Mean Quality Score Research Articles

Food security and diet quality among urban poor adolescents in Kuala Lumpur, Malaysia.

This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

Assessment of relationship between premenstrual syndrome symptoms with sleep quality and menstrual attitudes in medical students: A cross-sectional study

Background: Premenstrual syndrome (PMS) is defined as the recurring occurrence of some symptoms before and during the early days of menstruation and negatively impacts reproductive-age women and affects their standard of living. PMS is one of the physiological conditions that can affect women’s sleep quality, self-esteem, and impair their standard of living. Aims and Objectives: (i) To assess the correlation between the symptoms of pre-menstruation and quality of sleep; (ii) To assess the correlation between the symptoms of pre-menstruation and attitude towards menstruation; and (iii) To study the result of PMS scale (PMSS) scores by attitudes of menstruation and quality of sleep. Materials and Methods: Study participants who were medical students were instructed to complete the questionnaires regarding socio-anthropological information and questions related to their attitude towards menstruation, quality of sleep, and symptoms of PMS. Results: The study determines a high positive significant correlation between the PMSS score and the mean score of sleep quality (r = 0.894, P &lt; 0.001) and a high negative significant correlation between symptoms of the PMSS score and the total menstrual attitude mean score (r = −0.807, P &lt; 0.001). The total PMSS score was significantly affected by the total score of the Pittsburgh sleep quality index (β = 4.603; P &lt; 0.001) and the menstrual attitude questionnaire (β = −4.988; P = 0.001), as shown by multiple linear regression analysis. Conclusion: Poor quality of sleep and a negative menstrual attitude are associated with PMS symptoms. Identifying coping mechanisms for PMS and educating the girls in the reproductive age group may improve their standard of living.

Enhancing Workforce Capacity to Improve Immunization Data Quality using Low Dose High-Frequency Intervention Approach in Ebonyi State, Nigeria: A Randomized Controlled Study

ABSTRACT Background: Immunization data quality is poor, particularly in developing countries. This study evaluated the effect of a low-dose high-frequency (LDHF) capacity-building training approach in improving immunization data quality in Ebonyi State, Nigeria. Methods: A randomized controlled study was conducted in 145 health facilities selected through cluster sampling in Ebonyi State. The intervention comprised low but frequent training doses, supportive supervision, and peer mentoring delivered onsite by immunization officers to facility health workers. Immunization data quality was compared before and 6 months after the intervention using an interviewer-administered validated data quality self-assessment questionnaire. A percentage score ≥ 80% was classified as good quality. Variables were compared with the Student’s t and Chi-square significant tests. Findings: The total mean score of immunization data quality was higher in the intervention group, 66.8 ± 11.0, than in the control group, 55.5 ± 16.6 (P = 0.001). A higher proportion of facilities in the intervention (54.2%) than the control group (24.7%) had overall good quality data (P = 0.001). Similarly, a higher proportion of the intervention than the control group had good quality in the immunization monitoring system elements—recording, reporting, archiving, demographic information, core output, and use of evidence for action (P &lt; 0.05). Health facilities with accurate data were higher in the intervention group, 95.8%, than in the control group, 71.1% (P = 0.001). A higher proportion in the intervention (93.7%) compared to the control group (68.0%) had complete data (P = 0.001). Conclusion: The study found low-quality immunization data, which improved more in the intervention group compared to the control group. This intervention approach should be adopted and scaled up.

Teaching Medical Professionalism with a Scenario-based Approach Using Role-Playing and Reflection: A Step towards Promoting Integration of Theory and Practice.

