Study Participants Research Articles

A Case Study on the Operational Performance Evaluation of a Manufacturing Process and System (MaPS) Sustainability Analysis Tool for Engineering Education

As the future product and process design decision-makers, students in engineering should have knowledge of sustainability and its application in industry. However, educators are challenged in training students in these concepts. Existing analysis tools are deficient in supporting sustainability assessment by nonexperts. To address this gap, the Manufacturing Process and System (MaPS) Sustainability Analysis tool was developed under the Constructionism in Learning: Sustainable Life Cycle Engineering (CooL:SLiCE) project. The technical aspects of developing a framework and its associated proof-of-concept MaPS Sustainability Analysis tool are reported in a separate study. Herein, the educational aspects of the MaPS Sustainability Analysis tool and its operational performance in terms of ease of use and usefulness to assess its suitability for the classroom are investigated. Undergraduate and graduate engineering students at Tampere University and Oregon State University were recruited to use and evaluate the tool. Through application of the Technology Acceptance Model (TAM), it was determined that the 24 study participants found the tool easy to use and useful in analyzing product design, manufacturing process, and supply chain sustainability performance. To move this proof of concept toward general use, key software operational characteristics and a GUI should be investigated to improve efficiency, effectiveness, satisfaction, and learnability of the MaPS Sustainability Analysis tool.

COVID-19 Infection in Ultramarathon Runners: Findings of the Ultrarunners Longitudinal TRAcking Study.

Ultramarathon runners are a unique patient population who have been shown to have a lower rate of severe chronic medical conditions. This study aimed to determine the effect that COVID-19 infection has had on this population and their running behavior. The Ultrarunners Longitudinal TRAcking (ULTRA) Study is a large longitudinal study of ultramarathon runners. Questions on health status, running behavior, and COVID-19 infection were included in the most recent survey. Community survey. Seven hundred thirty-four ultramarathon runners participated in the study. None. Personal, exercise, and COVID-19 infection history. 52.7% of study participants reported having been symptomatic from a COVID-19 infection, with 6.7% testing positive multiple times. Participants required a total of 4 days of hospitalization. The most common symptoms included fever (73.6%), fatigue (68.5%), sore throat (68.2%), runny nose (67.7%), and cough (67.4%). Cardiovascular symptoms, which are of particular interest in the running population, included shortness of breath (46.3%), tachycardia (44.7%), chest pain (36.2%), and wheezing (33.3%). A total of 50 subjects (6.8%) reported long COVID (symptoms lasting more than 12 weeks). Severe COVID-19 infection has been rare in this population of ultramarathon runners, although symptomatic infection that affects running is common. To support the well-being of this group of highly active athletes, clinicians should appreciate that cardiovascular symptoms are common and the long-term significance of these symptoms in runners is unknown. Level 2 prospective study.

Factors Associated With Severity of COVID-19 Disease in Vaccinated Patients

Background: Vaccines are considered the most promising approach for restraining the COVID- 19 pandemic. We aimed to identify the disease profile and risk of severe disease despite vaccination. Methods: A cross-sectional study was done from June 2021 to August 2021 in the COVID-19 dedicated hospitals in Dhaka. Total 169 RT-PCR positive adult patients were enrolled by a purposive sampling method who had completed two vaccine doses of COVID-19. Disease profile and severity was identified according to the national guideline of Bangladesh. Results: Of the 169 patients, 19 (11%) had severe diseases. The mean age of the study participants was 50.46 (±14.03) year. The mean age of severely diseased patients was higher than that of non-severe disease 62.63 (±8.27) vs 48.91 (±13.86), p-value <0.0001. The overall mortality was 8 (4.7%). In univariate analyses, being elderly (e”60years) (cOR 6.14, 95% CI 2.09-18.03; p-value <0.0001) and male (cOR 5.06, 95% CI 1.13-2274; p-value <0.02 and having DM (cOR 32.94, 95% CI 4.28-253.69; p-value <0.0001, HTN (cOR 2.91, 95% CI 1.05-8.07; pvalue < 0.034, OAD (cOR 3.47, 95% CI 1.09-11.07; p-value < 0.044, IHD (cOR 7.54, 95% CI 2.67-21.31; p-value <0.0001, and CKD (cOR 26.43, 95% CI 4.69-148.92; p-value <0.0001were identified as factors related to severe disease of COVID-19. In multivariate analyses, DM (aOR 13.9, 95% CI 1.5-130.1; p-value <0.021, OAD (aOR 7.9, 95% CI 1.2-50.1; p-value <0.03, IHD (aOR 7.4, 95% CI 1.6-34.4; p-value < 0.011, and CKD (aOR 41.9, 95% CI 2.6-667.4; p-value < 0.008 were independently associated with severe disease. Conclusion: Vaccines against COVID-19 are showing a significant decrease in severity disease. Control of chronic diseases, exposure prevention and mass vaccination should be the main concern to mitigate the severity. J Dhaka Med Coll. 2022; 31(2) : 220-225

