Hygiene Education Research Articles

A Descriptive Study to Assess the Quality of Sleep and Sleep Hygiene among Patients Diagnosed with Neurotic Disorders attending OPD, LGBRIMH, Tezpur and to Develop a Sleep Hygiene Education Protocol

A Descriptive Study to Assess the Quality of Sleep and Sleep Hygiene among Patients Diagnosed with Neurotic Disorders attending OPD, LGBRIMH, Tezpur and to Develop a Sleep Hygiene Education Protocol

Associations between Knowledge, Attitude and Behavior with Helminthiasis in Children

Soil-transmitted helminths (STH) infection is currently one of the highest prevalence neglected tropical diseases in children. Factors contributing to such case are children’s hygiene, as well as the existence of helminths in the surrounding soil. A child’s education has large influence on their behavior and attitude towards hygiene. However, previous studies showed varying results on wether hygiene affects the rate of STH infection. Therefore, this research is done to determine whether there is significant association between hygiene and STH infection in children. This observational analysis with a cross-sectional design was conducted on elementary school children by interviewing the children and obtaining fecal samples. Analysis of 197 fecal samples shows that 14.7% of the children were infected with STH and results of the interview show more children had poor knowledge about STH infection (69%). Good hygiene attitude and behavior were found in the majority of the subjects (58.9% and 81.7% respectively). The chi-square analysis performed shows no significant relation between knowledge (p=0.626), attitude (p=0.975), and behavior (p=0.376) and the incidence of STH infection. In this study, although children demonstrated poor knowledge of STH infection but had good hygiene attitudes and behaviors, there was no significant link between these factors and STH infection. This emphasizes the need for ongoing hygiene education in elementary school children.

Evaluation of a Video-Based Concept for Hand Hygiene Education of Parents in a Neonatal Intensive Care Unit.

Current clinical guidelines support family-centered care in Neonatal Intensive Care Units (NICUs). This implies parents should also be involved in the most critical patient safety measures. Hand hygiene is the single most important tool to prevent healthcare-associated infections and related long-term effects. Although often studied in healthcare workers, the hand hygiene compliance of parents is rarely assessed. The aim of this study was to evaluate the effectiveness of an educational video, available in ten different languages, in teaching parents hand hygiene techniques in a NICU, lowering the burden on the staff. Parents in the intervention group were educated through a video; the control group received personal instruction from healthcare workers. The primary outcome parameter was the predicted probability of passing a subsequent hand scan. The quality of hand hygiene among parents educated through the video was at least as good as that of those who received instruction from a healthcare worker, demonstrated by a higher predicted probability of passing the hand scan (43.8% vs. 57.1% in male and 67.9% vs. 75.9% in female participants). The feedback from the intervention group was predominantly positive, with most parents (62%) expressing a preference for video-based education. Implementing a video-based approach seems to be effective for educating parents about hand hygiene in a NICU and was well accepted by the parents. This method offers a consistent standard of hand hygiene education, helps to overcome language barriers, and can also be used as regular reminder of the importance and proper technique of hand hygiene.

Risk factors associated with early childhood diarrhea: a case-control study

Purpose This study aims to explore the link between prevalent risk factors for early childhood diarrhea, including hygiene, feeding, weaning practices and maternal education and the occurrence and severity of early childhood diarrhea in Saudi Arabia. Design/methodology/approach A case-control study was conducted, involving 98 mothers from the Eastern Region of Saudi Arabia (51 cases and 47 controls). Data were collected from both hospital and community sources. The collected data were statistically analyzed and depicted using descriptive statistics and frequency tables. Findings Demographic data revealed that 60% of mothers were housewives, 75% had normal deliveries and all babies were full term. In the study cohort, 44% of children aged one to two years. Four domains were compared: diarrheal management, hygiene, weaning and feeding practices. Diarrheal management was suboptimal in some cases: 29% increased fluid intake, 10% maintained adequate food intake, 50% sought medical advice, 58% were familiar with oral rehydration solutions and only 37% used them. Hygiene practices were deficient, with 35% using wipes or sanitizers, 64% handwashing before feeding and 52% adhering to the recommended 10-s duration. Controls exhibited better hygiene practices. Weaning practices were generally similar, with no significant differences between the two groups. Originality/value To the best of the authors’ knowledge, this is the first study to collectively report on the risk factors linked to early childhood diarrhea in Saudi Arabia. This study yields significant insights, highlighting the crucial role of managing diarrhea, educating mothers and implementing proper household practices in impacting the occurrence and severity of this perilous ailment.