Professionalism, as one of the core competencies of physicians, is essential for providing the patients with higher quality care. It is an abstract concept and its education and assessment need objective and operational methods. The present study aimed at teaching the concepts of professionalism based on a scenario-based approach using role-playing and reflection. This is a pre-experimental study (one-group pretest-posttest design) with a mixed method approach. The study was conducted on 18 medical students (by voluntary sampling method) who had enrolled in the Medical Ethics Course at Kashan University of Medical Sciences in 2020. Twelve scenarios were designed about the most prevalent issues of medical professionalism. In each session, one group of students played out their scenarios and then, the participants and instructors discussed their role-playing. Participants' knowledge about professionalism was assessed at the beginning and end of each session, and they completed a satisfaction questionnaire and a reflection form. T-tests (one-sample and paired T-test) were applied for statistical analysis. Quantitative and qualitative data were analyzed using SPSS software (version 26), and P<0.05 was considered statistically significant. Conventional content analysis was used to analyze the qualitative data. The mean scores of the participants' knowledge in post-test were significantly higher than those in the pre-test (P=0.042, t=-2.074). The mean scores of the participants' role-playing quality (p<0.001) and satisfaction (p=0.001) were significantly higher than their corresponding test values. Qualitative analysis of the participants' reflections revealed their satisfaction with the study intervention. The scenarios, role-playing, and reflection could provide an opportunity for operationalizing the concepts of professionalism and deep learning of students. Medical instructors need to improve their knowledge and skills of using active methods in teaching professionalism to medical students.

The effect of educational intervention on the quality of life of family caregivers of hemodialysis patients: A randomized controlled trial.

Family caregivers of hemodialysis patients experience various physical, psychological, social, economic, and spiritual problems that reduce their quality of life. The present study aimed to determine the effect of a family-centered education program on the quality of life of family caregivers of patients undergoing hemodialysis. This was a randomized controlled trial that was performed on 70 caregivers of patients undergoing hemodialysis in the medical centers of Hazrate Ali Asghar and Hazrate Zahraye Marzieh in Isfahan. Caregivers were randomly divided into experimental and control groups, and the experimental group received an eight-session family-centered education program. Data were collected using the Quality of Life Scale (QOLS)-short form immediately after and 1 month after the intervention. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 18 and analysis of variance and covariance. The results showed that both experimental and control groups were homogeneous in terms of demographic information and there was no significant difference between them in this regard. Analysis of data on quality of life and its four domains showed that the mean scores of quality of life (P = 0.089) and its four domains including physical health (P = 0.367), mental health (P = 0.429), community relations (P = 0.132), and environmental health (P = 0.232) increased significantly immediately after and 1 month after the intervention (P < 0.001 in all cases). Educational programs can improve the quality of life of family caregivers of hemodialysis patients. Therefore, it is recommended that programs be developed and evaluated in various studies in the future.

The effect of implementing Peplau's theory of interpersonal communication on the quality of life of patients with acquired immunodeficiency syndrome.

Patients with AIDS face many problems, including problems related to treatment, social and family exclusion, high treatment costs, and drug complications, which affect the quality of life of these patients and change it. The aim was to determine the effect of the application of Peplau's theory of interpersonal communication on the quality of life of patients with acquired immunodeficiency syndrome. This quasi-experimental study was performed on 50 AIDS patients referred to Shahrekord Behavioral Diseases Counseling Center. Simple random sampling was performed and then the sample was assigned to two groups experimental and control. The theory of therapeutic communication of Peplau on patients in the experimental group was performed individually and immediately after the intervention and three months later the quality of life questionnaire was completed in both groups. In this research, the data collection tool includes a demographic information questionnaire and a WHOQOL-BREF. The WHOQOLBREF questionnaire measures the four domains of physical health, mental health, social relationships, and environmental health with 24 questions. The chi-square or Fisher's exact test, independent T-test and analysis of variance with repeated measurements were used to compare the quality of life of patients. Data analysis showed no statistically significant difference in the mean score of quality of life between the experimental and control groups before the implementation of Peplau's interpersonal communication theory (p=0.927). But after the intervention, there was a statistically significant difference in the mean score of quality of life between the two groups (p < 0.001). Findings of the study show the positive effects of using Peplau's therapeutic communication model on quality of life. Therefore, this method is recommended as an effective and cost-effective care model for all patients referred to the Shahrekord Behavioral Diseases Counseling Center.

