Reliability Of Questionnaire Research Articles

Parents' Willingness-to-Pay for Fissure Sealant and Fluoride Varnish Therapy in Public and Private Pediatric Clinics.

This study employed the willingness-to-pay (WTP) method to investigate parents' valuation of fissure sealant (FS) and fluoride varnish (FV) therapy. This cross-sectional analytical study was conducted in 2021 among 100 parents. The maximum WTP were collected using payment cards, an originally developed validated and reliable questionnaire, educational videos, and a hypothetical scenario. The data were analyzed using ANOVA, t-test, Pearson correlation coefficient, and linear regression tests (α = 0.05). The mean (±SD) WTP was 245 700 (±158 756.24) and 232380.0 (±166 561.71) IR Tomans for FS and FV, respectively. WTP was significantly higher among parents who visited private clinics (p < 0.05) and government employees. Both in the whole sample and in the public group, parents without supplemental insurance had lower WTP values. The WTP values elicited through the payment card method (p = 0.014) and the open-ended question (p = 0.031) for fathers with educational attainment below a high school diploma were significantly lower. There was no significant difference between the WTP values for these two therapies. Income level of the parents was the main indicator in the regression models, especially for WTP values of FS. The demographic and socioeconomic conditions of parents as well as their insurance status were associated with the WTP values.

Psychometric Evaluation of the Persian Version of the Tinnitus Cognitions Questionnaire

Background and Aim: Cognitive Behavioral Therapy (CBT) is the only evidence-based and method for tinnitus management. To assess a patient’s progress during and after CBT, an assessment tool such as a questionnaire is needed. Since there is no validated tool available in Iran for this purpose, this study aims to investigate the psychometric properties of the Persian version of the Tinnitus Cognition Questionnaire (P-TCQ). Methods: The TCQ was first translated to Persian based on the international quality of life assessment protocol. participants were 102 tinnitus patients and 7 audiologists. After translation and data collection, psychometric properties (content validity, face validity, construct validity, criterion validity, reliability) of the P-TCQ were evaluated. Results: The Content Validity Ratio (CVR) and Item-Content Validity Index (I-CVI) values were higher than the minimum acceptable values (0.74 and 0.79, respectively). Item-level Face Validity Index (I-FVI) and average of Scale-level Face Validity Indexes (S-FVI) were in a range of 0.8-0.96 and 0.88–0.90, respectively, all of which were higher than the acceptable value of 0.7. Furthermore, fit indices had higher than the acceptable values and showed the good fit of the confirmatory factor abalysis model. There was a positive correlations between the TCQ total scores and the tinnitus handicap inventory (r=0.60) and hospital anxiety and depression scale (r=0.61), indicating acceptaiuoble criterion validity. Furthermore, Cronbach’s alpha coefficient and the intraclass correlation coefficient showed that the TCQ has acceptable reliability. Conclusion: The P-TCQ is a valid and reliable questionnaire to evaluate the cognitive aspects of tinnitus in the Iranian samples.Keywords: Tinnitus; cognition; tinnitus cognitions questionnaire; cognitive behavioral therapy; tinnitus handicap inventory

Validation of a Questionnaire on COVID-19 Knowledge and Attitude for Dental Patients

Objectives: The current study aimed to develop a valid and reliable questionnaire in both English and Persian to assess dental patients' knowledge and attitude during the COVID-19 outbreak. Materials and Methods: Through a comprehensive literature review, we designed the primary questionnaire in English and then translated it into Persian. The questionnaire consisted of six sections covering background information, knowledge of emergency dental treatments, transmission routes of disease, required preparation, source of information, and attitude. To evaluate the validity of the questionnaire, the researchers obtained expert opinions using the Item Content Validity Index (I-CVI) and Scale Content Validity Index (S-CVI/Ave). They distributed online versions of the questionnaire to a total of 60 English-speaking adults in Nigeria and the United States, and 60 Persian-speaking adults in Iran to measure its reliability using Cronbach's alpha. Results: I-CVI score, S-CVI/Ave, and Cronbach’s alpha of the questionnaire ranged from 0.29-1, 0.62-0.99, and 41.1-87.6%, respectively. After reviewing the scores and comments received on each item, taking into account the opinions of the research team, a decision was made to remove, merge, modify, or retain certain items. This led to a final version of the questionnaire consisting of nine questions in the background section and 46 items in the remaining five sections. Conclusion: Overall, the developed questionnaire appears to be valid and reliable for assessing the knowledge and attitude of dental patients toward COVID-19 in dental settings. It can potentially serve as an appropriate scale in future infectious disease epidemics across diverse populations.

