Exploratory Cross-sectional Study Research Articles

COVID-19 Traumatic Stress, Working Memory Deficits, and Mindfulness

Stress is known to be a risk factor for deficits in working memory creating profound cognitive disturbances resulting in lingering impairments and losses in social and occupational functioning. Although a body of research has identified mindfulness as a potential means of mitigating deficits in working memory, there is a paucity of studies on the association between mindfulness and deficits in working memory among those who have experienced COVID-19 traumatic stress. This exploratory cross-sectional study sought to examine the mitigating effect of mindfulness on COVID-19 stress impacting working memory. The sample included 484 college students in Israel and the USA. Correlation and multiple regression analyses indicated that COVID-19 stress had a modest, inverse association with both a self-report and task-based indicator of working memory. In separate models predicting the different operationalizations of working memory, results revealed different effects for Israeli and USA students. Mindfulness was significantly associated with task-based but not self-reported working memory. The results offered evidence for a small but significant effect of mindfulness as moderating the impact of COVID-19 stress on working memory deficits. This exploratory, cross-­sectional study, used a convenience sample limiting the generalizability and its ability to test causal effects, calling for replication.

Relative-to-resident abuse in Norwegian nursing homes: a cross-sectional exploratory study.

In community settings, relatives often provide care to their older family members, which is sometimes perceived as a high burden, overwhelming and stressful, contributing to an increased risk of elder abuse. In most countries, relatives have no legal obligation to provide care when family members are admitted to nursing homes; nevertheless, studies have shown that relatives continue to provide emotional, instrumental, and personal care after admission, often related to the understaffing and high workload of nursing staff. Despite the growing interest in elder abuse in nursing homes, most studies have concentrated on the abuse perpetrated by nursing staff or co-residents, but few studies have explored the abuse that relatives may perpetrate. This study was a cross-sectional survey of 3,693 nursing staff members recruited from 100 nursing homes in Norway, to examine the extent of relative-to-resident abuse in Norwegian nursing homes, as observed by nursing staff. The findings indicate that 45.6% of the nursing staff had observed one or more episodes of relative-to-resident abuse during the past year. Among the subtypes of abuse, 44.8% of the nursing staff had observed psychological abuse, 8.4% had observed physical abuse, 2.7% had observed financial/material abuse, and 0.7% had observed sexual abuse at least once during the past year. This is the first large study exploring the extent of relative-to-resident abuse in nursing homes, which is a phenomenon that is significantly less addressed than abuse committed by staff and co-residents. The findings in our study illustrate that abuse committed by relatives needs more awareness and attention to improve the well-being of nursing home residents. Further research is recommended to enhance our understanding of such abuse and should include other approaches measuring the proportion of relative-to-resident abuse, as relying solely on staff observations is insufficient for determining the prevalence in this case. Future studies should also examine the cumulative impact of victimization in nursing homes and should include an analysis of how cases of abuse are reported and handled.

Exploring public perception and utilization of medication home delivery services in the United Arab Emirates: a cross-sectional study

IntroductionThe Medication Home Delivery (MHD) service from community pharmacies involves the safe and efficient delivery of pharmaceuticals (prescription and non-prescription medications), and health products directly to the patient’s/consumer’s home. There are several issues encountered by the users of the MHD service that have an impact on their satisfaction with the service. The study aimed to assess the public’s perceptions of the MHD service in the United Arab Emirates (UAE), their willingness to utilize it, and the practical use of the service.MethodA cross-sectional exploratory study was conducted in the UAE using a validated online survey. The inclusion criteria were adults residing in the UAE. Statistical analysis was performed to identify the association between the variables, the service use, and the level of service efficiency.ResultsA total of 556 participants filled out the survey, with 69.4% of them using the service. The majority of participants were females (75.9%) and aged less than 40 years old (71.6%). Three variables showed a statistically significant association with the use of the MHD service (P < 0.05): the participant’s educational level, their medical/health background, and the frequency of visits to community pharmacies. The most common issues raised were receiving the wrong order, delay in delivery, and paying delivery fees. Most participants agreed that the MHD service reduces the risk of exposure during pandemics, serves the elderly, serves disabled people, makes it more comfortable for parents with children at home, and reduces overcrowding in health facilities, as well as the MHD service making pharmacy services more efficient.ConclusionThe study indicated positive perceptions among the public in the UAE towards the MHD service. However, there was a concern that this service may diminish the communication between pharmacists and patients, which potentially minimizes the amount of information received by patients regarding their treatments.

