Multicenter Cross-sectional Study Research Articles

Critical assessment of the reported bidirectional associations between gallstone, non-alcoholic fatty liver, and kidney stone diseases

The recent article by Jiang et al published in World Journal of Gastroenterology reports substantial bidirectional associations between gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), and kidney stone disease (KSD), based on multicenter cross-sectional studies and a systematic review with meta-analysis. While the findings have the potential to significantly impact clinical and preventive strategies, several methodological issues merit closer examination. This letter critiques key aspects of the study, including sample population heterogeneity, potential confounding variables, and the reliance on cross-sectional data that may limit causal inferences. We also discuss the generalizability of these results to broader populations given the study's focus on the Chinese demographic. By addressing these concerns, we suggest a more nuanced interpretation of the associations between GSD, NAFLD, and KSD, advocating for longitudinal studies to validate these findings and enhance their applicability in global health contexts.

Predictors of Psychological Burnout Among Jordanian University Students: Multicenter Cross-Sectional Study

(1) Background: Psychological burnout (BO) is one of the most significant challenges faced by university students. This study aimed to explore the perceived levels of BO, psychological resilience (PR), and psychological hardiness among university students in Jordan. It also investigated the factors that may contribute to psychological BO. (2) Methods: Using a cross-sectional design, a total of 1219 university students (female = 933 (76.5%), male = 286 (23.5%)) were conveniently selected from four universities (two public and two private) to represent the study sample. (3) Results: Results found that 40.39% of university students had severe psychological BO levels, although most of them had acceptable PR (92.74%) and hardiness (83.7%) levels. Unmarried students at public universities, medical schools, and fourth-year students or beyond showed higher levels of psychological BO than any other category. A negative correlation (p < 0.05) was observed among psychological BO and both perceived PR and hardiness variables. Additionally, a positive correlation was found between perceived PR and psychological hardiness. Significant contributions of hardiness, university type, and academic year to BO were detected, with a variance of 29.7%. (4) Conclusions: Academic teachers and policymakers should tackle this problem among university students to help alleviate the different sources of stressors in university life.

Is Confidence in Mathematics Pedagogy Enough? Exploring Early Childhood Teachers’ Mathematics Beliefs and Confidence

Abstract A multicentre cross-sectional study of early childhood teachers (ECTs) from one large Australian not-for-profit early childhood organisation in preschool (3–5 years) classrooms, was conducted. This study was part of a quasi-experimental online Mathematics Professional Learning Program intervention aimed at developing ECTs’ mathematical pedagogical content knowledge; we report on ECTs’ (n = 325) pre-program survey scores, investigating their beliefs and confidence around mathematical pedagogy and their beliefs of preschoolers’ mathematical abilities. Scores were high, especially for confidence in pedagogical knowledge and pedagogical ability in helping children learn mathematics, and several survey constructs were significantly inter-related. However, more than half of the ECTs did not agree that most children enter preschool with some mathematics abilities, and confidence in their own mathematical abilities in areas of numeracy and spatial awareness varied. Mathematics focussed Environmental Rating Scale, Early Childhood Environment Rating Scale—Extension (ECERS-E) and Sustained Shared Thinking and Emotional Wellbeing (SSTEW) scale, item scores were evaluated for a representative subgroup of ECTs (n = 102) and overall showed minimal (3 out of 7) quality learning environments. Mathematical beliefs and confidence had a weak association with mathematics focused ECERS-E scores and no association with SSTEW scores. The results show that while beliefs and confidence were high, they did not predict the quality of the preschool learning environment. ECTs may be unaware of the specific mathematical content knowledge and pedagogical content knowledge required to effectively teach mathematics to preschool children and develop children’s complex mathematical thinking. Implications for professional learning are discussed.

Suicidal ideation among medical and surgical inpatients at South Gondar Public Hospitals, Northwest Ethiopia, 2023: a multicenter institution-based cross-sectional study.

