Research on internal exposure and assessment from food intake using a whole body counter and self-administered questionnaires

Associated factors of death acceptance among Thai Buddhist patients with cancer.

Awareness of colorectal cancer and screening uptake in Eastern KSA: Predictors and implications.

Abuse in individuals with multiple sclerosis: the SocialMS Italian study.

Lifestyle factors and DNA methylation-based aging clocks: cross-sectional and longitudinal associations in the Singapore diet and healthy aging cohort.

This study examined the impact of Supply Chain Risk Management (SCRM) practices on supply chain resilience. It was guided by three key questions: (1) What timely risk identification practices enhance resilience? (2) What monitoring practices strengthen resilience? and (3) What risk treatment strategies support resilient outcomes? A descriptive research design with a quantitative approach was adopted. The study targeted heads of departments, procurement and stores managers, administrative officers, production managers, project managers, and finance officers. Using purposive sampling, 40 respondents were selected from a population of 60, with 39 valid responses collected through self-administered questionnaires. The data were coded and analyzed using SPSS. Findings revealed that effective supply chain risk management is crucial to an organization's survival and resilience. Firms that identify risks early are better positioned to maintain control, allocate resources efficiently, enhance agility, and implement timely mitigation strategies. Continuous risk monitoring was found to improve flexibility, visibility, collaboration, and overall responsiveness. Similarly, structured risk treatment practices strengthened recovery capacity, resistance, redundancy, trust, financial stability, and competitive advantage. The study concludes that the timely and systematic implementation of risk identification, monitoring, and treatment practices significantly enhances supply chain resilience and organizational performance. It recommends that organizations adopt cost-effective, process-driven risk management systems, promote timely information sharing among stakeholders, decentralize risk-related decision-making, and foster a strong risk management culture. Further research with larger samples is encouraged to deepen the understanding of emerging dimensions of supply chain resilience.

Background: The growing integration of technology in education has made digital health literacy an essential skill for healthcare students. Academic stress and burnout are widely reported among healthcare undergraduates; however, their relationship with digital health literacy remains insufficiently explored, particularly in developing countries such as Pakistan. Objective: This study examined the association between digital health literacy, academic stress, and burnout among undergraduate healthcare students and assessed whether digital health literacy predicts burnout after controlling for demographic factors. Methodology: A cross-sectional analytical study was conducted from January to June 2025 among 300 undergraduate healthcare students from private universities in Pakistan. Data were collected using a self-administered online questionnaire including demographics, the Digital Health Literacy Instrument, Perceived Stress Scale-10, and Maslach Burnout Inventory-Student Survey. Descriptive statistics, Shapiro–Wilk normality testing, Pearson correlation, and multiple linear regression analyses were performed to identify predictors of burnout after adjusting for demographic variables, with statistical significance set at p<0.05. Results: The mean age of participants was 21.4±1.8 years, with females comprising 62% of the sample. Digital health literacy was significantly negatively correlated with academic stress (r= −0.34, p<0.001) and burnout (r= −0.29, p<0.001). Academic stress showed a strong positive correlation with burnout (r=0.63, p<0.001) and was the strongest predictor of burnout (β=0.56, p=0.001). Digital health literacy independently predicted lower burnout (β= −0.18, p=0.002). The model explained 46% of the variance in burnout. Conclusion: Higher digital health literacy is associated with reduced academic stress and burnout. Integrating digital health literacy training may improve student well-being and academic resilience.