1H NMR-Based Metabolomic Profiling and Comparison of Human Milk Across Different Lactation Stages in Secretors and Non-Secretors: A Study of Chinese Lactating Women

BackgroundHuman milk oligosaccharides (HMOs) and other milk-derived metabolites are crucial for infant health, influencing gut microbiota and overall development. ObjectiveThis study aims to uncover insights into the variations of HMOs and non-HMO metabolites based on secretor (Se) status, lactation time, mode of delivery, and infant sex. MethodsAn exploratory cross-sectional study was designed to compare the levels of HMOs and non-HMOs metabolites in milk samples from 129 lactating Chinese women within 1 year postpartum. Nuclear magnetic resonance analysis was employed for the identification and quantification of the metabolites. The metabolites measured were grouped into sugars, free amino acids, fatty acids, and metabolites related to energy metabolism. The influence of delivery mode and infant sex on milk metabolite composition were explored. ResultsUniform Manifold Approximation and Projection (UMAP) analysis of HMOs profiles revealed distinct clustering based on Se status, with significant differences in 2'-FL and 3-FL levels observed between Se+ and Se- groups. A decreasing trend for 2'-FL and 6-’SL levels, along with an increase in 3-FL levels, was observed with increasing lactating period within 12 months postpartum. Non-HMOs metabolite analysis indicated that Se status only affected glutamate levels. An increase in glutamine levels was observed 3–9 months postpartum. A continuous increase in o-phosphocholine levels was noted in 12 months postpartum, along with reductions in citrate and sn-glycero-phosphocholine levels. Delivery mode and infant sex did not affect both HMOs and non-HMOs levels. ConclusionsMetabolomic analysis of human milk reveals significant variation of HMOs, but not in non-HMOs, based on Se status. Changes in certain HMOs and non-HMOs levels were also observed over the one year of lactation. Understanding how these metabolites change over time may influence recommendations for maternal diet, supplementation, and the timing of breastfeeding to ensure optimal nutrient delivery to the infant.

The association between hip adductor and extensor strength, and hip-related patient-reported outcomes in patients with longstanding hip and groin pain: an exploratory cross-sectional study

ObjectiveThe objective of this study was to assess the association between hip muscle strength and hip-related patient-reported outcome measures (PROMs) in patients with longstanding hip and groin pain (LHGP). DesignCross-sectional design SettingOrthopedic care ParticipantsEighty-one patients with LHGP were consecutively recruited Main Outcome MeasuresHip muscle strength was measured in adduction and extension. Hip-related PROMs was measured with the Copenhagen Hip and Groin Outcome Score (HAGOS) which includes six subscales (Symptoms, Pain, Activity in Daily Living (ADL), Physical Function in Sports and Recreation (Sport/Rec), Participation in Physical Activities (PA), and Quality of Life (QoL). Linear regression examined the association between hip muscle strength and each HAGOS subscale. ResultsGreater isometric hip muscle strength in adduction was associated with better HAGOS score for Pain and ADL (p≤0.037), but not for Symptoms, Sport/Rec, PA, or QoL (p≥0.154). Greater isometric hip muscle strength in extension was associated with better HAGOS score for Symptoms, Pain, and ADL (p ≤0.034), but not for Sport/Rec, PA, or QoL (p ≥0.084). ConclusionsIn patients with LHGP, greater isometric hip muscle strength seems to be associated with less symptoms and pain, and better function in ADL. No association was found for Sport/Rec, PA, or QoL.

UNDERSTANDING THE PERCEPTION OF MENSTRUAL POVERTY IN HOMELESS WOMEN

Brazil faces profound social inequalities that impact millions of individuals, especially homeless women, who are subjected to conditions of heightened vulnerability. This study aimed to understand the perceptions and biopsychosocial repercussions of menstrual poverty in women living on the streets. A descriptive and exploratory cross-sectional study was conducted using a qualitative approach with semi-structured interviews. Four homeless women, selected through an active search in Goiânia/GO, were interviewed between April and June 2024. The interviews were analyzed according to Grounded Theory. The analysis of the interviews revealed four explanatory categories: (1) History before and after arriving on the streets; (2) Challenges related to living on the streets and health care; (3) Challenges for menstrual hygiene and coping with menstrual symptoms; and (4) Perception of the consequences of living and menstruating on the streets for health: a vision of the future. Period poverty is identified as a serious public health problem that affects the well-being of homeless women, with direct implications for their physical and mental health. There is an urgent need for public policies that guarantee access to hygiene products and health care, in addition to promoting the visibility and dignity of this group. The implementation of comprehensive support and assistance programs is crucial to mitigate the repercussions of period poverty and other vulnerabilities faced by these women, ensuring their dignity and quality of life.

