Lower Mean Scores Research Articles

Assessment of the quality of guidelines on oral health care during pregnancy: a systematic review.

Importance of oral health during pregnancy has been well reported. To prevent the occurrence of oral diseases and maintenance of oral health, a number of guidelines have been developed by different organizations. However, despite numerous efforts in development of these guidelines, a critical evaluation of the quality of guidelines has not been carried out. Thus, we aimed to perform a systematic review to assess the quality of guidelines on oral health care during pregnancy. PubMed, Embase, Scopus and Cochrane Databases were electronically searched in March 2024. We included guidelines that were carried out within last 10 years and focused on oral health during pregnancy were included in this review. Guidelines focused for both oral health professionals and non-oral health professionals were included in this review. The assessment of the guidelines in this review was carried out using the AGREE II instrument. The four appraisers who carried out the assessment comprised of a gynecologists, a dental practioners, a public health expert and a dental public health professional. The instrument comprises of 23 key items within six domains and two additional global rating items. We included eight guidelines in this review. The AGREE II showed two domains with mean score of more than 70% scores across the guidelines. A comparative evaluation of all the guidelines revealed consistently higher scores in scope and purpose (81.71 + 6.3) and clarity of presentation (71.61 + 11.7). Lowest mean scores were reported for editorial independence (47.87 + 7.21) followed by rigour of development (56.19 + 16.97), applicability (57.50 + 13.7) and stakeholder involvement domain (63.17 + 14.31). Although many guidelines have demonstrated adherence to systematic methodologies, there still exists a scope of improvement in domains such as editorial independence, rigour of development, applicability and stakeholder involvement. Addressing these shortcomings is essential for promoting evidence-based oral health care practices and improving maternal and neonatal health outcomes.

Evaluating factors affecting sexual abuse prevention education for primary school students according to the life skills approach

This comprehensive study delves into the intricate factors influencing sexual abuse prevention education for elementary school students, capturing insights from diverse stakeholders, including 423 students, 115 teachers, and 423 parents. Employing a Likert scale, the research evaluates various dimensions, shedding light on the nuanced dynamics that shape prevention programs. The results reveal that student-related factors, encompassing positive behavior, cognitive capacity, personality traits, and knowledge levels, received moderately positive mean scores. This underscores the significant contribution of inherent qualities and cognitive abilities of primary school students to the effectiveness of sexual abuse prevention education. Moving to family-related factors, parents’ extensive knowledge and understanding garnered a positive mean score of 2.91, signifying a favorable impact, while financial considerations received a slightly lower mean score of 2.92. Notably, parental educational methods and the inclination to delegate educational responsibilities to schools scored higher at 2.99 each, underscoring the influential role parents play in shaping their children's perspectives on sexual abuse prevention. Within the school environment, positive interactions between teachers and students stood out with a mean score of 2.97, emphasizing the pivotal role of supportive teacher-student relationships in facilitating effective sexual abuse prevention education. Societal factors exhibited varying influences, with local customs, culture, and social psychology receiving a mean score of 2.91, indicating a moderately positive impact. However, the development of the internet and information channels scored lower at 2.60, revealing potential challenges in adapting prevention education to the evolving landscape of online information dissemination. These nuanced findings contribute to a deeper understanding of the multifaceted factors shaping sexual abuse prevention education for elementary school students, providing a foundation for evidence-based interventions and policy decisions.

Seroprevalence of Brucellosis, Knowledge, and Risky Practices in Dairy Cattle Owners and Workers in Maekel and Debub Regions, Eritrea.

Brucellosis is a zoonotic disease with worldwide distribution. In Eritrea, the status of the disease in occupationally exposed dairy farmers is unknown. The objective of this study was to determine the seroprevalence of brucellosis, level of knowledge, and risky practices of dairy cattle owners/workers in Maekel and Debub regions, Eritrea. A cross-sectional study was conducted between August 2021 and February 2022. A total of 416 dairy cattle owners and workers underwent blood collection and interview using a standardized questionnaire. Blood samples were tested using Rose Bengal Plate Test, and positive samples were confirmed using competitive ELISA. Variation in knowledge scores by sociodemographic factors and practices were explored statistically. The apparent and true seroprevalence was 1.2% (95% CI: 0.05-2.8%) and 1.4% (95% CI: 0.6-3.4%), respectively. Apparent seroprevalence was similar in Maekel (1.1%) and Debub (1.2%) regions. Nearly half of the participants (49.5%) had never heard of brucellosis before. Overall, brucellosis knowledge score was low (mean score: 6.53/20). Knowledge score was higher in participants from Maekel region (P <0.001), older participants (P = 0.035), those with higher educational attainment (P = 0.001), and those with more years of experience working in dairy farming (P = 0.001). Knowledge score was lower in farm workers compared with family members (P = 0.016). No significant differences in knowledge score existed between participants who engaged in or did not engage in potential risky practices. In summary, the prevalence of brucellosis in dairy cattle owners/workers in Maekel and Debub regions, Eritrea, was low. Participants demonstrated limited knowledge of brucellosis and engaged in risky practices.

