Search

Aim: This study aimed to determine the knowledge, attitudes, and practices of male nurses towards human papillomavirus (HPV) and HPV vaccination and to examine whether knowledge about the HPV vaccine affects attitudes and beliefs about HPV vaccines. Background: HPV is responsible for ≈5% of all cancers worldwide. Therefore, vaccination against HPV is recommended to prevent HPV infections and HPV‐related cancers in men and women. Methods: The study group included 383 male nurses who were asked to complete online questionnaires. The data were collected using the following tools: a sociodeomographical characteristics form, the Human Papillomavirus Knowledge Scale (HPVKS), and The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). Results: It was determined that the general HPV knowledge of the male nurses participating in the study was at a moderate level, but their knowledge of HPV screening test, HPV vaccination, and current HPV vaccination programmes were at a low level. Male nurses' HPV vaccination rates were relatively low, and most of them did not intend to be vaccinated. In addition, CHIAS Attitudes and Beliefs scores of the male nurses were at an average level and HPV knowledge affected the attitudes and beliefs of the nurses. Conclusion: These results demonstrate an opportunity to improve information and awareness about HPV and vaccines by nursing education. Summary statement: What is already known about the topic? Although HPV vaccination is recommended to prevent HPV infections and HPV‐related cancers in men and women, vaccination rates are far behind the target, especially for men. What this paper adds? Findings showed that male nurses' HPV vaccination rates were relatively low.Male nurses' knowledge about HPV and HPV vaccine was not sufficient.HPV knowledge affected the attitudes and beliefs of these male nurses. The implications of this paper: Nurses need to be aware of the HPV vaccine during their undergraduate education. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

Objective: To determine age-related risk factors for chronic rhinosinusitis (CRS) with asthma. Methods: Data were obtained from a national survey of non-hospitalized civilians conducted by the Korean Center for Disease Control and Prevention. CRS diagnosis was based on the guidelines of the European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Asthma was judged based on whether the patient had been diagnosed with asthma in the past. Of the 45,811 survey participants, 26,335 were included in the cross-sectional study. Participants included in the study were divided into the control, CRS, and CRS with asthma groups. Age-related risk factors were analyzed in patients aged < 60 or > 60 years. Univariate logistic analyses were performed to evaluate the relationship between groups. Risk factors included age, sex, household income, residence, education level, occupation, and body mass index (BMI). Results: Education level (Odds Ratio [OR]: 0.342, P =.0003), BMI (OR: 1.09, P =.0082), and total IgE (TIgE) levels (OR: 5.582, P =.003) were significantly different between the control and the CRS with asthma group. Education level (OR: 0.478, P =.0016) and TIgE levels (OR: 4, P =.0218) were significantly different between the CRS and CRS with asthma groups under 60 years of age. BMI (OR: 1.087, P =.0443; OR: 1.104, P =.0224) showed a significant difference between all three groups with age > 60 years. Conclusion: Progression to CRS with asthma is influenced by education level, occupation, and TIgE levels in patients under 60 years of age. BMI was the only influencing factor associated with the progression to CRS with asthma in those aged > 60 years. [ABSTRACT FROM AUTHOR]

This paper examined gender (N = 1406;77.7% women) patterns of religious coping and psychological impact following the devastating 2023 Syrian earthquakes. Measures in this nation-wide convenience sample study included positive religious coping (PRC) and negative religious coping (NRC) using the Brief Religious Coping Scale (RCOPE), and probable PTSD, depression, and anxiety, using the PCL-5, PHQ-9, and GAD-7, respectively. Women reported higher endorsement of PRC items while men higher endorsement of NRC items. Within the women only sample, lower education and lower income, education and younger age predicted PRC and NRC, respectively. NRC was strongly positively associated with PTSD, depression and anxiety; while, PRC was positively associated only with PTSD. These vulnerable women require targeted support to adopt more adaptive religious coping strategies. [ABSTRACT FROM AUTHOR]

Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data. [ABSTRACT FROM AUTHOR]

Background Non-pharmaceutical interventions (NPIs) decrease COVID-19 transmission. Reliability and validity of adherence to NPIs in accordance with normalization process theory (NPT) in coherent and convenient social subgroups using reflective measurement model assessment has not been evaluated. Methods In February 2021, a sample of medical students and people with substance use disorders in treatment as coherent (based on continuous probability distribution) vs. convenient groups (based on convenience, not equal probability) composed of travellers and COVID-19 suspected persons from Split-Dalmatia County (SDC) (n  = 656) in the Mediterranean completed self-administered surveys. Partial least squares structural equation modelling (PLS-SEM) was used to measure reflective model assessment of adherence to NPIs according to NPT. Results PLS-SEM reflective model assessment provided two-group specific factors in inverse relationships which determined adherence to NPIs with excellent goodness-of-fit [ χ 2 = 1.292, df = 1; P  = 0.297, CFI = 1, TLI = 0.997, RMSEA = 0.011 (90% CI 0–0.105), RMSEA P  = 0.604, SRMR = 0.008, Hoelter CN (α = 0.05) = 2322.757]. Significant negative factors covariance estimate (−0.716) revealed an inverse relationship between first (adherence to NPIs and internal locus of control (LoC) (0.640)) and second factor; young adulthood age (≤25) and highest level of education (1362). As the first factor increased the second tended to decrease. LoC is expected potential mechanism by which sex (MLsex = −0.017, SE = 0.007, P  < 0.016) and belonging to coherent subgroups (MLgroup = −0.008, SE = 0.003, P  = 0.015) can produce indirect effect of adherence to NPIs. Conclusions Coherent subgroups had a more pronounced tendency toward integration of NPIs in everyday life. Group factors that facilitate the normalization were higher educated younger adults with a tendency toward external LoC. [ABSTRACT FROM AUTHOR]

