National Cross-sectional Study Research Articles

The relationship between spiritual health and COVID-19 anxiety among nurses: a national online cross-sectional study

The Coronavirus disease 2019 (COVID-19) outbreak has created many concerns in most countries. Nurses are among healthcare workers who are largely engaged in providing care to COVID-19 patients, which makes nurses prone to disease-related worries and stresses. Thus, it is essential to identify the factors which may alleviate their stress and anxiety. This study aimed to determine the relationship between COVID-19 anxiety and spiritual health among Iranian nurses. This cross-sectional online survey was conducted between March 2020 and January 2021 on 919 Iranian nurses who worked in healthcare centers in Iran during the COVID-19 outbreak. The participants were recruited by convenience sampling Method. The data were collected using a demographic questionnaire, Ellison’s standard Spiritual Well-Being (SWB) Scale, and the standard scale of Corona Disease Anxiety. Data were analyzed using SPSS software and p-value less than 0.05 was considered significant. Of the participants, 47.0% (95% confidence interval (CI) 43.7–50.2%) had moderate to severe anxiety. The mean score of spiritual health was 73.3 ± 12.5. The multiple linear model indicated a significant negative correlation with a medium effect size between SWB and COVID-19 anxiety levels in a way that for 10 units increase in the SWB was associated with 2.72 units decrease in anxiety score (Adjusted partial r = − 0.320, p < 0.001). The findings revealed a reverse significant relationship between spiritual health and COVID-19 anxiety. On the other hand, nurses with better spiritual health experienced a lower level of COVID-19 anxiety. Therefore, improving spiritual health could help decrease nurses’ anxiety during COVID-19.

GP’s GP, general practitioner’s health and willingness to contract family doctors in China: a national cross-sectional study

ObjectivesGeneral practitioners are trained to care for patients with a high level of responsibility and professional competency. However, there are few reports on the physical and mental health status of general practitioners (GPs) in China, particularly regarding help seeking and self-treatment. The primary aims of this study were to explore GPs’ expectations of their own family doctors and their reflection on role positioning, and to explore the objective factors that hinder the system of family doctors.Study designCross-sectional study.MethodsWe conducted an online survey of Chinese GPs. Descriptive statistics were used to summarize the findings.ResultsMore than half of the participants (57.20%) reported that their health was normal over the past year. A total of 420 participants (23.35%) reported having chronic diseases. For sleep duration, 1205 participants (66.98%) reported sleeping 6–8 h per day; 473 participants (26.29%) reported chronic insomnia. Two hundred thirty-one participants (12.84%) had possible depression. A total of 595 (33.07%) participants reported that they had contracted a fixed family doctor. In terms of preventing themselves from contracting for a family doctor, the following factors were identified: lack of sufficient time (54.81%), could solve obstacles themselves (50.97%), and embarrassment (24.24%). The proportion of the contract group (12.44%) taking personal relationship as a consideration was higher than that of the non-contract group (7.64%) (χ2 = 10.934 P = 0.01). Most participants (79.90%) in the non-signed group reported never having seen a family doctor. In terms of obstacles, more than half of the signed group thought that they could solve obstacles themselves, while the non-signed group (39.20%) was less confident in the ability of family doctors than the signed group (29.75%) (χ2 = 15.436, P < 0.01).ConclusionsGPs work under great pressure and lack of self-care awareness, resulting in an increased prevalence of health conditions. Most GPs did not have a regular family doctor. Having a family doctor with a fixed contract is more conducive to the scientific management of their health and provides a reasonable solution to health problems. The main factors hindering GPs from choosing a family doctor were time consumption, abilities to solve obstacles themselves, and trust in the abilities of GPs. Therefore, simplifying the process of family doctor visits, Changing the GPs' medical cognition, and strengthening the policy of GP training would be conducive to promoting a family doctor system that enhances hierarchical diagnosis and treatment. International collaboration could integrate GP health support into global healthcare system.