Suicide is a significant global public health issue impacting individuals, families, and communities across the world. People with medical and surgical conditions are at an elevated risk of experiencing suicidal thoughts. However, to the best of our knowledge, in Ethiopia, there has not been any published research that examines the magnitude and associated factors of suicidal ideation in this context. The objective of this study was to assess the prevalence of suicidal ideation among medical and surgically admitted patients in South Gondar public hospitals, Northwest Ethiopia, 2023. A multi-center institutional-based cross-sectional study was conducted in South Gondar public hospitals. A systematic random sampling technique was used to select 616 individuals with a response rate of 98.2%. Suicidal ideation was measured using the World Health Organization's Composite International Diagnostic Interview suicide module. Descriptive, bivariate, and multivariate binary logistic regressions were employed, with odds ratios and 95% confidence intervals. The significance of the association was determined with a p-value of less than 0.05. The prevalence of suicidal ideation in this study was 24.7% (95% CI: 20.8, 27.7). Poor life satisfaction (AOR = 2.64, 95% CI, 1.63, 4.3), poor social support (AOR: 3.38; 95% CI; 1.97, 5.8), being female (AOR: 1.98; 95% CI; 1.19, 3.3), depression (AOR: 2.67; 95% CI; 1.67, 4.22), prior suicidal ideation and/or attempt (AOR = 2.73, 95% CI; 1.47, 5.1), having high perceived threat (AOR = 3.0; 95% CI; 1.69, 5.29), and having poor sleep quality (AOR: 2.54; 95% CI 1.5, 4.25) were significantly associated with suicidal ideation at p-value < 0.05. The prevalence of suicidal ideation is notably high among patients hospitalized in surgical and medical wards. Effective screening, timely intervention, and enhanced support systems are essential for individuals, particularly for females, with poor social support, high perceived threat, prior suicidal ideation and/or attempt, poor sleep quality, depression, and low life satisfaction.

Emergency and critical care medicine residents’ competency to identify patient ventilator asynchrony using a mechanical ventilator waveform analysis in Addis Ababa, Ethiopia: a multicenter cross-sectional study

Backgroundpatient-ventilator asynchrony (PVA) describes a condition in which a suboptimal interaction occurs between a patient and a mechanical ventilator. It is common and often undetected, with a negative impact on patient outcomes if unrecognized and addressed. Mechanical ventilator waveform analysis is a non-invasive and reliable way of identifying PVAs for which advanced methods of identifying PVA are lacking; however, it has not been well studied in residents working in developing setups like Ethiopia.Objectivesto assess Emergency and Critical Care Medicine (ECCM) Residents’ competency and associated factors to identify PVA using mechanical ventilator (MV) waveform analysis at Saint Paul Hospital Millennium Medical College (SPHMMC) and Tikur Anbesa Specialized Hospital (TASH).Methodology: We conducted a cross-sectional study among senior ECCM residents who were on training at TASH and SPHMMC, Addis Ababa. The study enrolled all 91 senior ECCM residents with 80 completing it. A pretested and structured self-administered questionnaire was administered using an internally modified assessment tool. The completed data were collected via web links after being prepared using kobtoolbox. org, coded, manually checked, and exported to version 27 SPSS analysis. Descriptive statistics, the chi-square test, nonparametric tests, and multi-variable logistic regression were used for data analysis.ResultsEighty senior residents responded out of 91, including 42 from TASH and 38 from SPHMMC. The overall competency of identifying PVA by MV waveforms was 30%. A median of 3 (IQR 1–4) PVAs were correctly identified. Only 1 resident (1.25%) identified all 6 different types of PVAs,;(8.75%) identified 5 PVAs; 20% identified 4 PVAs,22.5% identified 3 PVAs; 17.5% identified 2 PVAs, 13.75% identified 1 PVA Correctly and 16.25% did not identify any PVA. Auto-PEEP was the most frequently identified PVA, and delayed cycling was the least frequently identified PVA. Presenting or attending a seminar on MV waveforms and having lectures on mechanical ventilation increased the probability of identifying ≥ 4 PVAs.ConclusionThe overall competency of identifying PVA by MV waveforms is low among ECCM residents. Presenting or attending seminars on MV waveforms, and having lectures on mechanical ventilation (MV) were associated with increased competency of identifying PVAs by MV waveform analysis.