Introduction: Ethiopia has made remarkable progress in expanding access to and provision of comprehensive abortion care. However, complications due to unsafe abortion persist. As efforts to increase quality of comprehensive abortion care continue, evaluating service quality is critical. Although "womencentered" abortion care is a central component of Ethiopia's technical guidelines for safe abortion, research has mostly focused on access to care, availability of services, and meeting clinical criteria, rather than examining service quality from abortion clients' perspectives. This study assesses the quality of comprehensive abortion care (CAC) in public health facilities, from clients' perspectives, in four regions of Ethiopia to examine how personcentered care differs based on facility and service characteristics. Methods: We conducted 1,870 client exit surveys in 2018 using structured questionnaires with women who received induced abortion or postabortion care services from 76 public health facilities across four regions: Tigray, Amhara, Oromia, and Southern Nations, Nationalities, and People's. We operationalized person-centered care by mapping 30 indicators of quality to five of the six domains in the Person-Centered Care Framework for Reproductive Health Equity developed by Sudhinaraset and colleagues (2017): dignity & respect; autonomy; communication & supportive care; trust, privacy, and confidentiality; and health facility environment. We calculated descriptive, bivariate, and multivariable statistics to examine associations between service characteristics and person-centered care. Results: CAC clients reported high levels of person-centered care, with exceptionally positive experiences for outcomes in the dignity and respect and trust, privacy, and confidentiality domains. However, there was notable room for improving client experiences across three domains: autonomy, communication and supportive care, and health facility environment. Clientreported quality outcomes differed significantly by diagnosis (induced or postabortion care), region, health facility type, and procedure type. Clients in Amhara, clients at tertiary and primary hospitals, and clients who received postabortion care reported lower levels of person-centered care. Discussion: The positive experiences reported by comprehensive abortion care clients bolster evidence of the impact of the Ethiopian government's strategy to increase abortion access in the public health sector. However, notable disparities exist for key subgroups, particularly those seeking postabortion care and people visiting tertiary and primary hospitals. Quality improvement efforts should concentrate on improving abortion clients' autonomy, communication and supportive care, and the health facility environment. The Ethiopian Ministry of Health and its partners must dedicate resources to improve postabortion care quality, integration of reproductive health services within CAC, and pain management for MA clients as vital interventions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the current state of oral frailty in oldely patients with require dental implants, analyze influencing factors in the characteristics of oral frailty across different patient categories, and provide a reference for clinical staff to identify high-risk groups and develop proactive management strategies. Methods: Between January 2024 and March 2024, 654 patients with dental implants were selected using convenience sampling from six secondary and tertiary stomatological hospitals in Jiangsu and Zhejiang provinces. Data were collected via a general information questionnaire and the Oral Frailty Index-8. The latent profiles of oral frailty were examined, and univariate and Logistic regression analyses were conducted to determine the impact of various factors on these profiles. Results: In this cross-sectional study, 605 valid questionnaires were returned, yielding an effective rate of 92.58%. The mean oral frailty score was 6.64 ± 1.21, with the sample comprising 223 males and 382 females, averaging 72.54 ± 6.33 years old. Oral frailty was categorized into three latent profiles: high (20.50%), moderate (53.72%), and low (25.78%) frailty groups. Factor analysis indicated that age, gender, education level, family income, number of implants, and dyslipidemia significantly predicted the classification of these profiles (P < 0.05). Conclusion: Oral frailty in oldely patients with dental implants exhibits heterogeneity and is influenced by age, sex, education level, family income, number of implants, and dyslipidemia. Clinical staff should recognize the characteristics of different patient categories and implement proactive measures for those at high risk of oral frailty to enhance their quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Pandemics are global health crises that have caused millions of deaths, enormous socio-economic disruptions, and considerable public and global health security consequences. This study assessed Nigerians' knowledge, attitudes, and perceptions regarding preparedness for the next pandemics. Methods: A cross-sectional questionnaire-based national survey was conducted among 1276 respondents in Nigeria to determine public knowledge, attitudes, and perceptions of preparedness for future pandemics. Descriptive and inferential statistics were used for analyses. Results: Of the 1276 respondents to this survey, > 50% had not heard of the Spanish flu and Zika disease. Approximately half (594) of the respondents did not consider antimicrobial resistance a possible cause of future pandemics. Over an average proportion of respondents reported unsatisfactory knowledge (655, 51.3%) and poor perceptions (695, 54.5%) about pandemic preparedness. The respondents' good knowledge and satisfactory attitudes toward pandemic preparedness decreased with age. The respondents' education, age, and state of residence were significantly associated with good knowledge, satisfactory attitudes, and positive perceptions of pandemic preparedness with respondents with tertiary education levels being at least two times more likely to have these positive outcomes. Conclusion: This study revealed serious gaps in Nigerians' knowledge, attitudes, and perceptions of their readiness for upcoming pandemics. To protect Nigerians' health, emphasis should be placed on these issues by all stakeholders, including the government. [ABSTRACT FROM AUTHOR]

Shared decision-making (SDM) is an essential component of patient-centered healthcare and disease management. However, the association of SDM with healthcare resource utilization and patient-reported outcomes among multimorbid individuals is not well understood. This study sought to evaluate the association of SDM with healthcare resource utilization and patient-reported outcomes among United States (US) adults with multimorbidity. Data were collected from the 2020 Medical Expenditure Panel Survey (MEPS) for this cross-sectional study. Eligible participants were US adults with two or more comorbidities. The predictor variable was SDM (optimal versus not optimal). The outcome variables were healthcare resource utilization and patient-reported outcomes. Logistic regression models, adjusted for demographic characteristics, assessed associations with SDM for each healthcare resource utilization and patient-reported outcome variable. The analysis maintained the complex survey data and was weighted to produce nationally representative estimates. Individuals who reported optimal SDM in adjusted analyses utilized more healthcare resources compared to those who reported not optimal SDM. Individuals with optimal SDM had more than one outpatient visit (odds ratio OR = 1.23, 95% CI = 1.03–1.47), emergency room visit (OR = 1.55, 95% CI = 1.17–2.06), and inpatient discharge (OR = 1.44, 95% CI = 1.05–1.96). Additionally, these individuals had higher odds of reporting limitations in their ability to work or engage in other activities due to their physical health in the past four weeks (OR = 1.27, 95% CI = 1.01–1.60). This study indicated evidence of increased healthcare resource utilization among patients who participate in SDM with their providers, which should be explored in future studies. [ABSTRACT FROM AUTHOR]

Background: Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators' job satisfaction and turnover intention. Methods: This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results: A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor's degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion: Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education. [ABSTRACT FROM AUTHOR]