Assessing the Relationship Between Sleep Duration and the Prevalence of Chronic Kidney Disease Among Veterans in the United States: A 2022 Behavior Risk Factor Surveillance System (BRFSS) Cross-Sectional Study.

Chronic kidney disease (CKD) is more prevalent among veterans in the United States than in the general population. Similarly, veterans also exhibit higher rates of abnormal sleep duration compared to the general population. The aim of this study was to investigate the association between self-reported length of sleep and the prevalence of CKD among veterans in the United States using responses from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). For this cross-sectional study, a total of 53,211 veterans who responded to the 2022 BRFSS survey were analyzed. Measures include the outcome variable which is self-reported CKD diagnosis and a major independent variable sleep duration. Sleep duration was recategorized into ≤ 5 hours (short sleep duration), 6-10 hours (normal sleep duration), and >10 hours (long sleep duration). Covariates included gender, age, race, residence, insurance, alcohol consumption, diabetes comorbidity, coronary artery disease (CAD) comorbidity, and stroke comorbidity. Descriptive, bivariate, and multivariate logistic regressions were conducted using the SAS software (SAS Institute Inc., Cary, North Carolina, United States). Results: The prevalence of CKD among veterans in the United States is 3332 (6.29%). Veterans with sleep duration of 6-10 hours had 17.5% lower odds of CKD than veterans who slept for ≤5 hours (adjusted OR (AOR)= 0.825, 95%CI= 0.821-0.830; P=<0.0001). Veterans who slept for more than 10 hours had 68.2% higher odds of having CKD (AOR=1.682, 95%CI= 1.662-1.702; P=<0.0001). Additionally, veterans diagnosed with diabetes, stroke, and coronary artery disease had 2.447-2.103, and 2.838, respectively, higher odds of developing CKD (AOR=2.447, 95%CI= 2.435-2.459; p=<0.0001). Veterans who were 65 years and older had higher odds of developing CKD compared to those aged 35-44 years (AOR= 5.743, 95%CI= 5.669-5.818; P<0.001). The odds of having CKD were also higher among veterans who identified as Black (AOR 1.397, 95%CI =1.388-1.405; P<0.01) or as Hispanic (AOR =1.318, 95%CI = 1.307-1.329; P<0.01) compared to non-Hispanic White veterans. Those who identified as Asian had lower odds of CKD (AOR= 0.87, 95%CI=0.853-0.888; P<0.01). Furthermore, veterans who consumed alcohol had 7.8% lower odds of having CKD as compared to individuals who did not consume alcohol (AOR= 0.922, 95%CI =0.918-0.927; p=<0.0001). Male veterans had 24.7% lower odds of having CKD as compared to female veterans (AOR = 0.753, 95%CI= 0.747-0.758; P<0.001). Conclusion: This research provides evidence of a greater prevalence of CKD among veterans with short sleep duration (≤ 5 hours) and long sleep duration (> 10 hours). Sleep hygiene education and sleep optimization programs can improve sleep and boost overall kidney health among veterans.

A Study of School Absenteeism During Menstruation Amongst Adolescent Schoolgirls in An Urban Area of North India

Introduction: WHO has defined adolescence period as the phase of life between childhood and adulthood. This study aimed to estimate the percentage of girls absent from school during menstruation, investigate the underlying causes of this absenteeism, and determine the association between school absenteeism and various factors. Methods: In present community-based study, 473 school going adolescent girls studying in 9th to 12th standards were selected by multistage stratified random sampling method. We selected 3 private and 3 government schools. Adolescent girls were interviewed by pretested, predesigned, semi-structured questionnaire for data collection. Results: The mean age of the students was 16.64 ± 1.4 years. 29.2% participants were absent from school during menstruation. Dysmenorrhea was the most prevalent reason for school absence, quoted by 51(37%) of the participants. In present study positive association between school absenteeism and various socio-demographic factors like the type of school, socioeconomic status, mother's education level, access to hygienic menstrual products and health education was observed. Conclusion: Nearly one-third of the girls were absent in school during menstruation. The main reasons for school absenteeism reported by girls were dysmenorrhea, mother's restrictions, fear of staining cloth and difficulty in changing pads in school.

