Exploratory Cross-sectional Study Research Articles

Access to Contraceptives among Venezuelan Migrant Women Residing in Peru: Analysis on a Population-Based Survey.

Introduction: The emigration of Venezuelans has seen a significant increase in recent years. The aim of this study was to identify factors associated with access to contraceptives in migrant women from Venezuela residing in Peru. Methods: An exploratory cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru. Access to contraceptives (yes/no) was established as the dependent variable. A Poisson regression model was performed for complex samples, and crude (PRc) and adjusted (PRa) prevalence ratios were reported. Results: A total of 3617 migrant women were analyzed, with 50.12% reporting access to contraceptives. Factors associated with greater access to contraceptives included being between 20 to 29 years old, having a university education, the entry period after the declaration of COVID-19 quarantine was associated with lower access to contraceptives. Conclusions: Access to contraceptives for Venezuelan migrants should be provided to all, as it is a free service in Peru. Additionally, education and family planning should be provided from the basic or middle school level to prevent unintended pregnancies in the future. Complete coverage should be provided regardless of the time of entry into Peru.

Organizational Factors Associated with Regulation Noncompliance in Home Care Services and Service Housing Facilities: An Exploratory Cross-Sectional Study

Rationale. Recent studies have highlighted organizational issues, work stressors, and moral distress as prevalent problems among staff working within care services for older people, but factors influencing regulatory compliance in care services for older people are currently uncharted. Aims and Objectives. The aim of this exploratory study was to investigate how organizational factors, the clinical characteristics of the clients, and perceived organizational factors are associated with staff regulation noncompliance within home care services and service housing facilities. Methods. A self-report survey was sent to practical and registered nurses working in home care services and service housing in Finland in October 2021. The sample consisted of 352 home care and 555 service housing staff members. Separate models were calculated for home care services and service housing facilities. The data were analyzed using logistic regression models. CROSS reporting guidelines were followed. Results. The results show that in service housing facilities, higher numbers of disruptions, lower team autonomy, and working for a private employer increased the odds of regulation noncompliance. In home care services, higher numbers of visits during a day, higher numbers of disruptions, and lower team autonomy increased the odds of regulation noncompliance, while attending to clients requiring less resources decreased the odds of regulation noncompliance. Perceived lack of time and resources were influential factors in both contexts. Conclusion. Allocating more time to attend to tasks, ensuring adequate staffing, as well as supporting team autonomy, may increase regulation compliance within care services for older people.

Comparison of vascular risk profile and clinical outcomes among patients with central (branch) retinal artery occlusion versus amaurosis fugax

BackgroundRetinal artery occlusions lead to sudden, painless vision loss, affecting millions globally. Despite their significance, treatment strategies remain unestablished, contrasting with acute ischemic stroke (AIS), where IVT has proven efficacy. Similar to AIS, retinal artery occlusions demand urgent evaluation and treatment, reflecting the principle "time is retina". Even for patients with transient monocular vision loss, also known as amaurosis fugax (AF), pertinent guidelines meanwhile recommend immediate emergency assessment in a specialized facility. However, data on the clinical benefit and comparability with persistent occlusions are missing. This study aimed to compare the results of a comprehensive stroke-workup among patients with persistent retinal artery occlusions (RAO), including both central retinal (CRAO) and branch retinal artery occlusion (BRAO) and those with AF.MethodsConducted at the University Hospital Giessen, Germany, this exploratory cross-sectional study enrolled patients with transient or permanent unilateral vision loss of non-arteritic origin. The primary outcome were differences between the two groups RAO and AF with regard to cardiovascular risk profiles and comorbidities, vascular and pharmacological interventions and clinical neurological and ophthalmological outcomes. Secondary outcome was a sub-group analysis of patients receiving IVT.ResultsOut of 166 patients assessed, 76 with RAO and 40 with AF met the inclusion criteria. Both groups exhibited comparable age, gender distribution, and cardiovascular risk profiles. Notably, RAO patients did not show significantly more severe vascular comorbidities than AF patients. However, AF patients received vascular interventions more frequently. Pharmacological intervention rates were similar across groups. RAO patients had slightly worse neurological outcomes, and IVT did not yield favorable ophthalmological outcomes within any observed patients.ConclusionThe study found similar vascular burden and risk factors in patients with RAO and AF, with implications for clinical workflows. IVT for RAO may only be effective in very early treatment windows. This emphasizes the need for public awareness and collaborative protocols between ophthalmologists and neurologists to improve outcomes.