Waste Separation and Perceptions of Environmental Health in a College Floral Design Course

Industries have found themselves under a microscope because consumers are basing more of their purchasing decisions on a company’s sustainability practices. The floral industry is perceived as being environmentally friendly by consumers. However, based on waste production, the life cycle of fresh merchandise, and the carbon footprint of flowers shipped across the world, this purchasing assumption is not entirely true. To align with consumer perceptions and become more sustainable, the industry must adapt to include more sustainable practices. New and experienced florists alike must determine how they can make slight changes in their businesses to become more environmentally savvy. The purpose of this study was to investigate whether the introduction of more sustainable waste practices into a college floral design course influenced the students’ perceptions of environmental health. Two groups of students enrolled in the basic floral design course at Mississippi State University completed a survey about environmental health at the start and at the end of the semester. However, one group sorted their laboratory wastes into compostable material and landfill material. The results of this study indicated that students who separated their floral waste maintained the same level of environmental concern throughout the testing period, whereas the environmental health scores of those who did not separate their waste declined slightly. The results also indicated that the participants who did not separate their floral waste had lower mean scores at the beginning and at the end of the study. Finally, the results of this study indicated that students who separated floral waste were ranked as having high environmental concern compared to those who did not separate their floral waste in the laboratory.

Associations of financial strain and unmet social needs with women’s bladder health

ObjectiveFinancial strain and unmet social needs are associated with greater risk for lower urinary tract symptoms. Little research has examined financial strain and unmet social needs in relation to the more holistic concept of bladder health. This study utilizes baseline data from RISE FOR HEALTH: A U.S. Study of Bladder Health to examine whether financial strain, unmet social needs, and meeting specific federal poverty level threshold levels are associated with lower urinary tract symptoms and poorer perceived bladder health, well-being, and function. Study DesignParticipants were 18 years or older, born female or currently identified as a woman, and from the civilian, noninstitutionalized population residing in 50 counties in the United States that included or surrounded nine recruitment centers. Data were collected through mailed or internet-based surveys. To address research questions, the 10-item Lower Urinary Tract Dysfunction Research Network Symptom Index and selected Prevention of Lower Urinary Tract Symptoms Research Consortium bladder health scores were separately regressed on each financial strain, unmet social need, and federal poverty level variable, using linear regression adjusting for covariates (age, race/ethnicity, education, and vaginal parity) and robust variance estimation for confidence intervals. Participants with no missing data for a given analysis were included (range of n=2,564 to 3,170). In separate sensitivity analyses, body mass index, hypertension, and diabetes were added as covariates and missing data were imputed. ResultsThe mean age of participants was 51.5 years (standard deviation=18.4). Not having enough money to make ends meet, housing insecurity, food insecurity, unreliable transportation, and percent federal poverty levels of 300% or less were consistently associated with more reported lower urinary tract symptoms and poorer perceived bladder health. For example, compared to food secure participants, women who worried that their food would run out at the end of the month had a Lower Urinary Tract Dysfunction Research Network - Symptom Index score that was 3.4 points higher (95% CI: 2.5, 4.3), on average. They also had lower mean scores across different bladder health measures, each assessed using a 100-point scale: global bladder health (-8.2, 95% CI: -10.8,-5.7), frequency (-10.2, 95% CI: -13.8,-6.7), sensation (-11.6, 95% CI: -15.1,-8.2), continence (-13.3, 95% CI: -16.7,-9.9), and emotional impact of bladder health status (-13.2, 95% CI: -16.5,-9.9). Across analyses, associations largely remained significant after additional adjustment for body mass index, hypertension, and diabetes. The pattern of results when imputing missing data was similar to that observed with complete case analysis; all significant associations remained significant with imputation. ConclusionFinancial strain and unmet social needs are associated with worse LUTS and poorer bladder health. Longitudinal research is needed to examine whether financial strain and unmet social needs influence the development, maintenance, and worsening of lower urinary tract symptoms; different mechanisms by which financial strain and unmet social needs may impact symptoms; and the degree to which symptoms contribute to financial strain. If supported by etiologic research, prevention research can be implemented to determine whether the amelioration of financial strain and social needs, including enhanced access to preventative care, may promote bladder health across the life course.

