Valid Questionnaires Research Articles

Translation into Portuguese (Brazil), cultural adaptation and validation of Parathyroid Assessment of Symptoms (PAS) in patients with chronic kidney disease and hyperparathyroidism.

Chronic kidney disease (CKD) is related to high morbidity and mortality and loss of quality of life. Likewise, hyperparathyroidism is associated to progressive loss of renal function, with increased phosphate and decrease calcium levels, which induce the secretion of parathyroid hormone. To translate into Portuguese (Brazil), culturally adapt and validate the questionnaire Parathyroid Symptoms Assessment (PAS), following reliability and validity criteria in patients with chronic kidney disease and hyperparathyroidism. Methodological and cross-sectional study, carried out at São Lucas Hospital/PUCRS, Porto Alegre, Brazil. The PAS questionnaire validation process followed protocols from previous studies. After translating into Portuguese, it was applied to 100 patients with secondary (SHPT) and tertiary or persistent (THPT) hyperparathyroidism. For PAS validation data, patients responded to the Short Form Health 36 (SF-36) questionnaire. Reliability criteria were evaluated using intraclass correlation coefficient (ICC) and Cronbach's alpha (α-C). Validity was assessed by Spearman's correlation coefficient between PAS and SF-36 values. Participant's mean age was 55.6 ± 15.6 years, 61% was male, and 68% was diagnosed with SHPT. Among 100 patients, 53% performed a PAS retest (ICC = 0.83). The internal reliability by α-C was 0.86. Negative correlations were observed between PAS questions and SF-36 physical and mental domains, which ranged from 0.3 to 0.7. The Brazilian version of the PAS questionnaire was found to be valid and reliable. The PAS questionnaire can be used to evaluate quality of life in Brazilian patients with hyperparathyroidism who speak Portuguese.

Cross-cultural adaptation and validation of Work Productivity and Activity Impairment questionnaires for caregivers of patients with pediatric inflammatory bowel disease in Spain. A multicenter study.

Introduction. The WPAI-UC/CD-Caregiver questionnaires assess the impact of ulcerative colitis (UC) or Crohn's disease (CD) on parents'/caregivers' work life and daily activities. Our objective was to adapt and validate these questionnaires in the Spanish population. Methods. A translation and back-translation were done. The document was assessed by an expert committee and a pilot group of families of patients with pediatric inflammatory bowel disease (p-IBD). For validation, the parents/caregivers of patients with p-IBD (10-18 years old) were recruited. The expert committee and the pilot group conducted a subjective assessment of the format and time necessary to complete the questionnaires. Cronbach's alpha coefficient was estimated and a factor analysis with varimax rotation was done. Kaiser- Meyer-Olkin (KMO) coefficients and Bartlett's sphericity test were estimated to test the adequacy of the factor analysis. Results. A total of 370 patients (median age: 14.1 years) and 263 parents/caregivers of patients with UC or unclassified IBD and 261 parents/caregivers of patients with CD were included. The KMO coefficients (0.6947 and 0.7179) and Bartlett's sphericity test (p < 0.001) confirmed the adequacy of the factor analysis. The 6 items targeted the same domain. The factor model accounted for 99.99% and 94.68% of variance, and Cronbach's alpha coefficients (0.6581 and 0.6968) showed an adequate consistency. The format and the median time of 2 minutes to complete the questionnaires were considered optimal. Conclusions. The versions of the WPAI-Caregiver questionnaires validated in the Spanish population may be used in families whose children have IBD.

Knowledge, attitude and practice of pediatric healthcare staff towards the therapy for patients with congenital heart disease.

