Web-based Cross-sectional Study Research Articles

Knowledge, attitudes, and practices among physicians and pharmacists toward antibiotic use in sepsis

BackgroundSepsis management in the Intensive Care Unit (ICU) presents a significant challenge within contemporary healthcare. The primary challenge lies in ensuring the timely and appropriate utilization of antibiotics. Inappropriate antibiotic use in sepsis management can result in a multitude of adverse outcomes. There has been insufficient focus on thoroughly understanding and resolving the issues related to the improper application of antibiotics in sepsis treatment by physicians and pharmacists. This gap in research is concerning, considering its potential implications for patient outcomes and public health. This study aimed to assess the knowledge, attitudes and practices (KAP) among physicians and pharmacists toward antibiotic use in sepsis.MethodsThis web-based cross-sectional study was conducted at Shanxi Bethune Hospital between June 2023 and October 2023. A self-designed questionnaire was developed to collect demographic information of physicians and pharmacists, and to assess their knowledge, attitudes and practices toward antibiotic use in sepsis.ResultsA total of 200 valid questionnaires were collected. Among the participants, 115 (57.5%) were female and 118 (59%) had experience with ICU patient management. The mean knowledge, attitudes and practices scores were 10.2 ± 1.14 (possible range: 0–12), 45.88 ± 4.00 (possible range: 10–50) and 48.38 ± 5.84 (possible range: 11–55), respectively. Multivariate logistic regression showed that attitudes (OR = 1.59, 95%CI: 1.34–1.87, p < 0.001), work experience of 15 years and above (OR = 7.17, 95%CI: 2.33–22.0, p = 0.001) were independently associated with proactive practices. For physicians, the structural equation model (SEM) demonstrated that attitudes directly affects practices, as indicated by a path coefficient of 0.91 (p < 0.001). For pharmacist, SEM showed that knowledge directly affect attitudes, with a path coefficient of 0.75 (p < 0.024), moreover, attitudes directly affect practices, with a path coefficient of 0.87 (p < 0.001).ConclusionThe findings revealed that physicians and pharmacists have sufficient knowledge, active attitudes, and proactive practices toward the antibiotic use in sepsis. Nonetheless, the findings also reveal the persistence of certain misconceptions, alongside notable shortcomings in both attitudes and practices. Comprehensive training programs are imperative for enhancing the practices of physicians and pharmacists in this field.

How COVID-19 pandemic impacted students’ and staff ’s physical activity at a Brazilian University?

Introduction: Physical activity and its positive effects on coronavirus have been extensively discussed in the literature. However, there is still a lack of evidence on the effects of the coronavirus pandemic on the health-related behaviors of the Brazilian university community. Objective: To describe physical activity practice during the coronavirus pandemic among students and staff of a southern Brazilian university, as well as its association with sociodemographic characteristics. Methods: This self-administered web-based cross-sectional study was carried out among a southern Brazilian community. The main outcome of this study was leisure time physical activity before and during the coronavirus pandemic. Results: Considering only leisure time, 21% and 24% of the students and staff, respectively, reported achieving physical activity recommendations (≥150 minutes per week). There was a decline of more than 15 percentage points in physical activity practice comparing to pre and during the pandemic, and those following the protocols of staying at home presented lower levels of leisure-time physical activity. Physical activity practice was mainly performed at home and without any professional help. Conclusion: Leisure-time physical activity prevalence during the pandemic was relatively low (compared with Brazilian population) among students and staff, and participants who followed the staying at home protocols presented lower levels of physical activity.