New Perspectives for Low Muscle Mass Quantity/Quality Assessment in Probable Sarcopenic Older Adults: An Exploratory Analysis Study

Background: Low muscle mass quantity/quality is needed to confirm sarcopenia diagnosis; however, no validated cut-off points exist. This study aimed to determine the diagnostic accuracy of sarcopenia through muscle mass quantity/quality parameters, using the bioimpedance analysis (BIA), isokinetic, and ultrasound tools in probable sarcopenic community-dwelling older adults (≥60 years). Also, it aimed to suggest possible new cut-off points to confirm sarcopenia diagnosis. Methods: A cross-sectional exploratory analysis study was performed with probable sarcopenic and non-sarcopenic older adults. BIA, isokinetic, and ultrasound parameters were evaluated. The protocol was registered on ClinicalTrials.gov (NCT05485402). Results: A total of 50 individuals were included, 38 with probable sarcopenia (69.63 ± 4.14 years; 7 men and 31 women) and 12 non-sarcopenic (67.58 ± 4.54 years; 7 men and 5 women). The phase angle (cut-off: 5.10° men, p = 0.003; 4.95° women, p < 0.001), peak torque (cut-off: 66.75 Newtons-meters (N-m) men, p < 0.001; 48.35 N-m women, p < 0.001), total work (cut-off: 64.00 Joules (J) men, p = 0.007; 54.70 J women, p = 0.001), and mean power (cut-off: 87.8 Watts (W) men, p = 0.003; 48.95 W women, p = 0.008) in leg extension, as well as the the forearm muscle thickness (cut-off: 1.41 cm (cm) men, p = 0.017; 0.94 cm women, p = 0.041), had great diagnostic accuracy in both sexes. Conclusions: The phase angle, peak torque, total work, and mean power in leg extension, as well as forearm muscle thickness, had great diagnostic accuracy in regard to sarcopenia, and the suggested cut-off points could lead to the confirmation of sarcopenia diagnosis, but more studies are needed to confirm this.

Climatic changes: knowledge and adaptation behavior to heat-related illness among solid waste disposal workers

BackgroundEarth’s climate changes are progressing at an alarming rate. One of the most severe effects of climate change is extreme heat. This study aimed to assess knowledge and adaptation behavior to heat-related illness (HRI) among solid waste disposal workers in the 10th of Ramadan City, Egypt, and to study the predictors for their knowledge and adaptation behavior.MethodsAn exploratory cross-sectional study was conducted on 220 solid waste disposal workers. A structured interview questionnaire was used to assess the studied workers’ sociodemographic and occupational characteristics, heat exposure risk, and their knowledge, and adaptation behavior.ResultsThe results showed that 40% and 30% of participants had adequate levels of total knowledge and adaptation behavior, respectively. There was a statistically significant relationship between workers’ knowledge and both age and education. There was a statistically significant relationship between workers’ adaptation behavior and age, duration of employment, working hours, and education. A binary logistic regression for significant predictors of knowledge and adaptation behavior showed that age and education were the most significant predictors.ConclusionSolid waste disposal workers were at high risk of HRI due to their low levels of knowledge and adaptation behavior regarding HRI. Educational health programs that guide workers to follow healthy behaviors and prevent HRI are recommended.

Enhancing EQ-5D-5L Sensitivity in Capturing the Most Common Symptoms in Post-COVID-19 Patients: An Exploratory Cross-Sectional Study with a Focus on Fatigue, Memory/Concentration Problems and Dyspnea Dimensions.

