Cross-sectional Survey Research Articles

Perspectives on non-emergent neonatal intensive care unit to pediatric intensive care unit care transfers in the United States

BACKGROUND There is a substantial population of long-stay patients who non-emergently transfer directly from the neonatal intensive care unit (NICU) to the pediatric intensive care unit (PICU) without an interim discharge home. These infants are often medically complex and have higher mortality relative to NICU or PICU-only admissions. Given an absence of data surrounding practice patterns for non-emergent NICU to PICU transfers, we hypothesized that we would encounter a broad spectrum of current practices and a high proportion of dissatisfaction with current processes. AIM To characterize non-emergent NICU to PICU transfer practices across the United States and query PICU providers’ evaluations of their effectiveness. METHODS A cross-sectional survey was drafted, piloted, and sent to one physician representative from each of 115 PICUs across the United States based on membership in the PARK-PICU research consortium and membership in the Children’s Hospital Association. The survey was administered via internet (REDCap). Analysis was performed using STATA, primarily consisting of descriptive statistics, though logistic regressions were run examining the relationship between specific transfer steps, hospital characteristics, and effectiveness of transfer. RESULTS One PICU attending from each of 81 institutions in the United States completed the survey (overall 70% response rate). Over half (52%) indicated their hospital transfers patients without using set clinical criteria, and only 33% indicated that their hospital has a standardized protocol to facilitate non-emergent transfer. Fewer than half of respondents reported that their institution’s non-emergent NICU to PICU transfer practices were effective for clinicians (47%) or patient families (38%). Respondents evaluated their centers’ transfers as less effective when they lacked any transfer criteria (P = 0.027) or set transfer protocols (P = 0.007). Respondents overwhelmingly agreed that having set clinical criteria and standardized protocols for non-emergent transfer were important to the patient-family experience and patient safety. CONCLUSION Most hospitals lacked any clinical criteria or protocols for non-emergent NICU to PICU transfers. More positive perceptions of transfer effectiveness were found among those with set criteria and/or transfer protocols.

Navigating recovery while postpartum: examining the relationship between maternal functioning and substance use disorders

Our current understanding of postpartum people’s functioning while managing substance use disorder (SUD) recovery is limited. This study explored whether having a SUD impacts maternal functioning and examined the reliability of the Barkin Index of Maternal Functioning (BIMF) in postpartum people with SUDs. We conducted a prospective, cross-sectional survey (n = 141) by administering the BIMF and a demographic questionnaire with a sample of postpartum people with SUD (n = 48) and a comparative sample of postpartum people without SUD (n = 93). The internal reliability (Cronbach’s alpha = .86) was consistent with previous studies. SUD diagnosis was significantly associated with lower functioning, with individuals in the SUD group having an 8-point lower BIMF score compared to persons without SUDs, although both groups reported moderately high BIMF scores (>80). While not statistically significant, participants with SUDs had reduced functioning scores over time. Considering the increasing rate of overdose deaths in postpartum persons, further examination of functioning in postpartum persons with SUDs is warranted. Integration of the BIMF into SUD screening and treatment can provide a holistic view of postpartum experiences in this high-risk population and serve as a unique tool to understand the needs of new mothers navigating SUD recovery.

Drug use patterns and health problems among people who use drugs in Guinea-Bissau (2022): A cross-sectional survey using respondent-driven sampling

BackgroundLittle data exists on the use of cocaine, methamphetamine, tramadol and heroin or related health conditions in Guinea Bissau. We aimed to estimate drug use practices and the prevalence of selected blood-borne infections, depression and population size estimates of people who use injectable drugs in Guinea-Bissau. MethodsWe used respondent-driven sampling to recruit adults who use injectable drugs in this cross sectional survey in three cities (Bissau, Bafatá and Gabú) between July and September 2022. Participants completed an interviewer administered survey enquiring about sociodemographic characteristics, drug use practices and mental health. Rapid diagnostic testing was done for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV). Data was weighted in RDS-Analyst using self-reported network size and Gile's Sequential Sampling Estimator. Population size estimates were generated using the two point capture-recapture method. ResultsOverall, 750 participants were recruited. People who use drugs were estimated to be mostly unemployed males aged between 25 and 49 years. Methamphetamine and crack cocaine were most commonly used. Prevalence of ever injecting ranged from 6 % to 44 %. Between 44 % and 52 % of people experience symptoms of depression. Prevalence ranges from 1.9 % to 5.2 % for HIV, and 5.7–8.3 % for HBsAg and 0.42–0.66 % for anti-HCV. The population estimates of people who use injectable drugs were 1637 in Bissau, 1314 in Bafatá and 424 in Gabú. ConclusionMethamphetamine and crack cocaine are the most commonly used injectable drugs in Guinea-Bissau. Symptoms of depression are common among people who use drugs in the country. Access to evidence-based drug use treatment and harm reduction interventions that integrate mental health care services are needed to improve the health and wellbeing of people who use drugs in Guinea-Bissau.