Comparing quality of life difference between diabetics and non-diabetics during the SARS-CoV-2 pandemic and post-pandemic: A web-based cross-sectional study India

Background: The COVID-19 pandemic has irreversibly altered the global landscape, with far-reaching consequences for individuals’ quality of life (QOL). In India, the series of lockdowns imposed to combat the pandemic presented unique challenges, exacerbating mental health concerns and amplifying anxiety and discontent among the population. Notably, the pandemic’s impact on QOL has been unevenly distributed, with diabetic individuals potentially facing distinct challenges compared to their non-diabetic counterparts. Existing research in India has primarily focused on the health-related concerns of diabetic individuals, leaving a significant knowledge gap regarding the QOL of non-diabetic individuals during and following the pandemic. A comprehensive understanding of QOL differences between diabetic and non-diabetic populations is crucial for developing targeted interventions and improving overall well-being. Objective: This study aims to address this gap by exploring and comparing the QOL of diabetic and non-diabetic individuals in India during and after COVID-19, providing valuable insights into the pandemic’s impact on this critical aspect of health. Materials and methods: A cross-sectional, comparative online-based survey study was conducted among 212 participants (diabetic and non-diabetic) aged 18 years and below 60 years visiting SRM General Hospital, between July and August 2021 during the COVID-19, and their self-reported scores were compared two years post-pandemic. A snowball sampling method was employed due to the pandemic's dynamic nature and online data collection feasibility. The RAND SF-36, a widely used 36-item quality-of-life questionnaire, was administered online via Google Forms and distributed through social media platforms and email invitations. Paired t-tests compared quality of life (QOL) during and after the SARS-CoV-2 pandemic. Multivariate regression analysis identified independent predictors influencing RAND SF-36 subscale scores. Results: The study involved the collection of responses from a total of 212 participants, with a mean age of 46.61±17.4 years. The RAND SF-36 questionnaire assessed the quality of life (QOL) during and after the SARS-CoV-2 pandemic. The results revealed significant differences in the general (45.8±13.0 vs 64.9±19.7; p=0.001) and mental health (53.5±12.3vs. 62.7±12.8, p<0.001) between the two time periods.Furthermore, the study revealed age (β=-0.369, p=0.004, 95%CI [-0.608, -0.101]) and employment status(β=-2.11, p=0.041, 95%CI [ -0.083, -4.139]) showed significant negative association with physical health-related component. In addition, the duration of comorbidities (β=-5.326, p=0.047,95%CI [-11.408, -0.756] gravely affected the mental health component, respectively.> Conclusion: Significant differences were noted in quality of life (QOL) between the SARS-CoV-2 pandemic period and after, with lower general health and mental health scores shown in diabetics as compared to non-diabetic individuals. Older age and unemployment were associated with worse physical health QoL, while the longer duration of comorbidities negatively impacted mental health QOL regardless of diabetes status. These findings suggest the pandemic substantially affected various aspects of QoL, underscoring the need for targeted interventions to support vulnerable populations.

Knowledge, attitude and practice toward fibromyalgia among fibromyalgia patients: A web-based cross-sectional study in China

BackgroundThis study aimed to explore the knowledge, attitude and practice (KAP) of fibromyalgia patients toward fibromyalgia.MethodsThis web-based cross-sectional study was conducted in China between February and March 2023 among fibromyalgia patients using a self-administered questionnaire.ResultsA total of 401 valid questionnaires were enrolled, including 326 (81.30%) females and with a mean age of 42.42 ± 11.78 years. The mean scores for KAP were 7.14 ± 2.72 (possible range: 0–10), 27.31 ± 4.24 (possible range: 8–40) and 28.08 ± 5.55 (possible range: 10–50), respectively. Multivariate logistic regression analysis showed knowledge (OR = 1.09, 95%CI: 1.04–1.15, P = 0.001) and patient global impression (PGI) on average pain severity in the last week (OR = 0.89, 95%CI: 0.81–0.97, P = 0.011) were independently associated with positive attitude. Attitude (OR = 1.08, 95%CI: 1.02–1.14, P = 0.006), initial consultation in orthopedics (OR = 2.15, 95%CI: 1.24–3.73, P = 0.006) and age (OR = 0.98, 95%CI: 0.96–1.00, P = 0.037) were independently associated with proactive practice. The structural equation model demonstrated that knowledge had a positive effect on attitude (β = 0.21, P = 0.006), and Widespread Pain Index (WPI) exhibited an impact on both knowledge (β = -0.04, P < 0.001) and attitude (β = -0.52, P = 0.001).ConclusionFibromyalgia patients showed suboptimal knowledge, moderate attitude and inactive practice toward fibromyalgia. To enhance fibromyalgia patient outcomes, recommendations include targeted education, addressing rural-urban disparities in knowledge, emphasizing early diagnosis, and adopting patient-centered approaches to promote positive attitude and better disease management.