Disordered eating behaviors (DEBs), food addiction (FA), and compulsive exercise (CE) represent increasing public health concerns among university students, particularly those enrolled in nutrition-related programs. Although research examining disordered eating attitudes in the Middle East, including Saudi Arabia, has expanded in recent years, studies specifically targeting nutrition major students and employing standardized assessment instruments remain limited. Therefore, this study aimed to estimate the prevalence of DEBs, FA, and CE and to examine their associations with body mass index (BMI), educational level, age, and academic achievement, as indicated by grade point average (GPA), among female nutrition students at Taibah University in Al Madinah Al Munawwarah. An analytical cross-sectional study was conducted from January 29 to May 1, 2025, among 138 undergraduate nutrition majors (aged 18-25) at Taibah University, Al-Madinah Al-Munawarah, using a self-administered online questionnaire to collect demographic data (age, BMI, GPA, educational level) and four validated instruments, the Eating Disorder Examination Questionnaire -Short (EDE-QS) and the Three-Factor Eating Questionnaire-Revised 18-item version (TFEQ-R18) for DEBs, the Modified Yale Food Addiction Scale Version 2.0 (mYFAS 2.0) for FA, and the Compulsive Exercise Test (CET) for CE. Descriptive statistics were calculated, and unadjusted Pearson correlation analyses were performed to examine associations between study variables. Based on the EDE-QS, 21.7% of 138 clinical nutrition students were classified as having a high risk of eating disorders. Eating behavior patterns assessed by the TFEQ-R18 indicated that body mass index (BMI) showed a low positive association with cognitive restraint and a positive association with emotional eating, both negligible, whereas uncontrolled eating was significantly negatively associated with age and educational level. Severe food addiction was identified in 11.6% of participants, and 21% demonstrated high levels of compulsive exercise, whereas age, educational level, and GPA showed limited to no significant associations with most outcomes. This study highlights the importance of BMI as a key indicator in identifying at-risk students for DEBs, FA and CE. These findings highlight the need for future longitudinal research to examine causal relationships and to assess preventive and supportive strategies targeting maladaptive eating and exercise behaviors among nutrition students.

Responding to long-term care staffing shortages: Addressing nurse aide turnover through perceived management support.

Neonatal encephalopathy, particularly situations involving neonatal hypoxic-ischaemic encephalopathy (NHIE) and neonatal stroke (NS), covers complex neonatal conditions associated with a risk of neurodevelopmental difficulties. Early prevention programmes have shown benefits for neurodevelopment, but few address both NHIE and NS populations. Following an initial joint development phase with families and professionals, we identified two areas of intervention: (1) Making infant care and referral more streamlined and (2) Increasing parent empowerment. The PRevention and support for Parenthood in an early Rehabilitation programme is a multidisciplinary intervention initiated in the neonatal intensive care unit and continuing at home until the infant reaches a corrected age of 4 months. Its objectives are to: (1) Ensure that the family environment is adapted to the child's needs, (2) Introduce parents to digital support suggesting information on the care pathway and developmental interventions, (3) Maintain continuity of care and (4) Maximise early detection by sharing videos for analysis of the child's movements. This longitudinal study uses a mixed-methods approach to assess the acceptability and feasibility of the early parenthood support programme involving parents and healthcare professionals. The qualitative research will be carried out through focus groups (parents and professionals) held at the end of the intervention programme. The corpus of semidirected collective interviews (focus group) will be processed by thematic content analysis. Initial coding and analysis will be conducted by the sociologist with expertise in qualitative methods, and the emerging themes and interpretations will then be discussed, refined and validated through interdisciplinary analysis meetings involving the broader research team. This collective analytical process will allow for deeper engagement with the data and ensure that interpretations are challenged and enriched by multiple professional perspectives. The quantitative research will rely on self-administered questionnaires (parents and professionals), assessment of child neurodevelopment using standardised tools by physiotherapists and assessment of parental skills using standardised observation grids. This study has full approval from an independent ethics committee (CPP Ile de France I). Its findings will be published in peer-reviewed journals and conference presentations. The trial was registered on Clinicaltrials.gov (NCT05457569).