Access to online medical records (OMRs) can help enhance cancer patient engagement and improve their health outcomes. This study investigates disparities in OMR access among cancer survivors and examines the association between OMR access and health perceptions. We conducted a cross-sectional analysis using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) from 2017 to 2022. The sample included 4713 cancer survivors. We employed regression analysis to assess the associations between the different factors. Overall, 18.78% of participants accessed their OMRs once or twice, while 36.69% accessed them three times or more. Gender minority groups (β = −0.0038, p = 0.01), older adults (β = −0.1126, p < 0.001), and racial minority groups (β = −0.059, p < 0.001) were less likely to access their OMRs. Additionally, higher education levels (β = 0.274, p < 0.001), insurance coverage (β = 0.365, p < 0.001), and higher incomes (β = 0.115, p < 0.001) were associated with increased OMR access. Positive health perceptions were significantly associated with OMR usage, including perceived good health (β = 0.148, p < 0.001), quality of care (β = 0.15, p = 0.026), and self-efficacy (β = 0.178, p = 0.002). Disparities in OMR access among cancer survivors are influenced by socio-economic factors and health perceptions. Interventions targeting vulnerable groups, enhancing digital health literacy, and improving health perceptions could promote equitable OMR usage. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether resilience mediates the connection between caregiver burden and hope among caregivers of patients with inflammatory bowel disease (IBD). Design: A cross‐sectional study. Methods: Two hundred patients with IBD were conveniently sampled from two tertiary hospitals in Jiangsu Province, China. The main instruments involved the Zarit Burden Interview, the 10‐item Connor‐Davidson resilience scale, and the Herth Hope Index. We conducted descriptive analysis and Pearson correlations using SPSS 25.0. The PROCESS v3.3 macro analysed the mediating effect. We report the results in line with the STROBE checklist. Results: Caregiver burden was significantly negatively connected with hope and resilience, whereas resilience positively correlated with hope. The mediation role of resilience was significant in the relationship between caregiver burden and hope, with mediating effects accounting for 47.86% of the overall effect. Conclusions: Resilience partially mediates the association between caregiver burden and hope among patients with IBD. This finding highlights the protective role of resilience in undermining caregiver burden and strengthening hope. Implications for Practice: In clinical practice, healthcare providers should perform routine psychological assessments for caregivers of patients with IBD. Furthermore, resilience training should be incorporated into interventions to alleviate caregiver burden and enhance hope. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess mental health nurses' empathy towards consumers with dual diagnosis in Australian mental health settings. The research question was What is mental health nurses' empathy towards consumers with co‐existing mental health and drug and alcohol problems? Design and Methods: A cross‐sectional survey was carried out to understand mental health nurses' empathy. The convenience sample included 96 mental health nurses from various mental health settings with experience working with consumers with dual diagnosis. We assessed empathy using the Toronto Empathy Questionnaire. We utilised SPSS™ software to analyse both the descriptive data and multiple‐regression. Results: The mean empathy score was 47.71 (SD 8.28). The analysis of the association between demographic variables and individual subscales showed an association between the clinical setting and empathy (p =.031) and sympathetic physiological arousal (p =.049). The work sector was associated with sympathetic physiological arousal (p =.045) and conspecific altruism (p =.008). Emotional contagion (β =.98, p <.001), emotional comprehension (β = 1.02, p <.001), sympathetic physiological arousal (β = 1.01, p <.001) and conspecific altruism (β = 10.23, p <.001) predicted mental health nurses' empathy. Conclusions: This study found that most mental health nurses showed empathy towards consumers with dual diagnosis. Mental health nurses who are more empathetic towards their consumers experience emotional contagion. They understand emotions better, show sympathetic physiological responses and exhibit kind behaviour towards consumers. Implications for the Profession and Patient Care: Further research is required to understand how mental health nurses adapt to consumers' emotional states in different mental health settings. This information can help clinicians make better decisions about care quality for consumers with dual diagnosis. Impact: This study addressed mental health nurses' empathy towards consumers with dual diagnosis. Mental health nurses showed increased empathy towards consumers with dual diagnosis. The empathy levels vary based on age, clinical setting, work sector and work experience. Mental health nurses' empathy levels were predicted by emotional contagion, emotion comprehension, sympathetic physiological arousal and conspecific altruism. Empathy enhancement among mental health nurses, particularly towards consumers with dual diagnosis, is crucial and should be regarded as a top priority by healthcare leaders and educators. Reporting Method: Outlined by the Consensus‐Based Checklist for Reporting of Survey Studies (CROSS). Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: This study examines the levels and predictors of malnutrition in Indian children under 5 years of age. Methods: Composite Index of Anthropometric Failure was applied to data from the India National Family Health Survey 2019–2021. A multivariable logistic regression model was used to assess the predictors. Results: 52.59% of children experienced anthropometric failure. Child predictors of lower malnutrition risk included female gender (adjusted odds ratio (AOR) = 0.881) and average or large size at birth (AOR = 0.729 and 0.715, respectively, compared to small size). Higher birth order increased malnutrition odds (2nd-4th: AOR = 1.211; 5th or higher: AOR = 1.449) compared to firstborn. Maternal predictors of lower malnutrition risk included age 20–34 years (AOR = 0.806), age 35–49 years (AOR = 0.714) compared to 15–19 years, normal BMI (AOR = 0.752), overweight and obese BMI (AOR = 0.504) compared to underweight, and secondary or higher education vs. no education (AOR = 0.865). Maternal predictors of higher malnutrition risk included severe anemia vs. no anemia (AOR = 1.232). Protective socioeconomic factors included middle (AOR = 0.903) and rich wealth index (AOR = 0.717) compared to poor, and toilet access (AOR = 0.803). Children's malnutrition risk also declined with paternal education (primary: AOR = 0.901; secondary or higher: AOR = 0.822) vs. no education. Conversely, malnutrition risk increased with Hindu (AOR = 1.258) or Islam religion (AOR = 1.369) vs. other religions. Conclusions: Child malnutrition remains a critical issue in India, necessitating concerted efforts from both private and public sectors. A 'Health in All Policies' approach should guide public health leadership in influencing policies that impact children's nutritional status. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STIs) are the most prevalent communicable diseases that impact people’s health and wellbeing. One of the main obstacles to successful prevention and control of STIs is the delay in seeking healthcare, which can result in significant personal and economic losses. However, there are limited studies on the delay in healthcare seeking among STI patients in resource-limited countries such as Ethiopia. Objective: This study aims to assess delays in seeking healthcare and associated factors among patients presenting with STIs at public health facilities in the Horo Guduru Wollega Zone, Oromia, Western Ethiopia, 2022. Methods: A cross-sectional study was conducted at public health facilities in the Horo Guduru Wollega Zone from 15 March to 15 May 2022. The study included 507 participants and used a consecutive sampling method. The outcome variable of the study was the delay in seeking healthcare among STI patients. A binary logistic regression model was used to identify candidate variables with a p-value of less than 0.25 after analyzing each variable separately. Finally, a multivariable analysis was performed to determine statistically significant variables at a p-value of less than 0.05, and an adjusted odds ratio (AOR) was reported. Results: The proportion of individuals with STIs who delayed seeking healthcare in the Horo Guduru Wollega Zone was 61.3% [95% confidence interval (CI): 57%– 65.5%]. Factors such as age >35 years (AOR = 2.23, 95% CI: 1.26–3.95), higher educational level (AOR = 2.72, 95% CI: 1.55–4.74), lack of condom use (AOR = 1.63, 95% CI: 1.05–2.55), and travel time to health facilities of >1 h (AOR = 4.30, 95% CI: 1.70–10.89) were found to be significantly associated with delayed healthcare seeking. Conclusion and recommendations: This study found that the magnitude of delay in seeking healthcare was higher than the national average and identified several contributing factors. Interventions such as developing educational programs and improving access to healthcare services are crucial for supporting patients with STIs. Enhancing healthcare accessibility in rural areas and promoting the use of condoms through targeted community outreach can reduce travel time and prevent delays in seeking healthcare for STIs. [ABSTRACT FROM AUTHOR]