Validation of a Nepali version of the questionnaire to assess preventive practices against the COVID-19 pandemic in the general population

BackgroundThe new coronavirus disease 2019 (COVID-19), caused by a virus in the coronavirus family called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to lack of effective treatment, the major way to breakdown the disease transmission is by application of preventive measures. For this, a preventive practice questionnaire was used to assess the preventive practice during COVID-19. A definite advantage of this questionnaire is its ability to identify individual level preventive practices. The objective of the study was to validate the Nepali version of Questionnaire to assess preventive practices against the COVID-19 pandemic in the General population.MethodsA web-based descriptive cross-sectional study was conducted from November 2022 to April 2023 using preventive practices against the COVID-19 pandemic questionnaire and was conducted among 351 respondents. The sensitivity and specificity of the questionnaire were calculated for validation. The best cutoff point for the Nepalese version of the questionnaire was identified and the area under the receiver operating characteristic curve (AUC) was calculated.ResultsThe overall prevalence of good preventive practices was 90.6%. The best cutoff points for the Nepali version of the questionnaire were 93% sensitivity and 67% specificity, respectively at a cutoff level of 47/48. The area under the curve was 0.859. Thus, the Nepalese version of the questionnaire concerning preventive practices during the COVID-19 pandemic in the general population had an accuracy of 85.9% (95% CI 0.757–0.961, p = 0.001).ConclusionThe Nepalese version of the questionnaire on preventive practices during the COVID-19 pandemic in the general population can be successfully used as a survey tool. These findings might help to detect appropriate adherence to preventive practices can be achieved in busy outpatient departments. Detecting adherence to preventive practices may help local health authorities and policymakers in identifying specific populations for future awareness campaigns during infectious disease outbreaks.

Knowledge, attitudes and practices among patients with periodontal disease toward disease management.

Periodontal disease is a common chronic inflammatory condition that affects oral health and carries broader public health implications. This study aimed to assess the levels of knowledge, attitudes and practices (KAP) among patients with periodontal disease toward disease management. This cross-sectional web-based study was conducted between March 2022 and March 2023. A self-administered questionnaire was designed to evaluate KAP toward disease management. A total of 514 questionnaires were collected. Among the patients, 313 (60.89%) of them were female, 309 (60.12%) resided in urban areas and 130 (25.29%) reported having severe periodontal disease. The mean scores of knowledge, attitudes and practices were 3.05 ± 2.03 (possible range: 0-8), 18.71 ± 3.64 (possible range: 6-30), and 14.85 ± 3.63 (possible range: 5-25), respectively. The knowledge item with highest correctness rate was the link between periodontal disease and systemic health (60.70%), while the lowest correctness rate was seen for understanding disease classification (36.96%). Pearson's analysis revealed positive correlations between knowledge and attitude (r = 0.31, p < 0.001), knowledge and practices (r = 0.23, p < 0.001) attitudes, as well as attitudes and practices (r = 0.17, p < 0.001). Multivariate logistic regression analysis showed that knowledge (OR = 1.30, 95% CI: 1.14-1.49, p < 0.001), age ≥ 33 years old (OR = 0.33, 95% CI: 0.18-0.62, p = 0.001), housewife/househusband (OR = 0.41, 95% CI: 0.17-0.95, p = 0.037) and student (OR = 0.43, 95% CI: 0.20-0.92, p = 0.029) were independently associated with practices. Patients with periodontal disease had insufficient knowledge, negative attitudes, and passive practices toward disease management. Further efforts could be directed toward enhancing patient education on periodontal disease to improve knowledge, thereby positively influencing attitudes and disease management practices.