Thriving beyond the stethoscope: Unveiling positive mental health among medical students at a University in South Africa

IntroductionMedical education presents significant challenges for medical students' mental health. Medical students are a vulnerable group, experiencing higher rates of mental health disorders, which can have implications for their well-being and academic performance. Consequently, evaluating Positive mental health (PMH) has become significant in a contemporary and demanding society, particularly among university students. AimThis study aimed to assess the levels of PMH and identify the association between PMH domains and socio-demographic and health related variables among medical students enrolled at a university in South Africa. MethodsThis quantitative, descriptive, and cross-sectional survey was conducted with 144 undergraduate medical students. Data were collected using a multi-dimensional PMH instrument and a sociodemographic and health related questionnaire, from 144 undergraduate medical students. The university's Research and Ethics Committee granted ethical clearance for the study. Results: The data were analysed using IBM SPSS version 29. The majority of the students were older than 20 years (79.2 %, n = 114), had no prior history of psychiatric illness, and had not previously taken any psychiatric medication (94.4 %, n = 136). More than half of the participants were single (66 %, n = 95), identified as Christians (76.4 %, n = 110), received a bursary (78.5 %, n = 113), had families living in rural areas (71.5 %, n = 103) and resided in the university housing (73.6 %, n = 106). Gender (p = 0.01), age (p = 0.02), religious affiliation (p = 0.03), history of psychiatric illness (p = 0.05) and treatment for psychiatric illness (p = 0.05) had a significant influence on the Total PMH score. Male participants reported higher mean scores in most PMH domains, excluding emotional support and spirituality domains. Participants aged between 22 and 23 years reported lower mean scores in Total PMH and most PMH domains. There is a significant difference in mean scores with gender (p = 0.02) and religious affiliation (p = 0.00) in the spirituality domain. ConclusionThe study results emphasised the complex nature of mental health and provided a rationale for assessing the various aspects of PMH in university students. By implementing evidence-based strategies and providing adequate support, medical schools can better support the mental health and well-being of their students, ultimately cultivating a healthier and more resilient future healthcare workforce.

Outcomes following humeral head autograft glenoid reconstruction in primary reverse total shoulder arthroplasty

Patients with severe glenoid bone loss are at increased risk for poor implant fixation, scapular notching, dislocation, joint kinematic disturbances, and prosthetic failure following reverse total shoulder arthroplasty (rTSA). Glenoid bone grafting has proven useful when performing rTSA in patients with inadequate glenoid bone stock, although the current literature is limited. The purpose of this study is to evaluate clinical outcomes in patients with significant glenoid deformity undergoing primary rTSA with one-stage glenoid reconstruction using a humeral head autograft. A database of prospectively enrolled patients was reviewed to identify patients who underwent primary rTSA with humeral head autograft (n=40) between 2008 and 2020 by 6 high-volume shoulder arthroplasty surgeons with a minimum 2-year follow-up. Variables studied included demographics, medical comorbidities, range of motion, Constant score, American Shoulder and Elbow Surgeons score, pain score, patient satisfaction, glenoid deformity, revisions, and complications. Preoperative glenoid deformity was characterized using glenoid version and beta-angles, measured on computed tomography. Improvement at final follow-up was compared to a matched control group of 120 standard primary rTSA patients. Following the post hoc Bonferroni correction, an adjusted alpha value of 0.004 was used to define statistical significance. Forty patients were included with a mean follow-up of 5.3 (range, 2.0-13.2) years. Patients exhibited a mean preoperative glenoid retroversion and beta-angle of 29° and 80°, respectively. At final follow-up, patients who received a graft exhibited lower mean scores for active external rotation (25° vs. 39°; P=.001) in comparison to those who did not receive a graft. No differences were observed in active abduction (P=.029), active forward elevation (P=.009), active internal rotation (P=.147), passive external rotation (P=.082), Global Shoulder Function score (P=.157), Constant score (P=.036), American Shoulder and Elbow Surgeons score (P=.009), or pain score (P=.186) between groups. Seven patients (17.5%) exhibited complications of which the most common being aseptic glenoid loosening (15%). This study demonstrates that patients undergoing primary rTSA with autogenous humeral head autograft for severe glenoid deficiency experience postoperative improvements in range of motion and functional outcome scores that exceeded the minimal clinically important difference and substantial clinical benefit but inferior to matched controls. This suggests that glenoid reconstruction using a resected humeral head autograft is an effective strategy when conducting primary rTSA in patients with significant glenoid deformity.

Body Mass Index, Adherence to a Healthy Lifestyle, and Breakfast Consumption Associated with Religious Affiliation in Peruvian University Students: A Cross-Sectional Study.