This study aimed to investigate the knowledge, attitude and practice (KAP) of pediatric healthcare staff towards the therapy for patients with congenital heart disease (CHD). CHD is a major global health concern, posing significant risks to health and life despite advancements in early detection and treatment. This web-based cross-sectional study was conducted from May 04, 2023 to August 12, 2023 in the Bengbu area (three counties and one city) for pediatric healthcare staff. Correlations between knowledge, attitude and practice scores were evaluated by Pearson correlation analysis. Factors associated with knowledge, attitude and practice scores were identified by multivariate logistic regression. A total of 332 valid questionnaires were enrolled, including 258 (77.7%) females, and 161 (48.5%) were pediatrician. The median (25% quartile, 75% quintile) of knowledge, attitude, and practice scores were 38 (36, 40) (possible range: 10-49), 28 (27, 31) (possible range: 7-35), and 35 (32, 39) (possible range: 9-45), respectively. Correlation analysis showed that significant positive correlations were found between knowledge and attitude (r = 0.528, P < 0.001), as well as practice (r = 0.399, P < 0.001). Meanwhile, there were also correlations between attitudes and practice (r = 0.528, P < 0.001). Univariate logistic regression showed that treated more than 100 children with congenital heart disease annually (OR = 2.976, 95% CI: 1.405, 6.303, P = 0.004) was independently associated with knowledge. Female (OR = 0.470, 95% CI: 0.277, 0.797, P = 0.005) and with more than 5years of work experience (OR = 0.507, 95% CI: 0.262, 0.982, P = 0.044) were independently associated with attitude. Female (OR = 0.584, 95% CI: 0.343, 0.994, P = 0.048) and treated more than 100 children with congenital heart disease annually (OR = 3.743, 95% CI: 1.702, 8.232, P = 0.001) were independently associated with practice. Pediatric healthcare staff had sufficient knowledge, positive attitude and proactive practice towards the therapy for patients with congenital heart disease. To improve clinical practice, prioritize training programs to build knowledge and positive attitudes among healthcare staff, encourage hands-on experience with CHD cases, and promote mentorship by experienced professionals for a collaborative work environment and better care.

Development of a digital canva-based interactive e-module by using geogebra for high school statistics material

The Merdeka Curriculum has an up-to-date flow of learning objectives in statistics material, especially data presentation. However, most students still need help presenting data because teaching materials at school only use printed books. This research aims to produce digital-based interactive e-module development products using the application Canva-assisted Geogebra in high school statistics material that meets the criteria of being valid, practical, and having potential effects. The research method used is R &amp; D (research and development). The development model in this research refers to the ADDIE model, which consists of stages of analysis (analysis), level design (plan), level of development (development), level implementation (implementation), and stage evaluation (evaluation). The trial was conducted on 41 class XI students at SMA Negeri 11 Palembang. Data was obtained from validation questionnaires for validity, student response questionnaires for practicality, and student learning outcomes tests to see potential effects. The results of the research obtained that Canvas digital interactive e-module product assisted by Geogebra on high school statistics material was categorized as very valid (88.04%), efficient (90.26%), and had an effect which was categorized as good (86.81%). The results of this development should be used as teaching materials and learning media in presenting statistical material, especially the scatter diagram sub-material data. It is hoped that teachers can apply the results of this research in presenting statistical material in class, especially the scatter diagram sub-material.

Development of an integrated statistics pocket book on culture and Islamic value

This research discusses the development of a statistical pocketbook integrated with Islamic values and culture to enhance students' understanding and appreciation of statistics within a cultural and religious context. This research aims to develop a statistical pocket book that meets valid criteria. This research uses the Research and Development (R&amp;D) method. The development model used is ADDIE which consists of 5 development stages, namely: (1) analysis stage, (2) design stage, (3) development stage, (4) implementation stage, (5) evaluation stage. However, this development research only uses four stages, namely (1) analysis, (2) design, (3) development and evaluation. This research was conducted at FTIK IAIN Manado. Data collection was carried out using questionnaires and tests. Instruments were a marketing/content expert validation sheet and a media/design expert questionnaire validation sheet. Based on the results of the questionnaire analysis, the results obtained were that the statistics pocket book integrated with Islamic values and culture met the valid criteria for use in statistics learning, seen from the assessment results for validation by content/material experts (85%) with very valid categories and media/design experts (91 %) is also in the very valid category, the average percentage of the practicality test is 91% in the very practical category. So, the Statistics pocketbook that has been developed is valid and practical for use in learning because it is integrated with Islamic values and culture.

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.