Physical activity and recreational screen time among Chinese children and adolescents: a national cross-sectional study

BackgroundThe increasing prevalence of physical inactivity and prolonged Recreational Screen Time (RST) among children and adolescents is emerging as a significant public health concern. This study investigates the current status of Physical Activity (PA) and RST among Chinese children and adolescents from 2017 to 2019. It also examines variations in PA and RST across different school levels, genders, urban–rural areas, regions, and seasons.MethodsA national cross-sectional survey, conducted in China from 2017 to 2019, included 53,101 children and adolescents from grades 4 to 12 (aged 10 to 18 years old). Data on PA and RST were collected via self-administered questionnaires. The study employed descriptive statistics, calculated weighted prevalence rates, and conducted differential analysis across diverse demographic groups.ResultsBetween 2017 and 2019 in China, merely 28.73% of children and adolescents adhered to World Health Organization’s PA guidelines, while 76.09% met China’s RST guidelines. Notably, females, higher-grade students, rural residents, and children and adolescents from southern regions exhibited significantly lower levels of PA compared to their male, lower-grade, urban, and northern counterparts. Concurrently, RST was significantly higher among males, lower-grade students, rural residents, and those from northern regions. Seasonal variations were also observed, with lower PA and higher RST in autumn and winter as compared to spring.ConclusionThe study reveals a concerning low level of PA among Chinese children and adolescents, with marked disparities in PA and RST across different groups. This underscores the need for targeted health promotion strategies to enhance PA and mitigate RST among various child and adolescent populations.

Nurse academics’ self-reported insights into the teaching of undergraduate nursing numeracy: A national cross-sectional study

AimsThe aim of this research was to explore the teaching of undergraduate nursing numeracy in tertiary education settings in Australia. Specifically, it explored and identified: (1) the most common basic numeracy concepts taught, (2) additional training and resources to support numeracy teaching, (3) who is best placed to teach numeracy and (4) the preferred methods of teaching medication calculations. BackgroundNurse academics are required to teach nursing numeracy to undergraduate nursing students who enter university unprepared to accurately calculate medication dosages. It is important that students understand numeracy concepts as this is then applied to contextualised clinical applications. Nurse academics teach basic numeracy; however, the literature reveals that nurse academics do not consider themselves mathematics teachers and that experts in this area are better suited to teaching this skill. There are a dearth of studies about the nurse academics who conduct the teaching and this study seeks to fill that gap by exploring firsthand the nurse academics’ self-reported insights into the teaching of undergraduate nursing numeracy. DesignCross-sectional survey. The setting was Australian universities that deliver an accredited undergraduate nursing degree. MethodsPurposive sampling was used to recruit Australian nurse academics (n = 170), sessional or permanent who currently teach all aspects of nursing numeracy and medication calculations to undergraduate nursing students. Data were collected between Nov 2023 - Feb 2024 using an online survey platform and analysed using a descriptive content analysis. ResultsNurse academics taught basic arithmetic most commonly (92 %), yet most (90 %) had not received professional development or additional training in how to teach these concepts. To assist with numeracy teaching, resources were requested (47 %) as were the need for mathematics learning support staff (82 %). The formula method was most commonly taught (91 %), however, most participants (94 %) were willing to learn and to teach other methods of calculating medications. ConclusionsThis research suggests an evidenced-based education framework be created to support and guide nurse academics when teaching all aspects of nursing numeracy and medication calculations. Building the teaching capacity of nurse academics in this vital area will enhance student competence and contribute to patient safety.

Prevalence, severity, and risk factors of eczema among young children and adolescents in Saudi Arabia: A national cross-sectional study, 2019

BackgroundEczema is a common inflammatory skin disease with a significant global health burden. Eczema has a significant impact on quality of life. ObjectiveWe aimed to estimate the prevalence, severity, and risk factors associated with eczema among schoolchildren in Saudi Arabia. MethodsUsing the standardized Global Asthma Network questionnaires and methodology, a nationwide cross-sectional study was carried out across 20 regions in Saudi Arabia between March and April 2019. Data were collected from 137 primary schools and 140 intermediate schools using a multistage stratified cluster sampling method. ResultsThe study included 3614 young children aged 6-7 years and 4068 adolescents aged 13-14 years. Current eczema was prevalent among 4.5% of children and 5.1% of adolescents. Severe eczema was reported in 0.8% and 0.9% of young children and adolescents, respectively. Several factors showed significant association with eczema. Among children, eczema was linked positively to having a history of chest infections and wheezing in early life as well as ever attending day care and current exposure to cats. Among adolescents, the main potential risk factors included paracetamol use in the previous year, adherence to a lifestyle of vigorous physical activity, and current exposure to cats. Conversely, high consumption of nuts was found to be negatively associated with eczema. ConclusionThe prevalence of eczema in schoolchildren in Saudi Arabia is lower than the global average but within the average range for the Eastern Mediterranean region. Further studies should be conducted in Saudi Arabia to identify variation among different regions.