Knowledge, Attitude, And Practice of Dermatologists and Family Physicians Regarding Probiotics in Atopic Dermatitis in Saudi Arabia

Background: Despite the growing evidence of significant probiotics’ role in various diseases, including dermatological conditions, there is limited data on awareness dermatologists and family phsycians about its role in atopic dermatitis in Saudi Arabia. Objectives: To assess knowledge, attitude, and practice of dermatologists and family physicians regarding probiotics in atopic dermatitis in Saudi Arabia Methods: This study was a web-based cross-sectional study. Data were collected via an online questionnaire, targeting dermatologists and family physicians from different Saudi regions.The questionnaire included closed-ended questions on sociodemographic characteristics, knowledge, attitude, and practice of probiotic in atopic dermatits. Knowledge level and atitude scoring were assessed and compared based on participants’ characteristics. Results: The study analyzed responses from 273 participants, with a mean age of 34.5 ± 8.3 years. The majority of respondents were dermatologists (71.8%). Among the participants, 23.1% demonstrated good knowledge about probiotics in relation to atopic dermatitis, with a significantly higher level of knowledge observed among consultants (38.5%), dermatologists (24%), and those with 10 or more years of experience. While most respondents displayed a positive attitude toward the use of probiotics, actual prescription rates were low. Notably, 53.8% of participants did not engage in prescribing probiotics, and only 33.3% monitored patient outcomes associated with their use. The main barrier identified was a lack of knowledge, with 66.7% of respondents citing this as a significant challenge. Conclusion: The study highlights the need for improved educational resources to enhance healthcare providers' understanding and confidence in using probiotics for atopic dermatitis. This research contributes to the growing body of literature on probiotics and underscores the need for targeted interventions to support healthcare professionals in delivering evidence-based care.

Intention to Seek Mental Health Services During the 2022 Shanghai COVID-19 City-Wide Lockdown: Web-Based Cross-Sectional Study.

The implementation of COVID-19 lockdown measures had immediate and delayed psychological effects. From March 27, 2022, to June 1, 2022, the Shanghai government enforced a city-wide lockdown that affected 25 million residents. During this period, mental health services were predominantly provided through digital platforms. However, limited knowledge exists regarding the general population's intention to use mental health services during this time. This study aimed to assess the intention of Shanghai residents to use mental health services during the 2022 Shanghai lockdown and identify factors associated with the intention to use mobile mental health services. An online survey was distributed from April 29 to June 1, 2022, using a purposive sampling approach across 16 districts in Shanghai. Eligible participants were adults over 18 years of age who were physically present in Shanghai during the lockdown. Multivariable logistic regression was used to estimate the associations between demographic factors, lockdown-related stressors and experiences, physical and mental health status, and study outcomes-mobile mental health service use intention (mobile applications and WeChat Mini Programs [Tencent Holdings Limited]). The analytical sample comprised 3230 respondents, among whom 29.7% (weighted percentage; n=1030) screened positive for depression or anxiety based on the 9-item Patient Health Questionnaire or the 7-item Generalized Anxiety Disorder Scale. Less than one-fourth of the respondents (24.4%, n=914) expressed an intention to use any form of mental health services, with mobile mental health service being the most considered option (19.3%, n=728). Only 10.9% (n=440) used digital mental health services during the lockdown. Factors associated with increased odds of mobile mental health service use intention included being female, being employed, being a permanent resident, experiencing COVID-19-related stressors (such as loss of income, food insecurity, and potentially traumatic experiences), and having social and financial support. Individuals with moderate or severe anxiety, as well as those with comorbid anxiety and depression, demonstrated a higher intention to use mobile mental health services. However, individuals with depression alone did not exhibit a significantly higher intention compared with those without common mental disorders. Despite a high prevalence of common mental disorders among Shanghai residents, less than one-fourth of the study respondents expressed an intention to use any form of mental health services during the lockdown. Mobile apps or WeChat Mini Programs were the most considered mental health service formats. The study provided insights for developing more person-centered mobile mental health services to meet the diverse needs of different populations.