Baseline audiometric assessment of newly diagnosed nasopharyngeal carcinoma patients: a multicentre cross-sectional study.

Hearing impairment is one of the most common chief complaints in newly diagnosed nasopharyngeal carcinoma (NPC) patients, but baseline audiometric assessments are seldom reported. This study aims to investigate the prevalence of hearing impairment in this population through comprehensive audiometric testing and analyse the associated factors. A cohort of 187 newly diagnosed NPC patients were recruited from three hospitals. Pre-treatment comprehensive audiometric assessments, including pure-tone audiometry, tympanometry, Eustachian tube function tests and distortion product otoacoustic emissions (DPOAE), were performed to evaluate hearing impairment. Patient characteristics and tumour invasion extent were also recorded. Binary logistic regression was employed to analyse factors associated with hearing impairment. Among the patients, 27.5% of ears showed conductive hearing loss (CHL), 13.6% had sensorineural hearing loss (SNHL), and 10.4% demonstrated mixed hearing loss. Additionally, 43.6% of ears exhibited abnormal tympanograms, 86.1% had Eustachian tube dysfunction, and 77.3% failed the DPOAE test. Multivariable analysis identified subjective hearing symptoms, mastoiditis, and invasion of the tensor veli palatini muscle and Eustachian tube as factors associated with CHL. T stage, mastoiditis, and invasion of the tensor veli palatini muscle and nasal cavity were linked to abnormal tympanograms. T stage, sinusitis, and invasion of the levator veli palatini muscle significantly affected Eustachian tube function, while age influenced both SNHL and DPOAE results. Hearing impairment is prevalent among newly diagnosed NPC patients, with over half exhibiting various forms. Comprehensive baseline audiometric assessment in this population is crucial for developing individualized treatment strategies and enabling early intervention to prevent further hearing deterioration.

Career Growth as a Mediator Between Scope of Practice, Importance of Practice and Emergency Nursing Competency Among School Nurses.

School nurses are sometimes the sole healthcare professionals in schools, highlighting their significant role in delivering emergency care and the vital necessity of their competence in emergency nursing care. The scope of practice and ongoing professional development are hypothesized to play significant roles in enhancing these competencies. Investigate the direct and indirect effects of the scope of current practice and the importance of training on the emergency nursing care competency of school nurses, with career growth serving as a potential mediator. A multi-center cross-sectional study was conducted with a convenient sample of 219 school nurses. Data were collected using the career growth of nurses' scale, the emergency nursing care competency scale for school nurses and the scope of school nursing practice tool. Mediation analysis was used to explore the direct and indirect effects of studied variables. Mediation analysis indicated that the scope of current practice had a significant direct effect on career growth (β = 0.179) and emergency nursing care competency (β = 0.389). The importance of practice also had significant direct effects on career growth (β = 0.164) and emergency nursing care competency (β = 0.220). Additionally, career growth significantly mediated the relationship between both the scope of current practice (β = 0.110) and the importance of practice (β = 0.120) with emergency nursing care competency. The findings emphasis the critical role of career growth as a mediator between the scope and importance of practice and emergency nursing care competency among school nurses. Expanding the scope of practice and emphasising the importance of professional activities can enhance career growth and improve emergency nursing care competencies. Nurses scope of practice and clear career advancement through mentorship, advanced certifications, further education and enforcing policies mandating regular emergency care is crucial. Establishing a regulatory framework to define and expand the scope of practice for school nurses is also important. No patient or public contribution.

Length of hospital stay and its factor associated among neonates with perinatal asphyxia in the Northwest Amhara Region, Northwest Ethiopia 2023: a multicentre retrospective cross-sectional study.