Sexual Victimization and Sexually Transmitted Infections Among a Nationally Representative Sample of Adolescents and Young Adults in Haiti.

Sexual assault victims are at major risk of being infected by sexually transmitted infections (STI). This article aims to examine and compare the prevalence of eight STIs (e.g., chlamydia, gonorrhea, hepatitis B, HIV/AIDS, human papillomavirus) among victims and non-victims of sexual abuse. A national cross-sectional study was conducted in Haiti, using a multistage sampling frame, stratified by geographical department, urban or rural setting, gender, and age groups (15-19 and 20-24years). The final sample included 3586 household participants (47.6% female). A weighted sample of 3945 individuals was obtained and used in the following analyses. Overall, 21.75% (95% CI 19.91-23.59) of participants reported having been diagnosed with at least one STI in their lifetime, with a higher prevalence among men (25.70%; 95% CI 22.89-28.52), compared to women (18.11%; 95% CI 15.73-20.49), χ2 = 16.43; p < 0.001). Sexual abuse victims were more likely to report STIs (31.27%; 95% CI 29.21-33.34), compared to non-victims (18.40%; 95% CI 16.68-20.13), χ2 = 27.89; p < .001. Sexual abuse was associated to an increased risk of contracting at least one STI (OR = 1.74; 95% CI 1.35, 2.24). The results demonstrate that sexual abuse is associated with a general increase of reporting STIs. They indicate the need for national sexual abuse prevention programs at early ages. These programs should be implemented in schools and churches, focusing on the role of families in sexuality education. Finally, programs must be developed to eradicate community violence-especially in the cities-as increased political and social violence has always been associated with increased sexual abuse in Haiti.

Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study

Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.

Awareness of consanguineous marriage burden and willingness towards premarital genetic testing in Sudan: a national cross-sectional study.

Despite the widespread practice of consanguinity in Sudan, there is a lack of exploration into the community's awareness of its health implications on offspring and their overall attitude towards consanguineous unions. This study aimed to evaluate the community's awareness of the possible health adversities of consanguinity on children and assess the effect of knowledge level on the prevailing attitude towards this practice in Sudan. From August to December 2018, data were collected from adults aged 18 years and above in five provinces of Sudan regardless of their marital status. The analysis involved both descriptive and multivariate statistical techniques. This study revealed a consanguinity rate of 30.2%. Despite a high awareness level (73.7%) regarding the effects of consanguineous marriage on the health of the offspring, a moderately negative attitude towards this practice (63.9%) was observed. The discordance between the high consanguinity rate in the Sudanese population and the moderately negative attitude suggests a potential persistence of this practice in the future. Without the implementation of educational programs and the provision of genetic counselling services to consanguineous couples, the prevalence of consanguinity is likely to endure.

The relationship between health literacy and problematic internet use in Chinese college students: The mediating effect of subject well-being and moderating effect of social support

BackgroundThe issue of problematic Internet use (PIU) amongst college students is emerging as a major concern for mental health. Factors such as health literacy, subjective well-being and the extent of social support may be critical in preventing PIU. However, the complex relationship between these factors has not been extensively explored in research. MethodsA national cross-sectional study based on multistage random sampling was conducted in China in 2022. The subjects for this study were 7669 college students who completed a set of questionnaires assessing their health literacy, subjective well-being, PIU and social support. A structural equation model (SEM) was utilised for exploring the mediating effect of subjective well-being, and the PROCESS macro was used to test the moderating effect of social support. ResultsAfter controlling for demographic factors, a significantly negative correlation was found between health literacy and PIU, and subjective well-being partially mediated this relationship. In addition, social support was negatively related to PIU and could moderate the relationship between health literacy and subjective well-being and between subjective well-being and PIU. LimitationsThis is a cross-sectional study, and the results cannot inform the causality between these variables. ConclusionResults revealed that the relationship between health literacy and PIU was partially mediated by subjective well-being in college students. The correlation between health literacy and subjective well-being and between subjective well-being and PIU were moderated by social support. Thus, future interventions for college students' PIU should be facilitated by improving health literacy, subjective well-being and social support.