Evaluation of community empowerment program for elderly care: Lessons learned from PUSAKA Wahyu Teratai

The current paradigm and health development policy in Indonesia have changed from development to empowerment. The community empowerment program for elderly care "PUSAKA Wahyu Teratai" is a leading community empowerment program in the subdistrict of Bambanglipuro, Bantul Regency. This study was conducted to evaluate The PUSAKA Wahyu Teratai program based on input, process, output, and outcome. This cross-sectional study was conducted in December 2019. Data on the input, process, and output were collected by interviewing three caretakers with a questionnaire and tracking organizational documents and activity reports, and observing activities implementation. The outcome in the form of 63 participants’ quality of life was measured by the Short Form-36 Questionnaire. Data were analyzed descriptively. Evaluation of the input showed: most of the caretakers were male (77.33%), entrepreneurs, with senior high school education level (26.67%). Most of the facilities and infrastructure belong to the organization, the principal source of funds from Yayasan Kesejahteraan Sosial Teratai Jakarta, which were sufficient. Evaluation of the process showed: all main activities were well-scheduled and conducted routinely and documented. Evaluation of the output showed: the level of participation in each activity was between 67.61% - 100.00%. The outcome evaluation showed that the mean score of quality of life domains was: Physical Functioning (88.17 ± 20.29), Role-Physical (71.03 ± 27.75), Bodily Pain (66.98 ± 17.47), General Health (54.76 ± 12.65), Vitality (64.29 ± 15.99), Social Functioning (71.14 ±16.08), Role-Emotional (68.05 ± 34.71), and Mental Health (72.44 ± 14.57). The PUSAKA Wahyu Teratai has sufficient capital input, a fair implementation process of activities, and produced exceptional outputs and outcomes.

The Quality of Life Associated with Oral Health in Patients Treated with Removable Denture in Prosthodontics Department of School of Dentistry in Sari, Iran, During 2019-2020

Background: Reconstruction of teeth using partial or complete dentures is the only treatment for most edentulous patients. The duration of edentulism and the use of complete dentures can affect the patient’s quality of life. Therefore, this study aimed to evaluate the quality of life associated with oral health in patients referring to the Prosthodontics Department, School of Dentistry, Sari, Iran. Methods: In total, 235 patients treated in the Prosthodontics Department, School of Dentistry, Sari, Iran were selected and studied in this descriptive-analytical cross-sectional study. The required information was collected using the Oral Health Impact Profile-14 questionnaire (OHIP-14). Data were analyzed through SPSS22 and using descriptive and analytical tests, such as Mann-Whitney, t test, one-way analysis of variance, and multivariate regression. Results: In total, 103 men (43.8%) and 132 women (56.2%) with mean age of 58±10.3 years participated in this study. The duration of denture use was between 3 and 108 months. The mean score of patients’ quality of life had a statistically significant relationship with the type of treated jaw, the type of removable prosthesis, and the duration of prosthesis use (P&lt;0.05). However, no statistically significant relationship was observed between the mean score of quality of life with age and gender (P&gt;0.05). Conclusion: Based on the obtained results, the quality of life was higher among those who used dentures for a longer period of time and also in patients with complete dentures. However, the quality of life was lower in people who used mandibular dentures, compared to other groups.

A Study to Evaluate Nursing Intervention Package on Self-efficacy, Dyspnoea and Quality of Life among COPD Patients, Residing in Selected Districts of Rajasthan