An Exploratory Study: Controversial Beliefs and Practices of Hijama Practitioners of Karachi, Pakistan

Background: Cultural and spiritual beliefs have preserved the use of traditional practices, including al hijama (wet cupping), which is widely recognized for its purported therapeutic value and historical significance. Despite its popularity, the practice often lacks formal training and is frequently administered by unqualified practitioners, leading to false beliefs and potentially unsafe practices. Objective: To investigate the scientific knowledge and beliefs of hijama practitioners of Karachi, Pakistan, with a focus on identifying misconceptions, variations in practice, and the influence of cultural and religious beliefs on the practice of hijama therapy. Methodology: A cross-sectional exploratory study was conducted involving 114 hijama practitioners from Karachi, who were recruited through various WhatsApp groups and enrolled in a seminar held in January 2023. The participants were required to complete a 37-item questionnaire covering their qualifications, practice methods, hygiene standards, and beliefs about the hijama therapy. Data were analyzed using spss version 20, employing mean, standard deviation, chi-square tests, and frequency distribution. Results: Most participants (97.4%) were female, with only 39.5% possessing a license to practice. Many practitioners (89.5%) were motivated by the religious significance of hijama. The knowledge regarding the scientific theories and mechanism of action of hijama therapy was known by 56.4%. Practices varied widely regarding hygiene, blade type, and cup placement. 38.1% did not consistently check for infectious diseases. Additionally, the practice of reciting Qur’anic verses was widespread, believed to enhance the therapy's effectiveness which shows strong religious connotation. Conclusion: The study reveals a substantial gap in formal training among hijama practitioners, leading to variations in practice and potential safety concerns. There is a pressing need for standardized training and regulations to ensure the safe and effective practice of hijama therapy. Further research is essential to establish evidence-based guidelines which improve the public and physician awareness towards this therapy’s risks and benefits.

Hemoglobin and hematocrit levels are positively correlated with phase angle in mixed cancer patients: an exploratory cross-sectional study.

The aim of this study is to verify the correlationbetween hemoglobin (Hb) and hematocrit (Ht) levels with phase angle (PhA) values in patients with cancer of the gastrointestinal tract and accessory digestive organs. A cross-sectional study was conducted with 82 patients (38 females/44 males) diagnosed with cancer of gastrointestinal tract and accessory organs of digestion. Hb (g/dL) and Ht (%) levels were assessed by the cyanomethemoglobin and microhematocrit methods, respectively. Body composition and PhA were evaluated by the bioelectrical impedance analysis (BIA). The cut-off point used to classify patients with low PhA was set < 4°. Fifty-five (67%) of patients had PhA ≥ 4° values. We observed that body weight, BMI, fat mass, % weight loss, Ht, and Hb were higher in the PhA ≥ 4° group than in the PhA < 4° group. In the regression analysis, we found a positive association between PhA, Ht, and Hb without and after adjustment for sex, age, BMI, and type of treatment. In mixed cancer patients, there was a positive correlation between blood-red cell markers and PhA. This may be evidence that we can use of hematological parameters to suggest changes in PhA values during oncological treatment.

Differences in Religious Commitment and Harm Reduction Attitudes Among US Medical Students by Sex Assigned at Birth: A Pilot Study.

Harm reduction emphasizes positive change by working with individuals without judgment, coercion, discrimination, or requiring abstinence from drugs to receive support. This study examines how religious commitment and medical student attitudes toward harm reduction approaches for substance use differ based on sex assigned at birth. Participants from a US osteopathic medical school completed the revised Harm Reduction Acceptability Scale and the Belief into Action Scale.Statistical analyses revealed that males had significantly higher harm reduction acceptability scores than females. Moreover, a significant negative correlation between religious commitment and harm reduction acceptance was found, indicating that stronger religious commitment was linked to lower acceptance of harm reduction. To build on this cross-sectional exploratory study, further research is needed to delve deeper into sex differences in medical students' attitudes and the role of religious commitment in harm reduction. Future studies should explore the direction and causality of these relationships.