Nonlinear associations between dietary zinc intake and cardiovascular disease risk, a National cross-sectional study based on the NHANES 2005–2018

ObjectiveTo explore the associations between dietary zinc intake and cardiovascular diseases (CVDs), including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and cerebrovascular accident (CVA), this study was performed. SettingData from the National Health and Nutrition Examination Survey (2005–2018) were used in this study. Dietary zinc intake was stratified into quartiles. Restricted cubic splines were constructed to assess nonlinear associations and identify cut-off values based on the type of nonlinearity. Binary logistic regressions were performed using the cut-offs. ResultsPositive associations were detected between the second, third, and fourth quantiles of dietary zinc intake and decreased risks of overall CVDs (Q2: OR = 0.83, 95 % CI = 0.72–0.96; Q3: OR = 0.83, 95 % CI = 0.71–0.96; Q4: OR = 0.79, 95 % CI = 0.67–0.93). The second, third, and fourth quantiles were significantly associated with decreased risks of various CVDs (all P < 0.05), except for CHD and angina (all P > 0.05). Restricted cubic spline regression revealed significant nonlinear trends for associations of dietary zinc intake with the risk of developing CVDs and CHF (both P for nonlinear <0.05), whereas those for heart attack and CVA were marginally significant (P for nonlinear = 0.072, and 0.075, respectively). ConclusionsThis study revealed that high dietary zinc intake is associated with reduced risks of developing CVDs, CHF, heart attack, and CVA, but not CHD or angina.

Comprehensive analysis of environmental exposure to hazardous trace elements and lung function: a national cross-sectional study

BackgroundThere is growing interest in the joint effects of hazardous trace elements (HTEs) on lung function deficits, but the data are limited. This is a critical research gap given increased...

Blood Lead Levels in the Population Living in Algeria: A Cross-Sectional National Study.

Lead poisoning, is currently recognized as a real public health problem, The WHO classifies lead as one of 10 chemicals of serious public health concern. In Algeria and North Africa, to date, no study on the evaluation of lead impregnation has been carried out at the national level. The main objective of this work is to assess the exposure of the general Algerian population to lead. A cross-sectional study was carried out over the entire Algerian national territory, on a population aged between 3 and 74years old. The survey lasted three years, A questionnaire, a clinical examination and a blood sample were carried out for each individual. Generalized linear regression models were used to determine the factors influencing lead levels measured in blood samples. The study population, spread over 39 wilayas and 121 districts, consists of 3674 individuals. The mean lead levels were 28.27μg/L, the median was 22.22μg/L, and the 95th percentile was 73.83μg/L, Blood lead levels were influenced differently by age, gender, wilaya of residence, dietary habits such as consumption of canned food and the way in which water is conserved for daily consumption. The use of kohl has been confirmed as a potential source of lead exposure. In Algeria, a blood lead value of 75µg/L serves as the Reference Exposure Value, guiding public health responses and risk management strategies, Recommendations have been issued to reduce the blood lead levels of the general population in Algeria in terms of limitation of lead in the sources of exposure, installation of an effective health monitoring system.

Social Activities and Depressive Symptoms Among Elderly Based on Rural and Urban Differences in China: a National Cross-Sectional Study

Social Activities and Depressive Symptoms Among Elderly Based on Rural and Urban Differences in China: a National Cross-Sectional Study

Independent and combined associations of handgrip strength and walking speed with cognitive function in older adults: evidence from a national cross-sectional study

Objectives Although there have been studies on the association of handgrip strength or walking speed alone with cognitive abilities, few studies have determined the combined associations of handgrip strength and walking speed with cognitive function. Therefore we aimed to explore the independent and combined associations of handgrip strength and walking speed with cognitive function in Chinese older adults using a nationally representative sample. Method This cross-sectional study included 4,577 adults aged 60 and older. Handgrip strength was measured using a dynamometer and walking speed was assessed using a 2.5-meter walking test. Both handgrip strength and walking speed were organized into low, normal, and high tertiles according to the sample distribution. Cognitive function was measured using the Telephone Interview for Cognitive Status. Results Handgrip strength and walking speed were significantly associated with cognitive function. Participants with low handgrip strength or low walking speed separately had a higher rate of lower cognitive function (adjusted odds ratio (OR): 1.22 (95% CI: 1.04 − 1.44) for low handgrip strength; 1.54 (95% CI: 1.31 − 1.81) for low walking speed). Those with both low handgrip strength and low walking speed had an additively higher rate of lower cognitive function (adjusted OR: 1.72 (95% CI: 1.32 − 2.24)). Conclusion Having low handgrip strength or low walking speed is associated with a greater likelihood of lower cognitive function and vice versa. The concurrence of having low handgrip strength and low walking speed has an additive effect on cognitive function in older adults.