Introduction: COPD is an emerging threat to the world as it affects the lives of individuals by decreasing their quality of life. In the current context, nurses can play an important role in the management of COPD by promoting an active lifestyle and some lifestyle modifications. Aim: To evaluate the effectiveness of the nursing intervention package on self-efficacy, dyspnoea and quality of life among COPD patients. Settings and Design: Quantitative experimental approach, and pre-experimental one-group pre-test and post-test research design were used. The study was conducted at 9 selected hospitals in various districts of Rajasthan. Method: 240 COPD patients were selected by non-probability, convenient sampling technique. Pre-test data were collected by socio-demographic proforma, General Self Efficacy Scale, Dyspnoea-12 Scale, and St. George’s Respiratory Questionnaire. After the pre-test, a nursing intervention package was administered by the researcher and post-test data was collected using the same research tools. Results: The obtained pre-test mean score of self-efficacy was 23.63 (SD = 4.548) whereas, in the post-test, mean score was 33.14 (SD = 2.969). The pre-test and post-test mean scores of dyspnoea were 18.51 (SD = 5.266) and 8.12 (SD = 3.290) respectively and the pre-test and post-test mean scores of quality of life were 71.06 (SD = 12.707) and 52.44 (S = 7.698) respectively. Conclusion: The investigator concluded that the nursing intervention package was effective in reducing dyspnoea and improving self-efficacy and quality of life in COPD patients.

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review.

Background: Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery. The objective of this study was to systematically review all published data that examined the assessment and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke. Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for stomatognathic system disturbances. The methodological quality was evaluated using the Mixed Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The most frequently reported symptoms in patients with stroke included stiffness and thickness of the masseter muscle on the affected side and suprahyoid muscles; facial muscles' asymmetry and weakness; temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva flow rate. The rehabilitation strategies more frequently reported included exercises directed to the jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was 85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on interventions for stomatognathic system disturbances are required before conclusions may be drawn. Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices, given that the results may help to develop early assessment and rehabilitation strategies for stomatognathic disturbances in patients with stroke.

The effect of Benson relaxation technique on the severity of symptoms and quality of life in children with irritable bowel syndrome (IBS): a quasi-experimental study

AimThis study aimed to determine the effect of the Benson relaxation technique on the severity of symptoms and quality of life in children with irritable bowel syndrome (IBS).DesignThis quasi-experimental study was carried out on children with irritable bowel syndrome in Iran.MethodSixty children were randomly divided into control and experimental groups. The Benson relaxation technique was implemented for three weeks for experimental group, while the control group only received the typical medical therapy with no special intervention. The questionnaire of Irritable Bowel Syndrome-quality of life-34 (IBS-QOL-34), and Bowel Symptoms Severity and Frequency Scale (BSS-FS) were used for data gathering before and three weeks after the intervention. Data were analyzed using statistics, appropriate parametric and non-parametric tests.ResultsAccording to the results, the experimental group had lower mean scores of qualities of life before the intervention (p < 0.05). The mean score of symptom severity in children with IBS was 13.88 in the experimental group, which changed to 9.83 in the post-test, indicating a significant difference (p < 0.000). The pre-test and post-test mean scores for quality of life in this group were 118.94 and 102.77, respectively, indicating a significant difference (P < 0.001).ConclusionThe Benson relaxation technique can be a non-pharmacological solution to reduce the severity of symptoms and improve the quality of life of children with IBS.Implication to practiceThis technique is supposed to contribute as a further intervention in clinical contexts.

Investigating different dimensions of infertile women’s quality of life: a descriptive cross-sectional study

