogens but also highlighted the lack of knowledge about other environmental carcinogens. These findings may provide a guide for future awareness programs by health authorities.

Bridging the Digital Competence Gap: A Comparative Study of Preservice and In-Service Teachers in Lebanon Using the DigCompEdu Framework

AbstractThis study investigates the digital competence levels of Lebanese preservice and in-service teachers using the European Framework for the Digital Competence of Educators (DigCompEdu). The research aims to explore the existing gap in digital competence between these two groups through a cross-sectional descriptive survey, involving 170 in-service teachers and 194 preservice teachers from various undergraduate teacher training programs in Lebanon. The findings reveal significant differences between in-service and preservice teachers in all six competence areas and no significant difference per subject areas, with in-service teachers demonstrating higher overall digital competence compared to preservice teachers. The study draws attention to the need for improved practical training and targeted interventions in teacher education programs to better prepare preservice teachers for the digital demands of modern classrooms. The findings have implications for policy and practice, particularly in enhancing teacher training programs to meet the evolving digital needs of education.

Kidnapping-Induced Trauma and secondary stress in armed conflicts: a comparative study among women in hostage families, volunteers, and the General Population

BackgroundExposure to armed conflict negatively impacts health. However, there is limited data on secondary stress from ambiguous loss contexts, such as kidnapping. In this study we aimed to quantify changes in modifiable health behaviors and well-being among women in hostage families and hostage crisis volunteers versus the general female population within the first two months of the 2023 Israel-Hamas war.MethodsA cross-sectional online survey was conducted on 318 Hebrew-speaking women aged 18–75 in Israel comparing: (1) a general population sample (n = 245); (2) hostage crisis volunteers (n = 40); and (3) hostage family members (n = 33). Participants provided demographic information, details on chronic illnesses, and responded to Likert-scale questions covering self-rated health, mental health, and lifestyle habits before the conflict and in current state.ResultsHostage family members reported the most severe health impacts, followed by volunteers. Fair/poor physical health status increased significantly in all groups during the war, with hostages’ families reporting the highest rate (61.6%). Mental health deterioration was more pronounced among hostages’ families, with 84% expressing a need for mental health support. Hostages’ families also reported the highest rates of sleep problems, reduced adherence to a healthy lifestyle, and weight loss. Mental and physical health declined significantly across the exposed groups, as measured by multiple assessments, with hostage families experienced the most pronounced impairments across various domains of well-being.ConclusionsThis period of conflict severely harmed the well-being of all women in the study population. Women from all three groups - hostage families, volunteers, and those from the general population - experienced health deterioration due to varying levels of stress and exposure to conflict-related factors. Hostage families faced the greatest impact with nearly all members of this group showing significant health damage. Long-term support is needed to help restore post-conflict health for all affected women. Further research may be needed to determine the most effective interventions for addressing these impacts across the different groups.

Birthing positions and mother`s satisfaction with childbirth: a cross-sectional study on the relevance of self determination.

Considering the inconclusive evidence regarding the clinical benefits of specific birthing positions, emphasis has been placed on adhering to women's preferences during the second stage of labour. Therefore, the present study aimed to assess the association between birthing position, the freedom to choose a birth position during the second stage of labour, and women's subjective satisfaction with childbirth. We performed a cross-sectional survey of women 8 or 12months after a vaginal birth in a hospital. The women were recruited via two cooperating health insurance companies. Multivariate analyses were conducted to assess the strength of the association between birthing position and maternal satisfaction with childbirth, with a particular focus on interactions with self-determination. In total, the data from 761 women were analysed. The supine position was the most frequently reported birthing position in the second stage of labour at 77.5%. Notably, 39.0% and 30.5% of the women who gave birth in the dorsal and lateral supine positions, respectively, stated that the birth position was not chosen voluntarily. The regression models show a significant negative association between supine birthing position and satisfaction with childbirth, which is significantly related to self-determination. The most common reason for the adoption of a specific birthing position was instructions from medical staff. The data provide insight into the perceived satisfaction with childbirth depending on the birthing position, whereby the relevance of self-determination is particularly evident. At the same time, self-determination is often not given, which is associated with reduced birth satisfaction.