Heated tobacco products- well known or well understood? A national cross-sectional study on knowledge, attitudes and usage in Pakistan

BackgroundHeated tobacco products (HTPs) are reshaping the tobacco industry and just recently, a plan was sought to regularize HTPs in Pakistan. Pakistan provides an intriguing case study in this context, as tobacco use is deeply ingrained in public use. To ensure that future evidence-based policy recommendations are grounded in the public’s knowledge, attitudes, and usage of HTPs, a nationwide survey must be conducted.MethodsA cross-sectional study was conducted using an online-based questionnaire nationwide in Pakistan. The questionnaire was validated and distributed through convenience sampling. The questionnaire assessed participants’ knowledge, attitudes, and usage of HTPs. Descriptive statistics was used to describe participants’ response and linear regression was performed at a p-value of < 0.05 using SPSS version 26.ResultsIn our sample of 1195 respondents (mean age of 33 years, 41.8% males and 58.2% females), 54.7% had previously heard about HTPs and 16.9% reported using HTPs at least once. Additionally, 38.24% were unsure of the legality of HTP use. Those with monthly household incomes of PKR 100,000 to 500,000, were more likely to have higher knowledge scores (OR:1.80[1.07–3.04]). On the other hand, males (OR:0.70 [0.55–0.89]) and respondents from Balochistan (OR:0.40 [0.22–0.71]) were more likely to have lower knowledge scores. The strongest motivators were the enjoyability of HTPs (55.73%) and usage as a cigarette alternative (54.64%), while the strongest deterrents were the negative health effects (82.68%) and potential for addiction (81.01%).ConclusionOur study underscores the need for awareness campaigns and interventions concerning HTPs, given prevalent preconceived notions and mixed attitudes among respondents. It was found that women and households with higher incomes scored higher on knowledge. Subjective enjoyment and a substitute for cigarettes were important motivators, but the most mentioned deterrents were the possibility of addiction and the detrimental effects on health. These insights form the basis for informed policy making for non-cigarette tobacco products.

Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study

BackgroundIn Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population.MethodsA nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted ‘high’ awareness, while the remaining two tertiles denoted ‘low’ awareness.ResultsThe final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07–1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71–3.58).ConclusionA high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.

Regular source of primary care and health services utilisation among Brazilian elderly with mental-physical multimorbidity

BackgroundIn ageing populations, multimorbidity is a complex challenge to health systems, especially when the individuals have both mental and physical morbidities. Although a regular source of primary care (RSPC) is associated with better health outcomes, its relation with health service utilisation in elderly patients with mental-physical multimorbidity (MP-MM) is scarce.ObjectiveThis study explored the relations among health service utilisation, presence of RSPC and MP-MM among elderly Brazilians.MethodsA national cross-sectional study performed with data from national representative samples from the Brazilian National Health Research (PNS, in Portuguese; Pesquisa Nacional de Saúde) carried out in 2013 with 11,177 elderly Brazilian people. MP-MM was defined as the presence of two or more morbidities, including at least one mental morbidity, and was evaluated using a list of 16 physical and mental morbidities. The RSPC was analysed by the presence of regular font of care in primary care and health service utilisation according to the demand for health services ≤ 15 days, medical consultation ≤ 12 months, and hospitalisation ≤ 1 year. Frequency description of variables and bivariate association were performed using Stata v.15.2 software.ResultsThe majority of individuals was female (56.4%), and their mean age was 69.8 years. The observed prevalence of MP-MM was 12.2%. Individuals with MP-MM had higher utilisation of health services when compared to those without MP-MM. RSPC was present at 36.5% and was higher in women (37.8% vs. 34.9%). There was a lower occurrence of hospitalisation ≤ 1 year among MP-MM individuals with RSPC and without a private plan of health.ConclusionOur findings demonstrate that RSPC can be an important component of care in elderly individuals with MP-MM because it was associated with lower occurrence of hospitalisation, mainly in those that have not a private plan of health. Longitudinal studies are necessary to confirm these findings.

Differences in colorectal cancer awareness between screening eligible vs. ineligible Palestinians: a national cross-sectional study.