What benefits do patients expect of community pharmacist-led medication reviews? A cross-sectional survey

What benefits do patients expect of community pharmacist-led medication reviews? A cross-sectional survey

Exploring the Relationship Between eHealth Literacy and Diabetes Knowledge, Self-Efficacy, and Self-Care Behaviors in Chinese Diabetic Patients: A Cross-Sectional Study.

The importance of online educational resources enhancing self-management among patients is underscored by the growing prevalence of diabetes. It is crucial to comprehend how patients with diabetes in China seek diabetes-related information and use mobile applications (apps) designed for diabetes management. Although the Knowledge-Attitude-Practice theory plays an integral role in diabetes management, in-depth studies on eHealth literacy (eHL) and Knowledge-Attitude-Practice in populations with diabetes remain scarce. This study was developed to provide insights into the online information-seeking behaviors of and diabetes apps used by individuals living with diabetes by exploring the relationships among eHL, diabetes knowledge, self-efficacy, and self-care behaviors. A cross-sectional survey was conducted from November 2022 to June 2023 on 380 inpatients with diabetes at the Yantai Yuhuangding Hospital in Shandong Province. The participants voluntarily completed surveys covering sociodemographic characteristics, diabetes status, diabetes app usage, online diabetes information searching, eHL, diabetes knowledge, self-efficacy, and self-care behaviors. Structural equation modeling analyses were employed to assess model fitness and the interrelationships between latent constructs and observable variables. Of the 380 participants, 57.1% (217/380) reported actively seeking diabetes information online, whereas only 3.7% (14/380) had used diabetes apps. eHL was shown to have a direct effect on diabetes knowledge (β = 0.377, p < .001) but no direct impact on self-care behaviors (β = 0.017, p = .860). However, an indirect effect on self-care behaviors was observed via diabetes knowledge and self-efficacy. The results of this study indicate that, despite widespread online information-seeking behavior, diabetes app utilization remains limited in China. Also, the findings indicate enhancing patients' eHL contributes to more comprehensive diabetes knowledge. Furthermore, eHL was shown to influence self-care behaviors via diabetes knowledge and self-efficacy. A self-managed intervention strategy should be developed to improve eHL that utilizes internet resources to improve patients' knowledge and self-efficacy and promote better self-care behaviors.

Understanding Determinants of Diabetes: Knowledge, Attitudes, and Practices among Non-Diabetic Pakistanis

Objective: To identify the determinants of diabetes-related knowledge, attitudes, and practices among the non-diabetic Population in Pakistan. Methodology: A cross-sectional survey was performed from July to December 2023 using snowball sampling 400 non-diabetic Pakistani nationals were enrolled; the data regarding diabetes knowledge, attitudes, and practice was acquired on a structured online questionnaire distributed through a social media platform. The sociodemographic variables and diabetic characteristics were the exposure of interest, and Diabetes Knowledge Attitude and Practice (KAP) was considered the outcome of interest. The data was analyzed using SPSS version 27, with chi-square testing and regression analysis used to study the relationship between sociodemographic variables and KAP outcomes. Results: The study revealed a high level of general awareness about diabetes (86.75% knew what it was), but specific knowledge about its management and complications was low (&lt;50% were sufficiently informed). Attitudes towards diabetes were proactive regarding diet and family support, yet less than half of the respondents recognized the importance of physical activity and regular glucose monitoring. Practices varied, with 88% avoiding fatty foods but only 18.75% maintaining a healthy weight and 31.5% engaging in regular blood sugar monitoring. Socioeconomic factors and education levels significantly (P&lt;0.05) influenced KAP, with higher education significantly associated with better knowledge and practices. Conclusion: Overall, the non-diabetic Pakistanis have a good general awareness of diabetes. However, there are significant gaps in comprehensive knowledge and practice. Keywords: Diabetes Mellitus; Knowledge Attitudes Practices; Non-diabetic Pakistani