Despite evidence suggesting a relationship between religiosity and health habits, there is a paucity of studies specifically examining this association in the context of Peruvian university students. This study compared body mass index (BMI), adherence to a healthy lifestyle, and breakfast consumption in Peruvian university students of four religious denominations: Seventh Day Adventists (SDA), Catholics, Baptists, and Evangelicals. A cross-sectional study was conducted online among 4557 students from a Peruvian university. The BMI and the frequency of breakfast consumption were evaluated, and the Diet and Healthy Lifestyle Scale (DEVS) was applied. The variables studied were associated using simple and multiple linear regression and Poisson models with robust variance. Baptist (B = 0.44, 95% CI: 0.10-0.78; p = 0.011), Catholic (B = 0.3, 95% CI: 0.12-0.47; p = 0.001), and Evangelical (B = 0.32, 95% CI: 0.09 to 0.64; p = 0.014) students had a significantly higher BMI compared to SDA. Baptist (B = -0.2, 95% CI: -0.37--0.05; p = 0.017) and Evangelical (B = -0.13, 95% CI: -0.28--0.03; p = 0.012) students exhibited a lower mean score on the measure of healthy lifestyles compared to SDA students. Additionally, Baptist (PR = -0.32, 95% CI: -0.92--0.12; p = 0.035) and Catholic (PR = -0.3, 95% CI: -0.99--0.19; p = 0.016) students exhibited a lower probability of eating breakfast regularly compared to SDA students. Health professionals should consider these findings when designing and implementing health promotion programs that are culturally sensitive and respectful of the beliefs and practices of all religious groups in university settings.

The perceived relevance, utility and retention of basic sciences in general practice

BackgroundBasic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs’ practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars’ retention and perceptions of the utility of basic sciences in clinical practice.MethodsUsing sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data.ResultsSixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (β = 0.83, 95% CI: 0.45 to 1.2, p < 0.001) and gender (β = -9.7, 95% CI: -17 to -2.3, p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates.ConclusionBasic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.

Evaluation of the impact of short term manual small incision cataract surgery (MSICS) training program on trainees with varying prior surgical experience using international council of ophthalmology-ophthalmology surgical competency assessment rubrics (ICO-OSCAR).

To assess the learning curve of MSICS in three different groups of trainees with varying prior MSICS experience. To evaluate the effectiveness of ICO OSCAR for objective assessment of surgical skill transfer. Ninety-five MSICS trainees were divided into three groups as 1st year resident, fellow and external trainee. Each group were evaluated for their surgical skill acquisition during one month MSICS training program using ICO-OSCAR. Each trainee performed an average of 19 surgeries. The progress in the learning curve of the three groups of trainees was analyzed by evaluating the mean scores in sets of five consecutive cases. Complications during the training period were also noted. The study evaluated a total of 1842 cases. The fellows and external trainees, with prior MSICS experience, had an initial mean score of 57.57 ± 16.16 and 56.86 ± 17.82 respectively, whereas the 1st year resident group had a relatively low initial mean score of 45.91(p = 0.009). The difference in mean scores between the 1st year resident group and other groups significantly reduced towards the end of training. The most common complications made by 1st year residents were in sclero-corneal tunnel construction. The external trainee group had statistically significant higher rates of zonular dialysis in the study. ICO-OSCAR is an effective tool for assessing MSICS training program. Structured short term MSICS surgical training program is effective in surgical skill transfer, especially in novice surgeons.

Cancer nurses’ experience during the COVID-19 pandemic: Multicenter mixed-methods study on coping and resilience strategies

BackgroundIn early 2020, the COVID-19 pandemic created severe difficulties in clinical and organizational fields. Healthcare workers needed to protect their health and avoid infecting their family members, but also limit the virus’s spread among vulnerable oncology patients undergoing hospital treatment.ObjectiveTo evaluate the resilience and coping strategies of nurses working in the oncology setting.MethodsA mixed-methods study was conducted. First, two questionnaires (CD-RISK and COPE- NVI-25) were used to assess nurses’ resilience strategies and coping mechanisms quantitatively. Second, qualitative semi-structured interviews were conducted to explore the personal experiences of nurses who cared for patients during the pandemic, and Colaizzi’s framework was used for content analysis.ResultsThe 164 participants, the majority of whom were women (88.4%), reported high resilience. The CD-RISK score varied according to education. With respect to COPE-NIV-25, transcendent orientation and avoidance strategies had the lowest mean scores, while problem orientation was higher in nurses aged ≥ 40. Five themes emerged: (1) changes in work and personal areas; (2) feelings/emotions, such as fear of infection of themselves or their loved ones, difficulty in using the face mask, relational repercussions with patients or their families; (3) personal and working group strategies used to counteract the suffering attributable to COVID-19; (4) professionalism/nursing responsibilities in developing new rules and protocols, and (5) metaphors to describe their experiences.ConclusionsThe COVID-19 pandemic led to major changes in the nurses’ roles, but they showed resilience and generated a positive working climate.Implication for practiceEven in emergency situations, nursing administrations and policymakers ought to ensure that nurses receive adequate training and support to develop resilience and coping strategies.