Long-term quality of life is an important consideration of patients in deciding on disease management options for low-risk papillary thyroid cancer (PTC). We conducted a prospective cohort study of Canadian patients who were diagnosed with small (<2 cm in maximal diameter), low-risk papillary thyroid cancer (PTC) and were given the choice of active surveillance (AS) or immediate surgery. We report the results of a self-administered questionnaire on patient-reported outcomes (PROs) that was completed approximately three years after the initial disease management choice. PROs included overall and subscale scores from questionnaires, including those on quality of life (EORTC QLQ-C30, EORTC THY-34), the Assessment of Survivor Concerns, the Decision Regret Scale, and the Generalized Anxiety Disorder 7-item Scale. We compared the results according to the initial disease management choice and according to the disease management status at the time of questionnaire completion. The participant response rate was 64% (120/188), including 98 individuals who chose AS and 22 who chose immediate surgery. The median duration of follow-up at the time of questionnaire completion was 42 months (interquartile range [IQR] = 39, 46). After statistical adjustment for multiple comparisons, there were no significant differences in the overall scores or subscales of any of the questionnaires between patients who chose AS and those who chose immediate surgery. However, in a secondary analysis, patients who crossed over from AS to surgery experienced greater cancer-related worry as well as overall worry (p = 0.021 for each) and decision regret (p = 0.031) as compared with patients who remained under AS and those who initially chose surgery. We observed that PROs do not significantly differ between patients who chose AS and those who chose immediate surgery a few years after the initial disease management choice. However, patients who crossover from AS to surgery may experience greater cancer-related worry and decision regret.

Background : Unintended pregnancy remains a major public health problem worldwide, and access to effective emergency contraception is essential for reducing unsafe abortion and maternal morbidity. Although the World Health Organization recommends emergency contraceptive pills (ECPs) for over-the-counter availability, evidence on women’s knowledge, attitudes, and use of ECPs in Kosovo is limited. Objective : To assess knowledge, attitudes, and practices regarding emergency contraceptive pill use among women in Kosovo and to analyze the influence of sociodemographic and social factors on access and utilization. Methods : A descriptive cross-sectional study was conducted in Kosovo from June to August 2025. A self-administered questionnaire was distributed online and in community pharmacies to women of reproductive age who had previously used emergency contraceptive pills. The survey collected data on demographics, usage patterns, sources of information, side effects, and attitudes toward ECP use. Participation was voluntary and anonymous. Results : Most participants were aged 18–30, highly educated, and living in urban areas. The majority used ECPs no more than once per month, and 77% obtained the pill without a prescription. No significant association was found between non-prescription access and frequent use ( p = 0.9181). Knowledge scores were significantly higher among women who received information from pharmacists (M = 6.02) and doctors or clinics (M = 5.86) than among those who relied on the Internet or Google (M = 3.33) or social media (M = 2.83) ( F = 90.91, p &amp;lt; 0.001). Rural residence was associated with higher odds of shame-related avoidance when requesting ECPs (OR = 2.60, 95% CI: 1.39–4.89) and with a stronger influence of cultural and family norms on ECP use (OR = 4.57, 95% CI: 2.20–9.49). Commonly reported side effects included menstrual irregularities, abdominal pain, headache, and nausea. Conclusion : Emergency contraceptive pills in Kosovo are generally used responsibly, even when accessed without a prescription. However, major knowledge gaps and social stigma persist, particularly among women in rural areas and those relying on unverified online sources for information. Strengthening professional counseling in pharmacies and clinics, establishing national OTC guidelines, and expanding sexual education programs are essential to improve the safe and informed use of emergency contraception.