Background: As one of the world's biodiversity hotspots, Indonesia contains over 25,000 plant species, including unconventional food plants (UFPs). These plants are integral to the dietary practices of rural communities, providing essential nutrients often overlooked in modern diets. However, the use of UFP is declining, with both their dietary and cultural values being undermined. In rural West Java, this decline in UFP biodiversity coincides with public health challenges related to malnutrition. This study aims to document the diversity of UFPs used by local communities in rural West Java, assess their nutritional value, and explore their consumption practices. Methods: Data were collected using mixed methods, including interviews with 20 key informants and food frequency questionnaire administered to 107 women in three villages in the area. The nutritional compositions of documented UFPs were obtained from literature and analysis. Bivariate correlation was used to analyze the relationships between UFP consumption frequency and potential correlates. Results: The study documented 52 species of UFPs from 29 families, many of which are rich in nutritional value. About half of respondents (56%) consumed UFPs moderately (2–3 times a week). UFP consumption frequency had a strong correlation (r = 0.70) with associated knowledge (r = 0.70, p < 0.01) and a weak correlation with age (r = 0.240, p = 0.015), livestock possession (r = 0.260, p = 0.008), and family size (r = − 0.220, p = 0.02). Motivations for UFP consumption included availability as free food (33%), medicinal value (26%), nostalgic value (23%), and preferred taste (18%). Most respondents (92%) agreed that consumption has declined compared to the past, with perceived reduced availability and lack of knowledge cited as the primary reasons for the declining trend. Conclusions: UFP use is common in the study area, where local communities value these plants for their critical roles in diet, medicine, and culture. Given their significant potential to meet dietary needs, educating and raising awareness about UFPs can enhance their consumption and contribute to food and nutrition security. [ABSTRACT FROM AUTHOR]

Aim. This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses' work performance and well‐being. Background. Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries. Design. Cross‐sectional study. Methods. We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face‐to‐face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse‐level outcomes included self‐directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling. Results. The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses' self‐directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses' organizational commitment or work stress. Conclusion. This study demonstrates a high‐level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs' organizational learning and primary care nurses' well‐being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. Implications for Nursing Management. In China's evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses' self‐directed learning and improve the quality of care. [ABSTRACT FROM AUTHOR]

Background: The nursing profession is undergoing rapid transformation, requiring innovation in management approaches and proactive behaviors among staff. Nurse Managers play a vital role through managerial innovation, but its impacts on intensive care nurses' proactivity and locus of control remain underexplored. Objectives: This study aimed to assess the levels of Nurse Managers' managerial innovation and relate it to proactivity behaviors and locus of control orientations among intensive care nurses. Methods: A cross-sectional correlational design was adopted, recruiting 242 intensive care nurses from Tanta University Hospital, Egypt. Participants completed standardized questionnaires measuring perceived managerial innovation, proactivity behavior, and locus of control. Results: Nurse Managers demonstrated moderately high innovation across all dimensions, especially in continuous learning and development (mean = 4.65) and advanced technology use (mean = 4.56). Nurses exhibited sound proactivity levels, particularly in adaptability (mean = 4.40) and planning (mean = 4.35). The majority of nurses showed an internal locus of control (64.5%). Managerial innovation had significant positive correlations with nurses' proactivity (r = 0.45, p < 0.001) and internal locus of control (r = 0.42, p < 0.001). Regression analysis revealed age, gender, experience, education, and ICU type as significant predictors of proactivity and locus of control. Conclusion: Innovative nursing leadership positively influences staff's proactivity levels and perceived control over their practice. This underscores the vital role of nurse managers in creating empowering environments in intensive care. [ABSTRACT FROM AUTHOR]

A healthy lifestyle is a key determinant of health, especially for people with chronic diseases such as diabetes or hypertension. The health behaviours which contribute to a healthy lifestyle include the following: regular physical activity, preventive examinations, maintaining a proper diet and avoiding the consumption of alcohol or cigarettes. They have a significant impact on the disease process, controlling symptoms and preventing complications. The aim of this study was to examine the health behaviours related to diet, physical activity and prevention among Polish primary health care patients and to identify predictors of health behaviours. For this reason, the standardized Health Behaviour Scale (HBS) questionnaire was used. The study was conducted among 269 patients (including 61.71% women) in primary health care facilities. The mean age of participants was 52.89 years (±17.76). The mean HBS score was 36.93 ± 9.66. A statistically significant association was found between HBS scores and such sociodemographic variables as education (p = 0.0061, r = 0.17), body mass index (p = 0.0018, r = −0.20, β = −0.36) and self-assessed economic status (p = 0.0094, r = 0.16). Women's health behaviours as measured by HBS were significantly better than men's (p < 0.001, β = −6.82). A special focus should be given to the groups manifesting poorer health behaviours (e.g., men, older people and persons with low socioeconomic status) by offering them tailored health-promoting interventions. [ABSTRACT FROM AUTHOR]