Physicians and hospital pharmacists’ knowledge, attitudes, and practices towards polypharmacy in older patients with chronic diseases

This web-based cross-sectional study aimed to evaluate the knowledge, attitudes, and practices of physicians and hospital pharmacists towards polypharmacy in older adult patients with chronic diseases in China. This study enrolled 374 physicians and pharmacists (270 females, 92 physicians) in 20 Chinese provinces between December 2022 and March 2023. The knowledge, attitude, and practice scores were 12.65 ± 2.05 (possible range, 0–18), 29.07 ± 2.68 (possible range, 7–35), and 26.16 ± 5.56 (possible range, 7–35), respectively. Working as a hospital pharmacist (vs. physician) was independently associated with adequate knowledge (OR = 2.190; 95% CI = 1.291–2.713; P = 0.004). Working in a tertiary hospital (OR = 4.296; 95% CI = 1.390-13.272; P = 0.011) was independently associated with a positive attitude. Knowledge score (OR = 1.176; 95%CI = 1.038–1.333; P = 0.011), hospital pharmacist (OR = 0.276; 95% CI = 0.137–0.557; P < 0.001), master’s degree or higher (OR = 1.754; 95% CI = 1.011–3.045; P = 0.046) and senior professional title (OR = 2.020; 95% CI = 1.032–3.952; P = 0.040) were independently associated with proactive practice toward polypharmacy in older adults. Physicians and hospital pharmacists had favorable knowledge, positive attitudes, and proactive practice toward polypharmacy. In conclusion, enhancing knowledge through continuous education, promoting interprofessional collaboration, educating patients, and conducting regular evaluations for quality improvement are necessary to improve the KAP of healthcare professionals toward polypharmacy in older adults.

Impact of Autism on the Relation Between Sleep and Life Satisfaction in Japanese Adults.

Sleep disorders, such as short sleep, are common comorbidities in individuals with autism spectrum disorder (ASD). Sleep quality and duration are directly associated with quality of life (QOL). Clarifying the influence of ASD on the association between short sleep duration and life satisfaction is an efficient way to improve the QOL of patients with ASD. To clarify the influence of ASD on the association between short sleep duration and life satisfaction scale scores, we conducted a web-based cross-sectional study involving 3823 Japanese adults aged 20-64 years. In all the participants, a significant inverse association was observed between short sleep duration and life satisfaction. The adjusted odds ratio (OR) and 95% confidence interval (CI) of short sleep for one standard deviation (SD), the increment of life satisfaction scale (2.5 for men and 2.4 for women), was 0.76 (0.70, 0.82). When the analyses were stratified by ASD status, a significant inverse association was observed only among participants without ASD. The corresponding ORs (95% CIs) were 0.73 (0.67, 0.80) and 1.08 (0.85, 1.39) for those with and without ASD. Patients with ASD also showed a significant interaction effect on the association between short sleep duration and life satisfaction. Only participants without ASD showed a significant inverse association between short sleep duration and life satisfaction. Although further investigations are necessary, these results can help clarify the mechanism underlying the association between QOL, short sleep duration, and ASD.