The Effectiveness of a Tamil Story Writing- Learning Module Guided by the 5E Inquiry Learning Model among Tamil School Students: Assessing Questionnaire Validity and Reliability

The Effectiveness of a Tamil Story Writing- Learning Module Guided by the 5E Inquiry Learning Model among Tamil School Students: Assessing Questionnaire Validity and Reliability

Validation of the Japanese version of the Esophageal Hypervigilance and Anxiety Scale for esophageal symptoms.

The Esophageal Hypervigilance and Anxiety Scale (EHAS) is an English questionnaire created in the USA to assess these factors in all patients with esophageal diseases. The aim of this study was to develop and validate the Japanese version of EHAS and investigate the relationship between EHAS scores and symptoms in untreated disorders of esophagogastric junction (EGJ) outflow. This prospective study recruited patients who underwent high-resolution manometry (HRM) at six tertiary centers in Japan. The EHAS was translated to Japanese using standard forward and backward translation methods. Patients completed the following questionnaires: the Japanese EHAS, Eckardt score, Gastroesophageal Reflux Disease Questionnaire, and Hospital Anxiety and Depression Scale for assessment of construct validity. Logistic regression analysis identified factors associated with esophageal symptom severity in untreated disorders of EGJ outflow. Overall, we analyzed 432 patients. Their main symptoms were dysphagia and reflux. The most common HRM diagnosis was normal (35.9%), followed by achalasia (29.4%). The Japanese EHAS demonstrated excellent reliability, and construct validity, with two subscales similar to the original EHAS. Total EHAS score moderately correlated to Eckardt score (r = 0.545, p < 0.001). In 113 patients with untreated disorders of EGJ outflow, multivariable analysis demonstrated that younger age, type II achalasia, and higher EHAS score were independently associated with higher Eckardt score. The Japanese EHAS is a reliable and valid questionnaire. Its subscale scores can be used as in the original version with some caution. Future studies are warranted to assess the appropriateness of factor loading.

Translation, cross-cultural adaptation, and psychometric analysis of the Indonesian version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), patient self-report section

Purpose To translate the American Shoulder and Elbow Surgeon (ASES) score into Indonesian and to assess its psychometric properties. Materials and methods The ASES score was translated into Indonesian following the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Next, the validity and reliability of the Indonesia-ASES (I-ASES) were investigated. Patients with shoulder problems at a hospital in Indonesia who were willing to participate completed three questionnaires: the I-ASES, the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12), and the Shoulder Pain and Disability Index (SPADI). Participants were asked to complete the I-ASES a second time after a one-week interval. In adherence to COSMIN guidelines, we assessed construct validity using hypothesis testing, test–retest reliability, internal consistency, floor and ceiling effects, and measurement error. The Bland–Altman method was used to evaluate systematic bias. Results The I-ASES showed good construct validity. No floor or ceiling effects were found. An ICC value of 0.82 was found, indicating a robust level of test–retest reliability. A Cronbach α of 0.90 implied good internal consistency. Bland and Altman analysis showed no systematic bias. The standard error of measurement (SEM), the minimal detectable change at the individual level (MDCind) and at the group level (MDCgrp) were 2.3, 6.5, and 0.6, respectively. Conclusions The I-ASES shows good validity and reliability for evaluating shoulder problems in Indonesian-speaking patients and reveals comparable psychometric properties to those of the other languages version of ASES. Implications for rehabilitation The Indonesian version of the American Shoulder and Elbow Surgeons standardized Shoulder Assessment Form (I-ASES) is now available. I-ASES demonstrated satisfactory reliability and validity. I-ASES can be considered a valid and reliable questionnaire for use in Indonesian patients with shoulder problem.