Context: Advance Care Planning (ACP), as a process for expressing and recording patients' preferences about end-of-life care, has received increasing attention in recent years. However, implementing ACP has been challenging in Iran. Objectives: To assess the readiness for advance care planning and related factors in the general population of Iran. Methods: This cross-sectional study was conducted on the general population of Iran in 2022. The data was collected using demographic information questionnaire and The RACP Scale. The purpose and methodology of the research was explained to all participants, and upon their agreement an informed consent was obtained. Participants were invited to fill out the questionnaires wherever is more convenient for them, either alone or if needed, with the help of the researcher to protect their privacy. Chi-square, fisher exact test and multiple logistic Regression model were used to assess the effective factors on the RACP. The data were analyzed by SPSS software version 26. Results: A total of 641 people with an average age of 36.85 ± 12.05 years participated in this study. Of those, 377 (58.8%) had high RACP. The logistics model showed an association between the chance of readiness for receiving ACP with participants' education level, such that the chance of readiness in those with Master's or Ph.D. degrees was three times higher than those with a diploma (p = 0.00, OR:3.178(1.672, 6.043)). However, the chances of readiness in those with bachelor's degrees was not significantly different from those with a diploma (p = 0.936, OR: 0.984 (0.654, 1.479)). Moreover, the chance of readiness was 1.5 higher in participants over 40 years of age compared with participants under the age of 40 (P = 0.01, OR: 1.571(1.10, 2.23)). Conclusion: According to the findings of this study, it can be concluded that there is a relatively RACP among people in Iranian society. The readiness of individuals for ACP increases by their age and education level. Therefore, by holding appropriate training intervention, we can increase the readiness of the public for ACP to improve their end-of-life outcome. [ABSTRACT FROM AUTHOR]

Introduction: Due to the type and nature of hospitalized psychiatric patients, nurses encounter many ambiguous and complex clinical situations that require intuitive decision-making. The present study was conducted to determine the use of intuition and its barriers and facilitators among psychiatric nurses. Methods: This study adopts a descriptive cross-sectional design and employs 123 nurses using convenience sampling in 2022. Demographic characteristics, the use of intuition in clinical practice, and the barriers and facilitators of intuition in clinical practice questionnaires were used for data collection. Results: The results of this study showed that the mean (SD) of intuitive decision-making among psychiatric nurses was 58 (13.07) out of a range from 25-125. The use of intuition had a statistically significant correlation with age and work experience in the psychiatry ward. The use of intuitive decision-making has a statistically significant difference in gender, work shift, and education level. The biggest barrier to the use of intuitive decision-making among psychiatric nurses was "The limitations of nursing role which restrict the use of intuition in the clinical setting". The most common facilitator in the use of intuition among psychiatric nurses was "having experience and clinical knowledge leads to the use of intuition in patient care". Conclusion: Given the low level of the use of intuition and the important role of intuitive decision-making in the quality of nursing care, nursing managers should provide some strategies for reducing the barriers to the use of intuition among nurses. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the situations and socio-economic and health-related factors associated with employment of older men and women in Vietnam. Design/methodology/approach: This study used the nationally representative data in 2019 with a sample size of 3,049 older persons (those aged 60 and over). This study applied logistic regression analyses. Findings: This study found that there were significant differences in employment rates between various groups of older men and women in terms of age group, residential place, marital status and educational level. Controlling for age, education, marital status, place of residence and (in) sufficient income for daily living, the results from logistic models indicated that health issues were strongly associated with lower probability to be employed for both genders. In all tests and regression models, that age and health condition were consistently related with lower employment probability of older persons implied an important consideration in raising normal retirement ages for both men and women. Research limitations/implications: Due to limitation of the cross-sectional data, this research could not explore how health influences older people's employment overtime. Practical implications: Findings of this research provide important and adaptive policy insights for Vietnam to take advantage of older workers for economic growth under an aging population. Originality/value: To the best of the authors' knowledge, this has been among the first studies exploring the role of health, which was presented by different indicators, determining employment of older men and women in Vietnam. [ABSTRACT FROM AUTHOR]

Background: Food insecurity significantly impacts children's health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition. Methods: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls. Results: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the "underweight" category and carbohydrates in the "wasting" category were identified as unique nutritional priorities. Conclusion: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking. [ABSTRACT FROM AUTHOR]

Background: Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregivers are often considered a population at risk of experiencing increased stress, isolation, and loneliness. During the COVID-19 pandemic in the US, social isolation and decrease in social activities were a top concern among older adults and their family caregivers. Using secondary analysis of survey data as part of a multi-site implementation trial of a caregiver skills training program, we describe differences in caregiver experiences of loneliness before and during the COVID-19 pandemic. Methods: Health and wellbeing surveys of family caregivers were collected on 422 family caregivers of veterans before and during COVID-19. Logistic regression modeling examined whether the loneliness differed between caregiver groups pre vs during COVID-19, using the UCLA 3-item loneliness measure. Rapid directed qualitative content analysis of open-ended survey questions was used to explore the context of how survey responses were affected by the COVID-19 pandemic. Results: There were no significant differences in loneliness between caregivers pre vs during COVID-19. In open-ended responses regarding effects of COVID-19, caregivers described experiencing loneliness and social isolation; why they were unaffected by the pandemic; and how caregiving equipped them with coping strategies to manage negative pandemic-related effects. Conclusion: Loneliness did not differ significantly between pre vs during COVID-19 caregivers. Future research could assess what specific characteristics are associated with caregivers who have resiliency, and identify caregivers who are more susceptible to experiencing loneliness. Understanding caregiver loneliness could assist other healthcare systems in developing and implementing caregiver support interventions. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is a serious public health issue. It is a significant but controllable factor in the emergence of cardiovascular disease. Controlling hypertension is a main target for individuals to prevent further illness. Objective: This study aims to explore the level of self-care behaviors, motivation, and self-efficacy among individuals with hypertension. Methods: A cross-sectional, descriptive, correlational design was used to recruit (n = 121) participants utilizing the Hypertension Self-Care Profile (HTN-SCP) questionnaire. Results: The analysis revealed that the mean score of self-care behavior was 49.7 (SD = 10.0) out of 20–80, which indicates that they are likely to have good self-care behavior. The mean score of motivation for self-care was 59.7 (SD = 11.8) out of 20–80, reflecting that individuals with hypertension have a good level of motivation for self-care, and the mean score of self-efficacy was 70.0 (SD = 9.8) out of 20–80, which means that individuals with hypertension have a high level of self-efficacy. Also, there was a significant positive correlation between self-care behavior and motivation for self-care (r =.527, p <.001), between motivation for self-care and self-efficacy (r =.554, p <.001), and between self-efficacy and self-care behavior (r =.572, p <.001). Conclusion: The study revealed that Jordanian patients with hypertension have good self-care practices, motivation, and high self-efficacy. Patients should therefore be strongly recommended to be compliant with self-care practices. The government should prioritize hypertensive patients by making it easier for them to receive information about self-management practices to improve their quality of care. [ABSTRACT FROM AUTHOR]