Knowledge, attitudes, and practices regarding keratopathy among diabetic patients

BackgroundThis study aims to investigate the knowledge, attitudes, and practices (KAP) regarding keratopathy among diabetic patients.MethodsA web-based cross-sectional study was conducted between May 26, 2023, and September 18, 2023, at Yantai Shan Hospital and Yantai Yuhuangding Hospital. Demographic information and KAP were assessed through the distribution of questionnaires.ResultsAmong the 521 participants, average knowledge, attitude, and practice scores were 6.11 ± 4.53, 27.61 ± 4.41, and 37.25 ± 5.21, respectively. Path analysis revealed a significant association between attitude and knowledge (β = 0.416, P < 0.001), and practice(β = 0.683, P < 0.001). Multivariate logistic regression indicated that attitude score (OR = 1.288, 95%CI: 1.203–1.379, P < 0.001), higher monthly incomes(> 10000 RMB) (OR = 3.494, 95%CI: 1.104–11.055, P = 0.033), higher self-rated control levels(4 and 5 points) (OR = 3.729, 95%CI: 1.687–8.243, P = 0.001 and OR = 3.801, 95%CI: 1.560–9.261, P = 0.003 respectively) and family history of ophthalmic diseases (OR = 0.297, 95%CI: 0.115–0.762, P = 0.012) were independently associated with proactive practice.ConclusionDiabetic patients demonstrated inadequate knowledge, moderately positive attitudes, and reasonably proactive practices concerning keratopathy. The study emphasizes the impact of attitude on practice, influenced by knowledge and other factors such as self-rated blood sugar control and family history of ophthalmic diseases.

Association between maternal exercise during pregnancy and attention-deficit/hyperactivity disorder among preschool children in Southwest China.

Maternal moderate-intensity exercise during pregnancy has important health benefits for the offspring, however, less is known about its association with offspring attention-deficit/hyperactivity disorder (ADHD). This study aimed to explore the association between maternal exercise during pregnancy and ADHD among preschool children in Southwest China. A web-based cross-sectional study was performed in 2021, and the revised Conners Parental Symptom Questionnaire and maternal exercise during pregnancy were obtained through a self-reported structured questionnaire. A binary logistic regression model was used to assess the association between maternal exercise during pregnancy and the likelihood of childhood ADHD after adjustment for covariates. A total of 4,184 preschool children aged 3-6 years were included in our final analysis. Children whose mothers exercised for <20 min per day were more likely to be at risk of ADHD (6.3%), compared to those whose mothers exercised for more than 40 min (3.1%) or 20-40 min (2.8%) per day. Daily exercise of <20 min during pregnancy was associated with higher odds of childhood ADHD (adjusted OR = 2.11; 95% CI: 1.41, 3.16) after multivariable adjustment. The association of maternal exercise during pregnancy with childhood ADHD was similar in subgroups stratified by child's sex, and by maternal smoking, sleep duration and gestational anemia during pregnancy. Our findings highlight the importance of maternal moderate-intensity exercise during pregnancy for the prevention of childhood ADHD. Prospective studies are needed to confirm our findings in the future.

Experience of Outing and Mental Health Among Sexual and Gender Minorities in Japan: A Web-Based Cross-Sectional Study

Experience of Outing and Mental Health Among Sexual and Gender Minorities in Japan: A Web-Based Cross-Sectional Study

Examining symptom and quality of life in polycystic ovarian syndrome: a web-based cross-sectional study.

Polycystic Ovarian Syndrome (PCOS) is a reproductive disorder that significantly impacts women's quality of life (QOL). Its unclear etiology, whether genetic or environmental, and the treatments associated with it have been widely studied globally. This study assessed the QOL of 108 women with PCOS, examining both physical and mental symptoms. Participants completed the Short Form-12 (SF-12) questionnaire through a web-based survey to evaluate their QOL scores. Common symptoms included menstrual irregularity (73.14%), hirsutism (65.7%), acne (62.03%), and obesity (22.22%). Complications such as diabetes mellitus (12.9%), hypertension (2.78%), infertility (1.85%), miscarriages (31.4%), hyperandrogenism (68.51%), and insulin resistance (28.7%) were reported. Patients with infertility had the lowest physical scores (PCS), while those working night shifts had the lowest mental scores (MCS). PCOS significantly affects QOL, with infertility contributing to the lowest physical scores and night shift work correlating with the lowest mental scores. These findings emphasize the need for integrated psychological and physical care, particularly for young working women with PCOS.