Comparison of the EQ-5D-5L and the patient-reported outcomes measurement information system preference score (PROPr) in the United States

BackgroundIn contrast to prior research, our study presents longitudinal comparisons of the EQ-5D-5L and Patient-Reported Outcomes Measurement Information System (PROMIS) preference (PROPr) scores. This fills a gap in the literature, providing a much-needed understanding of these preference-based measures and their applications in healthcare research. Furthermore, our study provides equations to estimate one measure from the other, a tool that can significantly facilitate comparisons across studies.MethodsWe administered a health survey to 4,098 KnowledgePanel® members living in the United States. A subset of 1,256 (82% response rate) with back pain also completed the six-month follow-up survey. We then conducted thorough cross-sectional and longitudinal analyses of the two measures, including product-moment correlations between scores, associations with demographic variables, and health conditions. To estimate one measure from the other, we used ordinary least squares (OLS) regression with the baseline data from the general population.ResultsThe correlation between the EQ-5D-5L and PROPr scores was 0.69, but the intraclass correlation was only 0.34 because the PROPr had lower (less positive) mean scores on the 0 (dead) to 1 (perfect health) continuum than the EQ-5D-5L. The associations between the two preference measures and demographic variables were similar at baseline. The product-moment correlation between unstandardized beta coefficients for each preference measure regressed on 22 health conditions was 0.86, reflecting similar patterns of unique associations. Correlations of change from baseline to 6 months in the two measures with retrospective perceptions of change were similar. Adjusted variance explained in OLS regressions predicting one measure from the other was 48%. On average, the predicted values were within a half-standard deviation of the observed EQ-5D-5L and PROPr scores. The beta-binomial regression model slightly improved over the OLS model in predicting the EQ-5D-5L from the PROPr but was equivalent to the OLS model in predicting the PROPr.ConclusionDespite substantial mean differences, the EQ-5D-5L and PROPr have similar cross-sectional and longitudinal associations with other variables. We provide the OLS regression equations for use in cost-effectiveness research and meta-analyses. Future studies are needed to compare these measures with different conditions and interventions to provide more information on their relative validity.

Critical care nurses’ orientations to caring for patients and their families at a selected hospital in KwaZulu-Natal

Background. Caring in a critical care environment may be conceptualised differently compared with other nursing disciplines because of the patient’s critical condition and the specialised staffing categories and skills. However, critical care nurses who prioritise caring can meaningfully connect with critically ill patient and their families, resulting in positive healthcare outcomes. Objective. To assess critical care nurses’ orientations to caring for critically ill patient and their families. Methods. A quantitative, descriptive, cross-sectional study was conducted with 139 purposively sampled critical care nurses working in a tertiary referral hospital in KwaZulu-Natal, South Africa. Data were collected using the Caring Assessment for Caregivers questionnaire, and analysis included descriptive and comparative statistics. Results. The overall mean score of critical care nurses’ orientations to caring was 116.01 (range of 25 - 125). Of the five subscales (dimensions), the dimension of ‘Maintaining belief ’ had the highest mean score of 24.25 and the dimension of ‘Being with’ had the lowest mean score of 22.70 (range 5 - 25). Conclusion. While critical care nurses reported high overall orientations to caring, lower mean scores on the subscale ‘Being with’ suggest that there are areas for critical care nurses to grow in their role as carers. Further research using qualitative approaches may shed valuable insights into how the critical care environment impacts the caring orientations of critical care nurses.