Gastrointestinal Helminthic Infection among the Population in Northern Thailand.

Gastrointestinal (GI) helminthic infections pose substantial public health threat, particularly in northern Thailand, with a heightened concern in Nan province. This study aims to evaluate the prevalence of GI helminthic infections in Nan province and identify associated risk factors in local population. A cross-sectional survey was conducted in 2022. Fecal specimens were collected and examined using Kato-Katz technique and Formalin Ethyl-Acetate Concentration Technique (FECT). Univariate analysis employed the Chi-square test to explore correlations, while logistic regression was defined risk factors associated with parasite infections. Among 739 individuals surveyed, 14.34% were revealed GI helminthic infections. Notably, infection rates were higher in males (20.40%) compared to females (8.95%), with a notable prevalence among individuals aged ≥ 60 (17.78%) and high infection rate was demonstrated in Kiew Chan village (21.67%). The most commonly detected helminths were minute intestinal flukes (MIFs) (10.01%) and Capillaria spp. (3.11%). Males were significantly associated with GI helminthic infections, while individuals aged 40-49 and aged 50-59 commonly displayed of parasite infections. Additionally, Kiew Chan village exhibited a significant association with GI helminthic infections, followed by Sop Puen village. Furthermore, fecal specimens of 13 rodent specimens were frequency revealed Strongyloides spp. (92.30%) and mostly exposed Ancylostoma caninum (41.93%) among 93 canines. These findings highlight the imperative for immediate public health interventions in Nan province and analogous areas in northern Thailand. Implementing strategies to enhance sanitation infrastructure and promote hygiene education can significantly contribute for reducing the prevalence of GI helminthic infections and improve overall community health.

Examining the Effect of Sleep Hygiene Education Given to Nursing Students on Sleep Quality.

The study aimed to ascertain the effect of sleep hygiene training on nursing students' sleep quality. The research study group consisted of 80 nursing students studying in the nursing department. A quasi-experimental model with a pretest-posttest control group was used. Sleep hygiene training was given to nursing students in the experimental group. The sociodemographic data form for nurse students and the Pittsburg Sleep Quality Index (PSQI) were used to collect data. The t-test for independent groups was used to compare the PSQI pre-test and post-test scores of the experimental and control groups, and the dependent group t-test was used to compare the PSQI pre-test and post-test scores within groups. There was a difference in the sleep-related data of the nursing students in the experimental and control groups and between the PSQI pretest and posttest score averages according to the groups. No significant difference between the pre-test and post-test mean scores was observed in the control group for subjective sleep quality, sleep duration, sleep disturbance, and daytime dysfunction. Sleep hygiene education helps nursing students develop regular sleep behaviors.

Implementation of a structured oral hygiene program through nursing assistant education to address non-ventilator hospital-acquired pneumonia: A quasi-experimental study.

Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed. A quasi-experimental pre-post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program. A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates. Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, p = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, p = 0.005) and toothbrushes (89.3% vs. 95.3%, p = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post-intervention cohort (0.25%) compared to the pre-intervention cohort (0.74%), p < 0.001. In the adjusted model, non-invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39). Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP.