Conservation agriculture measures as a strategy to create sustainable social and psychological changes in agricultural communities

The main aim of this study was to investigate the potential of encouraging intention to use conservation agriculture technologies to create sustainable social and psychological changes in agricultural communities. The study was carried out using a cross-sectional survey using 384 Iranian landowner farmers as the sample. The research instrument was a researcher-made questionnaire. Furthermore, its validity and reliability were evaluated using different quantitative and qualitative indices. The results revealed that the basic variables of Theory of Planned Behavior including attitude towards conservation agriculture (ACA), subjective norms of conservation agriculture (SNCA), and perceived behavioral control on conservation agriculture (PBCCA) positively and significantly affected the intention towards application of conservation agriculture technologies and practices (IACATP). Comparison of the original and extended versions of Theory of Planned Behavior showed that the inclusion of the variables perceived risk conventional agriculture (PRCA), knowledge about conservation agriculture (KCA), level of education, farm size, and income level in the original Theory of Planned Behavior could increase its explanatory power from 66.4% to 77.3%. This result was one of the most important contributions of the present study that can be considered a turning point for social change interventions in rural and agricultural communities. The study also led to new insights into the mechanisms of encouraging IACATP and social-psychological changes in agricultural communities. These innovative insights can be used by different users such as governmental policy-makers, technology developers, social change interventionists, environmental decision-makers, and researchers.

Cross-sectional survey of 43,517 dogs in the Dog Aging Project identifies owner-reported lifetime prevalence and characteristics of gastrointestinal disease.

To evaluate the prevalence of and characteristics associated with owner-reported gastrointestinal (GI) disease in companion dogs within the US. Cross-sectional owner-reported survey study of 43,517 dogs enrolled in the DAP between December 26, 2019, and December 31, 2022. Dogs were grouped on the basis of having an owner-reported GI disorder (ORGID) versus not having that ORGID at any point in their history (control group). Multivariable logistic regression analysis was used to estimate the association between dog characteristics and ORGIDs with prevalence ORs (PORs). Of the 43,517 dogs in the DAP Pack, 30,677 (70%) had no history of ORGIDs and 12,840 (30%) had at least 1 ORGID. The most common ORGIDs included infectious diseases (7,580 of 43,517 [17%]), chronic diarrhea (1,316 [3%]), foreign bodies (1,086 [2%]), anal sac impactions (1,031 [2%]), pancreatitis (857 [2%]), inflammatory GI disease (615 [1%]), chronic vomiting (519 [1%]), and acute hemorrhagic diarrhea syndrome (388 [1%]). Compared to controls, dogs with noninfectious ORGIDs had greater odds of having a history of being castrated (POR, 2.55; 95% CI, 2.29 to 2.85), underweight (POR, 1.58; 95% CI, 1.47 to 1.70), or fed primarily canned food (POR, 2.51; 95% CI, 2.21 to 2.85) or receiving probiotics (POR, 1.69; 95% CI, 1.58 to 1.81) or nonprescription GI medications (POR, 4.06; 95% CI, 3.80 to 4.33). Dog owners in the US recruited from the general public reported a high prevalence of GI disorders in their dogs. Infectious and noninfectious ORGIDs were reported with approximately equal frequency. Dogs with ORGIDs were more likely to have a history of receiving probiotics or nonprescription GI medications, which may indicate that owners are changing lifestyle practices to accommodate these GI disorders, although future longitudinal research is needed.

Determinants of knowledge regarding self-medication among professional students of the apothecary

Background: Self-medication or the use of over-the-counter drugs by the general public, including among professional students, is becoming an increasingly common practice. However, this practice can carry risks if done without adequate knowledge, especially for pharmacist students who will later play a role in providing education related to drug use. Objective: This study aims to identify factors that affect the level of knowledge of pharmacist program students regarding self-medication. Methods: This study was a cross-sectional survey using an online questionnaire, and the recorded data were analyzed using Logistic regression models. In total, 100 (66.7%) of 150 students practised self-medication at least once recently. Results: We observe that female students were more likely to have a higher level of knowledge about self-medication than male students—aOR = 4.52, 95 % CI = 1.41-14.42. Meanwhile, students living alone were less likely to have a higher level of self-medication knowledge than those staying with somebody else —aOR = 0.47, 95 % CI = 0.23-0.97. Conclusion: The effect of students who practised self-medication on a higher level of knowledge about self-medication was significant among students who live with somebody else—aOR =2.85, CI = 1.01-8.01 but not among students who live alone. There are more attempts to educate the students about self-medication and the possible risks of doing self-medication. We suggest a similar study can be observed among students during their bachelor study or in their Professional Program.

Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults.

Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults. A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses. Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actuallyassess walkability (χ2 = 78.7, p < .001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents. When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.

Determinats factors self-management barriers: characteristics, spiritual well-being, and religiosity in type 2 diabetes patients

Holistic nursing needs to evaluate barriers to self-management, insight from characteristics, religiosity, and spiritual well-being to understand and address the multifaceted needs of individuals with chronic conditions, such as diabetes mellitus type 2. This study aimed to identify the determining factors that affect the barriers to self-management and the variables affecting them among Indonesian patients with T2DM. A cross-sectional survey was conducted among 101 patients recruited via purposive sampling from March to May 2023. The research instruments used were the Spiritual Well-Being Scale, Islamic Religiosity Scale, and Summary of Diabetes Self-Care Activities. The potential multicollinearity effects among the predictors of the barriers to self-management were also evaluated using multiple linear stepwise regression and collinearity analysis of variable inflation factors (VIFs). Most of the respondents had moderate spiritual well-being (52.2%) and high Islamic religiosity (60.4%) but also had barriers to self-management (55%). The F value of 5.888 with a probability of 0.004 (&amp;lt;0.05) showed that based on their regression coefficients, spiritual well-being, and Islamic religiosity simultaneously affected the barriers to self-management by 10.7%. The determinants that were found to affect the barriers to self-management were spiritual well-being and religiosity. These results suggest that it is necessary to develop an intervention model to improve the self-management of T2DM with a holistic approach.

Assessing community pharmacists' thoughts on telepharmacy in Bali province

Telepharmacy describes the use of technology in interactions between pharmacists and patients. Given that telepharmacy is the most recent development in the delivery of digital pharmacy services, the question of how prepared pharmacists are to provide high-quality services frequently comes up and receives attention. The purpose of this study was to determine the viewpoints of pharmacists in telepharmacy services. From February to April 2023, a cross-sectional survey was done using a Google form. The study population included 111 pharmacists in charge of network pharmacies in Bali Province. Their thoughts were assessed using a credible and reliable questionnaire created by the researchers. The questions were split into two sections: a professional demographic items, and a section describing the perspectives, benefits, and challenges of telepharmacy. To get a more detailed or comprehensive response, open-ended questions were added. In general, especially during a pandemic, pharmacists were aware of being involved in remote services (non-face-to-face interaction) and telepharmacy services. This study makes clear that pharmacists' involvement is essential for creating a long-distance relationship between them and their patients. Therefore, pharmacists should learn how crucial communication is to increase patient satisfaction.

I had to tell to survive“- a cross-sectional study on exposure to intimate partner violence in pregnant women and the importance of screening

BackgroundThere is a lack of knowledge in Swedish healthcare regarding correlations of exposure to intimate partner violence (IPV) from before to during pregnancy, and associated factors as well as pregnant women’s perceptions related to screening for IPV in healthcare settings. The frequency of women exposed to IPV during pregnancy is difficult to establish as it is reported at different rates across different studies, depending on the definitions and screening strategies used. Aims1. Describe prevalence of IPV experienced by pregnant women. 2. Investigate changes in IPV exposure before and during pregnancy. 3. Examine frequency of screening and women’s opportunities and willingness to talk about IPV exposure. Methods.A cross-sectional survey in Stockholm, Sweden. Findings6.2 % of women (n = 202) reported exposure to IPV before pregnancy and 2.1 % (n = 72) reported exposure during pregnancy, of these, sixteen women reported exposure only during pregnancy. There were significant associations between exposure to IPV and symptoms of depression, age, living situations and employment status. Sixty-four percent of the exposed women were asked about violence in healthcare settings. DiscussionAn important finding was that the frequency of IPV decreased from before to during pregnancy. The reasons for this are unknown but may be multi-factorial. ConclusionOur investigation provides crucial insights into IPV during pregnancy. Results highlight that relying solely on prevalence rates is inadequate to understand the complexity of IPV exposure related to pregnancy. Screening for IPV and understanding how women perceive and disclose their exposure is complex yet vital for midwives in antenatal care.