BackgroundInfertility is a major challenge in the life of women which affects their quality of life. Infertile women's quality of life is a relatively new field of research that has recently been considered by health researchers. However, there has been no standard tool for measuring different aspects of infertile women's quality of life with female factors, and general and specific tools of infertile couples have been used to assess their quality of life. This study, thus, aimed to analyze different aspects of the quality of life of infertile women.MethodsThis descriptive cross-sectional study was conducted on 320 infertile women referred to a teaching hospital affiliated with Mazandaran University of Medical Sciences and private infertility treatment centers in Sari, Iran. Demographic and fertility characteristics and the quality of life questionnaire for infertile women questionnaire (a 25-item tool was designed which measured 7 factors of psychological effects, sexual life with infertility family and social effects, infertility-related concerns, physical effects, adaptive approaches and factors preventing infertility adaptation), were recruited for data gathering. Data were analyzed using SPSS version 22. Descriptive statistics (percentage, mean, standard deviation), correlation coefficient, independent sample t-test, and multiple linear regression were used. P-values less than 0.05 were considered statistically significant.ResultsThe total mean score of infertile women's quality of life was 65.68 ± 8.91%. Findings were indicative of infertile women's quality of life in the dimensions of adaptive approach (70.48 ± 15.02%), psychological (67.88 ± 12.06%), family and social (64.63 ± 10.76%), physical, 63.42 ± 11.36%), inhibitory factors/ factors preventing adaptation (60.98 ± 8.24%), related concerns (51.52 ± 10.21%) and sexual life (40.12 ± 14.28%). According to the final multiple linear regression model, women's education (B = 2.57, p < 0.001), spouse's education (B = 1.56, p = 0.046), economic status (B = 1.64, p < 0.001), age of women (B = -0.62, p < 0.001), age of spouse (B = -0.65, p < 0.001), duration of infertility (B = -0.36, p = 0.024) and duration of marriage (B = -0.39, p = 0.022) were the final predictors of the quality of life score in infertile women of the study.ConclusionGiven that infertility causes extensive changes in individuals, families, and social dimensions of infertile women, it can affect their quality of life. We can take steps to improve the health of infertile women by promoting various dimensions of their quality of life.

Comparing Diet Quality Indices for Low-Income 24-Month-Old Toddlers: Exploring Changes Driven by 2020–2025 Dietary Guidelines for Americans

BackgroundAccurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease. ObjectivesThe goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin. MethodsWe used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association. ResultsNearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed. ConclusionsWe found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.

Evaluating the Alignment and Quality of Microgreens Training Materials Available on the Internet: A Content Analysis

Interest in microgreens, young, edible seedlings of a variety of vegetables, spices, and herbs, is growing worldwide. A recent national survey of the U.S. microgreen industry reported 48% of 176 growers learned to grow microgreens by viewing websites and videos on the internet. However, it is unknown if the content related to growing microgreens is aligned with regulations and clearly presented. The aim of this research was to conduct a content analysis to determine alignment with the Food Safety and Modernization Act Produce Safety Rule (PSR)and the presentation quality of existing microgreen training materials available on the internet. Microgreen training materials were collected using two search engines – Google and YouTube. A deductive approach was used to inform the development of three coding manuals to evaluate the training materials meeting the eligibility criteria. One was used to determine the alignment of the content and was based on the PSR. The other two manuals were used to determine the presentation quality of Google and YouTube training materials according to CDC's Quality E-learning Checklist. A total of 223 training materials (86 Google and 137 YouTube), which fulfilled the inclusion criteria, were selected for the analysis. The results of the alignment with the PSR revealed that both sources minimally covered food safety principles with several areas minimally or not addressing specific information (e.g., water testing, worker training, environmental monitoring, and record keeping). In addition, some food safety information was unclear or presented conflicting information (e.g., requirement of washing microgreens, cleaning and sanitization methods, seed treatment methods, and waste management). The Google and YouTube quality scoring systems resulted in a mean quality score of 15.81 and 22 of a maximum score of 28, respectively. These findings indicate the quality and alignment with the PSR of microgreen training materials need to be improved.

The 50 most cited studies on posterior tibial slope in joint preserving knee surgery