This study aimed to determine whether the EQ-5D-5L tool captures the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, in patients with post-COVID-19 conditions while also investigating if adding these symptoms improves the explained variance of the health-related quality of life (HRQoL). In this exploratory cross-sectional study, two cohorts of Swedish patients (n = 177) with a history of COVID-19 infection answered a questionnaire covering sociodemographic characteristics and clinical factors, and their HRQoL was assessed using EQ-5D-5L with the Visual Analogue Scale (EQ-VAS). Spearman rank correlation and multiple regression analyses were employed to investigate the extent to which the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, were explained by the EQ-5D-5L. The explanatory power of EQ-5D-5L for EQ-VAS was also analyzed, both with and without including symptom(s). We found that the EQ-5D-5L dimensions partly captured fatigue and memory/concentration problems but performed poorly in regard to capturing dyspnea. Specifically, the EQ-5D-5L explained 55% of the variance in memory/concentration problems, 47% in regard to fatigue and only 14% in regard to dyspnea. Adding fatigue to the EQ-5D-5L increased the explained variance of the EQ-VAS by 5.7%, while adding memory/concentration problems and dyspnea had a comparatively smaller impact on the explained variance. Our study highlights the EQ-5D-5L's strength in capturing fatigue and memory/concentration problems in post-COVID-19 patients. However, it also underscores the challenges in assessing dyspnea in this group. Fatigue emerged as a notably influential symptom, significantly enhancing the EQ-5D-5L's predictive ability for these patients' EQ-VAS scores.

Knowledge Regarding Contraception and Previous Practices of Contraception Among Antenatal Women

Introduction: Contraceptive methods or devices are used to prevent pregnancy. Contraception enables women to realize their human rights and to choose whether or not to have children, as well as helps people achieve their desired family size. Currently, short-term family planning methods are available at levels of the health sector, but long-term methods are available at all levels. Objectives: To assess the knowledge regarding contraception and previous practices of contraception among antenatal women at term pregnancy attending gynaecology OPD. Methodology: An exploratory cross-sectional study was conducted. The total enumeration sampling technique was used, and 120 study participants were enrolled for the study. Data was collected by interviewing participants as per an interview schedule. Results: The study findings showed that a majority (76.6%) of the antenatal women had poor knowledge regarding contraception and 23.3% antenatal women had average knowledge. A majority (81.07%) of participants had previously practiced contraception. The most commonly used contraceptives were condoms and the calendar method. Conclusion: In the present study, more than half of the participants (antenatal women) had poor knowledge regarding contraception. It indicates the need for awareness regarding contraception and the appropriate use of contraceptive methods when required.

Widespread Misperceptions Among U.S. Adults About Tobacco Company Engagement in Black and African American Communities.

Menthol cigarettes and flavored cigars (MC/FC) bring profits to U.S. tobacco companies at the cost of Black/African American (B/AA) lives. This exploratory cross-sectional study describes perceptions of tobacco company engagement and activities in B/AA communities related to MC/FC. Among 2307 U.S. adults aged 18-45 surveyed in 2022, six items addressed beliefs about tobacco company funding of B/AA community organizations, payment of B/AA lobbyists to oppose public health policies, support of health equity efforts in B/AA communities, and targeted marketing of MC/FC in B/AA communities. Adjusted proportions were calculated for each belief overall and by race and cigarette smoking status. Among all adults, 37% believed that tobacco companies deny the harms of MC/FCs, 20% believed they pay Black lobbyists to oppose health policies, and 12% believed they fund Black community organizations. Compared with non-B/AA adults, a higher proportion of B/AA adults believed that tobacco companies target Black communities with MC/FC marketing (62% vs. 46%). More adult smokers (ie, menthol or non-MC) than nonsmokers thought that tobacco companies support health equity efforts and did not target Black communities with MC/FC marketing nor deny the harms of MC/FCs to B/AA communities. Few B/AAs and adult smokers believed that tobacco companies used B/AA organizations and lobbyists to oppose MC/FC policies in the B/AA community as well as reject MC/FC's harmfulness. Culturally tailored and community-engaged communication efforts are needed to correct disinformation about MC/FC tobacco companies' engagement and activities in B/AA communities among B/AA and menthol cigarette smokers. Tobacco companies have a history of predatory marketing that promotes flavored tobacco products to Black/African American (B/AA) individuals and more recently has spread disinformation to dissuade policy support for menthol cigarette/flavored cigar (MC/FC) bans. It is unclear what are the perceptions of tobacco company engagement and activities in B/AA communities related to MC/FC. Our study shows that B/AA adults and current cigarette smokers hold misperceptions about tobacco companies' role in spreading disinformation about MC/FC. This study identified beliefs about the industry's role in funding B/AA organizations and lobbyists who oppose policy, as well as the industry's denial of menthol cigarette and flavored cigar harms as potential messaging targets for communication efforts designed to correct disinformation about MC/FC policies among B/AA and those who currently smoke MC.