Ageing is an inevitable biological process associated with increasing health vulnerabilities. This study assesses the health issues of older adults (aged 60 and above) in Tansen Municipality, Nepal, with a focus on gender disparities, the impact of literacy, and access to social security. A descriptive survey design was employed, with data collected from 147 respondents through a self-administered questionnaire. Findings revealed that 82.5% of females and 62.2% of males reported health problems, indicating the vivid gender disparities in the elders’ health. Approximately dozens of diseases are prevalent among the respondents, where hypertension (46.6%), diabetes (22.3%), gastritis (16.5%), and arthritis (14.56%) ranked in the top four positions, respectively. Illiterate elders faced higher health issues (84.4%). Elders from the Magar community have remarkably high rates of health problems (92.7%), followed by the Brahmin, Newar, and Kshetri, underscoring the need for health education intervention programs to address the socio-cultural practices of elders from an ethnic perspective. About 87% respondents have reported varied suggestions to the government, focusing on the provision of reliable cum accessible social security services regarding the care of the elderly. Results showed that older adults’ health problems were significantly associated with sex, caste, and literacy status. Due to the cross-sectional design, the study lacks the establishment of causal relationships, indicating the need for future longitudinal studies to explore the varied cum deeper findings related to the elders’ health problems. The study highlights the urgent need for gender-sensitive health policies, literacy-based health education, and strengthened elder care programs in Nepal.

The gut microbiome may modify the associations between lifestyle factors and colorectal cancer (CRC) risk, but their complex interplay, including the interactions between lifestyle factors, remain underexplored. We examined associations between CRC-related lifestyle patterns and gut microbiome diversity and composition in Finnish adults. Our data included 1,228 adults aged 25-64years from the National FINRISK/FINDIET 2002 Study. Information on lifestyle and background factors was obtained through self-administered questionnaires. Dietary data were gathered using a 48-h dietary recall. CRC-related lifestyles were modelled using a CRC lifestyle index based on nine major risk factors for CRC. Lower index points reflected higher-risk lifestyles. The gut microbiome profiles were analyzed using shallow shotgun metagenome sequencing. Associations between the index and microbial diversity and composition were assessed using, e.g., linear regression and permutational multivariate ANOVA adjusted for relevant confounders. The index explained 0.2% of the variation in microbial composition between participants (p < 0.05). Higher-risk lifestyles for CRC were associated with lower microbial diversity (β 0.037, p 0.009). Higher-risk lifestyles were also associated with a higher relative abundance of species representing primarily the family Lachnospiraceae and genera such as Dorea and Mediterraneibacter, and lower relative abundance of species within the genus Bifidobacterium (< 0.0001). Participants with higher- and lower-risk lifestyles showed clear differences in their gut microbiome diversity and composition, higher-risk lifestyles being associated with potentially adverse microbial traits. These findings contribute to identifying microbial features that may characterize early stages of CRC development in individuals with high-risk lifestyles.

School-based interventions have proven effective in enhancing knowledge and altering attitudes toward cervical cancer among adolescents. This study aimed to evaluate the effect of a school-based educational intervention on the attitudes, beliefs, and knowledge of cervical cancer among adolescents in mixed-day high schools in Embu County. This study used a single-group, repeated cross-sectional design to assess the effect of a structured health education session on cervical cancer among adolescent boys and girls in mixed-gender secondary schools. A self-administered anonymous questionnaire was administered before and immediately after the post-intervention. The education session lasted 30-45min, and the study population included teenage boys and girls in selected mixed-day secondary schools in Embu County. Schools were conveniently sampled, and students in Form One and Form Two were purposively selected. Data were analyzed using R version 4.2.2 Descriptive statistics included means, standard deviations, counts, and percentages. Welch's two-sample t-test to compare pre and post- intervention groups scores. Effect sizes were estimated using Cohen's d with 95% confidence intervals. Statistical significance was set at α = 0.05. Our findings revealed that the respondents had low knowledge of cervical cancer and the HPV vaccine before the health education session. The overall knowledge score increased from a pretest mean of 105.23 to a posttest mean 131.8, respectively, which was a statistically significant change (t (567.66) = 6.89, p < 0.001) with a 95% confidence interval for the mean difference of 19.02 to 34.18. The magnitude of the difference corresponded to a moderate effect size (Cohen's d = 0.58, 95% CI: 0.41-0.74). Many adolescents indicated a willingness to engage in discussions about cervical cancer, with several expressing intent to talk with friends, with 40.99% strongly agreeing to talk to parents about the topic. Approximately 73% of the students expressed a desire to share information with their parents and friends, whereas 70.22% indicated that they would ask their guardians to take them for the HPV vaccine. The majority (70%) of the students agreed that the lecture delivery method was good. However, 48% of the students felt that the lecture was complicated. The single session educational intervention on cervical cancer was associated with improved knowledge of cervical cancer among adolescents. Majority of the respondents expressed willingness to discuss the topic with peers and parents, suggesting potential for information dissemination within their communities.