Are cervical curvature and axioscapular muscle activity associated with disability in patients with chronic nonspecific neck pain? - a cross sectional exploratory study.

To ascertain the relationship between cervical curvature, neck muscle activity and neck disability in patients with chronic nonspecific neck pain (CNNP). Ninety participants (mean age = 27.2, female/male ratio = 7/2) with CNNP volunteered. The Neck Disability Index was used to assess neck disability. To indicate the electromyographic characteristics of the axioscapular muscles, the root mean squares and median frequencies of upper trapezius and levator scapula were used. Cervical curvature was measured with a flexible ruler. Disability of the neck was significantly correlated with curvature (r = -0.599, p < 0.001), upper trapezius root mean square (RMS) (r = 0.694, p < 0.001) and levator RMS (r = 0.429, p < 0.05). Multiple regression analysis produced a significant predictive equation that could predict disability: 33.224- 0.515 × Curvature + 0.156 × Levator RMS - 0.059 × Upper trapezius median frequency + 0.636 × upper trapezius RMS + 0.020 × levator median frequency, with R2 = 0.622. Cervical curvature as well as different axioscapular muscle activity were found to be related to level of disability. These findings have implications for clinical management of CNNP.

Role of Meaningful Social Participation and Technology Use in Mitigating Loneliness and Cognitive Decline Among Older Adults.

Community social participation aids dementia prevention and alleviates loneliness among older adults. Incorporating occupational therapy using information and communications technology (ICT) could potentially delay dementia onset and reduce loneliness. To quantify how meaningful social participation, participation frequency, ICT use, and expanded social networks influence cognitive function and loneliness among socially active older Japanese adults. Cross-sectional exploratory study using structural equation modeling. Meetings organized by older adults at seven community gathering places in Osaka Prefecture, Japan. One hundred thirteen healthy older adult cohort members. Cognitive function assessed via Mini-Cog; loneliness assessed via the condensed UCLA Loneliness Scale. The final model demonstrated excellent fit, χ2(23) = 28.291, p = .205 (root mean square error of approximation = .045, 90% confidence interval [.000, .094]; confirmatory factor index = .995; Tucker-Lewis Index = .993). ICT use directly affected social networks (β = 0.472), which directly influenced participation frequency (β = 0.324) and meaningful social participation (β = 0.381). The indirect effect of meaningful participation significantly improved cognitive function (β = 0.237). The only indirect effect of meaningful interpersonal participation was a reduction in loneliness (β = -0.235). ICT use contributes to the expansion of social networks among elderly people. Furthermore, the frequency of social participation and the meaningfulness of such participation are related to reduction in loneliness and maintenance of cognitive function. Although the frequency of social participation was not directly related to these outcomes, the results suggest that meaningful social participation may play an important role in reducing loneliness and maintaining cognitive function. Plain-Language Summary: The promotion of social participation among older people is a global phenomenon, driven by the recognition of its positive relationship with cognitive function and the alleviation of loneliness. Nevertheless, older people's social participation is constrained by a combination of physical and social factors. To address this issue, there has been a push to promote social participation based on information and communications technology (ICT). However, no specific study has been conducted on occupational therapists' perspective in capturing social participation and the use of ICT. The findings of this study show that using ICT has the potential to enhance opportunities for social interaction for older adults, thereby improving the quality and quantity of social participation. The quality of social participation was identified as the sole factor that had a positive impact on cognitive function and loneliness. This study suggests the need for occupational therapists to consider means of facilitating the use of ICTs among older adults as well as interventions that use occupational therapy theory to enhance the meaningfulness of existing social participation opportunities.