How leisure involvement impacts visitors’ perceived health benefits in urban forest parks: examining the moderating role of place attachment

Urban forest park leisure is a significant means for residents to achieve health and well-being, thus possessing high public health value. However, the relationship between visitors’ leisure involvement and perceived health benefits has not been clarified. This study introduced restorative experiences and positive emotions as mediators and place attachment as a psychological moderator, innovatively constructing a stimulus-organism-response-moderator (SORM) integrated model. This moderated mediation model aimed to examine the mechanism through which visitors’ leisure involvement influenced perceived health benefits. A field survey was conducted in Fuzhou National Forest Park in Fujian, China, resulting in the collection of 588 valid questionnaires. The results showed that visitors’ leisure involvement positively impacted restorative experiences and positive emotions. Restorative experiences and positive emotions completely mediated the indirect relationship between visitors’ leisure involvement and perceived health benefits. Place attachment enhanced the impact of restorative experiences on perceived health benefits, thereby positively moderating the mediation effect of restorative experiences. Place attachment also diminished the impact of positive emotions on perceived health benefits, thereby negatively moderating the mediation effect of positive emotions. Therefore, significant differences existed in the psychological processes involved in acquiring perceived health benefits among visitors with different levels of place attachment. Our findings might enrich the existing knowledge of place attachment and forest health benefits, providing valuable references for designing and optimizing urban forest parks.

Analysis of influencing factors of orthopedic nurses' spiritual care competencies based on structural equation model

PurposeTo comprehensively understand the spiritual care competencies of orthopedic nurses and analyze the factors that affect them.MethodsThis study employed convenience sampling to conduct a cross-sectional survey among orthopedic nurses at Hefei First People's Hospital. Data was collected utilizing a general information questionnaire, alongside the Chinese versions of the Spiritual Care Competence Scale, the Spiritual Care Perspective Scale, the Professional Identity Assessment Scale, and the Hospital Ethical Climate Scale. Guided by the Person-Environment Fit theory and the Triadic Reciprocal Determinism theory, a structural equation model was utilized to analyze the influencing factors and pathways related to the spiritual care competence of orthopedic nurses.ResultsA total of 112 valid questionnaires were obtained, yielding an overall score of 68.92 ± 11.03 for orthopedic nurses' spiritual care competencies, with an average score of 3.14 ± 0.50 per item. The results of the Pearson correlation analysis revealed a significant positive correlation (all P &amp;lt; 0.01) between spiritual care competence and the scores for spiritual care perspective, professional identity assessment, and hospital ethical climate. The spiritual care perspective, professional identity, and hospital ethical climate emerged as the influencing factors of orthopedic nurses' spiritual care competence, exhibiting total effects of 0.30, 0.53, and 0.85, respectively. Notably, the hospital ethical climate exerts an indirect influence on spiritual care competence through the mediation of spiritual care perspective and professional identity, with the indirect effect accounting for 61.18% of the total effect.ConclusionThere remains significant potential for enhancing the spiritual care competencies of orthopedic nurses. The hospital's ethical climate not only has a direct and positive impact on spiritual care competence but also indirectly influences it through the lens of nurses' spiritual care perspectives and professional identity assessments. Hospital administrators may wish to consider strategies for bolstering the hospital's ethical climate, fostering a deeper spiritual care perspective and heightened professional identity among nurses, and ultimately improving their spiritual care competence.

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.

Multidimensional analysis of art education teachers’ attitudes and self-efficacy toward artificial intelligence: exploring relationships and strategies for enhancement

ABSTRACT This study investigates the attitudes and self-efficacy of university art education teachers in Wuxi, China, toward Artificial Intelligence (AI). Using Social Cognitive Theory and Diffusion of Innovations Theory, 384 valid questionnaires were collected. The results show that teachers generally lack confidence in AI, with only the “ease of use” dimension receiving positive feedback among five dimensions: relative advantage, compatibility, ease of use, trialability, and observability. Differences in attitudes and self-efficacy were found, with single teachers, associate professors, and digital art instructors exhibiting more positive attitudes and higher confidence. A significant positive correlation was found between teachers' attitudes toward AI and their self-efficacy in applying it in classrooms. The study proposes strategies to foster more positive perspectives and self-efficacy regarding AI for art educators.

Reflective Tool on Advanced Access to Support Primary Healthcare Teams: Development and Validation of an Online Questionnaire.