Aim: To assess the perceived health-related quality of life (HRQoL) in hospitalized patients with rheumatic diseases and to determine whether selected characteristics can affect their perceived quality of life. Design: A cross-sectional study. Methods: Data were collected between September 2022 and March 2023 using the standardized instrument to measure HRQoL, namely the RAND 36-Item Health Survey (SF-36). The sample consisted of 170 patients with rheumatic diseases hospitalized in a teaching hospital in the Czech Republic. Results: The average perceived HRQoL was 34.94 (SD = 17.06), indicating poor quality of life. The most highly rated subscale was 'emotional well-being' (56.02 ± 15.71), and the lowest rated subscale was 'role limitations due to physical health' (11.76 ± 28.54). The HRQoL subscales were significantly correlated with Mini-Mental State Examination (MMSE) score, self-care activities, pain severity, age of the patients, and length of hospitalization. Differences in HRQoL were identified based on education, social status, use of compensatory aids, attendance at social events, and history of falls in the past year (p < 0.05). Conclusion: The study contributes to the existing body of knowledge on the subject, but also underscores the importance of considering holistic factors when evaluating HRQoL in individuals with rheumatic diseases. [ABSTRACT FROM AUTHOR]

Background Socioeconomic inequalities constitute an important focus area for public health, and it has long been established that higher educational level and longer lifespan are correlated. Little is known about decennial time trends in poor self-rated health and mental distress. Methods This study linked decennial cross-sectional survey data on self-rated health and mental distress from the Trøndelag Health Study (HUNT) from 1984 to 2019 with educational registry data using personal identification numbers. Survey participation ranged from 50 807 to 77 212. Slope index of inequality (SII) and relative index of inequality (RII) were calculated using generalized linear models in Stata. Analyses were stratified by sex and age, using the age categories of 30–59 years and 60–80 years. Results Absolute inequalities in self-rated health and mental distress between educational groups have stayed relatively stable throughout all rounds of HUNT. Relative inequalities in self-rated health and mental distress have generally increased, and both men and women with the lowest education level were more likely to experience poor self-rated health and mental distress relative to those with the highest education level. RII in self-rated health increased over time for both sexes and both age groups. RII for mental distress increased in both sexes and both age groups, except for men and women aged 60–80. Discussion This study shows that relative inequalities in self-rated and mental health in the Norwegian population are still persistent and have increased. Further knowledge about groups with a disadvantageous health situation should have implications for health care resource allocation. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate coronavirus disease 2019 (COVID-19) vaccination rates and factors affecting vaccination in children with rheumatic diseases. Patients and methods: This multicenter cross-sectional survey-based study was conducted between July 2022 and September 2022. Four hundred seventy-four patients (256 females, 218 males; median age: 15 years; interquartile range, 13 to 16 years) were included in the patient group, and 211 healthy children (124 females, 87 males; median age: 15 years; interquartile range, 13 to 16 years) were included in the control group. A questionnaire was administered to the parents face-to-face during routine outpatient visits. Results: Of the patients, 220 were followed up with the diagnosis of autoinflammatory disease, 174 with juvenile idiopathic arthritis, 48 with connective tissue disease, 23 with vasculitis, eight with uveitis, and one with sarcoidosis. In the study group, 256 (54%) patients and 115 (54.5%) healthy children received at least one dose of COVID-19 vaccine. Parents' concern regarding potential side effects of the vaccine was the most common reason for COVID-19 vaccination hesitancy in both groups. The median patient age, follow-up period, colchicine treatment rates, childhood vaccination and influenza vaccination rates, median parental age, parental vaccination rate, and parental education level were higher in vaccinated patients (p<0.05 for all). In addition, vaccination rates were high in patients who shared their concerns about vaccination with the rheumatology team (p<0.001). Conclusion: Parents' concerns about safety and side effects were found to be the most important factors affecting vaccination success. Identification of the underlying causes of parental vaccine hesitancy will facilitate the development of effective vaccination strategies for potential future outbreaks. [ABSTRACT FROM AUTHOR]

Background: Fertility is a crucial component of population maintenance and growth. A declining fertility trend has been observed over the past two decades, and it continues. The birth rate in the Republic of Croatia is continuously decreasing, which is insufficient to maintain its population. Objective: This research aimed to examine the level of fertility knowledge, factors influencing fertility knowledge, and the relationship between fertility knowledge and the decision to have a child. Methods: A cross-sectional study was conducted on a sample of mothers in five hospitals on the Adriatic coast of the Republic of Croatia, involving 1541 mothers, 18 years and older, from September 2021 to December 2023. The Cardiff Fertility Knowledge Scale (CFKS) was used for the research. The participants were divided into four groups according to age. The analysis was conducted using SPSS software (version 22.0). Descriptive statistics, chi-squared tests, t-tests, and Pearson's correlations were used for the data analysis. Results: The average percent correct score on the CFKS was 51.8% (SD 22.6), with greater knowledge being significantly related to married status and higher education status (both p < 0.05). A total of 83% of mothers who have one child want to have more children. Fewer mothers who have two children want to have more children (42%), while only 11% of mothers who have three or more children want to have more children. There is no significant relationship between the CFKS and the importance of childbearing in the future (p = 0.12). Respondents indicated that they gained most of their knowledge from the internet (31%) and from the healthcare system (33%). Conclusions: The research results reveal a lack of fertility knowledge among participants, as well as an intention to have a child in the later stages of life. The lack of formal education on this topic leads to information gathering from friends, newspapers, television, and the internet. This study was not registered. [ABSTRACT FROM AUTHOR]