Perceptions towards practicability of humanitarian principles for emergency cases in Ethiopia: case of Tikur Anbessa Specialized Hospital

IntroductionThe health of people is negatively impacted by emergencies and catastrophes, and many lives are lost as a result. The guidelines for humanitarian action during times of crisis, whether brought on by armed war or natural disasters, are provided by the humanitarian principles. The purpose of this study was to evaluate how the staff and clients at Tikur Anbessa Specialized Hospital felt about the applicability of the four humanitarian principles when responding to emergency conditions.MethodologyFacility-based descriptive and explanatory cross-sectional study designs were employed. The study intended to collect data with structured questionnaires from a total of 209 individuals in Tikur Anbessa Specialized Hospital. The participants were selected randomly based on, their willingness. Of the 209 participants, 105 included staff and the rest 104 included clients (patients and caregivers in the emergency room) of Tikur Anbessa Specialized Hospital. The collected data were analyzed using Statistical Package for Social Science version 23.ResultsThe descriptive analysis shows that principles of humanity are practiced better with (mean = 3.5) and principles of impartiality are practiced less with (mean = 3.2) as to the perception of the participants. Correlational analysis was used to examine the relationship between the ages, profession, gender, status, work experience, and familiarity with humanitarian principles, and the results indicated a non-significant correlation between variables, r (209) = 0.01 (2 tailored), “p = ns”. This suggests that familiarity with humanitarian principles or other independent variables does not affect the applicability of humanitarian principles in healthcare settings.ConclusionFrom the results of this study, it can be concluded that the state of being a staff (health care practitioners and those providing ancillary services) and client of Tikur Anbessa Specialized Teaching Hospital has nothing to do with developing a certain perception towards the practicability of the four humanitarian principles (humanity, impartiality, neutrality, and independence).

Complementary feeding and food handling practices among caregivers in a semi-urban setting in Northern Uganda

Background: Complementary feeding practices influence the nutritional status and health of children, especially in developing countries where sub-optimal infant feeding practices are the major cause of childhood undernutrition, morbidity, and mortality. This study sought to characterize the adequacy of complimentary feeding and food handling practices among caregivers of children aged 6-23 months in a semi-urban setting. Methods: Exploratory cross-sectional study was conducted in Adyel division, Lira district in Northern Uganda among 127 child-caregiver pairs randomly selected from three villages. Caregivers were interviewed about their child-feeding practices, complementary foods used, and common practices in handling and preparation of foods used as complementary feeds. Results: Overall, children’s feeding patterns met the recommended dietary intake when assessed using the child feeding index (CFI) whereby children aged 6-8, 9-11, and 12-23 months scored 8.03, 9.17, and 7.59, respectively. However, most children were complemented with foods from the household meals and dietary diversity was limited by frequent use of food leftover from the previous meals. Conclusions: Inappropriate meal patterns and food handling practices identified are likely to compromise child nutrition and health. Nutrition education is needed to improve the caregivers’ child-feeding and food handling practices within their socio-economic and cultural context. Keywords: Complementary feeding practices; food handling; diet quality; food safety; children; Uganda.

Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study

Introduction:Intra-abdominal pressure (IAP) and gravity may both challenge pelvic organ support and contribute to the development or worsening of pelvic organ prolapse (POP). This study aimed to assess whether pelvic floor morphometry differs between supine and standing positions in women with and without POP, at rest and with elevated IAP, and to compare the change in measures from the supine to standing position between groups. Methods:Thirty premenopausal vaginally parous women with (n=15) and without (n=15) POP were included. Transperineal ultrasound was used to assess pelvic floor morphometry (bladder neck [BN], rectal ampulla [RA], levator plate angle [LPA], anorectal angle [ARA], levator anteroposterior distance [LAP], and levator hiatal area [LHA]) in supine and standing, at rest and bearing down. Measures were compared between positions (supine and standing) and groups (women with and without POP). Results:At rest, BN and RA were lower and LPA was smaller in standing than supine for all participants (all p<0.04), and LHA and LAP distance were greater in standing than supine for women with POP (p<0.001). In standing rest, BN and RA were lower and LHA was greater in women with than without POP (p<0.001). There were no differences between women with and without POP in these measures in supine (all p>0.23). ARA was greater in with POP than without POP in both positions at rest (p=0.002). During bearing down, BN and RA were lower, ARA and LPA were smaller, and LHA and LAP distance were larger in standing than in supine for all participants (all p<0.023). In bearing down in both positions, BN and RA were lower and ARA and LHA were greater in women with than without POP (all p=0.013). Conclusion:Our findings indicate lower pelvic floor support in women with POP compared to women without POP that is evident during bearing down in supine, and at rest and during bearing down in standing. These findings underscore the utility of transperineal ultrasound to assess pelvic floor morphometry in standing to guide management of women with POP.