Fentanyl, carfentanil and other fentanyl analogues in Canada’s illicit opioid supply: A cross-sectional study

BackgroundDespite the increase in fentanyl-involved overdose deaths in Canada, there have been no national-level studies evaluating the proportion of illicit opioids containing fentanyl or fentanyl analogues in Canada. MethodsThis cross-sectional exploratory study characterized trends in fentanyl, carfentanil and other fentanyl analogues within opioids seized by law enforcement agencies in Canada from 2012 to 2022 and submitted to the Health Canada Drug Analysis Service (DAS). Analyses were stratified by province/region. Mann-Kandell tests were used to test for trends. ResultsA total of 157,616 samples containing any opioid (“opioid-containing samples”) were submitted to the DAS from Canadian provinces between 2012 and 2022, of which 81,165 (51.5%) contained fentanyl or a fentanyl analogue. The percentage of opioid-containing samples that were positive for fentanyl or a fentanyl analogue increased from 3.0% (95% CI: 2.6-3.4%) in 2012 to 68.3% (67.7-68.9%) in 2022 (p < 0.001 for trend). The percentage of opioid-containing samples that were positive for fentanyl or a fentanyl analogue increased between 2012 and 2022 in all regions. In 2022, the percentage of samples containing fentanyl or an analogue followed an east-to-west gradient: 15.8% (13.3-18.6%) of samples in Atlantic Canada and 84.7% (83.6-85.7%) in British Columbia. Carfentanil was present in 4.9% (4.6-5.2%) of opioid-containing samples in Canada in 2022 and 19.7% (18.3-21.2%) of opioid-containing samples in Alberta. ConclusionsThe illicit opioid supply in Canada increasingly contains toxic synthetic opioids. As of 2022, important regional differences existed in the illicit opioid supply in Canada.

What Is Considered Healthy Eating? An Exploratory Study among College Students of Nutrition and Food Science.

In modern industrialized societies, the focus on healthy eating has increased significantly across multiple sectors, including the media, public policy, expert opinion, and public awareness. The aim of this research was to explore the perceptions of healthy eating and the barriers to adopting a healthy diet among undergraduate students in Human Nutrition and Dietetics (HND) and Food Science and Technology (FST) degrees in Spain. An exploratory and descriptive cross-sectional study was conducted using a qualitative and quantitative methodology and convenience sampling. Two focus groups and a questionnaire were utilized (300 participants from all academic years completed the survey). Differences in definitions of healthy eating and perceived barriers were found between genders and students at different stages of training (p < 0.05). In their understanding of healthy eating, the students placed importance on balance, variety, moderation, and individual factors. Although students considered it easy to follow a healthy diet, family's eating habits, time availability, and emotional states were found to be the main barriers to the implementation of healthy practices. The obtained data supports the need to critically address perceptions of healthy eating throughout the training of nutrition and food science professionals. The insights obtained on the perceived barriers highlight the importance of considering both individual and environmental factors.