Bone Pain and Survival Among Patients With Metastatic, Hormone-Sensitive Prostate Cancer

The presence of bone pain is significantly associated with worse overall survival (OS) in patients with castration-resistant prostate cancer. However, there are few data regarding bone pain and survival outcomes in the context of metastatic, hormone-sensitive prostate cancer (MHSPC). To compare survival outcomes among patients with MHSPC by presence or absence of baseline bone pain at diagnosis. This post hoc secondary analysis, conducted from September 1 to December 31, 2023, used patient-level data from SWOG-1216, a phase 3, prospective randomized clinical trial that enrolled patients with newly diagnosed MHSPC from 248 academic and community centers across the US from March 1, 2013, to July 15, 2017. All patients in the intention-to-treat population who had available bone pain status were eligible and included in this secondary analysis. In the SWOG-1216 trial, patients were randomized (1:1) to receive either androgen deprivation therapy (ADT) with orteronel, 300 mg orally twice daily (experimental group), or ADT with bicalutamide, 50 mg orally daily (control group), until disease progression, unacceptable toxic effects, or patient withdrawal. Overall survival was the primary end point; progression-free survival (PFS) and prostate-specific antigen (PSA) response were secondary end points. Cox proportional hazards regression models were used for both univariable and multivariable analyses adjusting for age, treatment type, Gleason score, disease volume, Zubrod performance status, and PSA level. Of the 1279 male study participants, 301 (23.5%) had baseline bone pain at MHSPC diagnosis and 896 (70.1%) did not. Bone pain status was unavailable in 82 patients (6.4%). The median age of the 1197 patients eligible and included in this secondary analysis was 67.6 years (IQR, 61.8-73.6 years). Compared with patients who did not experience bone pain, those with baseline bone pain were younger (median age, 66.0 [IQR, 60.1-73.4] years vs 68.2 [IQR, 62.4-73.7] years; P = .02) and had a higher incidence of high-volume disease (212 [70.4%] vs 373 [41.6%]; P < .001). After adjustment, bone pain was associated with shorter PFS and OS. At a median follow-up of 4.0 years (IQR, 2.5-5.4 years), patients with bone pain had median PFS of 1.3 years (95% CI, 1.1-1.7 years) vs 3.7 years (95% CI, 3.3-4.2 years) in patients without initial bone pain (adjusted hazard ratio [AHR], 1.46; 95% CI, 1.22-1.74; P < .001) and OS of 3.9 years (95% CI, 3.3-4.8 years) vs not reached (NR) (95% CI, 6.6 years to NR) in patients without initial bone pain (AHR, 1.66; 95% CI, 1.34-2.05; P < .001). In this post hoc secondary analysis of the SWOG-1216 randomized clinical trial, patients with baseline bone pain at MHSPC diagnosis had worse survival outcomes than those without bone pain. These data suggest prioritizing these patients for enrollment in clinical trials, may aid patient counseling, and indicate that the inclusion of bone pain in prognostic models of MHSPC may be warranted. ClinicalTrials.gov Identifier: NCT01809691.