Using the behaviour change wheel to develop a tailored intervention to overcome general practitioners’ perceived barriers to referring insomnia patients to digital therapeutic sleepio

BackgroundDigital therapeutic Sleepio has proven effective in improving sleep quality and decreasing symptoms of anxiety. The National Institute for Health and Care Excellence (NICE) guidance recommends Sleepio as an alternative treatment to usual sleep hygiene education and hypnotic medications. General practitioners (GPs) play a critical role in the adoption of digital therapeutics in patient care. Previous interventions did not adopt theoretical frameworks to systematically understand GPs behaviour toward referring patients to digital therapeutics.ObjectivesThis study aimed to report the systematic and comprehensive development of an intervention to encourage GPs to refer insomnia patients to Sleepio, using the Behaviour Change Wheel (BCW).MethodsThe eight steps outlined in the BCW were followed to develop an intervention. The Capability Opportunity Motivation-Behaviour Self-Evaluation Questionnaire (COM-B-Qv1) was adopted to understand GPs perceived facilitators and barriers to refer insomnia patients to Sleepio. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate changes in GPs’ behaviour in relation to Sleepio.ResultsThe BCW design process resulted in the identification of five intervention functions, three policy categories and five behaviour change techniques (BCTs) as potential active components for an intervention. The intervention includes providing GPs with an orientation about using Sleepio to improve their knowledge and confidence, sending visual reminders to GPs to recommend Sleepio to their patients, providing ongoing technical support.ConclusionThe BCW can be successfully applied through a systematic process to understand the drivers of GPs’ behaviour and to develop an intervention that can encourage them to refer insomnia patients to Sleepio.

Can sleep hygiene interventions affect strength and power outcomes for female athletes?

AbstractImproved sleep can enhance sprint, endurance, and sports-specific skills; however, it is yet to be investigated whether improved sleep indices could enhance strength and power performance. Sleep hygiene (SH) is growing in popularity as a tool to enhance sleep indices amongst athletic cohorts, yet the optimal delivery strategy of sleep hygiene education is yet to be determined. Using a randomised, controlled design with repeated measures, this study recruited 34 female footballers playing in WSL or WSL academy league. Participants were split into 3 groups: one receiving both group-based and individualised sleep hygiene education, one receiving only group-based SH education and a control group receiving no education. Monitoring of sleep (actigraphy, diaries) and physical performance (countermovement jump, isometric mid-thigh pull) was carried out at week 1, week 4 and week 7. Split-plot ANOVAs were used to assess for differences between groups × weeks, and groups × time. Individualised sleep hygiene education resulted in significantly improved sleep duration (p = 0.005), latency (p = 0.006) and efficiency (p = 0.004) at week 7 compared to controls, whilst also resulting in significantly improved countermovement jump scores (p = 0.001) compared to control. Results of this study suggest that jump performance may be affected by sleep factors, and that individualised SH may be superior to group-based SH, providing information to coaches regarding training optimisation and the efficacy of SH education methods.

Exploring Menstrual Hygiene Education and Awareness among Medical Students: A Cross-Sectional Study

Exploring Menstrual Hygiene Education and Awareness among Medical Students: A Cross-Sectional Study

Insomnia prehabilitation in newly diagnosed breast cancer patients: Protocol for a pilot, multicentre, randomised controlled trial comparing nurse delivered sleep restriction therapy to sleep hygiene education (INVEST trial).