Enhancing Emergency Management Skills Through Manikin-Based Basic Life Support Simulations: An Evidence-Based Approach for Nursing Students

Introduction: Effective Basic Life Support (BLS) is crucial in improving survival rates during emergencies. Current nursing education often relies on traditional methods, which may not fully prepare students for the pressure and decision-making required in real-life situations. Objective: This study explores the effectiveness of manikin-based BLS simulation with scenarios in enhancing nursing students' skills in emergency management. Method: This study employed a one-group pre-test post-test design. Thirty nursing students were randomly assigned to participate in a Manikin-Based BLS Simulation training program. Their BLS skills were assessed using a validated and reliable questionnaire based on the American Heart Association (AHA) 2020 guidelines, administered both before and after the training. Data collection occurred in May 2024. The subsequent analysis will compare pre-test and post-test scores to evaluate the effectiveness of the Manikin-Based BLS Simulation in improving students' BLS skills. Result: Post-training, knowledge improved significantly (p &lt; 0.001), with 93.3% of students achieving 'Good' knowledge and 96.7% passing skill assessments. Conclusion: Manikin-based simulations effectively enhance knowledge and skills, supporting their integration into nursing curricula.

Osteoporosis Knowledge Assessment Tool – Tamil (OKAT-T) in Postmenopausal Women: A Validity and Reliability Study.

IntroductionOsteoporosis is a silent disease that is more prevalent among postmenopausal women (PMW) due to hormonal transition. Various toolkits, including the Osteoporosis Knowledge Assessment Tool (OKAT), were available for the knowledge assessment. The Osteoporosis-related knowledge is crucial for preventing osteoporosis, but there is no validated, reliable questionnaire in Tamil to measure this knowledge. AimTo validate the Tamil version of the OKAT (OKAT-T) and its psychometric properties to measure the knowledge of osteoporosis for use in postmenopausal women. MethodologyThis cross-sectional study was done in two phases, as translation of OKAT in Tamil and validation of OKAT-T among 430 postmenopausal women in both rural and urban regions. Reliability was examined by the Flesch reading ease (FKRE&G) and McNemar’s test, along with difficulty index, item discrimination and item-total correlations, inter-item consistency (Cronbach’s alpha coefficient). ResultThe overall mean age of the 430 PMW was 59.53 ± 9.83 years. The results showed a good and satisfactory face validity and FKRE&G score (55.9). The Cronbach’s alpha for the overall scale was calculated as 0.85 and considered to be good and satisfactory. As per the difficulty index, 19 items had a 0.3 to 0.7, implying that the questionnaire was easy to understand and satisfactory. Similarly, a test-retest was assessed, which was statistically significant for only six items out of 26, showing that the tool has stable reliability. ConclusionThe management of chronic disorders such as osteoporosis has become more challenging for patients especially among PMW and healthcare professionals due to the increasing life expectancy and urbanization. The use of an Osteoporosis Knowledge Assessment tool that has been tailored to people’s understanding and developed in the local language can raise awareness levels about osteoporosis, encourage the adoption of osteoprotective strategies, and provide guidance on treatment options.

Assessing community pharmacists' thoughts on telepharmacy in Bali province

Telepharmacy describes the use of technology in interactions between pharmacists and patients. Given that telepharmacy is the most recent development in the delivery of digital pharmacy services, the question of how prepared pharmacists are to provide high-quality services frequently comes up and receives attention. The purpose of this study was to determine the viewpoints of pharmacists in telepharmacy services. From February to April 2023, a cross-sectional survey was done using a Google form. The study population included 111 pharmacists in charge of network pharmacies in Bali Province. Their thoughts were assessed using a credible and reliable questionnaire created by the researchers. The questions were split into two sections: a professional demographic items, and a section describing the perspectives, benefits, and challenges of telepharmacy. To get a more detailed or comprehensive response, open-ended questions were added. In general, especially during a pandemic, pharmacists were aware of being involved in remote services (non-face-to-face interaction) and telepharmacy services. This study makes clear that pharmacists' involvement is essential for creating a long-distance relationship between them and their patients. Therefore, pharmacists should learn how crucial communication is to increase patient satisfaction.

Chinese ELF Teachers’ Emotional Self-Efficacy, Job Satisfaction, and Self-Regulation

This study aimed to investigate the relationship among emotional self-efficacy, job satisfaction, and self-regulation among Chinese EFL teachers to propose a professional development plan for teachers to enhance college English teaching and learning. A descriptive quantitative method was employed with 385 Chinese EFL teachers through an online survey questionnaire. To ensure the reliability of the questionnaire, a pilot test was conducted, and indicated the reliability of the whole questionnaire. The findings of this research indicated an overall favorable attitude towards emotional self-efficacy, job satisfaction, and self-regulation among Chinese EFL teachers. In terms of emotional self-regulation, reflective of the respondents’ emotional regulation self-efficacy was strongly agreed by the respondents showing the strong confidence in their ability to control and regulate their emotions effectively. Teachers experienced a profound feeling of achievement and satisfaction in their roles, which was slightly higher than satisfaction with social support and autonomy. In the assessment of self-regulation, teachers’ self-monitoring was accepted of self-regulation. This suggested that educators diligently monitor and evaluate their instructional techniques and results. In addition, there are highly significant correlations among the three variables Additionally, a professional development plan is proposed to enhance Chinese EFL teachers’ professional development. Recommendations are forwarded concerning the school stakeholders to help EFL teachers enhance their profession.