This study aimed to compare colorectal cancer (CRC) awareness between screening-eligible and ineligible individuals in Palestine. Convenience sampling was utilized to recruit Palestinian adults from diverse settings, including hospitals, primary healthcare centers and public spaces across 11 governorates. The evaluation of CRC awareness in terms of signs/symptoms, risk factors and causation myths was conducted using Arabic-translated, modified versions of the validated instruments, the Bowel Cancer Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale. The final analysis included 2698 participants, with 2158 (80.9%) eligible for CRC screening and 540 (19.1%) ineligible for it. The most recognized CRC sign/symptom was 'lump in the abdomen' in both screening-eligible (n = 386, 71.5%) and ineligible (n = 1582, 73.3%) groups. 'Lack of physical activity' was the most recognized risk factor in both groups (eligible: n = 451, 83.5%; ineligible: n = 1766, 81.8%). The most reported causation myth in both groups was 'having a physical trauma' (eligible: n = 340, 63.0%; ineligible: n = 1353, 62.7%). In the screening-eligible group, only 210 participants (38.9%) demonstrated high awareness of CRC signs/symptoms, 213 participants (39.4%) showed high awareness of CRC risk factors and only 46 participants (8.5%) displayed high awareness of CRC causation myths. There were no significant associations between being eligible for screening colonoscopy and the awareness levels of CRC signs/symptoms, risk factors and causation myths. Overall, awareness levels of CRC signs/symptoms, risk factors and causation myths were notably low among screening-eligible participants. There were no differences in awareness levels between individuals eligible for colonoscopy and those who were not.

Antireflux Procedures in Children With Neurologic Impairment: A National Survey of Physician Perspectives.

Decision-making about antireflux procedures (ARPs) to treat gastroesophageal reflux disease in children with neurologic impairment and gastrostomy tubes is challenging and likely influenced by physicians' experience and perspectives. This study will explore physician attitudes about ARPs and determine if there are relationships to clinical practice and personal characteristics. This is a national observational cross-sectional study that used an electronic questionnaire addressing reported practice, attitudes regarding the ARPs, and responses to clinical vignettes. Participants were physicians in Canadian tertiary-care pediatric settings. Descriptive statistics were used to analyze physician attitudes. Multivariable logistic regression modeling was used to determine associations between physician and practice characteristics and likelihood to consider ARP. Eighty three respondents represented 12 institutions, with a majority from general or complex care pediatrics. There was a wide disparity between likelihood to consider ARP in each clinical scenario. Likelihood to consider ARP ranged from to 19% to 78% depending on the scenario. Two scenarios were equally split in whether the respondent would offer an ARP. None of the demographic characteristics were significantly associated with likelihood to consider ARP. Often, gastrojejunostomy tubes alone were considered (56% to 68%). There is considerable variability in physician attitudes toward and recommendations regarding ARPs to treat gastroesophageal reflux disease. We did not find a significant association with clinical experience or location of practice. More research is needed to define indications and outcomes for ARPs. This is a scenario where shared decision-making, bringing together physician and family knowledge and expertise, is likely the best course of action.

Attitudes towards snakebite health education and associated factors among residents in China: A national cross-sectional study.

This study aimed to investigate attitudes towards health education on snakebites and to identify the influencing factors among Chinese residents. Additionally, we proposed effective health education strategies for snakebite management. Between May 2022 and February 2023, we conducted a nationwide cross-sectional questionnaire survey using a multistage sampling method with supplementary snowball sampling. We used descriptive analysis, χ2 tests, and univariable and multivariable binary logistic regression models to analyse the data. We included 56 669 respondents in the analysis. The average score for snakebite knowledge was 12.13 ± 5.26 points, with a maximum score of 28. Among the respondents, 72.66 and 63.03% of the residents believed that it was necessary to disseminate knowledge about snakebites and expressed a willingness to receive snakebite training, respectively. Respondents from the northeast region, respondents with a higher education level, and respondents with higher scores for snakebite knowledge, health knowledge, health skills, and social-psychological adjustment skills exhibited more positive attitudes towards snakebite knowledge dissemination and training. Conversely, respondents from eastern or southern China, respondents older than 60, and respondents who lived in rudimentary housing conditions showed a lower perception of the need for snakebite knowledge dissemination and were less willing to participate in snakebite knowledge and skill training. Generally, Chinese residents have positive attitudes towards snakebite knowledge dissemination and training. However, the public lacks sufficient knowledge about snakebites. Therefore, we should pay close attention to areas south of the Yangtze River to strengthen snakebite health education using engaging formats that align with residents' interests, such as short videos or television programmes, in an attempt to and ultimately improve health literacy and prevention awareness.