A Case Study on the Operational Performance Evaluation of a Manufacturing Process and System (MaPS) Sustainability Analysis Tool for Engineering Education

As the future product and process design decision-makers, students in engineering should have knowledge of sustainability and its application in industry. However, educators are challenged in training students in these concepts. Existing analysis tools are deficient in supporting sustainability assessment by nonexperts. To address this gap, the Manufacturing Process and System (MaPS) Sustainability Analysis tool was developed under the Constructionism in Learning: Sustainable Life Cycle Engineering (CooL:SLiCE) project. The technical aspects of developing a framework and its associated proof-of-concept MaPS Sustainability Analysis tool are reported in a separate study. Herein, the educational aspects of the MaPS Sustainability Analysis tool and its operational performance in terms of ease of use and usefulness to assess its suitability for the classroom are investigated. Undergraduate and graduate engineering students at Tampere University and Oregon State University were recruited to use and evaluate the tool. Through application of the Technology Acceptance Model (TAM), it was determined that the 24 study participants found the tool easy to use and useful in analyzing product design, manufacturing process, and supply chain sustainability performance. To move this proof of concept toward general use, key software operational characteristics and a GUI should be investigated to improve efficiency, effectiveness, satisfaction, and learnability of the MaPS Sustainability Analysis tool.

Social Media Programs for Outreach and Recruitment Supporting Aging and Alzheimer Disease and Related Dementias Research: Longitudinal Descriptive Study.

Social media may be a useful method for research centers to deliver health messages, increase their visibility in the local community, and recruit study participants. Sharing examples of social media-based community outreach and educational programs, and evaluating their outcomes in this setting, is important for understanding whether these efforts have a measurable impact. The aim of this study is to describe one center's social media activities for community education on topics related to aging, memory loss, and Alzheimer disease and related dementias, and provide metrics related to recruitment into clinical research studies. Several social media platforms were used, including Facebook, X (formerly Twitter), and YouTube. Objective assessments quantified monthly, based on each platform's native dashboard, included the number of followers, number of posts, post reach and engagement, post impressions, and video views. The number of participants volunteering for research during this period was additionally tracked using a secure database. Educational material posted to social media most frequently included content developed by center staff, content from partner organizations, and news articles or resources featuring center researchers. Multiple educational programs were developed, including social media series, web-based talks, Twitter chats, and webinars. In more recent years, Facebook content was occasionally boosted to increase visibility in the local geographical region. Up to 4 years of page metrics demonstrated continuing growth in reaching social media audiences, as indicated by increases over time in the numbers of likes or followers on Facebook and X/Twitter and views of YouTube videos (growth trajectories). While Facebook reach and X/Twitter impression rates were reasonable, Facebook engagement rates were more modest. Months that included boosted Facebook posts resulted in a greater change in page followers and page likes, and higher reach and engagement rates (all P≤.002). Recruitment of participants into center-affiliated research studies increased during this time frame, particularly in response to boosted Facebook posts. These data demonstrate that social media activities can provide meaningful community educational opportunities focused on Alzheimer disease and related dementias and have a measurable impact on the recruitment of participants into research studies. Additionally, this study highlights the importance of tracking outreach program outcomes for evaluating return on investment.

Patient motivation as a predictor of digital health intervention effects: A meta-epidemiological study of cancer trials.

The objective of this meta-epidemiological study was to develop a rating that captures participants' motivation at the study level in digital health intervention (DHI) randomised controlled trials (RCTs). The rating was used to investigate whether participants' motivation is associated with the effect estimates in DHI RCTs for cancer patients. The development of the rating was based on a bottom-up approach involving the collection of information that captures participants' baseline motivation in empirical studies from the Smartphone-RCCT Database. We specified three indicators for rating: indicator 1 captures whether the study team actively selects or enhances the motivation of the potential study participants; indicator 2 captures the study participants' active engagement before the treatment allocation; and indicator 3 captures the potential bond and trust between the study participants and the person/institution referring to the study. The rating of each indicator and the overall rating varies between high motivation, moderate motivation, and low motivation. We applied the rating across 27 DHI RCTs with cancer patients. We performed meta-regression analysis to examine the effect of patient motivation on quality of life (QoL), psychological outcomes, and attrition. The intraclass correlation coefficient (ICC) indicated moderate to poor inter-rater reliability. The meta-regression showed that cancer patients' overall motivation before engaging in the intervention was associated with the treatment effect of QoL. Patient motivation was not found to be associated with psychological outcomes or attrition. Subgroup analyses revealed that the clinical effects of DHIs were more prevalent in the high-motivation subgroups, whereas the low-motivation subgroups were unlikely to show intervention benefits. The likelihood of dropouts from DHIs seems to be especially high among the low-bond (indicator 3) subgroup. We suggest using single indicators since they reflect specific content. Better reporting about baseline motivation is required to enable meaningful interpretations in not only primary studies but also in evidence syntheses.