Awareness of their standing relative to best practices motivates primary healthcare (PHC) teams to improve their practices. However, gathering the data necessary to create such a portrait is a challenge. An effective way to support the improvement of the practices of PHC teams is to simplify the availability of data portraying aspects of their practices that might need improvement. Timely access is one of the foremost challenges of PHC. Yet, very few tools supporting reflections on the implementation of best practices to improve access are available to PHC teams. To develop an online reflective tool that evaluates the state of a PHC team member's advanced access practice and formulates customized recommendations for improvement. This sequential multimethod study was informed by a literature review and an expert panel composed of researchers, patients, provincial and local decision-makers, and PHC clinical and administrative staff in the province of Quebec, Canada. Consensus was reached on the content of the questionnaire and the prioritization of the recommendations. No reflective tool on advanced access practices was found in the literature review. Grey literature was used to create an initial version of the questionnaire. This version was revised and enriched through consultation phases with the expert panel. Then, five iterations of the tool were tested with 169 PHC team members, which led to the conception of two distinct versions: one for clinical staff and one for administrative agents responsible for appointment booking. The final versions of the reflective tool are available online in both English and French. This reflective tool provides a portrait of PHC team members' advanced access practices as well as an automated report that contains personalized and prioritized recommendations for improvement. Further developments are necessary for its optimal use among PHC professionals other than physicians and nurse practitioners.

The Chinese version of the physical activity questionnaire for adolescents: a psychometric validity, reliability, and invariance study.

The Physical Activity Questionnaire for Adolescents (PAQ-A) is one of the most commonly used questionnaires for assessing adolescents' levels of moderate to vigorous physical activity (PA). Although a Chinese version of the PAQ-A (comprising nine items) exists, it has been assessed for only internal consistency coefficients, test-retest reliability, and correlations with the GT3X + accelerometer. Therefore, this study aimed to evaluate the psychometric properties of the Chinese version of the PAQ-A among Chinese adolescents. This study included three samples of 1,101 secondary school students (12-19years old). The first sample consisted of 518 participants (50.4% males, 49.6% females) for correlation tests and exploratory factor analysis (EFA). The second sample consisted of 227 participants (55.75% males, 44.24% females) for confirmatory factor analysis (CFA), convergent validity, and sample size invariance tests. The third sample consisted of 356 participants (54.50% male, 45.50% female) for the internal consistency reliability test, invariance test (cross sample size, education level and gender), and t-test. Pearson correlation analysis of the PAQ-A indicated that all the total-item correlations exceeded 0.2, indicating good consistency across the items. Subsequent EFA of the Chinese version of the PAQ-A revealed a two-factor structure. CFA subsequently validated this structure. One of the items exhibited a standardized loading below 0.4 and was excluded. The exclusion of this item resulted in increased standardized loadings for the remaining items, ranging from 0.40 to 0.82, which indicates improved fit indices. This adjustment underscores the questionnaire's satisfactory convergent validity and robust discriminant validity. The overall Cronbach's alpha was 0.821, with the values for the first and second factors being 0.757 and 0.716, respectively. The questionnaire demonstrated stable invariance across sample sizes and education levels and additionally showed partial scalar invariance across genders. A t-test revealed a significant difference between males and females, which aligns with previous findings. These findings supported the construct validity of the questionnaire. This study validated the Chinese version of the PAQ-A for assessing adolescent PA in China, with a two-factor structure improved by removing one item.

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

Abstract Purpose County-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. Methods A 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. Results The 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. Conclusion While 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.

A Questionnaire-based Research and Analysis Report on the Demand and Status of Language Services in the Energy and Power Industry in Hebei Province

This report analyzes the demand for language service professionals in Hebei’s energy and power industry from three key perspectives: enterprise requirements, translation education, and student employment planning. The 45 valid questionnaires cover four key aspects related to enterprises including the business scope, international business activity, language service team building and employment requirements. Despite the energy and power industry in Hebei Province have made significant strides in international collaboration, there is a gap between professional training and industry requirements. Enterprises demand language service personnel to maintain proficiency in terminology, have industry knowledge, master technical competence, and own international communication skills that most translation students lack. It can be seen that there are issues with the alignment between educational content and the actual need of enterprises. In addition, the results from teachers’ survey identified challenges in terms of aspects of teaching methods, curriculum setting, and the cooperation with enterprises. The report thus recommends to enhance the professional skills and industry knowledge of energy and power language services of translation students through various measures, including establishing professional knowledge bases and terminology bases of energy and power, designing relevant courses and practical projects, and strengthening school-enterprise cooperation. By performing these practices, it could better adapt to the future energy and power industry market demand. Furthermore, this report emphasizes that the education system needs to better adapt to the development of the industry, especially in the cultivation of interdisciplinary language service capabilities, and strengthen cooperation with energy and power companies to jointly develop language service talent training programs that meet the specific needs of the industry.