Background: Being aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period is often overlooked but remains a significant contributor to unintended pregnancies and may lead to maternal and neonatal comorbidities. Exploring the extent of awareness and associated factors could help tailor more interventions toward reducing the rates of short-interval unplanned pregnancies. Objective: This study explores the extent to which Ghanaian women are aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period and its associated factors. Design: A cross-sectional study was conducted using the 2017 Ghana Maternal Health Survey. The women participants were sampled using a two-stage cluster sampling design. Methods: We analyzed the 2017 Ghana Maternal Health Survey data of 8815 women who had given birth and received both antenatal care and postnatal checks after delivery in health facilities (private and public) and responded to questions on being aware of short interpregnancy intervals. A multivariable survey logistic regression was used for the analysis. Results: Of the 8815 women, approximately 62% of women who received both antenatal care and postnatal examinations before discharge reported being aware of short interpregnancy intervals. Postnatal examination before discharge but not antenatal care was associated with a higher awareness of short interpregnancy intervals. Women who received a postnatal examination were more aware of short interpregnancy intervals than their counterparts (adjusted odds ratio = 1.29, 95% confidence interval: 1.03–1.61). Also, awareness of short interpregnancy intervals increased with age, education, knowledge of the fertile period, contraceptive use, and delivery via cesarean section. Conclusion: Over a decade following the initiation of Ghana's free maternal health policy, there remains a significant gap in the awareness of short interpregnancy intervals, even among women who received both antenatal pregnancy care and postnatal examinations before discharge. The unawareness of the short interpregnancy interval observed in approximately 38% of women raises concerns about the effectiveness of counseling or education provided during antenatal care and immediate post-partum care regarding birth spacing, contraceptive use, the timing of resumption of sexual activity, and the extent to which women adhere to such guidance. Plain Language Summary: A study found more women were unaware of pregnancy soon after birth before menses Unplanned pregnancies may lead to worsened health conditions for mothers and newborn infants. One possible way this unplanned pregnancy could happen is through unknowingly becoming pregnant soon after birth before menstruation resumes. However, the more we know about pregnancy soon after birth before menstruation resumes, the better we can introduce measures to reduce it. This study examines how well Ghanaian women are aware of the possibility of becoming pregnant soon after birth before menstruation resumes and factors that may influence the awareness. This study analyzed 2017 data collected from women who received pre-delivery care and post-delivery checks before discharge from a health facility. The study findings revealed that 38% of the 8815 women who received both pre-delivery care and post-delivery checks were unaware of pregnancy soon after birth before menstruation resumed. Factors such as post-delivery checks, contraceptive use, delivery through cesarean section, women aged 30 years and over with secondary education and higher, and having knowledge of the periods more appropriate for a woman to be pregnant were more aware of pregnancy soon after birth before menstruation resumed. We proposed that effective counseling and adherence from women who are not planning to get pregnant soon after birth could help reduce the rate of pregnancy soon after birth before menstruation resumes. These unplanned pregnancies can also be avoided by educating women about birth spacing, contraceptive use, and the timing of resumption of sexual activity. [ABSTRACT FROM AUTHOR]

Aim: Investigate the influence of organizational intelligence on the development of soft skills and the overall thriving of nurses at Alexandria Main University Hospital in Egypt. Design: A cross-sectional descriptive design following STROBE guidelines examined the relationship between organizational intelligence, soft skills, and nurses' thriving. Methods and tools: Data were collected from 740 nurses working across critical care units using structured questionnaires. The questionnaires assessed organizational intelligence, soft skills, and thriving at work. Sociodemographic characteristics, including age, gender, education, and nursing experience, were also collected. Statistical analyses were used to analyze the data, including ANOVA, t-tests, Pearson correlation, and stepwise regression. Results: The findings revealed nurses' positive perceptions of organizational culture and documentation skills. However, areas such as measures and rewards and staff relations and communication indicated opportunities for improvement. Nurses reported high vitality levels but needed more learning opportunities at work. Significant correlations were found between demographic variables, organizational intelligence, soft skills, and thriving. Organizational intelligence demonstrated a robust positive relationship with both soft skills and thriving. Age, gender, education, and experience significantly influenced nurses' soft skills and thriving. Conclusion: The study highlights the importance of organizational intelligence in enhancing nurses' professional capabilities and well-being. Addressing demographic factors and fostering a supportive work environment is crucial for optimizing nursing practice and organizational effectiveness. Nursing implications: Insights from this study can inform targeted interventions and policy decisions to enhance nursing practice, organizational development, and healthcare outcomes in Egypt. Fostering organizational intelligence and soft skills among nurses can improve patient care, increase job satisfaction, and overall organizational success. [ABSTRACT FROM AUTHOR]

Purpose: To explore care requirements of older adults with urinary incontinence (UI) and contributing factors. Method: This cross-sectional study used the Older Adults Urinary Incontinence Care Needs Inventory to survey participants with UI in three large-scale tertiary hospitals located in Guangzhou City, China, from January 2023 to November 2023. Statistical analyses, including analysis of variance, t tests, correlation analyses, and linear regression models, were conducted to assess factors influencing participants' care needs. Results: A total of 530 older adults with UI participated in the survey and mean standardized score for overall care needs was 78.65 (SD = 5.01), with mean scores for each dimension ranging from 70.88 (SD = 10.55) for social participation needs to 82.45 (SD = 7.11) for health education needs. Factors that were found to influence incontinence care needs in older adults included age, literacy level, number of leaks, and type of disease (F = 37.07, adjusted R2 = 0.290, p < 0.001). Conclusion: Comprehensive care for older adults with UI, encompassing physiological, psychological, and social aspects, is crucial. It is essential to tailor care to individual needs and characteristics, taking into account factors, such as age and education, to ensure effective care. [Journal of Gerontological Nursing, 50(5), 43–49.] [ABSTRACT FROM AUTHOR]

Background: The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care. Aim: The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience. Methods: A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data. Results: The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses. Conclusions: The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern. [ABSTRACT FROM AUTHOR]

Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with 752 registered nurses and nurse practitioners recruited from a regional teaching hospital in southern Taiwan. EBP competency was evaluated using the Taipei Evidence-Based Practice Questionnaire (TEBPQ). The results showed that participation in evidence-based courses or training within the past year had the strongest association with EBP competencies (Std. B = 0.157, p < 0.001). Holding a graduate degree (Std. B = 0.151, p < 0.001), working in gynecology or pediatrics (Std. B = 0.126, p < 0.001), searching the literature in electronic databases (Std. B = 0.072, p = 0.039), and able to read academic articles in English (Std. B = 0.088, p = 0.005) were significantly associated with higher TEBPQ scores. Younger age (Std. B = −0.105, p = 0.005) and male gender (Std. B = 0.089, p = 0.010) were also identified as factors contributing to higher EBP competencies. The study highlights the importance of ongoing professional development, including EBP training and language proficiency, in enhancing EBP competencies among nursing professionals in Taiwan. [ABSTRACT FROM AUTHOR]

Introduction: Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA). Methods: This study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023. Results: The mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001). Conclusion: Health literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it. [ABSTRACT FROM AUTHOR]