A Study on Prevalence and Risk Factors of Depression Among Adolescents (16-19 years) in the Urban Area of Andhra Pradesh

Background: Depression is a major contributor to sickness globally and is often associated with a decline in social, occupational, and interpersonal performance. Depression is more prevalent in young adults going through this transition since late adolescence and early adulthood are the life stages when people make significant decisions in a number of areas. Objective: This cross sectional study was done in September-November 2023 with objective to find out prevalence of depression and risk factors associated with depression among College going Adolescents [16-19 years] in the Urban area of Vizianagaram city, Andhra Pradesh. Methodology: A Semi structured questionnaire was used to collect information on socio demographic characteristics. Study participants were screened using Beck’s Depression Inventory Questionnaire (BDI –II) to gather information regarding depression &amp; its risk factors. Results: The overall prevalence of depression was found to be 58.4%; in which 117 (28%) were having mild depression, 63 (15.3%) were having severe depression and 64 (15.1%) were having moderate depression. The study showed a highly significant association between levels of depression and selected demographic variables such as Age in years, No. of persons in their family, BMI, Socio- economic status, Father’s education, Father’s occupation and Parents with any addictions. Conclusion: There is a need for college students to be educated about depression in order to improve recognition and diagnosis. Also student counselling service offering mental health assistance needs to be established at colleges.

Evaluating the Application of Nail Polish as an Ostomy Baseplate: A Comparative Analysis With Conventional Ostomy Pastes in the Market and in a Clinical Trial.

Peristomal skin complications are prevalent among patients with ostomies and significantly impact their quality of life. Ostomy care is crucial for patients with ostomies, as it ensures proper adhesion, and protects and reduces the peristomal skin complications. To assess the effectiveness of nail polish as a novel skin barrier and compare its performance with the commonly available ostomy barriers in the market. Phase I randomized control trial. A single trauma and surgery center. Forty patients who were hospitalized for ostomy implantation were enrolled. Twenty cases were included in each group. The use of nail polish as a baseplate was tested against the common ostomy pastes. Over a period of 6 months, the study enrolled 40 patients who required loop ileostomy and they were followed up for 8 weeks. Postoperative evaluation was performed by using the City of Hope-quality of life ostomy and SF-36 questionnaires, as well as physical examinations conducted 1 day after surgery and at 4 and 8 weeks after surgical treatment. Forty patients were included in the study. In all 3 time points, significant differences were observed in SF-36 scores, time, and costs spent on ostomy care. The intervention group experienced fewer peristomal skin complications (skin itching, redness, inflammation, and burning), and also skin allergies at the first and second time points (p < 0.05). Furthermore, none of the patients in either the intervention or control group experienced rare complications such as folliculitis, candidiasis, contact dermatitis, or pyoderma gangrenosum. Single institution. The utilization of nail polish as a baseplate reduces skin allergies, peristomal skin complications, and the time and financial resources spent on ostomy care. Furthermore, using nail polish has demonstrated promising results in patients' quality of life. Consequently, utilizing nail polish emerged as the preferred choice among study participants. See Video.

African Immigrant Women's Experiences of Maternity Care in the United States.

The purpose of this study was to explore maternity care experiences of African immigrant women during the perinatal period including factors affecting access to and use of care. We used Sandelowski's (2010) qualitative descriptive approach to examine how African immigrant women from various countries of origin and with diverse ethnic backgrounds experienced and navigated the maternity care system in the United States during pregnancy and childbirth. We conducted semi-structured interviews with 15 African immigrant women living in the Columbus, Ohio area. Participants were recruited using purposive and snowball sampling between February 2021 and May 2021. Interviews were recorded, transcribed, and analyzed using a reflexive thematic analysis approach. Four major themes defined the experiences of our study participants: access to information, patient-clinician relationships, experiences of discrimination, and costs of maternity care. Findings highlight key barriers to providing quality and acceptable maternity care to African immigrant women at multiple levels. This group's unique barriers underlie the importance of incorporating their diverse experiences into maternity care models and clinical practice. Further research is needed to evaluate and improve maternity care for African immigrant women.