Insomnia is a prevalent sleep disorder that negatively impacts daytime functioning and quality of life. Breast cancer patients report higher rates of insomnia and more circadian disruption than other cancer groups. Approximately 50% of patients experience acute insomnia following breast cancer diagnosis, which often persists during cancer treatment and rehabilitation. Sleep Restriction Therapy (SRT) is a clinically effective and tolerable treatment for persistent insomnia in breast cancer survivors. However, SRT has never been tested on patients with early signs of sleep disturbance who are undergoing cancer treatment. The aim of this pilot randomised controlled trial is to explore the feasibility and preliminary effectiveness of nurse delivered SRT for newly diagnosed breast cancer patients with acute insomnia. The trial has been registered on ClinicalTrials.gov (identifier: NCT06294041). The INVEST (INvestigating the Value of Early Sleep Therapy) trial will recruit 50 newly diagnosed breast cancer patients who meet criteria for acute insomnia. Patients will be recruited from breast cancer results clinics within two Scottish health boards (NHS Grampian and NHS Greater Glasgow and Clyde) and will be block randomised (1:1) to receive nurse delivered SRT or Sleep Hygiene Education (SHE). SRT will be delivered over 4 weekly sessions comprising two face-to-face meetings (either in person or online) and two telephone calls, whereas SHE will be administered in booklet form. Outcomes will be collected at baseline, 6 weeks, and 12 weeks post-randomisation. Primary outcomes in this trial relate to the feasibility of SRT for newly diagnosed breast cancer patients with acute insomnia. Specifically, we will explore (i) rates of patient recruitment and retention, (ii) intervention fidelity, (iii) data collection procedures and outcome measure completion, (iv) intervention acceptability. Secondary outcomes will focus on preliminary evaluation of patient responses to SRT, including insomnia severity, rest-activity rhythms, and mental health. Our dissemination plan comprises publishing trial outcomes in high-impact, peer-reviewed journals and on breast cancer charity websites and other patient resources. The outcomes from this pilot trial will also inform the development of a full-scale, multicentre RCT of SRT for acute insomnia in newly diagnosed breast cancer patients. University of Strathclyde is the sponsor (reference: UEC23/52). Protocol version v1.2 4 October 2023. This trial is the first to explore the value of sleep prehabilitation for newly diagnosed breast cancer patients.This will be the first trial to assess the feasibility of delivering SRT during breast cancer treatment, providing valuable insight into its tolerability and preliminary effectiveness.An embedded process evaluation will assess the acceptability of SRT, providing insight into potential optimisation of the intervention and recommendations for enhancing its future scalability and translation within cancer care.Due to the nature of the SRT intervention, nurse therapists and patients cannot be blinded to treatment allocation, increasing the risk of bias.

Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma.

Vocal process granuloma (VPG) is a chronic condition resulting from a mucoperichondrial injury of vocal process. Initial conservative treatment typically involves vocal hygiene education and antireflux medication. Treatment challenges arise with refractory cases. Outcomes of second-line treatments such as surgical excision and botulinum toxin injections remain inconsistent. Thus, we propose this study to investigate the effectiveness of intralesional steroid injections for refractory VPG. We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure. Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p < .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction <75%), whereas prior intubation was associated with better response. For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.

Beyond the surface: exploring contributing factors to bone anchored hearing implant complications.

Bone anchored hearing implants (BAHI) are considered for conductive and mixed hearing loss, relying on osseointegration of a titanium implant. Limitations relate to constant skin contact, with resultant percutaneous infections and granulation. This study investigates whether patient characteristics and implant-specifications contribute to BAHIs' skin complications in a cohort with a uniform surgical approach. A 10year (2014-2024) retrospective cohort study was conducted on BAHI procedures that were undertaken using a tissue-preserving 'punch' technique. Data on patient demographics, co-morbidities, implant type, surgical approach, and complications were collected. Poisson regression analysis was used to identify predictors of complications. A total of 53 patients undergoing 55 BAHI surgeries by three ENT consultants were included. Factors that greatly increased implant-related percutaneous infections included the Cochlear™ BIA400 implant when compared to the Ponto™ BHX implant (twofold, CI 2.03-2.16), abutment sizes ≤ 10mm (fourfold, CI 3.99-4.12) and male gender (9%, CI 1.07-1.12). Granulation episodes were affected by cardiovascular disease (CVD) status (1.5-fold, CI 0.26-0.78), BIA400 implant (threefold, CI 8.8.-9.2) and abutment sizes ≤ 10mm (fourfold, CI 3.6-3.73). Revision surgery episodes increased with diabetic status (1.2-fold, CI 0.06-0.37) and abutment sizes ≤ 10mm (threefold, 3.303-3.304). Larger cohort studies are required to confirm findings, particularly for implant and abutment size contributions. However, the findings suggest that using a larger abutment size when skin thickness meassuremets are borderline, improved hygiene education in male patients, pre-operative optimisation of CVD and diabetes, and adjusted patient follow-up based on risk stratification of the contributing factors to complication rates could reduce complication rates.