Colorectal tumor comorbidity is common in patients with duodenal tumors: Exploratory cross-sectional study.

Background and study aims The duodenum and colorectum are target organs for familial colorectal adenomatous polyposis, however, the association of duodenal epithelial tumors (DETs) and colorectal tumors is still controversial. The aim of our study was to elucidate the association between DET and colorectal tumor. Patients and methods This was an exploratory cross-sectional study of patients with DETs treated by endoscopic resection at our hospital, between November 2018 and October 2022. Individuals who underwent colonoscopy as part of the health screening comprised the reference control group for comparison. In both groups, lesions suspected of being tumors were resected. The main outcome was the adenoma detection rate (ADR). Other outcomes were the detection rate for advanced neoplasia (AN) and risk factors for colorectal adenoma and AN, evaluated using univariate and multivariable analyses. Results Analyses were based on data from 163 individuals in the DET group and 177 in the control group. ADR was higher in the DET (63.2%) than in the control (23.6%) group ( P < 0.001). AN and invasive cancer rates were also significantly higher in the DET than in the control group (AN: 20.9% vs 3.4%, respectively, P < 0.001; invasive cancer: 3.1% vs 0%, respectively, P < 0.001). On logistic regression analysis, DET was found to be associated with a 5-fold increase in the detection rate of adenoma and 6-fold increase in AN detection. Conclusions The study revealed significant association between DET and high ADR and a higher frequency of AN and invasive cancer. Screening colonoscopy is suggested for patients with DETs.

Health-related quality of life among pediatric patients with acute lymphoblastic leukemia: An exploratory cross-sectional study.

Improved survival rates broadened the pediatric oncology focus to include health-related quality of life (HRQoL). This cross-sectional study aimed to examine HRQoL by treatment phase and disease risk level in pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL), including those in early survivorship. A subset of data from a larger prospective cohort study was analyzed. Data were collected from 73 patients (73 parent reports and 28 self-reports). Parent proxy and self-report PROMIS measures assessed HRQoL across treatment phases (early intensive, maintenance, and off treatment) and disease risk groups (standard vs high). Analyses assessed the relationship between parent proxy and patient self-reports and the differences in HRQoL among treatment phases and risk groups. Parent proxy reports generally indicated worse fatigue, pain interference, and mobility compared with patient self-reports. Self-reports in the early intensive treatment group suggested worse depressive symptoms, fatigue, mobility, and upper extremity function compared with those in later phases. Parent proxy reports showed worse fatigue and depressive symptoms in early intensive treatment group relative to those in later phases. Patient self-reports in the maintenance group demonstrated the best peer relationships scores. Parent proxy reports in the high-risk group reported significantly higher depressive symptoms and fatigue compared with the standard-risk group. Differences in HRQoL suggest targets for further assessment and intervention. The early treatment and immediate post-survivorship periods may represent particularly critical time points. Longitudinal studies with larger and diverse samples should further explore HRQoL trajectories in this population.

Physical Activity, Kinesiophobia, Pain Catastrophizing, Body Awareness, Depression and Disease Activity in Patients With Ankylosing Spondylitis and Rheumatoid Arthritis: A Cross-Sectional Explorative Study.

The aim was to compare the levels of physical activity, kinesiophobia, pain catastrophizing, body awareness, and depression in patients with Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA) and to explore the associations between these outcomes and disease activity. Seventy-eight patients with AS (n=30) and RA (n=48) were included. Outcomes were assessed using the International Physical Activity Questionnaire-Short Form, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale, the Body Awareness Questionnaire, and the Beck Depression Inventory. Disease activity levels were determined using the Bath Ankylosing Spondylitis Disease Activity Index for AS and the Disease Activity Score 28 score for RA. AS patients were younger, had a higher proportion of men, and were more physically active than RA patients (p<0.05). Both groups exhibited high levels of kinesiophobia but low levels of pain catastrophizing, similar body awareness and mild depression scores. Moderate correlations (r≥0.5) were observed between kinesiophobia and depression, body awareness and pain catastrophizing and depression, and pain catastrophizing and disease activity in AS patients. In RA patients, moderate correlations (r≥0.5) were found between kinesiophobia and pain catastrophizing. Addressing physical activity, kinesiophobia, pain catastrophizing, body awareness, and depression is important in managing AS and RA patients. Notably, correlations among outcomes differed between groups, with more significant correlations in AS. Further studies are needed to explore these in greater detail.