PurposeTo determine the 50 most cited studies on posterior tibial slope (PTS) in joint preserving knee surgery and assess their level of evidence, objective study quality scores as well as to examine whether the study quality correlated with the citation count and citation density in the top 50 list.MethodsA literature search on Web of Science was performed to determine the 50 most cited studies on the topic of PTS in joint preserving knee surgery between 1990 and 2022. The studies were evaluated for their bibliographic parameters, level of evidence rating (LOE), citation counts, the Modified Coleman Methodological Score (MCMS), the Methodological Index for Non-Randomized Studies (MINORS), and the Radiologic Methodology and Quality Scale (MQCSRE).ResultsOf the top 50 list, 16 studies were published in the American Journal of Sports Medicine. A total of 23 studies were produced in the United States (46%). Of 10 different study types, case control studies (n = 16, 32%) and cadaveric studies (n = 10, 20%) were most common. 15 studies (30%) were purely radiological studies. 6 studies were level II (12%), 23 level III (46%), 15 level IV (30%), and 6 level V studies (12%), respectively. The number of citations ranged from 42 to 447 (mean 105.6 ± 79.2 citations) and showed a mean citation density of 10.3 ± 5.2, composed of the decades 1994 – 2000 (8.3 ± 4.1), 2001 – 2010 (11.1 ± 5.9), 2011 – 2019 (10.1 ± 5.1). Mean quality scores were 55.9 ± 13.0 for MCMS (n = 18), 14.5 ± 3.2 for MINORS (n = 18) and 18.1 ± 3.7 for MQCSRE (n = 20), respectively. High citation counts did not correlate with higher study quality scores (p > 0.05). Radiological studies were not significantly cited more often than non-radiological studies (mean 116.9 ± 88.3 vs. 100.8 ± 75.8 citations; p > 0.05).ConclusionIn joint preserving knee surgery, the 50 most cited studies on PTS did not represent a ranking of the highest methodological quality scores. Citation counts and citation density over the past three decades did not significantly differ, even though the number of articles in the presented list multiplied over the same period. This list can serve as a reference tool for orthopedic surgeons aiming to review PTS literature.

The quality of health information provided on web sites selling cannabis to consumers in Canada is poor

BackgroundCannabis is used by millions of people for both medical and recreational purposes, and this use is even greater in jurisdictions where it is legalized, such as Canada. Online cannabis vendors have gained popularity for purchasing cannabis due to easy access and convenience to consumers. The objective of this study was to evaluate the quality of health information provided by web sites of cannabis vendors selling products to Canadian consumers and to further identify trends in the information provided.MethodsSix different searches were conducted on Google.ca, and the first 40 webpages of each search were screened for eligibility. A total of 33 unique web sites of cannabis vendors selling products to Canadian consumers were identified and included. The DISCERN instrument, which consists of 16 questions divided into three sections, was used to evaluate the quality of cannabis-related health information on these web sites.ResultsAcross the 33 web sites, the average of the summed DISCERN scores was 36.83 (SD = 9.73) out of 75, and the mean score for the overall quality of the publication (DISCERN question 16) was 2.41 (SD = 0.71) out of 5. Many of these web sites failed to discuss uncertainties in research evidence on cannabis, the impact of cannabis use on quality of life, alternatives to cannabis use, risks associated with cannabis use, and lacked references to support claims on effects and benefits of use.ConclusionOur findings indicate that the quality of cannabis-related health information provided by online vendors is poor. Healthcare providers should be aware that patients may use these web sites as primary sources of information and appropriately caution patients while directing them to high-quality sources. Future research should serve to replicate this study in other jurisdictions and assess the accuracy of information provided by online cannabis vendors, as this was outside the scope of the DISCERN instrument.

Health-related quality of life and associated factors among cancer patients in Ethiopia: Systematic review and meta-analysis.