Business Formalization to Strengthen the Commercial Negotiation of Independent Waste Recyclers

In Latin America, cities are experiencing serious environmental problems due to rapid growth that exceeds their capacity for governance. At this juncture, the independent informal recycler is the workforce dedicated to the collection of recyclable inorganic solid waste that contributes to the effectiveness of municipal management. Thus, the objective was to determine the influence of business formalization and commercial negotiation from the perspective of these people. It was a basic, non-experimental, quantitative, causal correlational study. Three hundred waste pickers were surveyed using two validated and reliable questionnaires. The data was analyzed by ordinal logistic regression. It was determined that business formalization had a significant influence on commercial negotiation; however, there are aspects related to productivity and the application/compliance with legality that should be analyzed from a governmental management perspective, in order to provide better conditions to guarantee the sustainability of this activity within the communes. The role of municipal managers should be oriented on two main fronts: technical-legal and strategic management with a sustainable vision within the framework of the state modernization plan and the need to maintain the ecological balance that will sustain human survival in the future.

Cross-cultural adaptation, validation, and establishment of the minimal clinicallyimportant change score of the European Portuguese Core Outcome Measures Index in patients with cervical degenerative spine disease.

We aimed to validate and cross-culturally adapt the Core Outcome Measures Index (COMI) neck for use in Portuguese patients with cervical spine degenerative disease and define the minimal clinically important change score (MCIC) for this questionnaire and population. The COMI translation and cross-cultural adaptation was done following published guidelines. Patients awaiting surgery in a neurosurgical centre completed the COMI, Neck Disability Index (NDI) and EQ-5D questionnaires, a pain visual analog scale (VAS) twice within a 5-to-15-day period, and a Global Treatment Outcome (GTO) question evaluating whether a clinical status change had occurred during that period. The MCIC was obtained through an anchor method by analysis of changes in pre- to postoperative total COMI scores and GTO dichotomized answers. The COMI first assessment was completed by 101 patients and 72 patients completed both assessments. The questionnaire showed good construct validity (n = 72 patients) as predefined hypotheses were confirmed: scores on each COMI domain correlated with a Spearman ρ > 0.4 with scores for the corresponding domain on other questionnaires and COMI total score displayed good correlation with total NDI score (ρ = 0.67) and EQ-5D total score (ρ = 0.55). Test-retest reliability (n = 72 patients) was confirmed through high intraclass correlation coefficients. The MCIC (n = 76 patients) was calculated as 2 points. The COMI (neck) psychometric qualities were confirmed, such that it can be considered a valid and reliable questionnaire to be applied in the European Portuguese population with surgical cervical spine degenerative disease, with an MCIC of 2 points.

Extensiveness of Classroom Presentation in Enhancing Active Learning among Public Secondary School Students in Moshi Municipality, Tanzania

This study weighed the extensiveness of classroom presentation in enhancing active learning among public secondary school students in Moshi municipality, Tanzania. The study focused on the extent to which classroom presentations, experiments, subject projects, and case studies boost active learning among students. Out of 1499 targeted individuals from Moshi Municipality, a sample of 4 public secondary schools through which 128 students, 32 teachers, 4 heads of schools, and 1 district secondary education officer (165 respondents) were obtained using probability and non-probability techniques. Research experts in education ensured the validity of the questionnaires, interview guides, and observation guides. A pilot study was conducted in two public secondary schools, and the reliability of questionnaires was estimated using Cronbach's Alpha technique for Likert-type items whereby .834 and .821 coefficients for teachers and students' instruments was correspondingly achieved while reliability for qualitative data was established through peer debriefing and triangulation methods. Quantitative data was descriptively analyzed to frequencies, percentages, and mean with the aid of SPSS version 22, while qualitative data was scrutinized thematically and presented in tables and quotations, respectively. The study adhered to research ethical principles throughout the research process. According to the study, classroom presentations significantly boosted students' critical thinking, active engagement, and comprehension to improve active learning in public secondary schools. The study concluded that presentations are, to a high extent, useful instructional tools for grabbing students' attention visually and efficiently communicating ideas. For improved educational outcomes, the government and other education stakeholders should prioritize active learning strategies, encourage teacher development, empower students' active engagement, allot resources, and enforce policies.