NEED ANALYSIS FOR PROBLEM BASED LEARNING E-COMIC ON EARTH AND SOLAR SYSTEM TOPIC

The aim of this study was to analyse the need for the development of science e-comic as learning media on earth and solar system topic. This research was conducted in 3 junior high schools in Sutera sub-district, based on the results of observations it is known that the school applies the kurikulum merdeka, and uses lecture and discussion methods in the learning process. However, there are obstacles that must be faced by teachers, namely the current package books/printed books are quite limited, so students have enough difficulty if they want to repeat learning material at home. This type of research is Research and Development (R&amp;D) using the 4-D development model. This research instrument consists of a validation questionnaire, a practicality questionnaire, and an effectiveness questionnaire. The data obtained were analyzed using a formula to analyze the results of the validity test, practicality test, and effectiveness test. Based on the above problems, researchers found the right and appropriate media to be developed and can be used easily by students and teachers, namely problem-based science e-comic learning media on earth and solar system material.

The Impact of Built Environment in Shanghai Neighborhoods on the Physical and Mental Health of Elderly Residents: Validation of a Chain Mediation Model Using Deep Learning and Big Data Methods

As urban aging issues intensify, the impact of the built environment in urban neighborhoods on the physical and mental health of elderly residents has garnered increasing attention. Previous studies have demonstrated that the built environment is related to various health outcomes; however, most empirical research typically focuses on the objective physical environment, lacking measurements of subjective environmental perceptions. This study, using 24 neighborhoods in Shanghai as case studies, employed deep learning, big data methods, and surveys to collect 462 valid questionnaires from elderly residents. Structural equation modeling was applied to explore the relationship between the built environment and the physical and mental health of elderly residents, incorporating respondents’ subjective perceptions, physical activity, and neighborhood relationships as chain mediation effects. The results indicate that although there is no direct relationship between the built environment and the mental health of elderly residents, the built environment positively impacts mental health through enhancing subjective.

Nutritional guidance needs and influence factors for gastric cancer survivors in primary healthcare setting: a cross-sectional survey.

This study aimed to build a comprehensive understanding of the nutritional guidance needs of gastric cancer survivors in the primary healthcare setting that could be fulfilled by community health service centers as part of their primary healthcare services. Gastric cancer survivors were invited to participate in a questionnaire-based survey by convenience sampling method from the community health center. Relationships between nutritional demand and potential influence factors were examined by a multivariable logistic regression model. A total of 200 gastric cancer survivors were recruited from the community health service center in Shanghai, China, from whom we obtained 194 valid questionnaires, resulting in a 97.0% response rate. Of these gastric survivor participants, 48 individuals (24.7%) expressed a need for nutritional guidance administered by community health service centers, whereas 146 participants (75.3%) held the perspective that such guidance was unnecessary. Preferences for nutritional guidance included having a dietitian as the provider (68.8%), home-based engagement (72.9%), face-to-face consultation (68.8%), individual counseling (87.5%), and beginning immediately post-discharge (89.6%). A notable reluctance (66.7%) towards financial contribution was also observed. After adjusting for confounders, participants with higher income level (odds ratio (OR) = 4.45, 95% confidence interval (CI) = 1.39-15.50), history of food intake reduction (OR = 14.96, 95% CI = 3.49-82.28), and gastrointestinal symptoms (OR = 4.40, 95% CI = 1.35-14.33) were more likely to seek nutritional guidance. Gastric cancer survivors have a certain need for nutritional guidance administered by primary health service centers. Personal guidance by the primary health service center should be provided to gastric cancer survivors to support their dietary and nutritional intake needs. There is a need to develop and implement nutritional guidance programs in community health service centers as part of their primary healthcare services for gastric cancer survivors.