Latent Profile Analysis of Eating Disorders and Emotional Well-being in College Students

Abstract Background: University students face a unique combination of academic pressures, transitional life stages, and potential social isolation, which can contribute to the development of unhealthy eating patterns and emotional problems. Objectives: To explore the association between quality of life, emotional problems, and eating disorders (ED) among university students, using Latent Profile Analysis (LPA) to identify distinct eating profiles. Methods: This cross-sectional exploratory study involved a total of 1,798 university students from Brazil and Canada (mean age= 21.2; women = 78.4%). The instruments used included the Addiction-like Eating Behaviour Scale (AEBS), Depression, Anxiety, and Stress Scale (DASS-21), WHOQOL-bref, Yale Food Addiction Scale 2.0 (YFAS), Difficulties in Emotion Regulation Scale (DERS), and Impulsive Behavior Scale (UPPS-P). Results: The LPA, conducted based on the AEBS raw scores due to the absence of diagnostic criteria, identified three eating behavior profiles: Profile 1 with lower scores in AEBS and YFAS, indicating a healthy eating pattern; Profile 2 with high scores, reflecting eating compulsion; and Profile 3 with intermediate characteristics. Profile 2, associated with higher levels of anxiety, depression, and stress, showed a significantly reduced quality of life. No differences were detected regarding nationality, gender, type of university, or housing. Conclusion: The results highlight the complex relationships between eating behavior, mental health, and quality of life in university students, underscoring the need for targeted interventions to improve their well-being. Thus, ED and their consequent impact on mental health and quality of life are increasingly recognized as critical issues among university students, a group uniquely vulnerable to such challenges due to transitional life stages and academic pressures. Keywords: Latent Profile Analysis, Eating Disorders, University Students, Mental Health, Cross-Sectional Study.

Spiritual Needs and Life Satisfaction of Lithuanian Palliative Care Patients.

Life satisfaction remains a value-based orientation and an important positive dimension of human well-being. Little is known about the relationship of this construct with palliative care patients' spiritual needs. This study assesses spiritual needs of palliative care patients and their association with life satisfaction. An exploratory cross-sectional study design was employed. During structured face-to-face interviews, 110 hospitalized palliative care patients responded to the Spiritual Needs Questionnaire (SpNQ) regarding their spiritual needs and the Brief Multidimensional Life Satisfaction Scale (BMLSS) regarding life satisfaction. The patients, generally satisfied with their health and future prospects, showed variations in life satisfaction based on education and family status. Stronger Existential and Inner Peace needs were expressed. Factors such as age, gender, education, family status, and religiosity make a difference in the expression of spiritual needs. Religiosity emerged as the key predictor for Religious, Inner Peace, and Existential needs. Life satisfaction had a very weak negative correlation (-0.207, p < 0.05) with Inner Peace needs. Recommendations include understanding and addressing the spiritual needs of palliative patients and preparing healthcare professionals to address them.

Correlates of Domestic Violence Victimization Among Immigrants During COVID-19 in the United States

ABSTRACT Domestic violence has been a cause of concern during the pandemic. Immigrants have been more vulnerable to the impacts of COVID-19, given systemic and cultural barriers. Utilizing a bio-psycho-social framework, the goal of this exploratory cross-sectional study was to examine the correlates of DV victimization among immigrants (N = 419, 41.5% male and 56.8% female) across the United States. Gender, age and race were included as biological and demographic factors (model 1); mental health and psychological stress were included as psychological factors (model 2); and generational position, household income, and family connections were included as social factors (model 3). A hierarchical logistic regression was performed. The sample comprised male and female participants. About 31.3% of participants were White, while the remaining were from diverse racial groups and 43.5% were 1st generation. We observed that 35.1% (60) men and 28.3% (66) women experienced at least one form of DV victimization. Women and those who were older were less likely to experience victimization. An increase in mental health distress and limited family connections were associated with a higher likelihood of DV victimization. This study examined the rates of physical, sexual, verbal, emotional, financial and immigration-related abuse experiences of immigrants in the United States. Our findings point to the need for services to be offered to all genders and the need for more social support for immigrants. The inclusion of male and female survivors of DV adds to the novelty of this study. Practitioners in particular can play an important role in providing culturally responsive support to immigrants experiencing victimization.