To determine the length of hospital stay and related factors in newborns with perinatal asphyxia in comprehensive specialised hospitals in Northwest Ethiopia. A multicentre institutional-based cross-sectional study. Tertiary hospitals in Northwest Amhara Regional State, Northwest Ethiopia, from 1 to 30 December 2023. A total of 609 neonates with perinatal asphyxia were admitted to the neonatal intensive care unit of selected public hospitals in Northwest Amhara from September 2018 to October 2023. Length of hospital stay and associated factors in newborns with perinatal asphyxia were noted. A total of 609 newborns with perinatal asphyxia were included in this study. The mean hospital stay for the newborns was 13.9 days (coef=13.9, 95% CI 13.43 to 14.38), with minimum and maximum hospital stays of 4-28 days, respectively. Neonatal sepsis, AKI, hypoxic ischaemic encephalopathy, fetal macrosomia and prolonged labour were significantly associated with a longer hospital stay in neonates with perinatal asphyxia. The current study indicated that the mean length of hospital stay in newborns with perinatal asphyxia was 13.9 days. Contributing factors to prolonged hospital stays include neonates with neonatal sepsis, prolonged second-stage labour, acute neonatal kidney injury stages 2 and 3 hypoxic ischaemic encephalopathy and fetal macrosomia. The length of hospital stay for neonates with perinatal asphyxia can be reduced by implementing appropriate standards of care.

WCN25-1035 Association between Anti-Erythropoietin Receptor Antibodies and Cardiac Function in Patients on Hemodialysis: A Multi-center Cross-Sectional Study

WCN25-1035 Association between Anti-Erythropoietin Receptor Antibodies and Cardiac Function in Patients on Hemodialysis: A Multi-center Cross-Sectional Study

Regional economic level moderates the impact of patients' and family carers' cancer-related work changes and hospital level on financial toxicity in China: A multi-centre cross-sectional study.

To explore how regional economic levels moderate the relationships between cancer-related financial toxicity (FT) and its associated risk factors. A secondary analysis was conducted using data from a cross-sectional survey of 1208 adult patients with cancer, conducted in six tertiary and six secondary hospitals across three Chinese provinces from February to October 2022. The interactions between the regional economic level-categorised as high- or low-/middle-income based on the gross domestic product per capita- and 13 previously identified risk factors for FT were examined via moderation analysis using the PROCESS macro for SPSS software. Regional economic level moderated the impacts of both patients' and family carers' negative work changes due to cancer and the hospital level on FT (all p-values for interaction effect <0.05). Job changes had more severe effects on FT in high-income regions (patients: B=-2.07, standard error [SE]=0.67, p=0.002; carers: B=-1.58, SE=0.66, p=0.017), while treatment in tertiary hospitals had a stronger negative impact on FT in low-/middle-income regions (B=1.81, SE=0.87, p=0.037). These findings highlight the need for region-specific FT mitigation strategies. In high-income regions, more attention could be paid to managing the adverse work-related effects of cancer on patients and their families. In low-/middle-income regions, increased awareness and management of cancer-related FT in tertiary hospitals is needed. Future research should explore other risk factors associated with FT that may be moderated by regional economic levels.

Association of nutritional and inflammatory status with patient self-reported symptoms in oesophageal cancer patients: A multicentre cross-sectional study

Association of nutritional and inflammatory status with patient self-reported symptoms in oesophageal cancer patients: A multicentre cross-sectional study

The interplay between organizational culture and burnout among ICU professionals: A cross-sectional multicenter study

PurposeOrganizational culture is considered a protective factor against burnout among ICU professionals. The aim of this study is to study the association between organizational culture as a potential antecedent to previously found mediating risk factors for burnout, namely, work-life balance and moral distress. Materials and methodsMulticenter cross sectional study in eleven Dutch ICUs. The primary outcome measure was the core symptom of burnout, emotional exhaustion, measured using the validated Dutch version of the Maslach Burnout Inventory. Organizational culture was assessed using the Culture of Care Barometer, which measures five aspects of organizational culture. Moral distress and work-life balance were measured with validated questionnaires. Results696 ICU professionals (39.7 %) responded. All aspects of the CoCB were negatively associated with the emotional exhaustion component of burnout, both in univariable and multivariable models. Four aspects of organizational culture were significantly associated to the serial association between moral distress, work-to-home spillovers, and emotional exhaustion. For these aspects, the total indirect association was equal or larger than the total direct association. ConclusionsMultiple aspects of organizational culture reduce burnout among ICU professionals in a largely indirect manner, via moral distress and work-life balance. Improving organizational culture can mitigate burnout symptoms among ICU clinicians.