Impact of Digital Marketing Content on Brand Awareness among Jordanian Consumers

The study aimed to identify the impact of digital marketing content on consumer awareness of the brand. To achieve its objectives, the researcher adopted a descriptive-analytical approach. A data collection tool was developed in the form of a questionnaire consisting of 27 items, which was distributed electronically to a simple random sample of 650 consumers from the study population. A total of 365 valid questionnaires were collected and approved for analysis. Statistical methods appropriate to the study were applied using SPSS 22 for data analysis.The study yielded several key findings, most notably that digital marketing content—specifically information recombination, accessibility, and speed—has a statistically significant effect on Jordanian consumers' brand awareness at a significance level of (α &lt; 0.05). Notably, accessibility accounted for 35.6% of the variance in consumer brand awareness.Based on these findings, the study recommends that businesses focus on ensuring the accessibility of their digital marketing content to enhance brand awareness among customers. Since the results suggest a deficiency in this dimension, the study also advises companies that provide digital marketing content with information recombination to focus on delivering valuable information to boost positive brand perception among consumers. Additionally, it is essential for businesses to explore effective methods for managing the speed aspect of digital marketing content to positively impact brand recognition, particularly in terms of how relevant advertising content is presented.

Development of circulatory system mobile learning (CSML) for grade XI students

The utilization of communication devices such as mobile phones as a learning support tool in the development of technology 4.0 is still low. The low mobile phone utilization as a learning support tool causes the variety of learning media used by teachers to be low. The low variety of learning media results in students having difficulty mastering the concept of learning material, especially circulatory system material in class XI. The difficulty of concept mastery on circulatory system material can be overcome through the development of circulatory system mobile learning (CSML). The research objectives are: 1) Develop CSML on circulatory system material in grade XI, 2) Test the feasibility of CSML, and 3) Know the response of teachers and students to CSML. The type of research is Research and Development (R&amp;D) using the ADDIE model (Analysis, Design, Development, Implementation, and Evaluation). Data collection uses feasibility validation questionnaires and response questionnaires. The data analyzed were the results of the feasibility assessment from media experts and material experts, and the results of responses from teachers and students. Data analysis was carried out quantitatively descriptive using a Likert scale of 1-4. The results of the study are 1) The result of developing CSML can be accessed online; 2) The results of the feasibility assessment from media experts were 82.27% and material experts were 89.59% with a very feasible category; 3) The results of teacher responses were 87.02% and student responses were 88.55% with a great category.

A Decade-Long Comparison of Heavy Metal(loid)s in the River and Children’s Health Risk Assessment of an E-Waste Recycling Area

Informal e-waste recycling can cause serious heavy metal(loid) pollution to nearby bodies of water, thereby increasing the risk of heavy metal exposure to local residents. This study investigates metal(loid) pollution levels in the Lianjiang River, which flows through Guiyu, an e-waste recycling town in Shantou, Guangdong. In 2009 and 2020, water samples from the Lianjiang River were taken, and the levels of 12 metal(loid)s (V, Cr, Mn, Sr, Ni, Cu, Zn, As, Se, Cd, Ba, and Pb) were measured by ICP-MS. In total, 380 valid questionnaires from Guiyu kindergarten children were selected to assess child health. Exposure health risks for children were calculated using two forms of exposure (dermal and inhalation) and statistical methods (multiple linear regression and Bayesian kernel machine regression—BKMR). The concentrations of Mn, Ni, Pb, and Cd in 2009 were significantly higher than those in 2020. The concentration of heavy metal(loid)s had been decreasing in 2020. The non-carcinogenic risk levels of the 12 metal(loid)s in both exposure routes were at an acceptable risk level. The average carcinogenic risk levels for As, Cr, Ni, Pb, and Cd exceeded the ILCRi &lt;10–6 acceptable range. According to MLR, it was found that daily oral intake doses of Pb [β(95% CI): −0.949 (−1.596, −0.863), p &lt; 0.001 and Se [β(95% CI): −0.911 (−1.888, −0.092), p = 0.031] were negatively associated with body mass index. A BKMR model was developed, through which the synergistic effects of co-exposure to 12 heavy metal(loid)s on growth and development indicators in children were analyzed. Concentrations of heavy metal(loid)s in rivers near e-waste recycling sites have been decreasing for 10 years. It was found that the growth and development of children are affected by the intake of heavy metal(loid)s in water. The reduction in heavy metal(loid) contamination in e-waste recycling areas needs to be continued, and concern about its impact on children’s health must remain.