Coronavirus Disease 2019 Knowledge, Its Vaccine Uptake Intentions, and the Influence of Personality Traits among Undergraduate Pharmacy Students in a University Setting: Findings and Implications

Abstract Context: Coronavirus disease 2019 (COVID-19) is the greatest global health catastrophe of the century, with its vaccine hesitancy compounding the woes. Relevant stakeholders, including pharmacy students (whose education was disrupted) are important bulwarks against these catastrophes, but their COVID-19-related information are scarce. Aims: We assessed COVID-19 knowledge, its vaccine uptake intentions, and the influence of personality traits among pharmacy undergraduates in a Nigerian university. Settings and Design: This was a post-lockdown cross sectional study conducted at the Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto. Subjects and Methods: A 61-item questionnaire was used to collect data among pharmacy undergraduates who attended Usmanu Danfodiyo University, Sokoto, Nigeria, in May 2021. Statistical Analysis Used: Summary statistics– mean (±standard deviation), range, frequency, proportion; inferential statistics– Chi square statistics, binary logistic regression. Results: The response rate was 88% (168/191). The average COVID-19 knowledge score, the frequency of acceptance, and hesitancy to take COVID-19 vaccine among study participants were 42.9% (95% confidence interval [CI] = 42.1–43.7), 39.1% (95% CI = 37.3%–41.8%), and 61.9% (95% CI = 58.0%–64.2%), respectively. In addition, of the 168 study participants, 73 (43.5%) considered themselves to have high self-esteem, 67 (39.9%) were highly extroverted, 91 (54.2%) highly privately self-conscious, 96 (57.1%) highly publicly self-conscious, and 60 (35.7%) highly self-restrained, with 57 (34.0%) not believing in the existence of COVID-19. COVID-19 knowledge varied significantly by level of study (F [2,165] = 5.539; P = 0.005; η2 = 0.06). Similarly, those with high self-esteem were twice as knowledgeable regarding COVID-19 as those with low self-esteem (odds ratio [OR]: 2.02; 95% CI: 1.08–3.78; P = 0.03) with gleaning COVID-19-related information from social media platforms predicting COVID-19 vaccine hesitancy (CVH) (OR: 0.37; 95% CI: 0.16–0.85; P = 0.02). Conclusions: The observed suboptimal COVID-19 knowledge was associated with participants’ low level of self-esteem, and the prevalent CVH was associated with obtaining COVID-19-related information from social media platform.

تأثير لقاح كوفيد -19 على الدورة الشهرية

Background: The implementation of vaccines is a major step in saving humanity from the consequences of COVID-19, and there has become hope for everyone in the world. Menstruation is a key indicator of overall women's health. The COVID-19 vaccination has been associated with changes in the menstrual cycle. Objective: To evaluate the effects of COVID-19 vaccines on the menstrual cycle. Methods: This is a face-to-face interview-based cross-sectional study that recruited 403 vaccinated women with the COVID-19 vaccine who had normal MC before receiving the vaccine for at least six months in Mosul, Iraq, from February 1 to July 31, 2022. We asked the women about their menstrual cycle parameters before and after the vaccination. The results were analyzed statistically. Results: The most frequent age group among study participants was 20–34 years (52.9%). About half of women (58.3%) had received the Pfizer vaccine. 12.2% and 13.65% of women reported significant changes in their menstrual cycle following the first and second doses, respectively. These changes included irregularities in the cycle and modifications in the amount and duration of menses, and the Pfizer vaccine was significantly responsible for these changes. Conclusions: In a small number of women who had a normal menstrual cycle before vaccination, post-Covid-19 vaccination menstrual cycle changes occurred, and the reported changes were not critical. This result can reassure the community about the vaccine's impact on the menstrual cycle.

Dose-specific clinical outcomes in patients with opioid use disorder treated with 24-32 mg/day of buprenorphine.