Incorporating postmenopausal women's perspectives into osteoporosis clinical guidelines: a systematic review

ObjectivesTo assess the inclusion of individuals’ perspectives in the development of osteoporosis Clinical Practice Guidelines (CPGs) for primary fracture prevention in postmenopausal women. Study Design and SettingWe performed a comprehensive systematic search across guideline databases and (CPGs) developing organizations websites. Using the AGREE II tool, we assessed the quality of the guidelines, with particular emphasis on the inclusion of patients, or representatives in the development process. We also examined if women's perspectives were considered at the recommendations level and explored the potential association between the inclusion of patients' values and preferences with the quality of the CPGs. ResultsWe retrieved a total of 491 eligible CPGs, of which 33 were finally included. The majority of the CPGs were developed by scientific societies (63.6%), primarily from Europe (39.4%) and North America (30.3%). One in every four (24.2%) guidelines explicitly included individuals' perspectives in their development, and one in ten (12.1%) included research evidence about this aspect to support their recommendations. The domains with the lowest mean scores in the quality assessment were applicability (42.4%), rigor of development (44.7%), and stakeholder involvement (45.7%), and 61% were recommended for use according to our assessment. Guidelines of higher quality were more likely to include women's perspective in their development (mean difference 39.31, P = .003). ConclusionThe incorporation of women's perspectives into the process of developing guidelines for primary fracture prevention in osteoporosis remains inadequate. Our findings serve as a call for guideline developers to improve this situation, and for users, and policymakers to be aware of these limitations, when using or implementing guidelines in this field.

Knowledge and Attitude Toward Sciatica Pain and Treatment Methods Among the Population of Qassim in Saudi Arabia: A Cross-Sectional Study.

Background: Sciatica, a pain radiating along the sciatic nerve, can cause significant suffering and functional limitations. Understanding individual populations' knowledge and attitudes about sciatica pain is crucial for designing targeted interventions and enhancing healthcare delivery, especially in Saudi Arabia. This study aimed to evaluate the knowledge and attitude towardsciatica pain and treatment methods among the population of Al-Qassim in Saudi Arabia. Methods and materials:This online cross-sectional study was conducted in the Al-Qassim region, Saudi Arabia, using a self-administered questionnaire. The data was analyzed using SPSS software, with numeric data presented as mean ± SD and categorical variables as frequencies and percentages. Correlation analyses included the Chi-squared test and one-way ANOVA. Results: The study received 398 responses, from mostly female (n=305, 76.6%)and Saudi adults aged under 30 (n=248, 62.3%). Most participants sought treatment for sciatica pain from a specialist doctor (n=28, 56.0%) or a general doctor (n=10, 20.0%). Physical therapy was the most common self-treatment method (n=11, 32.4%), followed by painkillers and muscle relaxants (n=10, 29.4%). Knowledge and attitude towardsciatica were generally low (mean score: 3.54 ± 2.61 out of 9), with only 70 (17.6%) showing good knowledge. Most respondents recognized practices like spinal imaging, surgery as a last resort, and exercise/sitting habits as impacting sciatica outcomes. Traditional therapies like massage, cupping, acupuncture, and cautery were considered beneficial. Educational level significantly impacted knowledge scores, with higher mean scores among postgraduate education holders and bachelor's degree holders (mean scores: 4.06 ± 2.48 and 3.98 ± 2.53, respectively). Age, gender, occupation, nationality, and region showed no significant differences in mean knowledge scores. Attitude scores were similar across sociodemographic spectra, with younger respondents having slightly more positive attitudes. Conclusion: The study showed poor knowledge, influenced by education levels, and neutral attitudes about sciatica among residents of Al-Qassim. Therefore, educational programs and engagement of healthcare stakeholders are recommended to raise awareness and improve knowledge and attitudes.

Kavalactones support motivation to move during intensive training in males preparing for military special operations forces.

Military special operators, elite athletes, and others requiring uninterrupted optimal performance currently lack options for sleep and mood support without performance-inhibiting effects. Kavalactones, derived from the root of the kava plant (Piper methysticum Forst), have been shown to elevate mood and wellbeing by producing a feeling of relaxation without addiction or cognitive impairment. In this placebo-controlled, crossover study (NCT05381025), we investigated the effects of 2 weeks of kavalactones use on cortisol (diurnal salivary), sleep (RSQ-W; Restorative Sleep Questionnaire, Weekly), mood (DASS-21; Depression Anxiety Stress Scale-21), and motivation state to expend (Move) or conserve (Rest) energy (CRAVE; Cravings for Rest and Volitional Energy Expenditure, Right Now) in a cohort of 15 healthy, physically fit young males engaged in a rigorous, two-a-day preparation class for special operations forces qualification. Cortisol, sleep, and mood were within normal, healthy parameters in this cohort at baseline. This remained unchanged with kavalactones use with no significant findings of clinical interest. However, a statistically similar, positive slope for within-group Move scores was seen in both groups during kavalactones loading (first group Move slope 2.25, second group Move slope 3.29, p = 0.299). This trend was seen regardless of order and with no apparent effects on the Rest metric (all p ≥ 0.05). Moreover, a significant between-group difference appeared after 1 week of kavalactones use in the first phase (p = 0.044) and persisted through the end of the first loading period (p = 0.022). Following the 10-day washout, this between-groups divergence remained significant (p = 0.038) but was reversed by 1 week after the crossover (p = 0.072), with Move scores once again statistically similar between groups and compared to baseline at study end. Furthermore, the group taking kavalactones first never experienced a significant decrease in Move motivation state (lowest mean score 21.0, highest 28.6, all p ≥ 0.05), while the group receiving kavalactones in the last 2 weeks of the study had Move scores that were statistically lower than baseline (lowest mean score 8.6, highest 25.9, all p ≤ 0.05) at all time points but the last (p = 0.063) after 2 weeks of kavalactones exposure. We report a novel finding that kavalactones may support performance by maintaining or rescuing the desire to expend energy in the context of significant physical and mental strain in well-conditioned individuals, even in a context of already normal cortisol, sleep, and mood.