BackgroundAs the population ages, older adults face an increasing risk of physical inactivity and related health complications, highlighting the need for scalable interventions. Smartphone-based programs have emerged as a promising strategy to support sustained physical activity among older adults.ObjectiveThis study aimed to evaluate whether a smartphone lecture program incorporating a digital peer support app would increase physical activity among older adults, compared to a conventional smartphone lecture program.MethodsThis 2-arm, 1:1 parallel-arm, cluster-randomized trial was conducted in 2 urban regions of Japan (Sumida Ward, Tokyo, and Chiba City, Chiba). Eligible participants were community-dwelling adults aged ≥60 years, able to walk independently, and smartphone users; exclusion criteria included prior use of the peer support app or medical restrictions on walking. Participants were recruited offline during community smartphone lectures (closed-group recruitment). The intervention combined face-to-face lectures with app-based peer support, while outcomes were assessed both objectively (via smartphones) and through self-administered paper questionnaires. All participants received a baseline smartphone lecture. Intervention participants attended 2 additional sessions using a digital peer support app (Minchalle; A10 Lab Inc), which included features such as daily step goals, peer sharing, and group encouragement. Control participants attended 2 standard follow-up smartphone lectures. The primary outcome was the change in weekly average daily step count from baseline to Week 12. Secondary outcomes included total metabolic equivalent of task (MET)–minutes per week (assessed via the International Physical Activity Questionnaire), walking time (≥30 minutes per day), daily smartphone use, and number of smartphone use purposes.ResultsA total of 156 community-dwelling older adults were grouped into 40 clusters and randomized (20 intervention clusters, n=80 and 20 control clusters, n=76). In total, 124 participants (79.5%) completed the follow-up, and valid step data were available for 117 participants, with missing data ranging from 5.1% to 29.1%. Baseline daily steps averaged 3951 (SD 1686) in controls versus 4583 (SD 1973) in the intervention arm. An unadjusted mixed model for repeated measures showed significantly higher step changes for intervention participants at Week 12 (difference=579, 95% CI 36-1123; P=.04). No significant differences emerged for total METs (difference=646 MET-min per week, 95% CI –12 to 1303; P=.054) or walking ≥30 minutes per day (odds ratio [OR] 1.56, 95% CI 0.63-3.90; P=.33). However, the intervention arm demonstrated a significant increase in daily smartphone use (OR 4.10, 95% CI 1.15-14.6; P=.03) and in the number of smartphone use purposes (difference=0.58, 95% CI 0.12-1.05; P=.01).ConclusionsA smartphone lecture program integrated with app-based peer support led to modest but meaningful improvements in step counts among older Japanese adults, at Week 12 of the 12-week intervention. Future research should investigate long-term maintenance, additional measures of physical activity, and subpopulation responses to optimize digital health programs for older adults.

This study aimed to explore the gap between attitudes towards and personally observed breaches of research integrity among medical postgraduates in China, a critical yet understudied population. We conducted an online, cross-sectional survey among postgraduates at three Chinese medical schools. A self-administered questionnaire was used to evaluate their attitudes toward research integrity breaches and their perceptions of such behaviors among peers. Among 983 respondents (719 master's, 264 doctoral), a strong majority condemned serious research misconduct. Only 0.93% expressed acceptance for falsifying images to reverse results, and 1.53% for manipulating data to achieve significance. However, peer-reports revealed a higher prevalence of observed misconduct, with 18.41% indicating knowledge of data fabrication among peers. In conclusion, while Chinese medical postgraduates largely condemn serious research misconduct, the peer-reported occurrence of such behaviors indicates that ethical awareness has not been fully translated into practice. These findings highlight the need for bolstered educational initiatives and suggest that the peer-report method can be a key tool for educators to assess and address integrity issues within their institutions.