Examining preventive occupational health and safety management in the Swedish welfare sector-questionnaire development, its validity and reliability, and initial findings on employers' knowledge.

A preventive approach to occupational health and safety management (OHSM) can improve working conditions, but more knowledge is needed on how this should be organised in practice. Here, we describe the development, validity and reliability of a questionnaire used to examine employers' preventive OHSM within the Swedish welfare sector. Furthermore, employers' knowledge of preventive OHSM was explored using the survey data. A questionnaire was developed based on interviews with key actors (n = 7), experts (n = 6) and intended respondents (n = 5). Using the final questionnaire, 197 responses were collected from employer (n = 126) and employee representatives (n = 71) and used to assess the validity and reliability of the questionnaire. Qualitative and quantitative analyses of open-ended and multi-choice items were used to assess the response distribution, content validity and interrater reliability (i.e. employer-employee correspondence from 32 matched pairs from the same workplace). Quantitative and qualitative analyses of survey responses from employer representatives were performed to assess their knowledge of preventive OHSM. The final questionnaire included 91 items covering employers' working routines, resources and work environment economics. Qualitative analyses indicated a high content validity in the questionnaire, with a satisfactory response distribution and very small proportion of missing data on individual survey items. Overall, the interrater reliability was high (>60%), but the employer representatives generally gave more examples within different areas of the OHSM compared to the employee representatives. Most of the employer representatives (74%, n = 90) assessed that their organisation had sufficient knowledge regarding preventive OHSM but that the knowledge of work environment economics was lower. By combining work environment research with questionnaire design research, high validity and reliability was achieved for this questionnaire. Furthermore, the employers generally perceived that they have high knowledge of preventive OHSM but that more knowledge is needed on work environment economics.

Students’ ratings to evaluate effective teaching practices of secondary schools in Bangladesh

PurposeInternational studies have emphasised the importance of effective teaching for student learning. However, few studies have investigated teaching practices in Bangladesh. The purpose of the study set out to explore the mathematics teaching behaviour of secondary school level of Bangladesh.Design/methodology/approachA convenient sampling strategy was used to collect 502 grade nine students’ perceptions from 15 mathematics classes within Dhaka Metropolitan City (DMC). A valid and reliable student questionnaire was used where the students rated their mathematics teachers' teaching behaviours identified in the dynamic model of educational effectiveness (DMEE).FindingsThe findings from the quantitative analysis of the student evaluations revealed that the mathematics teachers demonstrated structuring, modelling, questioning, teacher–student interactions and teacher dealing with misbehaviours in their daily classroom teaching.Research limitations/implicationsA small sample of mathematics classes were chosen in the study; hence, the findings may not be totally representative nor generalisable to the population of secondary mathematics teachers within Dhaka, Bangladesh.Practical implicationsThe study conducted in Bangladesh contributes to the international dimension to educational effectiveness research. The findings from the study provide partial support for teaching factors and dimensions in DMEE (Creemers and Kyriakides, 2008), and emphasise the need for further studies, particularly in cross-cultural contexts.Originality/valueThis is the first study to evaluate teaching behaviours of secondary mathematics teachers through students’ perceptions in Bangladesh. It contributes important insights about teaching behaviours to inform the development of evidence-based policy and practice on quality teaching in the region.