Needs and expectations of healthcare professionals regarding the topic of alcohology: Results of a survey conducted in France in 2022

ContextAlcohol-related health problems represent a significant public health concern, and it is imperative for the healthcare team to accurately perceive and detect these issues to provide appropriate care. The objective of this survey was to evaluate the knowledge, practices, and educational background of healthcare professionals in the field of alcohol-related health concerns, aiming to identify their information requirements. MethodsThis study employs a cross-sectional descriptive survey methodology, in which data were gathered through a digital questionnaire designed for healthcare professionals (including those in medical, paramedical, and medico-social professions) working in addictology services as well as other relevant services across France and its overseas departments. ResultsA total of 611 questionnaires were deemed usable for analysis. A considerable percentage of participants reported their knowledge and skills to be insufficient or very insufficient, with rates of 33 % and 36 %, respectively. Moreover, a significant proportion of respondents (≈ 28 %) stated that they had received no education in addictology. Our results highlight differences in levels of knowledge and competence among the various healthcare settings, notably with lower reported levels of satisfaction in hospital settings (public and private), private practice, and in Harm Reduction Centers. Furthermore, certain professions reported unsatisfactory levels of skills and knowledge in alcohol-related issues, particularly support staff, pharmacists, expert patients, administrative staff, and social workers. These findings suggest the need to enhance knowledge and skills by tailoring interventions according to the specific healthcare settings and professions. Additionally, the priority themes and channels for disseminating information varied depending on age, region, and professional category. ConclusionThis survey reveals a low level of knowledge, practice, and education in addictology, emphasizing the critical need for training. The importance of training extends not only to the priority topics addressed but also to the channels used for dissemination, all while customizing them to suit the age, professional category, structure, and region of healthcare professionals.

Characterising HIV acquisition risk, treatment gaps and populations reached through venue-based outreach and clinical services in Blantyre, Malawi: findings from a district-wide CLOVE Study.

In 2017, Blantyre district had the highest adult HIV prevalence in Malawi (17.7%) and lowest viral suppression (60%). In response, the Ministry of Health expanded prevention and treatment services. We assessed whether outreach to social venues could identify individuals with increased HIV acquisition risk or with unsuppressed HIV not currently reached by clinic-based services. We conducted a cross-sectional bio-behavioral survey in Blantyre, Malawi, from January to March 2022. We visited social venues where people meet new sexual partners and government clinics providing HIV testing or STI screening. Participants aged > 15 years were interviewed, and tested for HIV infection if not on ART. HIV recency tests were performed on those testing positive, and dried blood spots (DBS) was collected to quantify viral load and also to identify acute infection in those with HIV- results. HIV prevalence (18.5% vs 8.3%) and unsuppressed HIV infection (3.9% vs 1.7%) were higher among venue-recruited (n=1802) compared with clinic-recruited participants(n=2313). Among PLHIV at both clinics (n=199) and venues (n=289), 79% were virally suppressed. Few had acute(n=1) or recent infection(n=8). Among women, HIV prevalence was four times higher (38.9% venue vs 8.9% clinic). At clinics, PLHIV reporting visiting venues were less likely to be suppressed (54.6 vs 82.6%). More men at venues than at clinics reported paying for sex (49% vs 30%) or having multiple sex partners in the past 4 weeks (32% vs 16%). Enhanced venue-based prevention and testing for men and women could reduce treatment lapses, HIV treatment outcomes and reduce onward transmission.