In people with opioid use disorder (OUD), buprenorphine is a vital treatment to decrease opioid use and overdose. The US Food and Drug Administration's prescribing information for buprenorphine advises dosing up to 24 mg/day; however, doses of buprenorphine up to 32 mg have been shown to be safe and effective. We compared outcomes associated increased dosing from 24 to 32 mg/day. Prospective cohort investigation. Low-barrier buprenorphine clinic in Washington, District of Columbia, USA. Participants in the ANCHOR study (people with hepatitis C virus (HCV), OUD, and active opioid misuse who were treated for HCV and offered buprenorphine) who received buprenorphine at doses of 24 and/or 32 mg/day. 72 participants were included in the analysis: 24 (33%) patients stabilized on 24 mg, and 48 (67%) patients stabilized on 32 mg. Patients were predominantly male (78%), Black (96%), unstably housed (57%), and used opioids by injection (93%). Patient-reported drug use, use frequency, triggers for use, and urine drug screens were collected at each visit. For analysis, the cohort was divided into individuals stabilized on 24 mg (24 mg cohort) or 32 mg (32 mg cohort). Drug use outcomes were assessed between cohorts at 24 mg dosing and at respective maximum dosing. Within the 32 mg cohort, outcomes were compared at 24 mg versus 32 mg dosing. Within the 32 mg cohort, increased dosing from 24 to 32 mg was associated with a decline in opioid use (68.5% [5.2%] at 24 mg vs 59.5% [5.6%] at 32 mg; P = 0.02), frequency of use per week (1.58 [0.19] at 24 mg vs. 1.15 [0.16] at 32 mg; P = 0.0002) and physiologic triggers for use (38.2% [6.0%] at 24 mg vs 7.0% [1.9%] at 32 mg; P < 0.0001). At the end of the study period, there were significantly more patients retained in the 32 mg cohort (78.7%) compared with the 24 mg cohort (50.0%, P = 0.02). Higher buprenorphine dosing (32 mg/day) appears to improve outcomes in people with opioid use disorder, even in the absence of abstinence.

Draft genome assemblies of three Klebsiella grimontii strains isolated from catheterized urine samples from the same male participant over the course of 6 months.

Klebsiella grimontii is a newly identified species within the Klebsiella oxytoca complex. Here, we present the draft genome sequence of three K. grimontii strains that were isolated from catheterized urine samples collected from a participant in a longitudinal study over ~6 months.

Developing a Short Course on the Ethical, Legal, and Social Issues of Biobanking Practice-A Participatory Action Research Study in South Africa.

Introduction: There is a paucity of available training opportunities on the ethical, legal, and social issues (ELSI) of biobanking in South Africa and other low- and middle-income countries. For this purpose, an online short course was developed on the ELSI of biobanking practice. Study Aims and Objectives: This study aimed to review the short course to determine its relevance for identified stakeholders in biobanking practice in South Africa. Methods: This in-depth exploratory study was conducted using a qualitative approach. Two groups of volunteers were purposively identified for the review of the course. Group 1 (Biobanking group, n = 11) comprised researchers, biobankers, postgraduate students in biobanking research, and research ethics committee members. Group 2 (Curriculum group, n = 10) comprised academics with expertise in curriculum development and review who were invited to participate in the study. A separate online open-ended questionnaire was used to collect data from each group. Both questionnaires focused on the description of the module structure and coherence. In addition, participants in Group 2 were asked to comment on the assessment strategy used. Thematic analysis was conducted on the collected data. Summary of the Study Findings: The following themes were identified as strengths and shortcomings of the developed course and suggestions to improve both the content and delivery of the course. Participants were generally satisfied with the course design and structure. The module content was seen as being clear and aligned with the learning objectives. While the course structure was seen as easy to follow, some respondents did express difficulty in navigating through the modules while others experienced varying online technical problems. The general opinion was that the assessment strategy was consistent with the course aim and objectives. Conclusion: Study participants responded positively to this course and provided constructive criticism to improve the educational offering.

Developing a Short Course on the Ethical, Legal, and Social Issues of Biobanking Practice-A Participatory Action Research Study in South Africa.