Impact of gout flare on health-related quality of life: a multi-center cross-sectional study in Thailand.

Although the 5-level EQ-5D version (EQ-5D-5L) instrument has been used to determine health-related quality of life and health utility in gout, it is used in comparing health utility among gout flare (GF) and non-gout flare (non-GF) patients is still limited. This study aimed to compare health utility among GF and non-GF patients in Thailand. In this multi-center cross-sectional study, patients with GF and non-GF were interviewed for the EQ-5D5L and EQ-Visual Analog Scale (VAS) instruments by rheumatologists or trained research staffs. Patients with GF were subdivided into 2 subgroups (those who received no treatment and those who received treatment less than 48h after GF episode). Two hundred and sixteen patients (108 GF and 108 non-GF patients), males in 90.28%, were included. The gout disease duration was significantly longer in the non-GF than in the GF groups (median, 10 vs 5years; p = 0.004). There was no difference in the tophi present between the two groups. When compared with the non-GF group, the GF patients significantly had low health utility (0.34 ± 0.36 vs. 0.89 ± 0.15, p < 0.001) and EQ-VAS score (54.73 ± 25.14 vs. 84.06 ± 13.38, p < 0.001). In the subgroup analysis of the non-GF group, there was insignificant health utility and EQ-VAS score between those with tophi and those without tophi (0.87 ± 0.14 vs. 0.90 ± 0.15, p = 0.124 and 83.36 ± 14.92 vs. 84.33 ± 12.83, p = 0.938, respectively). This study found that GF clearly had a substantial impact on patients' quality of life. Targeted interventions in managing GF patients to improve their health outcomes are needed. Key Points •Patients with gout flare had lower health utility than those without gout flare. •The clinical significance of the utility and EQ-VAS was evaluated by the EQ-5D-5L instrument between gout flare and non-gout flare groups in Thai gouty patients. •Regarding the presence of tophi or disease duration, no significant differences in health utility and EQ-VAS were observed in the gout flare or non-gout flare group. •Targeted interventions for management of gout flare are needed to improve the health outcomes of gout flare patients.

Socio-demographic and clinical determinants of self-care in adults with type 2 diabetes: a multicenter cross-sectional study in Zhejiang province, China

BackgroundSelf-care, a process of maintaining health through health-promoting practices and managing illness, is pivotal for the management of type 2 diabetes. This study aimed to explore the self-care level and investigate its socio-demographic and clinical determinants among Chinese adults with type 2 diabetes.MethodsIn this multicenter cross-sectional study, we enrolled 495 Chinese adults with type 2 diabetes from the outpatient departments of three tertiary hospitals in Zhejiang province, China. The Self-Care of Diabetes Inventory (SCODI) was used to measure self-care maintenance, self-care monitoring, and self-care management as three critical components of the dynamic self-care process. Self-care self-efficacy is a critical factor affecting the self-care process, which was measured by the SCODI. Multiple quantile regression models were employed to identify the determinants of each self-care component and self-care self-efficacy.ResultsParticipants had a median age of 62 years, of whom 55.4% were male. The median scores for self-care maintenance, self-care monitoring, and self-care management were 66.67 (50.00-85.42), 47.06 (32.35–58.82), and 53.13 (34.38–68.75), respectively, whereas the median score for self-care self-efficacy was 70.45 (52.27–84.09). Living in the southwest of Zhejiang province and having lower self-care self-efficacy were associated with lower self-care maintenance. Female gender, belonging to minorities, having complications, not attending diabetes self-management education in the last year, living in the southwest of Zhejiang province, and having lower self-care self-efficacy were associated with lower self-care monitoring. Having complications, using insulin, living in the southwest of Zhejiang province, and having lower self-care self-efficacy were associated with a lower level of self-care management. Living in the southwest of Zhejiang province was associated with lower self-care self-efficacy.Conclusions/interpretationThe findings of this study provide invaluable insights into the factors affecting self-care among Chinese adults with type 2 diabetes. By enhancing self-care self-efficacy and participating in diabetes self-management education, healthcare providers can develop tailored self-care interventions to improve diabetes care, particularly for adults with type 2 diabetes who are female, belong to minority groups, have complications, use insulin, or reside in the southwest of Zhejiang province.