Determination of the effects of hand hygiene education given to nursing students in intensive care unit on hand microbiota

Purpose: This study is conducted with the purpose of comparing fourth-year nursing students' hand hygiene practices and beliefs with their hand flora. Additionally, we aim to assess the effectiveness of hand hygiene education in this context. Material and Methods: This research has been conducted using a pre-test, post-test, and control group quasi-experimental design. The Hand Hygiene Application Inventory and the Hand Hygiene Belief Scale administered as pre-tests. Students underwent tape stripping and swab methods to collect samples for their hand flora before any interventions. A post-test was conducted for the experimental group. Results: The hand hygiene beliefs and practices of both groups were similar before training. When the Hand Hygiene Application Inventory and Hand Hygiene Belief Scale scores before and after the training were examined, an increase was observed in the scale scores after the training. In this study, the microorganisms present in the general hand flora were identified simplistically, and the changes were observed after hand hygiene education. Furthermore, the study shed light on the structure of hand flora after education in terms of microbial load. Conclusion: It has been experimentally determined that there is a significant decrease in hand microbiota load and pathogenic groups with hand hygiene education.

Research on sleep disorders and related risk factors among healthcare workers from Fujian province supporting Hubei province during the COVID-19 pandemic.

To explore the impact of COVID-19 on the sleep of healthcare workers from Fujian Province supporting Hubei Province and its related risk factors. A cross-sectional, anonymous, self-reported online questionnaire survey was conducted among all participants. The questionnaire consisted of five parts: sociodemographic characteristics and COVID-19 epidemic-related factors, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Morningness-Eveningness Questionnaire-5 (MEQ-5), and 12-item General Health Questionnaire (GHQ-12). Among 552 participants, 203 (36.8%) had a PSQI score > 7, indicating the presence of sleep disorders. Logistic regression analysis revealed that sleep disorders were independently associated with a history of previously diagnosed sleep disorders (OR 6.074, 95% CI 2.626-14.049, P < 0.001), rotating night shifts > 3 times per week (OR 3.089, 95% CI 1.650-5.781, P < 0.001), using electronic devices before sleep >1 h (OR 1.685, 95% CI 1.131-2.511, P = 0.010), concern about contracting COVID-19 (OR 1.116, 95% CI 1.034-1.204, P = 0.005), perception of societal support for supporting healthcare workers in Hubei (OR 0.861,95% CI 0.744-0.998, P = 0.047) (OR 0.861, 95% CI 0.744-0.998, P = 0.047), non-medical staff (OR 0.257, 95% CI 0.067-0.987, P = 0.048), ESS score (OR 1.068, 95% CI 1.018-1.121, P = 0.007), and GHQ-12 score (OR 1.511, 95% CI 1.281-1.782, P < 0.001). Sleep disorders were highly prevalent among healthcare workers from Fujian Province supporting Hubei Province during the COVID-19 pandemic. Risk factors for sleep disorders included a history of previously diagnosed sleep disorders, rotating night shifts > 3 times per week, using electronic devices before sleep >1 h, excessive concern about contracting COVID-19, and poorer psychological health. Higher perceived societal support and understanding of support for healthcare workers supporting Hubei were associated with a reduced risk of sleep disorders, as was being non-medical staff. Providing more sleep hygiene education and psychological health services for frontline healthcare workers is necessary.

Social jetlag affects jump skills in sub-elite volleyball players.