Introduction: There is a paucity of available training opportunities on the ethical, legal, and social issues (ELSI) of biobanking in South Africa and other low- and middle-income countries. For this purpose, an online short course was developed on the ELSI of biobanking practice. Study Aims and Objectives: This study aimed to review the short course to determine its relevance for identified stakeholders in biobanking practice in South Africa. Methods: This in-depth exploratory study was conducted using a qualitative approach. Two groups of volunteers were purposively identified for the review of the course. Group 1 (Biobanking group, n = 11) comprised researchers, biobankers, postgraduate students in biobanking research, and research ethics committee members. Group 2 (Curriculum group, n = 10) comprised academics with expertise in curriculum development and review who were invited to participate in the study. A separate online open-ended questionnaire was used to collect data from each group. Both questionnaires focused on the description of the module structure and coherence. In addition, participants in Group 2 were asked to comment on the assessment strategy used. Thematic analysis was conducted on the collected data. Summary of the Study Findings: The following themes were identified as strengths and shortcomings of the developed course and suggestions to improve both the content and delivery of the course. Participants were generally satisfied with the course design and structure. The module content was seen as being clear and aligned with the learning objectives. While the course structure was seen as easy to follow, some respondents did express difficulty in navigating through the modules while others experienced varying online technical problems. The general opinion was that the assessment strategy was consistent with the course aim and objectives. Conclusion: Study participants responded positively to this course and provided constructive criticism to improve the educational offering.

Factors Affecting the Clothing Purchase Intention of Young Consumers through Online

This research paper was conducted for the purpose of identifying the factors that influence the clothing purchase intention of young consumers who are used to shopping through online market. To serve the purpose of the study, a total of 100 (one hundred) respondents were selected through convenience sampling. The collected data were analyzed using Pearson correlation and multiple regression analysis. The authors found that all factors namely time &amp; convenient, perceived past experience, perceived security; product variety, Website design and Service quality have significant impact on online clothing purchase intention of young generation. Through this study the authors suggest that social media has a beneficial effect on how customers behave while buying clothing companies. Social media experiences online are influencing study participants' decisions to purchase intention of clothing from a certain brand. The authors expect that this study will help the clothing brands to understand the purchase intention of their young consumers through online and it will help them to take necessary step to increase their online sales based on the significance level of each factor and contribute to the clothing industry.

Prevalence of Clinical malaria and associated symptoms in pregnant women at Hamusit Health Center, Northwest Ethiopia

BackgroundMalaria is the disease caused by intracellular parasites known as Plasmodium species and is mainly transmitted by blood sucking female Anopheles mosquitoes. During pregnancy, malaria results in severe complications to the mother, the fetus and the newborn. Symptoms of malaria, such as fever, malaise, headache, nausea and vomiting, in pregnant women can be mistakenly attributed solely to pregnancy. In Ethiopia, the prevalence of malaria in asymptomatic pregnant women has been well documented. However, studies indicating the prevalence and clinical presentation of malaria in pregnant women are lacking. Therefore, there is little information on the prevalence of malaria and significantly associated signs and symptoms in pregnant women. The aim of this cross-sectional study was to determine the prevalence of malaria and identify clinical signs and symptoms associated with malaria which suggest presence of malaria in pregnant women at Hamusit Health Center, Northwest Ethiopia. MethodsA health facility-based cross-sectional study was conducted on 231 malaria symptomatic pregnant women from April to June 2023. A convenience sampling technique was employed. The socio demographic and clinical data of the study participants was collected through face-to-face interview using questionnaire. Thick and thin blood films were prepared from capillary blood and stained with 10% Giemsa. The stained blood smear was washed with clean water, air dried and examined under a light microscope. The Statistical Package for Social Sciences software version 20 (SPSS 20) was used to analyses data. Logistic regression was used to assess signs and symptoms associated with malaria. An adjusted odds ratio with a 95% confidence interval was calculated, and a P value < 0.05 was considered statistically significant. ResultsThe overall prevalence of malaria among symptomatic pregnant women in the study area was 22.9% (53/231) (95% CI: 17.3-29%). The most prevalent species was P. falciparum, with a frequency of 14.3% (33/231) (95% CI: 10% -18.6%), followed by P. vivax, 5.2% (12/231) (95% CI: (2.6% – 8.2%). The remaining 3.5% (8/231) (95% CI: 1.8% – 6.7%) were mixed infections of P. falciparum & P. vivax. Primigravidae (62.3%) and first trimester pregnancies (52.8%) were more affected. Malaria signs and symptoms mainly, fever [(P=0.002, AOR (95%CI); 5.1(1.84, 14.30)], joint pain [(P=0.001, AOR (95%CI); 7.8(2.24, 27.32)], vomiting [(P=0.007, AOR (95%CI); 2.9(1.34, 6.43)], malaise [(P=0.005, AOR (95%CI); 3.6(1.48, 8.67)] and fatigue [(P=0.0039, AOR (95%CI); 2.1(1.04, 4.37)], were significantly associated with malaria infection in pregnant women. ConclusionsMalaria positivity in pregnant women with fever, joint pain, vomiting, malaise and fatigue is considerably high in the study area. These signs and symptoms in pregnant women are strong indicators of malaria infection.