Patient Acceptance of Death and Symptom Control/Quality of Care Among Terminal Cancer Patients Under Inpatient Hospice Care: A Multicenter Cross-Sectional Study.

Patient attitude to death is associated with outcomes in hospice care settings. This Korean study investigated the association between terminal cancer patient death acceptance and symptom control and quality of care (QoC) as perceived by family caregivers (FCs). A multicenter cross-sectional survey was conducted in nine inpatient hospice care units, and the data of 108 dyads (terminal cancer patients who responded to the revised Death Attitude Profile and their primary FCs) were analyzed. Dyads were dichotomized into high and low groups by death-acceptance level. Multivariate regression models were used to examine the association between death acceptance and symptom severity/QoC as perceived by FCs. Patients in the high acceptance group were younger, educated to a higher level, more religious, and had better-functioning families. Patients with severe shortness of breath were less likely to accept the inevitability of death. FCs of patients with high acceptance of death were more satisfied with QoC, particularly in domains of individualized care and family relationships. In addition, the positive association between patient acceptance and FC satisfaction with care was significant in dyads of young or female patients, patients with a low education level, and patients not cared for by a spouse. Terminal cancer patient death acceptance is associated with symptom control and FC perceived QoC.

Relationship between accelerometer-measured physical activity and depressive symptoms in hemodialysis patients with comorbid diabetes mellitus: a multicenter cross-sectional study

Relationship between accelerometer-measured physical activity and depressive symptoms in hemodialysis patients with comorbid diabetes mellitus: a multicenter cross-sectional study

Predictors of Nurses' Job Satisfaction in Home Care Settings: Findings From the AIDOMUS-IT Study.

Nurses' job satisfaction in hospitals is fundamental for the quality of care and the safety of patients. However, sociodemographic trends require moving care to patients' homes, and the predictors of job satisfaction for nurses working in the home care settings remain largely unknown. Therefore, the aim of this study was to investigate job satisfaction of nurses working in Italian home care settings and its determinants. Multicenter observational cross-sectional study. This study was conducted in the districts of 70 local health authorities in Italy. Data on the characteristics of the organization and nurses were collected. Nursing job satisfaction was evaluated on a four-point scale ranging from "very satisfied" to "very dissatisfied." Additionally, the following variables were assessed: workload, quality of leadership, work-private life conflict, burnout symptoms, possibility for development, staffing and resource adequacy, nurse manager ability, safety climate, and teamwork climate. A logistic regression analysis was conducted to identify factors influencing job satisfaction. Only organizational variables had a predictive value for nurses' job satisfaction. Workload (OR = 1.01; p = 0.033), work-private life conflict (OR = 1.02; p < 0.001), burnout (OR = 1.02; p < 0.001), and staffing inadequacy (OR = 1.44; p = 0.003) predicted higher levels of nurse dissatisfaction. Instead, high-quality leadership (OR = 0.981; p < 0.001), possibility for development (OR = 0.973; p < 0.001), and good teamwork climate (OR = 0.994; p = 0.003) were predictors of better levels of satisfaction. This study suggested that home care nurses are generally satisfied with their jobs. To enhance job satisfaction, it is essential to improve nurses' work environment, the leadership quality and ensure professional development. Our results are globally relevant as they contribute to the limited evidence available on this topic in home care settings. This study emphasizes the need of measuring nurses' job satisfaction and implementing interventions to promote healthy work environments.

Silicone Leakage From Breast Implants and its Association With Capsular Contracture in 657 Patients.