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

BackgroundThis 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.MethodsThis 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.ResultsA 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 5 years 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.ConclusionPediatric 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.

Knowledge, attitude, and practice of adolescents and parents toward malocclusion and orthodontic treatment

Malocclusion is the misalignment of teeth and jaws, affecting oral health and appearance. This study aimed to examine the knowledge, attitude, and practice (KAP) of both adolescents and parents toward malocclusion. This web-based cross-sectional study was conducted at Tianjin between July 2019 and July 2022, enrolled adolescents and their parents. The structural equation model (SEM) was used to analyze the interactions between KAP. A total of 478 adolescents and 380 parents were included. For knowledge, the scores were 6.95 ± 2.69 for adolescents and 7.07 ± 2.90 for parents (possible range, 0–12). For attitude, the scores were 36.96 ± 7.86 for adolescents and 33.26 ± 9.20 for parents (possible range, 13–65). For practice, the scores were 39.88 ± 7.85 for adolescents and 25.75 ± 8.56 for parents (possible range, 11–55). In parents, knowledge, practice, being a service personnel and production personnel, and acquiring knowledge through the Internet were associated with receiving orthodontic treatment. The SEM showed that knowledge directly affected attitudes (β = 0.551, P < 0.001) and practices (β = 1.122, P < 0.001). But attitudes did not affect practices (β=-0.003, P = 0.923). Adolescents and parents demonstrate unsatisfactory levels of knowledge, attitudes, and practices toward malocclusion. Improvements can be made by focusing on enhancing knowledge and encouraging proactive practices.

Effect of ethnocentrism and professional attitudes on moral sensitivity in midwives and nurses: A web-based cross-sectional and correlational study

ObjectiveThe aim of this study was to investigate relation between ethnocentrism, professional attitudes and moral sensitivity of midwives and nurses working in Turkey using linear regression model. MethodA descriptive and cross-sectional and correlational study was adopted. Data were collected online between 20.10.2023 and 25.12.2023. The study was completed with total of 400 nurses and midwives. Data were collected through a personal information form, the Generalized Ethnocentrism Scale (GENE), the Moral Sensitivity Questionnaire (MSQ) and Inventory of Professional Attitude at Occupation (IPAO). ResultsNurses’ and midwives’ ethnocentric attitudes were high and their professional and moral sensitivity was moderate. A negative and statistically significant relationship was found between GENE and MSQ (r=−0.150 and p<0.05). Moreover, it is concluded that ethnocentrism and professional attitudes have a negative effect on the moral sensitivity of nurses and midwives. ConclusionsBased on these results, interventions aimed at improving the ethnocentric and professional attitudes of nurses and midwives will also contribute to improve their moral sensitivity.

Antimicrobial resistance and infection prevention in care for people with intellectual disabilities

Abstract Background Antimicrobial resistance (AMR) has become one of the major public health threats worldwide. However, little is known about antimicrobial resistance and infection prevention and control (IPC) in long-term care facilities for people with intellectual disabilities. This study aims to assess knowledge, attitudes and perceptions towards AMR and IPC among healthcare professionals working in long-term care facilities for people with intellectual disabilities (ID-LTCFs) in the Netherlands. Methods We conducted a web-based cross-sectional survey study among medical and nonmedical trained healthcare professionals working in ID-LTCFs in the Netherlands. The survey study was carried out between July and November 2023 and consisted of validated survey items expanded with expert opinion and setting-specific items. Results In total, 109 medical and nonmedical trained healthcare professionals working in 37 long-term care organizations for people with intellectual disabilities throughout the Netherlands completed the questionnaire. Overall, knowledge levels about AMR and IPC differed between medical and nonmedical trained healthcare professionals working in ID-LCTFs, with medically trained professionals having a significant overall higher score on both topics. Knowledge regarding the perceived protective value of glove use was found to be insufficient. Moreover, healthcare professionals expressed a need for easy-to-read resources and tailored setting-specific information on AMR and IPC targeting both healthcare professionals as well as people with disabilities. Conclusions There is room for improvement regarding setting-specific IPC and hygiene policies, such as appropriate glove use in ID-LTCFs. As nonmedically trained professionals comprise most of the workforce within this setting, it is important to further tailor follow-up studies to the underlying factors that influence knowledge, attitudes and perceptions of these specific professionals within ID-LTCFs. Key messages • Developing setting and context-specific policies for infection prevention and control is crucial, particularly in long-term care facilities for people with intellectual disabilities. • Inclusive policy-making is key to combating antimicrobial resistance, and improving infection prevention and control in long-term care facilities for people with intellectual disabilities.