Willingness to pay for chronic disease management services provided by primary care nurses

BackgroundDue to the rapid increase in chronic diseases in South Korea, the Korean government has expanded chronic disease management to primary care. Thus, the role of primary care nurses is critical. However, the fee for chronic disease management services provided by primary care nurses has not been set, and few studies have evaluated the value of nursing services. This study aimed to estimate the willingness to pay (WTP) for chronic disease management services provided by primary care nurses and to identify the factors that affect WTP.MethodsThis study adopted a descriptive research design and conducted a cross-sectional online survey from January 16 to 18, 2023. The inclusion criteria were community residents aged ≥ 20 years living in South Korea and capable of participating in online surveys. A total of 520 people participated in this study. A contingent valuation method (CVM) was used with double-bound dichotomous choice questions along with open-ended questions. The mean WTP was calculated using a Tobit model.ResultsThe mean WTP of the 520 study participants for one chronic disease management service provided by primary care nurses was 15,390.71 Korean won ($11.90). Factors affecting WTP were having a chronic disease, recognition of primary care nurses, and the first-bid price. Community residents with fewer chronic diseases, high awareness of primary care nurses, and a higher first-bid price showed higher WTP for chronic disease management services provided by primary care nurses.ConclusionsPrimary care is important worldwide due to the increasing number of chronic diseases, and Korea is no exception. However, payment for services by primary care nurses is undervalued compared to their critical role and skills. This has led to problems such as a primary care nurse shortage and burnout. This study estimated individuals’ WTP for chronic disease management services provided by primary care nurses. The results can be used as a basic resource for setting the fee for services provided by primary care nurses. It is also a good starting point to understand the benefits of primary care nurse services.

The relationships between blood lead levels and nocturia prevalence in adults: A retrospective study.

The purpose of this study was to examine the association between blood lead levels and the prevalence of nocturia in American adults. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020, focusing on individuals aged 20 years or older (n = 11,919). Blood lead levels were categorized into two groups (<2 µg/dL and ≥2 µg/dL), and the presence of nocturia was assessed based on questionnaire responses. We used multivariable logistic regression models to explore the association between blood lead levels and nocturia while adjusting for various covariates, including sex, ratio of family income to poverty (RIP), lipid profile, age, body mass index (BMI), race, citizenship, sleep trouble, diabetes, and hypertension. To verify whether certain covariates influence blood lead levels and the risk of nocturia, we conducted subgroup analyses. Of the study participants, 31.70% reported experiencing nocturia. Individuals with higher blood lead levels (≥2 µg/dL) exhibited a higher likelihood of experiencing nocturia compared to those with lower levels (<2 µg/dL) in all three models (Model 1: OR 1.46, 95% CI 1.29-1.66, p < 0.0001; Model 2: OR 1.25, 95% CI 1.09-1.44, p = 0.002; Model 3: OR 1.22, 95%CI 1.06-1.41, p = 0.01). Subgroup analyses revealed that factors such as age, sex, sleep trouble, diabetes, hypertension, BMI, RIP, and race did not affect the association between blood lead levels and the risk of nocturia (P for interaction >0.05). This study reported the correlation between blood lead levels and nocturia. We found that compared to blood lead levels below 2 µg/dL, when lead levels reached or exceeded 2 µg/dL, the risk of nocturia occurrence increased by 22%. This study is based on existing data from a public database and not from a specific clinical trial; hence, clinical registration information is not provided.