Cancer is the main cause of morbidity and mortality in every part of the world, regardless of human development. Cancer patients exhibit a wide range of signs and symptoms. Being diagnosed with cancer has a variety of consequences that can affect one's quality of life. The term "health-related quality of life" refers to a multidimensional concept that encompasses a person's whole health. The availability of data on the prevalence of poor quality of life among cancer patients in Ethiopia is critical in order to focus on early detection and enhance cancer treatment strategies. In Ethiopia, however, there is a scarcity of information. As a result, the aim of this study was to determine the pooled estimated prevalence of quality of life among cancer patients in Ethiopia. This systematic review and meta-analysis were searched through MEDLINE, Pub Med, Cochrane Library, and Google Scholar by using different search terms on the prevalence of health-related quality of life of cancer patients and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal of studies. The analysis was done using STATA 14 software. The Cochran Q test and I2 test statistics were used to test the heterogeneity of studies. The funnel plot and Egger's test were used to show the publication bias. The pooled prevalence of health-related quality of life of cancer with a 95% confidence interval was presented using forest plots. A total of 12 studies with 3, 479 participants were included in this review and the overall pooled estimates mean score of health-related quality of life among cancer patients in Ethiopia was 57.91(44.55, 71.27, I2 = 98.8%, p≤0.001). Average monthly income (AOR:3.70;95%CI:1.31,6.10), Stage of cancer (AOR:4.92;95% CI:2.96,6.87), Physical functioning(AOR:4.11;95%CI:1.53,6.69), Social functioning(AOR:3.91;95% CI:1.68,6.14) were significantly associated with quality of life. Subgroup meta-analysis of health-related quality of life of cancer patients in Ethiopia done by region showed that a higher in Addis Ababa 83.64(78.69, 88.60), and lower in SNNP region16.22 (11.73, 20.71), and subgroup analysis done based on the type of cancer showed that higher prevalence of health-related quality of life among cancer patients was breast cancer 83.64(78.69, 88.60). This review showed that the overall health related quality of life was above an average. Furthermore, average monthly income, cancer stage, physical, and social functioning were all significant determinants in cancer patients' QOL.as a result, this review suggests that quality of life evaluation be incorporated into a patient's treatment routine, with a focus on linked components and domains, as it is a critical tool for avoiding and combating the effects of cancer and considerably improving overall health. In general, more research is needed to discover crucial determining elements utilizing more robust study designs.

Evaluation of quality of clinical management of neuroendocrine tumors.

Neuroendocrine tumors (NETs) are a group of biologically and clinically heterogeneous neoplasms predominantly found in the gastrointestinal and bronchopulmonary tractus. Despite a rising incidence, implementation of evidence-based standardized care for this heterogenous group remains challenging. The European Neuroendocrine Tumor Society regularly reviews guidelines regarding diagnostic and treatment strategies for NETs. The aim of this study is to shed light on the care of patients with a NET in Belgian Limburg, to provide data as a basis for future studies and to check whether data and results are according to consensus guidelines and outcomes described in literature. Our study concerned a detailed observational data collection of two large Belgian hospitals (Jessa Hospital Hasselt and Hospital Oost-Limburg Genk) with special interest in patient profile, quality of pathology reports, use of diagnostic imaging, and overall survival. Data on 188 patients were assembled between January 2010 and December 2014 with follow-up until June 2016 (median follow-up: 33.6 months). Fifty percent of patients were male. NETs were located mainly in the digestive tract (63.8%) and lung (20.2%). Appendiceal NETs were diagnosed at a significantly younger age than other tumors (41.3vs. 64.0years). Overall, a mean pathology report quality score of 3.0/5 was observed with the highest scores for small bowel NETs. Diagnostic and nuclear imaging was performed in 74.5% and 29.8% of cases, respectively. Seventy-four percentof the population survived until the end of the observation period with highest survival rates for appendiceal and small bowel NETs. Overall, epidemiological results were comparable with findings in the literature. Gastrointestinal NETs met most of the requirements of qualitative pathology reporting and diagnostic imaging as listed in the European Neuroendocrine Tumor Societyconsensus guidelines. However, consensus with regard to bronchopulmonary NETs is still scarce and remains an objective for future research. Moreover, discussing treatment strategies in specialized multidisciplinary tumor boards would facilitate regional care.

Assessment of health system readiness for routine maternal and newborn health services in Nepal: Analysis of a nationally representative health facility survey, 2015.