Social jetlag (SJL), resulting from misalignment between biological rhythms and social schedules, has emerged as a prevalent phenomenon in modern society, particularly among young athletes. However, the effect of SJL on performance is poorly studied. Jump and dynamic balance are two key skills in volleyball, as the first allows the player to perform better both during the offense and defense phase, and the second is fundamental in landing and in injury prevention. Therefore, our aim was to investigate the effect of SJL on jump skill performance and balance in female volleyball players. Thirty female volleyball players (mean age: 17.3 ± 0.88 years) participated in the study. SJL was assessed using the Munich ChronoType Questionnaire (MCTQ), integrated with Jankowsky's sleep-corrected formula. Jump skill performance was evaluated using a standardized jump test, the Vertec Jump Test, while balance was assessed with the Y Balance Test. The tests were performed at 09:00 a.m. and at 06:00 p.m. The results revealed that players with greater SJL exhibited decreased jump performance, characterized by lower vertical jump height (p = 0.02). Furthermore, players with lower SJL showed the typical difference between morning and afternoon performance (p = 0.001), demonstrating their synchronization between biological rhythms and social commitments, while no statistically significant difference between the two sessions was shown in players with higher SJL. Regarding balance, no significant association with SJL was found, but the morning session yielded lower results than the afternoon one (p = 0.01). These findings highlight the detrimental impact of SJL on jump skill performance, underscoring the importance of optimizing sleep-wake schedules and circadian alignment to enhance athletic performance. Future research should explore targeted interventions, such as sleep hygiene education, to minimize social jetlag and promote optimal performance in adolescent athletes.

Contribution of water, sanitation, hygiene and basic education to reduce under-five mortality in Sudan

ABSTRACT Until 2015, the under-five mortality rate (U5MR) in Sudan was 65.9 per 1,000 livebirths, higher than the MDG4 target, and it has to be reduced by 5.04% per year from its 2020 level to achieve the SDG3.2 by 2030. This target cannot be achieved without improvements in access to safe drinking water (ASW), sanitation and hygiene (ISF) (WASH) and basic education. An estimated autoregressive distributed lag bounds test model confirms a long-run equilibrium relationship between U5MR, WASH, basic education, economic growth and health care. In the short run, U5MR decelerates itself with a coefficient of 0.56. Sanitation and basic education significantly reduce U5MR. Collectively, health care and economic growth affect U5MR adversely. In the long run, declines of U5MR are driven respectively by access to sanitation, hygiene and basic education (a factor of 1.79), economic growth (a factor of 0.21), and health care (a factor of 0.18). The study recommends promotion of access to safe drinking water with investments in sanitation and hygiene of 32 million $US annually between 2020 and 2030, in order to meet the SDG3.2 in Sudan. Skilled physicians and full vaccination of children can be more effective in reducing U5MR, dependent on progress in safe WASH.

Assessment of Motivations, Treatment Risks, and Oral Health in Adults with Fixed Orthodontic Care: A Cross-Sectional Study.

Aim: This cross-sectional study aims to investigate the reasons why adults seek orthodontic treatment, their perceived treatment risks, oral hygiene habits, and awareness of oral health. Materials and Methods: This study, which involved 246 adults, used a self-report questionnaire to collect sociodemographic data and examine the participants' understanding of oral health, self-assessment of oral health status, adherence to oral hygiene routines, and use of oral hygiene products. In addition, the reasons for opting for orthodontic treatment, negative associations, and expected outcomes were examined. The collected data were subjected to statistical analysis, including descriptive and regression methods. Results: The results showed that factors such as previous oral health education and regular use of specialized toothbrushes, including rotary toothbrushes, were significantly associated with higher knowledge levels (p < 0.05). However, daily oral hygiene practices were suboptimal, with the low utilization of aids: only 58.9% reported using interdental brushes, and 36.6% used dental floss regularly. Commonly reported dental problems included food debris between teeth (46.3%), tartar (35.4%), and tooth sensitivity to cold (26.4%). The primary motivations for orthodontic treatment were aesthetic improvement (63.8%), enhancements in oral function (49.6%), and addressing psychosocial concerns (42.7%). In contrast, the most frequently mentioned negative aspects associated with fixed orthodontic treatment were aesthetic concerns (30.9%), treatment duration (27.6%), and mouth ulcers (24.0%). Conclusions: Based on the research findings, regular oral hygiene education is recommended for adult patients considering fixed orthodontic therapy, including the use of additional tools such as interdental brushes and floss to improve oral health and reduce the risk of complications during treatment. The importance of chemical compounds in dentifrices and mouthwashes cannot be overstated, as they play a crucial role in addressing various dental issues. In addition, it is crucial to carefully weigh the pros and cons of therapy and to visit a dentist regularly to maintain oral health and monitor progress during treatment.