Nonalcoholic fatty liver disease and female sexual dysfunction in Egyptian premenopausal women: is there a link between metabolic syndrome and sexual function?

Nonalcoholic fatty liver disease (NAFLD) is a major health problem with a paucity of available information about its impact on female sexual dysfunction (FSD). We aimed to study the association between NAFLD and FSD in Egyptian premenopausal women. Sexually active married premenopausal women who visited our NAFLD outpatient screening clinic (2019 to 2022) were divided into NAFLD and non-NAFLD (control) groups based on liver ultrasound and fatty liver index data. All participants completed the Arabic Female Sexual Function Index (ArFSFI) questionnaire. The resulting data were used to calculate the domains and total scores. FSD is then graded as follows: no FSD (≥28.2), minimal (21.7-28.1), mild (14.5-21.6), moderate (7.3-14.4), and severe (≤7.2). We determined the proportions of patients and controls for whom ArFSFI scores indicated dissatisfaction with their sexual lives. Of 995 women participants whose FSFI scores were available, NAFLD was detected in 487 (48.9%) and absent in 508 (51.1%). The two groups were comparable in age, socioeconomic level, residence, and history of female genital cutting. The NAFLD patients had significantly much lower mean scores for the sexual arousal, lubrication, orgasm, satisfaction, and pain domains of the FSFI (P< .001 for all), while no statistical difference was noticed in the desire domain for NAFLD patients compared with the controls. NAFLD women had significantly lower mean total FSFI scores than the controls (mean [SD] 16.7[6.8] vs 21.7[5.1], respectively; P< .001) with higher rates of FSD (98.5% vs 82.1%; P< .001, respectively). Most NAFLD women had higher FSD grades than controls (%): no FSD (1.5, 17.9), minimal (20.6, 51.8), mild (42.5, 38.8), moderate (26.2, 9.4), and severe (10.7, none), respectively. Given the high prevalence of FSD in patients with NAFLD, greater attention to FSF could improve the quality of life in patients with NAFLD. This study was limited by the lack of testing of sex hormones and some other important factors that were not tested (eg, age, socioeconomic level, residence, and female genital cutting), as these characteristics were previously matched. Strengths of the study include the large study size, to our knowledge the largest to date to investigate the possible link between FSD and NAFLD in premenopausal women, together with the inclusion of the detailed version of the validated ArFSFI. In Egyptian premenopausal women, NAFLD could harm their sexual function.