Effectiveness of Teachers Training Program in Enhancing Teaching Competence of Public Primary School Teachers in Ilemela Municipality, Tanzania

The study aims to investigate the Effectiveness of Teachers Training Program in Enhancing Teaching Competence of Public Primary School Teachers in Ilemela Municipality, Tanzania. The problem of this study was answered by the one research questions; TCPD training programs in enhancing teaching competence. The study was guided by the Social Cognitive Theory. The current study employed convergent design under mixed research methods approach. The target population consisted of various stakeholders, including 81 public primary schools, 1,047 teachers, 19 Ward Education Officers, 81 head teachers, and 8 District quality assurers making total number of 1155 population. The sample size for the current study consisted of 16 public primary schools, 192 teachers, 16 head teachers, 6 Ward Education Officers (WEO), and 2 District School Quality Assurers (DSQA), totaling 216 respondents. Questionnaires, interview guides, and document analysis guides were used to collect data from respondents. Data collection instruments were validated by MWECAU research experts. A pilot study was conducted in two public primary schools. The reliability of questionnaires for Likert-type items was estimated using Cronbach's Alpha Coefficient whereby r= 0.889 for teachers while that of qualitative established through peer debriefing and triangulation. The study adhered to ethical considerations throughout the research process. Descriptive statistics were analyzed quantitative data using SPSS version 26. Qualitative data was analyzed thematically. The study found that the TCPD is highly effective in improving teaching competence through focused training on classroom management, instructional design, differentiated instruction, student engagement, and technology integration significantly improved their teaching skills. The study concluded that Continuing Professional Development (CPD) effectively Enhanced Teaching Competence of Public Primary School Teachers in Ilemela Municipality to the high extent. The study recommended that a similar training program should be implemented regularly to equip teachers with up-date skills and knowledge.

Prevalence of mental disorders and related risk factors in refugees and asylum seekers in Campania.

In recent years, the increasing presence of refugees and asylum seekers displaced from their country of origin, determined significant social, economic, humanitarian and public health implications in host countries, including Italy. These populations are exposed to several potential stressful experiences which make them vulnerable to psychological distress. In fact, the majority of studies addressing the topic found a higher prevalence of mental disorders, especially post-traumatic stress disorder and major depressive disorder, in refugees and asylum seekers with respect to the general population. However, heterogeneous prevalence rates have been reported among studies, due to methodological factor as well as to the impact of a variety of risk factors related to stressful experiences lived in the country of origin, during the migration journey and in the host country. The aim of the present study was to assess the prevalence of the main psychiatric diagnoses in a large group of adult refugees and asylum seekers (N=303) in the reception centers of two provinces of the Campania region, as well as to investigate the impact of potential risk factors on the occurrence of psychiatric disorders. The diagnosis of psychiatric disorders and the identification of subjects at high risk to develop psychosis were carried out by means of structured diagnostic interviews. The following variables were explored as potential risk/protective factors to the occurrence of psychiatric disorders: socio-demographic variables, migration status (refugees/asylum seekers) and characteristics of the reception center,assessed by means of an ad hoc questionnaire; cognitive indices assessed by using standardized neuropsychological tests; traumatic experiences and level of political terror in the country of origin, assessed by means of reliable and valid self-report questionnaires. At least one mental disorder was found in 29.7% of the sample. Most prevalent diagnoses were depressive disorders, anxiety disorders and PTSD. Women showed, with respect to men, a higher prevalence of anxiety disorders, higher trauma levels, and came from more at-risk countries. Higher trauma levels, better cognitive abilities and unemployment and refugee status were associated to the presence of a current psychiatric disorder in the whole sample. Our findings showed a higher prevalence of depressive disorders and PTSD in the sample of refugees and asylum seekers with respect to the general population and highlighted the role of potential risk factors whose identification may guide the implementation of preventive strategies and early treatments in these people.

Nutritional education on health beliefs, metabolic profiles, and quality of life among high-risk pregnant women for gestational diabetes mellitus: a randomized controlled trial