Food insecurity and substance use among young adults in the United States

PurposeThe purpose of this study was to examine the association between food insecurity and substance use among young adults aged 18–25 in the U.S. MethodsA cross-sectional online survey was completed by a diverse sample of 1024 young adults (50.2 % female; 62 % non-white; m age = 21.7[SD = 2.26]) between January–April 2022. Logistic regression analyses were used to examine the association between food insecurity and current cigarette use, Electronic Nicotine Delivery System (ENDS) use, cannabis use, alcohol use, and binge drinking controlling for socio-demographic and economic factors, mental health, and experiences of discrimination. ResultsNearly 70 % of participants reported being food insecure over the past year. Substance use was also common: 45.9 % of participants reported current cigarette use, 50.9 % ENDS use, 57 % cannabis use, 65.9 % alcohol use, and 50.4 % engaged in binge drinking in the past two weeks. Being food insecure was associated with greater odds of cigarette use (OR = 2.49, 95 % CI = [1.77, 3.50]), ENDS use (OR = 2.18, 95 % CI = [1.58, 3.01]), cannabis use (OR = 1.73, 95 % CI = [1.26, 2.37]), alcohol use (OR = 1.60, 95 % CI = [1.16, 2.19]) and binge drinking (OR = 1.98, 95 % CI = [1.44, 2.72]), controlling for all other factors. ConclusionFood insecurity may serve as an important indicator of substance use among young adults. Practitioners should consider screening for food insecurity, providing information about food access, and developing interventions to address food insecurity among the young adults with whom they work. Future research should examine these associations prospectively to better understand how food insecurity may contribute to the initiation and/or escalation of substance use.

Ability of a dietary index based on the updated algorithm underpinning the Nutri-Score to discriminate food consumption and nutrient intake in a French population of children and adolescents

IntroductionPreventing chronic diseases among children and adolescents requires a comprehensive approach. The Nutri-Score, a front-of-pack nutrition labeling system, may play an important role in public health by enhancing overall nutritional quality of dietary intake, a key modifiable risk factor. The aim of this study was to investigate the ability of the 2015 and 2023 NS-NPM to discriminate food consumption and nutrient intake in a population of French children and adolescents. MethodsChildren and adolescents (6 to 17 years old) participating in the cross-sectional representative ESTEBAN survey conducted in mainland France were included. Food consumption was assessed with three repeated 24 h dietary recalls. To obtain a dietary score at the individual level, the Nutri-Score nutrient profiling model dietary index (NS-NPM DI) was computed as an energy-weighted mean using the 2015 and the 2023 NS-NPMs and categorized into quartiles. Linear contrasts were used to assess the linearity of the association between the indexes and the intakes. Results1,279 participants (50.2 % boys and 49.8 % girls, mean age 11 years) were included in this study. Using the 2023 NS-NPM DI, participants with more favorable DI (lower NS-NPM DI) consumed higher amounts of fruits, vegetables, whole grain cereals, milk, poultry, fish and seafood and vegetable oils and lower amounts of, processed meat and sweetened foods. In addition, using the NS-NPM DI 2023, participants with more favorable DI (thus more favorable Nutri-Score) had higher intakes of proteins, fiber, vitamins and minerals, and lower intakes of lipids, SFA, MUFA and simple sugars. Compared to the NS-NPM DI 2015, with the updated algorithm, higher differences between quartiles were observed for tubers, fish and seafood, poultry, red meat, processed meat, vegetable oils and vitamin D and E, all in the expected direction (better discrimination). ConclusionThe results of the present study suggest that the NS-NPM algorithm underlying Nutri-Score is a useful tool for characterizing the diet quality of children and adolescents. The updated version of this algorithm showed a more discriminatory ability when assessing some animal food groups and vitamin D and E, indicating that the revision of the Nutri-Score represents an improvement for public health purposes.

Prevalence and predictors of misperceptions of 'better-for-you' alcohol products among Australian adult drinkers.

This study investigated the prevalence and predictors of misperceptions about the healthiness of alcohol products carrying common health-oriented marketing cues and the relative importance of the type (versus amount) of alcohol consumed in contributing to health risks. Data were from a 2022 cross-sectional national population survey. Australian adults (18-65 years) who consumed alcohol in the past year (n = 1960) reported their agreement with statements that a selection of health-oriented marketing cues meant an alcohol product was 'better for you' and rated the importance of the type and amount of alcohol consumed in causing health risks. The majority of participants misperceived the type of alcohol to be at least as important as the amount in causing health risks (61%) and misperceived at least one health-oriented marketing cue as meaning a product was 'better for you' (75%). Misperceptions about low sugar, calorie and carbohydrate; and preservative-free claims (46-56%) were most common. Misperceptions about natural, organic, vegan, low sugar, low calorie, gluten-free and seltzer cues were less prevalent among older (45-65 years) than young adults (18-24 years, PR = 0.27-0.86). A lower proportion of women (compared to men) held misperceptions about vegan (PR = 0.66) and gluten-free claims (PR = 0.78), but a higher proportion held misperceptions about low sugar claims (PR = 1.13). There were also variations by socioeconomic status, alcohol consumption, education and regional/metropolitan location. Misperceptions about health-oriented marketing of alcohol are widespread. Further regulation of permissible alcohol marketing content is needed, but until then, differences in misperceptions between population segments may inform targeted health promotion efforts.