P-456 Sexual attitudes in men undergoing Infertility treatment:Turkish sample

Abstract Study question 1. What are the sexual attitudes in men undergoing Infertility treatment ? Summary answer When the infertility reason arises from their spouse, men tend to display a more self-centred sexual attitude. What is known already Men experiencing infertility often hesitate to seeking information or ask questions about sexuality due to prevailing societal norms.Health professionals predominantly focus on addressing women’s issues, leaving the male partner feeling like an outsider who observes the treatment process from a distance. Study design, size, duration This research was conducted in cross-sectional type.,September and December 2017. 141 participant. Participants/materials, setting, methods 141 men who applied to an infertility clinic in Istanbul on Tuesdays and Thursdays between September 2017 and December 2017. The participants’ inclusion criteria were as follows: being men between the ages of 18-49, literate, accepting to participate, and having no diagnosed psychiatric illness.. All men meeting the sampling criteria were invited to participate, and there were no refusals. This setting accepts couples who have been married for at least one year and infertility problems. Main results and the role of chance The mean score of Hendrick Sexual Attitude Scale (HSAS) was 69.78 ± 9.46. Among its subscales, Birth Control had the highest mean score (11.95 ± 2.81), while Instrumentality had the lowest mean score (10.43 ± 4.34). Men whose spouse was over 30, whose marriage age was over 27, and the cause of infertility was unexplained had higher HSAS mean scores. Additionally, men with male-factor infertility scored higher in HSAS than female-factor infertility. Healthcare professionals involved in infertility treatment must prioritise addressing the sexuality of both partners. Male partners may struggle in this aspect, leading to potential misunderstandings or incomplete understanding of sexual information. By addressing and dispelling erroneous cognitive schemas, false beliefs, and self-centred attitudes, healthcare professionals can play a significant role in supporting both partners in their sexual well-being throughout the infertility treatment process. Providing sexual counselling for couples, both jointly and individually, can have a positive impact. However, it is essential to recognise that male partners may be reluctant to engage in such counselling, resulting in suppressed problems and thoughts. Healthcare providers must actively involve male partners and encourage them to share their feelings and concerns professionally and openly. Limitations, reasons for caution The participants included from a single outpatient clinic and little sample size which may limit the generalizability of the findings. Due to the topic’s taboo in Turkish society, some men might not feel openly expressing their thoughts and feelings while answering the questions, potentially affecting the accuracy of the responses. Wider implications of the findings The findings of this research highlight the significance of further investigations into men facing infertility issues from various cultural backgrounds. Qualitative and quantitative research can offer valuable insights into the complexities of sexual attitudes in diverse cultural settings. Collobaration between infertility clinics and liaison psychiatry may be advantageous. Trial registration number not applicable

Understanding International Students' Perspective of Health Service Quality: A Cross-Sectional Study in a Hungarian University.

Understanding patient's preferences is important to delivering good quality services. Patients' feedback provides healthcare providers with valuable information about the services provided. The increasing number of international students enrolling in Hungarian Universities raises the need to ensure the quality of services meets international students' requirements, which includes healthcare. This study aimed to assess service quality in the University Health Center (UHC) from the international student's point of view to be used to improve the quality of services. This cross-sectional study was conducted at the university health center. We used a mixed methods approach to collect both quantitative and qualitative data. We used the importance-performance analysis (IPA) for quantitative analysis to understand expectations and perceptions in service research. The qualitative analysis was conducted from responses to reflection questions. The qualitative data were then analyzed using thematic analysis. 437 international students participated in the study, but only 402 (91.99%) were analysed. The gaps between the importance and performance of service quality were negative in all dimensions (P-value < 0.001). This suggests that there is an unmet need for student expectations and university health center performance. From the Importance factor, the highest and lowest were related to safety (4.54 ± 0.56) and efficiency (4.31 ± 0.66) dimensions. The Performance factor's highest and lowest mean scores were also related to safety (4.22 ± 0.72) and efficiency (3.91 ± 0.87), respectively. From qualitative analysis, there are two major themes several secondary themes from the thematic analysis of free-text responses were identified. The importance and performance analysis could provide useful information to university policymakers about university health center service quality. There is a need for improvement and obviating the importance-performance gaps, especially in the efficiency dimension. Decision-makers can use the IPA analysis results to allocate limited resources more effectively, giving special attention to possible organizational weaknesses for further direction.

The skin tears knowledge among geriatric ward nurses and associated factors: A cross-sectional study

AimTo determine the level of knowledge about skin tears among geriatric ward nurses and identify associated factors. MethodsIn this cross-sectional study in Southwest China, 1172 geriatric ward nurses from 10 hospitals participated. Data were collected using Sojump, a Chinese web-based platform, and the Skin Tear Knowledge Assessment Instrument was used to assess their knowledge. The analysis involved descriptive statistics, correlation analysis, and multiple linear regression. ResultsThe study involved participants with an average age of 36.73 (SD = 6.54) years. More than half of the participants had less than 10 years of experience in geriatric wards. 27 % specialized in wound care, and 68.1 % lacked specific training in skin tear (ST) knowledge. Additionally, 82.7 % of geriatric nurses had never been exposed to guidelines on ST prevention and management. In the geriatric ward, 36.6 % of nurses received training in ST prevention. The average knowledge score about Skin Tears (STs) was 9.52 (SD = 2.39) out of 18. 'Treatment' had the lowest mean score, while 'Specific patient groups' had the highest. The multiple linear regression analysis found that nurses' knowledge of STs was influenced by sex(β = 0.096, P < 0.001), educational level(β = 0.062, P < 0.001), participation in ST (β = −0.193, P < 0.001 and wound care training(β = −0.120, P = 0.004), and specialization as a wound care nurse(β = −0.350, P = 0.001). These factors explained 61.3 % of the variance in knowledge about STs among the participants. ConclusionThe geriatric ward had limited knowledge of STs. To improve their skills in dealing with STs, managers should provide tailored training to nurses and establish a standardized, evidence-based nursing process.