Pointe Readiness in Youth Ballet Dancers: A Pilot Study on Dance Instructor Decision Making.

Introduction: Transiting to dancing en pointe is an important milestone for young dancers who wish to progress in ballet training. Various criteria exist regarding pointe readiness, including age, range-of-motion, endurance, strength, balance, and technique. However, awareness and use of these criteria by dance instructors is currently unknown. The purpose of this pilot study was to assess the awareness and use of pointe readiness criteria by youth ballet instructors. Methods: A cross-sectional web-based survey study design was used, which included questions regarding dance instruction experience, dance studio characteristics, and criteria used to assess pointe readiness. Ballet instructors were recruited for participation. Data are presented as percentages and frequencies. Results: Thirty-one ballet instructors completed the survey from 15 states (1 international). Years of pointe ballet instruction ranged from 2 to 30+ years, with 35% indicating more than 30 years of experience. Instructors reported students begin pointe at age 11.8 years (range 9-15 years). A majority of instructors require 5 years of ballet experience prior to dancing en pointe (range 2-8 years). Reported pointe readiness criteria included strength (100%), dance technique (94%), age (87%), and years of ballet experience (71%). While all instructors reported evaluating a dancer's strength, assessments of flexibility and movement quality were not evaluated by 42% and 45% of instructors, respectively. Strength, dance technique, and age were rated as the greatest indicators of a dancer's readiness to begin pointe. Finally, instructors reported low knowledge of existing pointe readiness criteria. Conclusion: Ballet instructors initiated pointe work at age 12 and required 5 years of ballet experience before beginning to dance en pointe. While strength, dance technique, and age were the top considerations for evaluating readiness, approximately 40% of instructors did not evaluate flexibility or movement quality prior to progressing to pointe, and overall, knowledge of existing criteria was low.

Sleep quality and sex-related differences in an older adult population: a web-based cross-sectional study

Introduction: Aging has significant economic and social implications leading to an increase in chronic diseases and reduced autonomy of the elderly. Sleep disorders are common in the elderly, manifesting reduced sleep quality. Objective/Purpose: The study aimed to measure the prevalence of sleep disorders in older adults and assess sex differences in sleep quality and sleep problems. Method: A cross-sectional study based on an online survey was performed according to the STROBE checklist, using pre-validated questionnaires (Pittsburgh Sleep Quality Index) distributed to a sample of older adults. This is the first study evaluating sex differences in sleep quality and problems in the Italian population context using the Pittsburgh Sleep Quality Index assessment tool. The study was conducted in a university hospital in Rome from October 2020 to November 2020, on patients aged &gt;65 years, independent in activities of daily living, with comorbidities and on treatment with up to 2 medications. Results: 59 patients were included in the study, with an average age of 71.12 years. The results show that among males, the prevalence of poor sleep quality was 51.9%, while among females, the prevalence of poor sleep quality was 62.5%. According to Shapiro-Wilk, the Pittsburgh Sleep Quality Index was not normally distributed. Pittsburgh Sleep Quality Index total scores in males did not differ significantly from females. Conclusions: Considering scientific literature, recent studies have highlighted the prevalence of sleep disorders in the elderly population and their underreporting. Providing early intervention not only improves the sleep quality of these people but may also reduce the risk of experiencing adverse health outcomes and susceptibility to frailty.