Access to and utilisation of routine maternal and newborn health (MNH) services, such as antenatal care (ANC), and perinatal services, has increased over the last two decades in Nepal. The availability, delivery, and utilisation of quality health services during routine MNH visits can significantly impact the survival of mothers and newborns. Capacity of health facility is critical for the delivery of quality health services. However, little is known about health system readiness (structural quality) of health facilities for routine MNH services and associated determinants in Nepal. Data were derived from the Nepal Health Facility Survey (NHFS) 2015. Total of 901 health facilities were assessed for structural quality of ANC services, and 454 health facilities were assessed for perinatal services. Adapting the World Health Organization's Service Availability and Readiness Assessment manual, we estimated structural quality scores of health facilities for MNH services based on the availability and readiness of related subdomain-specific items. Several health facility-level characteristics were considered as independent variables. Logistic regression analyses were conducted, and the odds ratio (OR) was reported with 95% confidence intervals (CIs). The significance level was set at p-value of <0.05. The mean score of the structural quality of health facilities for ANC, and perinatal services was 0.62, and 0.67, respectively. The average score for the availability of staff (e.g., training) and guidelines-related items in health facilities was the lowest (0.37) compared to other four subdomains. The odds of optimal structural quality of health facilities for ANC services were higher in private health facilities (adjusted odds ratio (aOR) = 2.65, 95% CI: 1.48, 4.74), and health facilities supervised by higher authority (aOR = 1.96; CI: 1.22, 3.13) while peripheral health facilities had lower odds (aOR = 0.13; CI: 0.09, 0.18) compared to their reference groups. Private facilities were more likely (aOR = 1.69; CI:1.25, 3.40) to have optimal structural quality for perinatal services. Health facilities of Karnali (aOR = 0.29; CI: 0.09, 0.99) and peripheral areas had less likelihood (aOR = 0.16; CI: 0.10, 0.27) to have optimal structural quality for perinatal services. Provincial and local governments should focus on improving the health system readiness in peripheral and public facilities to deliver quality MNH services. Provision of trained staff and guidelines, and supply of laboratory equipment in health facilities could potentially equip facilities for optimal quality health services delivery. In addition, supervision of health staff and facilities and onsite coaching at peripheral areas from higher-level authorities could improve the health management functions and technical capacity for delivering quality MNH services. Local governments can prioritise inputs, including providing a trained workforce, supplying equipment for laboratory services, and essential medicine to improve the quality of MNH services in their catchment.

SLEEP QUALITY AND SLEEP DISTURBING FACTORS AMONG NURSES IN A SELECTED HOSPITAL IN COLOMBO, SRI LANKA

Sleep is a naturally recurring state of mind and body which is a vital human physiological process. The sleep quality of nurses has become a prominent social focus since they are engaging in work based on a shift schedule. The paucity of data available on sleep quality and associated factors in Sri Lanka led this study to be conducted among nurses at Apeksha Hospital, Sri Lanka. A descriptive cross-sectional study was conducted among 215 nurses at Apeksha Hospital, using a simple random - sampling method. A self-administered structured questionnaire was used as the data collection instrument and Pittsburgh Sleep Quality Index (PSQI) was used to measure the sleep quality among nurses. The majority (86.5%) were females. Of the participants 65.58% had deficient sleep (PSQI≥5) and 34.42% had healthy sleep (PSQI&lt;5). The mean score of the sleep quality was 7.16±3.30. Sleep quality was significantly (p&lt;0.05) associated with chronic symptoms (p=0.003), children status (p=0.007), night shift frequency per month (p=0.029), number of patients per night shift (p=0.048), number of working hours per week (p=0.001), sleep duration (p=0.032), sleep disturbances at night (p=0.001), sleep medication use (p=0.020), and daytime dysfunction (p=0.001). In conclusion, sleep quality was poor among nurses working at Apeksha Hospital, Sri Lanka. The characteristics of night shifts, such as number of shift duties, number of hours, and number of patients in the night shift, were associated with the sleep quality of nurses. Therefore, scheduling working hours and night shifts according to the `national and international guidelines are vital.