Is it fear or politics? A qualitative exploration of stakeholders’ views on the failed Ebola vaccine trial in Southern Ghana

Background: The negative meaning and rumours associated with the conduct of clinical trials regarding their experimental nature adversely affect trust and their conduct. A typical example of the challenges in conducting clinical trial studies was where Ghana was selected to conduct the ebola vaccine trials, which was not successful. This study explored the social and political perspectives on the unsuccessful implementation of the ebola vaccine trial in Ghana. Methods: This was a cross-sectional exploratory study using qualitative research approach where 31 in-depth individual interviews and Key informant interviews were conducted with participants. The interviews were recorded, transcribed and coded into themes using Nvivo 12 software to aid thematic content analysis. Results: The views expressed by participants suggested that lack of stakeholder engagement to create awareness on the Ebola vaccine trial led to doubts on the purpose for the trial. Also, media propaganda, negative influence and the perception that conducting the vaccine trial in Ghana could introduce the Ebola virus into the country created panic and fear, which affected public trust and support for the Ebola vaccine trial conduct in Ghana. Furthermore, political influence linked with site selection and timing for the study in particular, led to mistrust and the subsequent suspension of the trial in Ghana. Conclusions: Based on the interpretation of our data, we conclude that the indefinite suspension of the Ebola vaccine trial in Ghana could largely be attributed to both fear and political influence as well as misinformation resulting from media propaganda leading to mistrust.

Social inequalities portrayed in the occupational experiences of girls ahead of incarceration in Brazil

ABSTRACT Literature demonstrates that most girls incarcerated in juvenile justice institutions in Brazil come from socially vulnerable groups that face social inequality and racial and gender discrimination, which results in occupational inequities. This study aims to understand the daily lives of young Brazilian girls ahead of their incarceration based on their occupational experiences and clarify how these occupations express the deep social inequalities that mark their life trajectories. This cross-sectional qualitative exploratory study used oral history as the research method. Twelve young girls incarcerated at a juvenile justice institution in Minas Gerais, Brazil in 2020 were the study participants. The impact of gender and class issues on these young girls’ daily experiences and occupations point toward the oppressions and social inequalities to which they were exposed since childhood. Their life stories were marked by daily violations of their rights, such as the difficulty of accessing and staying in school, exploitation as child labor, the lack of leisure opportunities, exposure to various forms of violence, including sexual violence, and general vulnerability. The concept of occupation, read through the lens of intersectionality, makes it possible to understand the social inequalities that cross the daily lives of vulnerable populations, as well as provoking a critical and activist position in the area in the face of occupational injustices.

Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening

A well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears a significant proportion of the world's communicable disease burden. This study assessed the capacity of laboratories in selected hospitals to conduct AMR surveillance in Zambia. This cross-sectional exploratory study was conducted among eight purposively selected hospitals in Zambia between August 2023 and December 2023. Data were collected using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. Of the assessed facilities, none had full capacity to conduct AMR surveillance with varying capacities ranging from moderate (63% (5/8)) to low (38% (3/8)). Some of the barriers of AMR-LBS were the lack of an electronic laboratory information system (63% (5/8)) and the lack of locally generated antibiograms (75% (6/8)). Quality control for antimicrobial susceptibility testing (AST), pathogen identification and media preparation had the lowest overall score among all of the facilities with a score of 14%, 20% and 44%, respectively. The highest overall scores were in specimen processing (79%), data management (78%), specimen collection, transport and management (71%), and safety (70%). Most facilities had standard operating procedures in place but lacked specimen-specific standard operating procedures. The absence of laboratories with full capacity to conduct AMR surveillance hinders efforts to combat AMR and further complicates the treatment outcomes of infectious diseases. Establishing and strengthening LBS systems are essential in quantifying the burden of AMR and supporting the development of local antibiograms and treatment guidelines.

Electrocardiogram Electrode Positioning on the Back During Echocardiography: An Exploratory Cross-Sectional Study.