Uncertainties Regarding Cerebral Palsy Diagnosis: Opportunities to Clarify the Consensus Definition.

We have established that physicians, including neurologists, variably diagnose cerebral palsy (CP) when using the most recent CP definition from 2006. We also know that child neurologists and neurodevelopmentalists view themselves to be optimally suited to diagnose CP based on their training backgrounds. Therefore, to reduce variability in CP diagnosis, our objective was to elucidate uncertainties child neurologists and neurodevelopmentalists may have regarding practical application of the 2006 definition. We conducted a cross-sectional survey of child neurologists and neurodevelopmentalists built into a discussion seminar at the 2022 Child Neurology Society (CNS) Annual Meeting, the largest professional meeting of these specialists in North America. Seminar attendees were provided the 2006 definition and asked whether they had any uncertainties about the practical application of the definition across 4 hypothetical clinical vignettes. A group of national and international CP leaders then processed these data through iterative discussions to develop recommendations for clarifying the 2006 definition. The seminar was attended by 50% of all conference attendees claiming CME (202/401). Of the 164 closing survey respondents, 145 (88%) expressed uncertainty regarding the clinical application of the 2006 definition. These uncertainties focused on 1) age, both regarding the minimum and maximum ages of brain disturbance or motor symptom onset (67/164, 41%), and 2) interpretation of the term "nonprogressive" (48/164, 29%). Almost all respondents (157/164, 96%) felt that we should revise the 2006 consensus definition of CP. To address the most common CP diagnostic uncertainties we identified, we collectively propose 4 points of clarification to the 2006 definition: 1) motor symptoms/signs should be present by 2 years old; 2) CP can and should be diagnosed as early as possible; 3) the clinical motor disability phenotype should be nonprogressive through 5 years old; and 4) a CP diagnosis should be re-evaluated if motor disability is progressive or absent by 5 years old. We anticipate that clarifying the 2006 definition of CP in this manner could address the uncertainties we identified among child neurologists and neurodevelopmentalists and reduce the diagnostic variability that currently exists.

Parental Leave in Neurosurgery: A US Cross-Sectional Study

BACKGROUND AND OBJECTIVES: The Accreditation Council for Graduate Medical Education implemented a minimum of 6 weeks parental leave for residents in July 2022. The implementation and impact have not previously been studied in neurosurgery. Our primary study objectives were to determine whether an institution had a parental leave policy and quantify the Family and Medical Leave Act (FMLA) and total parental leave (TPL) time taken by neurosurgeons. METHODS: We conducted a cross-sectional survey (August 2023 to December 2023) of neurosurgeons (residents and faculty) in Accreditation Council for Graduate Medical Education–accredited programs. We elicited demographic information, experience with parental leave, and career satisfaction. Association between continuous variables was evaluated using Pearson's correlation. Data distribution was evaluated using the Shapiro–Wilks test. Central tendency comparison was performed using one-way analysis of variance, Kruskal–Wallis, or Mann–Whitney U tests. RESULTS: There were 147 anonymous survey respondents (response rate 15.7%), with an average age of 41 years. The majority (72.2% and 73%) were female and married. The mean age of first pregnancy was 32 years. On average, female residents and faculty took more TPL (7.7 weeks vs 9.0 weeks) and FMLA (6.0 weeks vs 6.8 weeks) than men (resident TPL:2.0 weeks, FMLA: 1.5 weeks. faculty TPL: 2.1 weeks, FMLA: 1.6 weeks). There was a significant difference between how much parental leave leadership believe residents have vs amount of FMLA (P-value = .004) and TPL (P-value = .001) residents took. There was a correlation between age and the amount of TPL (Pearson's R −0.307, P-value = .009). CONCLUSION: Our survey demonstrates that neurosurgeons, in general, took less than the minimum suggested leave. Departmental leadership perceived that residents took more leave than they reported. This study highlights an opportunity to increase support for parental leave among neurosurgeons.