The objectives of this paper are, first, to explore factors influencing customers' satisfaction with private healthcare services, and second, to investigate the relationship between patient attributes and the factors influencing customer satisfaction. The SERVQUAL model was employed to assess the quality of healthcare services from the patients’ perspective, offering valuable insights for private healthcare providers in Limpopo, South Africa. The study surveyed 242 patients from the Thulamela District Municipality using a self-administered questionnaire. A quantitative research approach and stratified random sampling were used to collect the data. The results indicate that factors influencing customer satisfaction in private medical services include the physical environment of the practice, the competence of reception staff, and the professionalism of medical doctors. Additionally, the study found a significant relationship between patient attributes and these key factors. The study underscores the importance of aligning healthcare service delivery with patient needs and expectations to enhance competitiveness and ensure long-term sustainability. To enhance customer satisfaction, the medical doctors are encouraged to focus on tangible aspects of their facilities and human resources, operational and structural enhancements, accessibility and pricing.

Aim: This study examined the influence of payment practices and supplier capability on firm participation in public procurement among private firms in Gulu City, Uganda. The specific objectives were to find out the combined effect of payment practices and supplier capability on firm participation in public procurement among private firms in Gulu city. Methods: A quantitative descriptive cross-sectional research design was adopted. Through the use of purposive and simple random sampling, 367 firms were selected to form the sample for the study, out of a population of 8,000 registered firms. The respondents per firm included a procurement manager, finance manager, production manager, stores manager, marketing manager and proprietor who knew the subject matter. A self-administered questionnaire was used to collect data from the respondents. Data were analysed using descriptive statistics, correlation analysis and multiple regression. Results: The results indicate that both payment practices and supplier capability have a significant influence on Firm Participation. The regression model explained 11.9%of the variance in firm participation (Adjusted R² =0.119, p &lt; 0.05) Conclusion: The findings reveal that the timely payment of suppliers, coupled with strong supplier capability, are fundamental determinants of private firms’ participation in public procurement. Recommendations: The study recommends that the government of Uganda should enforce strict payment timelines and strengthen monitoring mechanisms to reduce delayed payments. This may inspire firms to participate in public procurement opportunities. Additionally, private firms should strengthen their financial capacity, technical expertise, and compliance systems to improve eligibility and competitiveness in public tenders. These measures are likely to enhance the participation of the firms in public procurement opportunities.

Abstract Background Hepatitis B virus (HBV) infection is a primary global public health concern since it is commonly recognized as the primary risk factor for cirrhosis and liver cancer globally. This study aims to evaluate the level of knowledge and the prevailing attitudes of Jordanian nursing students toward hepatitis B, with a particular focus on identifying knowledge gaps and factors influencing their understanding and perceptions. Materials and methods A descriptive design was employed to collect data from December 1, 2023, to April 1, 2024. A self-administered questionnaire was used to conduct convenience sampling among senior Jordanian nurses. Result A total of 455 participants were analyzed, revealing a young cohort with a mean age of 22.5 years. The participants demonstrated moderate knowledge of hepatitis B, with specific misconceptions identified. Besides, participants demonstrated a moderately positive attitude toward hepatitis B. However, demographic characteristics showed significant differences in knowledge by sex, whereas certain factors did not. Still, attitudes significantly differed based on those infected with hepatitis B and family members infected with hepatitis B. Conclusion This study focused on training and awareness programs to enhance knowledge and foster a positive attitude towards hepatitis B amongst nursing students. Moreover, combining these training and awareness activities would help improve hospital safety protocols in Jordan and ensure that a hepatitis B virus outbreak is averted.