In recent years, nutrition has become increasingly important in treating and managing gestational diabetes mellitus. The Health Belief Model (HBM) is a conceptual framework in health behavior research used in some medical research. The present study aimed to evaluate the effect of glycemic index training based on the HBM on metabolic indicators and pregnant women’s health-related quality of life. In this open-label, parallel-controlled randomized trial, 90 pregnant women from primary health centers in Iran were recruited and randomly assigned to either the intervention group or the control group, using a block randomization method with a block size of six. The intervention group underwent 12 weeks of nutritional education on the glycemic index and load of foodstuff. The control group only received routine health care. Valid and reliable questionnaires included demographic and prenatal information, physical activity, three days of food records, quality of life (SF-12), and HBM constructs. Fasting blood samples were taken at baseline and end of the study, to assess fasting blood glucose (FBS), fasting insulin, hs-CRP, and lipids. Eighty-four pregnant women with an age mean of 30.12 ± 4.35 completed 12 weeks of intervention. At baseline, there were no significant differences between groups in the HBM subscales (P > 0.05). However, within the intervention group, there was an increase in perceived susceptibilities (mean change 1.45 ± 4.21; P = 0.03) and cue to action (mean change: 1.22 ± 3.38; P = 0.02). In the adjusted model, the General Health subscale of Quality of Life showed a significant increase in the comparison between groups (mean change 13.69 ± 29.83 vs. 0.00 ± 29.58; P = 0.04). Additionally, the adjusted model revealed a notable difference between the groups in serum hs-CRP level, (mean change -0.877 ± 3.47 vs. -0.067 ± 3.40; P = 0.01) and triglyceride level (mean change − 55.24 ± 111.21 vs. 40.92 ± 142.01; P = 0.001). However, in the adjusted model, the total cholesterol levels increased between groups (mean change 22.75 ± 66.17 vs. 30.12 ± 61.33; P = 0.01) at the end of the study. There was no significant difference in glycemic indices (P > 0.05). Participation in a nutrition education program might positively impact nutritional beliefs, behaviors, and some biochemical indicators among pregnant women. Future studies with larger sample sizes and longer follow-ups are warranted.Trial registration number: IRCTID: IRCT20190227042858N1. Registration date: 2019-07-18.

Current situation and capacity of cancer diagnosis and treatment in county hospitals in China: a multicenter cross-sectional survey

PurposeCounty-level hospitals in China constitute a vital component of the healthcare system, delivering essential medical services, emergency care, and specialized treatments, particularly in oncology. This study aimed to comprehensively evaluate the current status of cancer diagnosis and treatment in county hospitals and assess their overall capacity.MethodsA nationwide cross-sectional survey by the China Anti-cancer Association (CACA) from February to May 2023 assessed cancer diagnosis and treatment in mainland China's county hospitals. Using a multi-center approach, a fifty-five-question questionnaire was administered to oncology professionals and management staffs, focusing on hospital facilities, oncology specialists, cancer cases, treatment capabilities, and healthcare collaboration. Questionnaire reliability and validity were established in a 2022 national survey. Participants, aged 18 or older, were recruited through purposive sampling, receiving self-administered questionnaires for confidentiality. SAS 9.4 software facilitated statistical analysis.ResultsThe study encompassed 76 county-level medical institutions, with 82.9% of them featuring established oncology departments providing comprehensive cancer care, including early screening, diagnosis, treatment, and long-term follow-up. Notably, a total of 56.6% of the institutions surveyed implemented programs for cancer screening and early diagnosis. A significant proportion of advanced cancer patients received treatment and follow-up at the county level. Persistent disparities in medical insurance policies at the county level were identified as a continuing challenge. Furthermore, 82.9% of hospitals had cultivated collaborative relationships with higher-level institutions to enhance patient care quality and treatment capacity. The study revealed a 56.6% shortage of remote collaboration platforms in these hospitals. The need for a patient-centered approach in county hospitals was underscored.ConclusionWhile county-level hospitals face challenges, such as a shortage of specialized oncologists and advanced resources, they exhibit progress in standardizing cancer care to enhance diagnosis and treatment in rural areas.

The Correlation Between Math Anxiety Level and Numeracy Skills of Fifth-Grade Students

This study aims to determine the correlation of math anxiety to numeracy skills. The sample in this study was one class, namely class V at 5 Elementary School Selong with a total of 27 people. The research design used is correlational with quantitative research type. The results of the validity and reliability tests stated that there were 17 valid and highly reliable math anxiety questionnaire statement items and there were 20 valid and reliable numeracy test items. To analyze the data, researchers used the Person Product Moment correlation which previously conducted a normality test manually with the help of excel using the Saphiro Wilk formula. Based on data analysis, the calculation of the variable relationship is -0.40. This means that math anxiety with numeracy skills is a negative correlation. Based on the interpretation of the correlation coefficient, the relationship between the two variables is in the moderate category. The amount of contribution of math anxiety variables to numeracy skills is 16% and 84% is determined by other variables. After that, the significance test is carried out with the T-test, then seen from the hypothesis testing criteria, namely obtained tcount = -2.17 while ttable (5%) = 2.06. From the calculation results, it can be seen that the result of tcount = -2.17 &lt; ttable = -2.06. This shows that H0 is rejected and H1 is accepted. So it is concluded that "there is a significant correlation between math anxiety level and students' numeracy skills"