ECG interpretation is sometimes difficult due to baseline fluctuations and electrode detachments when placed on the subjects' front side, leading to misinterpretation of the rhythms and phases of the cardiac cycle. We aimed to compare the differences in the wave amplitudes and respiratory variations between conventional ECG electrode positioning on the front side of patients and an alternative position on the backs of patients. Echocardiography was performed in 85 patients lying in the left lateral position. We attached the red electrode to the right clavicle, the yellow to the left clavicle, and the green to the left lateral abdomen on the front side of the patients; on the back, we attached the electrode to the right clavicle, the right upper posterior iliac spine, and the left upper posterior iliac spine. The ECG monitor amplitudes were greater on the front side compared to the back side, but the BF-breath values were smaller on the back side (6.0 pixels) compared to the front side (10.5 pixels, p<0.05). The P wave amplitude divided by the BF-breath on the back side was greater than that seen on the front side (2.8 vs. 1.8, p<0.05), whereas the QRS amplitude divided by the BF-breath was 15.0 and 16.3, respectively (p=ns). As an alternative to front-side ECG monitoring, electrodes placed on the back can help avoid misinterpretation of the ECG rhythms and the phases of the cardiac cycle due to respiration during echocardiography.

Parenting practices and interventions during the COVID-19 pandemic lockdown: an exploratory cross-sectional study of caregivers in Brazil, Mexico, and the United States.

The COVID-19 pandemic led countries' governments to rapidly establish lockdowns and social distancing, which altered family routines and the quality of family relationships worldwide. This exploratory cross-sectional study aimed to identify the impacts of the social distancing and lockdown in parenting practices of caregivers from Brazil, Mexico, and the USA, and to analyze the continuity of parenting intervention support for children and their families at the beginning of the pandemic in these countries. The sample consisted of 704 caregivers of children (286 from Brazil, 225 from Mexico, and 193 from the USA) who answered an online survey about parenting practices before/after quarantine, caregiver/child routines, feelings related to quarantine, changes in everyday life since the beginning of the COVID-19 pandemic, contact with health professionals, and sources of parenting information. Data indicate that caregivers from the three countries experienced similar parenting practices during this time, and did not report significant changes before and after the lockdown. They sought information about parenting predominantly via social media. Those receiving previous mental health care perceived the transition from in-person to telehealth services during the pandemic as feasible and acceptable. This study will be helpful for clinicians and parents to contextualize their practices amid long-standing effects that the COVID-19 pandemic can have on children and their families during and post-pandemic from multiple cultural backgrounds.

Factors associated with pregnant women’s willingness to receive maternal pertussis vaccination in Guizhou Province, China: An exploratory cross-sectional study

ABSTRACT The rise in pertussis incidence among infants in Guizhou, China underscores the need for maternal acellular pertussis vaccine (aP) immunization, a key strategy in protecting infants from severe health consequences. However, the willingness of pregnant women in Guizhou to receive this vaccine is not well-understood. This study aimed to explore pregnant women’s intentions toward maternal pertussis vaccination in Guizhou and identify the associated factors. A questionnaire based on the health belief model, was administered in an exploratory cross-sectional study from January to February 2022. Data from 564 participants were collected and analyzed. The chi-square test, Mann-Whitney U test, and Poisson regression were used to identify potential factors associated with vaccination intentions. Participants’ median age was 27 y (interquartile range (IQR): 24–31), and the median number of children per participant was one. The study found that only 36.0% of the participants intended to receive the aP vaccine while 64.0% were uncertain or negative in this regard. Significant factors associated with intentions to vaccinate included perceived barriers and cues for action and perceived benefits. The major barriers for low vaccination intentions were safety concerns for both the fetus and the mother, and family members’ negative attitudes. Free vaccines, perceiving preventive benefits, observing other pregnant women getting vaccinated, and healthcare provider recommendations may facilitate vaccination intentions. Multiple immune strategies should be developed or optimized to cope with the resurgence of pertussis.

Chaplaincy and spiritual care in Australian ambulance services: an exploratory cross-sectional study

Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics’ perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain’s role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.