Capsular contracture is a common complication following breast reconstruction and augmentation, but there is limited evidence for the association between silicone leaking from the implant and capsular contracture. To determine the association between silicone leaking into the surrounding fibrous capsule and the risk of capsular contracture. This multicenter cross-sectional study included patients undergoing revisional surgery for any indication following breast reconstruction or augmentation with silicone implants. Silicone in the fibrous capsule was quantified using histopathological analysis, and capsular contracture was diagnosed using the Baker classification. Multivariable logistic regression was used to assess the association between the amount of silicone leakage and the predicted risk of capsular contracture. The association was tested in a sensitivity analysis excluding potential confounders and misclassifications. Among 657 included patients (1147 breasts), 272 patients (346 breasts) had either unilateral or bilateral capsular contracture. Capsular contracture was significantly associated with the amount of silicone in the fibrous capsule (p<.001), independent from the time of implantation (p<.001). The risk of capsular contracture increased rapidly by 12% (95%CI 5.0-18), going from 0.00 mL (0-32nd percentile) to 0.26 mL (60th percentile) of silicone in the fibrous capsule. The association was confirmed in the sensitivity analysis of 421 patients (654 breasts) with intact implants. Even small amounts of silicone leakage are associated with a significantly increased risk of capsular contracture. This highlights the importance of using breast implants with low silicone leakage rates such as highly cohesive implants to prevent capsular contracture.

Parent-Reported Burn-Specific Health-Related Quality of Life in Children 5–7 Years After Burns: A Multicenter Cross-Sectional Study

Surviving a burn can dramatically alter a child’s life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5–7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5− &lt; 18 years) who were hospitalized or had burn surgery between 08/2011 and 09/2012 completed the Burn Outcomes Questionnaire (BOQ). Outcomes were compared between two subgroups: children with mild/intermediate burns (&lt;10% total body surface area (TBSA) burned) versus severe burns ((1) aged &lt;10 years old at the time of injury with &gt;10% (TBSA) burned; (2) aged ≥10 years with &gt;20% TBSA burned; or (3) &gt;5% full-thickness burns). A total of 102 children were included (mean age at survey: 8.4 (3.0) years; mean former TBSA: 7.1%). At a mean of 5.7 years post-burn, many parents rated their child’s health as excellent (46.1%) or very good (35.3%), with few reporting issues with ‘pain’ (2.3%), ‘physical function and sports’ (1.6%), and ‘upper extremity function’ (0.9%). Parents of children with severe burns indicated significantly more problems with ‘appearance’ (89.2% versus 71.5%; p = 0.014) and ‘parental concern’ (94.1% versus 84.8%; p = 0.021). Upper limb burns, facial burns, burn size, length of hospital stay, full-thickness burns, and the number of surgeries predicted poorer outcomes. In general, these findings indicate positive long-term HRQL, though especially children with full-thickness burns and/or surgical interventions face a higher risk of reduced HRQL. The results can be used to inform children and their families about the long-term implications. Furthermore, healthcare professionals can use these insights to identify children at higher risk of poorer long-term HRQL.

Family History of Nonsyndromic Orofacial Clefts: A Brazilian Multicenter Study.

To summarize the evidence on the relationship between hereditary family history and nonsyndromic orofacial clefts (NSOC) in patients from various Brazilian states. This cross-sectional multicenter study was conducted at six specialized orofacial cleft services across different regions of Brazil. The sample consisted of 1899 patients with NSOC, including cleft lip only (NSCLO), cleft palate only (NSCPO), and cleft lip and palate (NSCLP). Data were collected from clinical records between June 2023 and May 2024. Family history was classified as positive or negative, with additional details on the number of affected relatives, degree of kinship, and type of oral cleft. Statistical analysis was performed using SPSS version 27.0, with chi-square tests and z tests to assess associations between variables, and Student's t test to compare the mean number of affected relatives among cleft types. Of 1899 patients, 52.6% had NSCLP, 24.11% had NSCPO, and 23.27% had NSCLO. NSCLP and NSCLO were more common in males, while NSCPO was more frequent in females. NSCLP and NSCLO showed similar rates of positive family history, whereas NSCPO had significantly fewer cases with hereditary links. Third-degree relatives were the most affected across all groups. NSCLP and NSCLO showed a higher frequency in males and more cases of positive family history compared to NSCPO. Further studies are needed to explore the genetic basis of NSOC, particularly in genetically diverse populations like Brazil.