An exploratory cross-sectional study of awareness and barriers to adoption of telemedicine services among patients in Bangladesh

Objectives Telemedicine has emerged as a promising solution to address healthcare challenges, particularly in resource-constrained settings such as Bangladesh. Understanding patient perspectives on telemedicine adoption is vital for improving healthcare delivery in such contexts. Material and Methods This cross-sectional study surveyed 120 patients in Bangladesh to explore awareness, acceptance, and barriers to telemedicine adoption. Data were collected using structured surveys administered face-to-face in 2024. Descriptive statistical techniques were employed for data analysis. Results Most respondents demonstrated awareness of telemedicine services, primarily learning about them through friends or online sources. They viewed telemedicine positively, especially for follow-up appointments and mental health services, expressing satisfaction with the services used. However, concerns regarding its effectiveness for emergency consultations were noted. Barriers to adoption included limited internet connectivity, trust/security issues, lack of awareness, regulatory challenges, and cultural resistance. Conclusion Despite positive attitudes towards telemedicine, challenges such as internet connectivity, trust concerns, and cultural barriers persist in Bangladesh. Addressing these challenges is essential for the successful implementation and widespread adoption of telemedicine, ultimately improving access to quality healthcare services. Future research should explore the perspectives of healthcare providers and policymakers and employ longitudinal and qualitative methods to gain deeper insights.

Renal Profile of Herbal Medicine Users and Nonusers: An Exploratory Cross-sectional Study in a Family Medicine Clinic in Nigeria

Abstract Context: A major risk of herbal medicine is the potential for toxicity and serious side effects. Unlike orthodox medicine, herbs are usually consumed without prior safety assessment via clinical studies. This means that the clinical effects of herbs may be detected only through an assessment of the health parameters of consumers. Aim: The study aimed to evaluate participants’ renal profiles, comparing that of herb users with nonusers, thereby identifying any differences between the two groups. Settings and Design: It is a cross-sectional, analytic study among adult patients attending the general outpatient unit of Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. Materials and Methods: The study assessed and compared estimated glomerular filtration rate, microalbuminuria, and proteinuria among patients who reported using herbs and those who did not report any use. Statistical Analysis: Data were analyzed using Epi Info 7.2. Results: Three hundred and forty-one participants were enrolled. The mean eGFR was 87.47 ± 25.44 ml/min/1.73 m2 for participants who used herbs and 84.76 ± 25.49 ml/min/1.73 m2 for those who never used herbs (P value 0.48). Among all participants, proteinuria ≥0.3 g/l was present in 29 (8.50%) and microalbuminuria ≥30 mg/l in 138 (40.47%). There was no statistically significant difference in the renal parameters of both groups. Conclusion: The study found no evidence of the harmful effect of the herbs reported on kidney function. This could be because that the study participants mainly reported using edible—and, therefore, presumably safe—herbs. Further studies in human subjects of the effect of herbal medicine on the kidney and other systems are suggested.

Strategies Used by Puerto Rican Children in the Cognitive Assessment System and Their Relationship with Planning Performance.

Studies involving the Cognitive Assessment System (CAS) planning scale typically use only the subtest and scale scores without assessing the strategies employed by the participants. This study addressed this gap and examined the planning strategies used by children in the CAS2: Spanish version and their relationship with planning performance. We conducted an exploratory cross-sectional study with 26 Puerto Rican children aged 8 to 11. Results showed that no strategies were consistently used by participants according to examinees' reports (f = 0-46%), but examiners observed consistent use of some strategies such as "coded left to right, top to bottom", f = 92%; "scanned the page for the next number or letter", f = 100%. Welch's t-tests did not show relationships between participants' performance and the strategies observed by examiners, | mean differences | = 0.05-0.81, ps ≥ 0.05, nor with the strategies reported by participants, | mean differences | = 0.05-1.69, ps ≥ 0.05. These findings suggest that although the examiners may observe the use of strategies, the examinees are unaware of the strategies they use, and the strategies used are not associated with their performance. Future studies are needed to confirm these findings.