Background: To enhance patient satisfaction, nurses engaged in preoperative care must possess a comprehensive understanding of the most up-to-date evidence. However, there is a notable dearth of relevant information regarding the current status of preoperative care satisfaction and its impact, despite a significant rise in the number of patients seeking surgical intervention with complex medical requirements. Objective: To assess patient satisfaction with preoperative nursing care and its associated factors in surgical procedures of, 2023. Methods: A cross-sectional study was conducted, and the data was collected from the randomly selected 468 patients who had undergone surgery during the study period. The collected data was entered into Epidata version 3.1 and analyzed using SPSS version 25 software. Results: The complete participation and response of 468 participants resulted in a response rate of 100%. Overall patient satisfaction with preoperative nursing care was 79.5%. Sex (Adjusted odds ratio (AOR): 1.14 (95% confidence interval (CI): 0.21–2.91)), payment status for treatment (AOR: 1.45 (95% CI: 0.66–2.97)), preoperative fear and anxiety (AOR: 1.01, 95% CI: 0.49–2.13)), patient expectations (AOR: 3.39, 95% CI: 2.17–7.11)), and preoperative education (AOR: 1.148, 95% CI: 0.54–2.86)) exhibited significant associations with patient satisfaction with preoperative nursing care. Conclusion: It is important to exercise caution when interpreting the level of preoperative nursing care satisfaction in this study. The significance of preoperative nursing care satisfaction lies in its reflection of healthcare quality, as even minor deficiencies in preoperative care can potentially lead to life-threatening complications, including mortality. Therefore, prioritizing the improvement of healthcare quality is essential to enhance patient satisfaction. [ABSTRACT FROM AUTHOR]

Aims: To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents. Design: A cross-sectional study design. Methods: In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage= 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis. Results: All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females. Conclusion: Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours. Impact: Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking. [ABSTRACT FROM AUTHOR]

Knowledge about insulin pen storage significantly and directly affects treatment efficacy and quality for people with type 2 diabetes mellitus. Accurate and complete understanding and practice are vital for properly managing this chronic condition. However, studies on insulin pen use and storage have not been well-researched in Vietnam. This descriptive cross-sectional study aimed to assess the knowledge of people with type 2 diabetes regarding insulin pen use and storage. Data were collected through convenience sampling from 132 people with diabetes at a provincial hospital in Vietnam from September 2022 to May 2023. We developed the Vietnamese Insulin Pen Storage Knowledge Questionnaire (VIPSKQ) based on guidelines, Addendum 1: Forum for Injection Technique and Therapy Expert Recommendations, India 2021. Data were analyzed using descriptive statistics, the Chi-square test, and binary logistic regression. Results indicated that only 35.6% of participants had good knowledge of insulin pen storage, whereas 64.4% did not. Four factors that affected the participants' understanding of insulin-pen storage were age, education level, duration of diagnosis, and years of treatment for diabetes mellitus. Nurses need to educate people with diabetes to increase their knowledge and skills of insulin pen use and proper storage using various strategies, such as using videos, phone applications, and monitoring their practice regularly. Nurses must also keep abreast of the latest information on insulin treatment modalities and pen storage guidelines. Our questionnaire shows promise for use in practice but needs further testing in different settings with larger groups of individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Existing studies have identified specific factors influencing some dimensions of evidence-based practice (EBP) competence and use. However, the way these factors interact still needs to be clarified. The purpose of the study was to test a model based on the Determinant Frameworks that explain the relationships and the direct pathways between the characteristics of the nurses, the context, and the implementation strategies and the dimensions of EBP competence, attitude, knowledge, skills, and use of EBP. A cross-sectional study was carried out in Spain during January and February 2020, involving 2,370 nurses employed in public health centers across all autonomous communities within the National Health System. An online survey was administered to gather data, addressing various topics related to the nurses' characteristics, the context in which they worked, the implementation strategy, and their competence in evidence-based practice (EBP). As depicted in the conceptual framework, a structural equation model was constructed to test the hypothesized relationships among key study variables. The model obtained showed a good fit (χ2/df = 3.20, p < 0.001 ; RMSEA = 0.030 [90% CI 0.025, 0.036]; CFI = 0.989; GFI = 0.990; TLI = 0.983). The context, more specifically, the dimensions of nurse participation in the center's affairs, nursing foundations for quality of care, nurse manager ability leadership and support of nurses, and implementation strategy have a direct and positive effect on EBP use. Training in EBP, reading scientific articles, and having a doctorate are associated with higher competence and knowledge in EBP. The final fit shows the #Evidencer model for the use of EBP (#EvidencerMUSEBP) with two main components: the contextual and strategic factors that influence the implementation of EBP and the characteristics of the professionals, such as their training and reading of articles, which have an impact on EBP competence. This model could guide healthcare organizations in proposing comprehensive interventions to improve EBP use and the competency of nurses. [ABSTRACT FROM AUTHOR]

Introduction: The deterioration of white matter pathways is one of the hallmarks of the ageing brain. In theory, this decrease in structural integrity leads to disconnection between regions of brain networks and thus to altered functional connectivity and a decrease in cognitive abilities. However, in many studies, associations between structural and functional connectivity are rather weak or not observed at all. System segregation, defined as the extent of partitioning between different resting state networks has increasingly gained attention in recent years as a new metric for functional changes in the aging brain. Yet there is a shortage of previous reports describing the association of structural integrity and functional segregation. Methods: Therefore, we used a large a large sample of 2,657 participants from the Hamburg City Health Study, a prospective population-based study including participants aged 46-78 years from the metropolitan region Hamburg, Germany. We reconstructed structural and functional connectomes to analyze whether there is an association between age-related differences in structural connectivity and functional segregation, and whether this association is stronger than between structural connectivity and functional connectivity. In a second step, we investigated the relationship between functional segregation and executive cognitive function and tested whether this association is stronger than that between functional connectivity and executive cognitive function. Results: We found a significant age-independent association between decreasing structural connectivity and decreasing functional segregation across the brain. In addition, decreasing functional segregation showed an association with decreasing executive cognitive function. On the contrary, no such association was observed between functional connectivity and structural connectivity or executive function. Discussion: These results indicate that the segregation metric is a more sensitive biomarker of cognitive ageing than functional connectivity at the global level and offers a unique and more complementary network-based explanation. [ABSTRACT FROM AUTHOR]

Background: Caring for individuals with mental disorders poses significant challenges for caregivers, often leading to compromised quality of life and mental health issues such as stress, anxiety, and depression. This study aims to assess the extent of these challenges among caregivers in Greece, identifying which demographic factors influence their well-being. Method: A total of 157 caregivers were surveyed using the SF-12 Health Survey for quality-of-life assessment and the DASS-21 questionnaire for evaluating stress, anxiety, and depression symptoms. t-tests, Kruskal–Wallis tests, Pearson's correlation coefficients, and regression analyses were applied to understand the associations between demographics, quality of life, and mental health outcomes. Results: The study found that caregivers, especially women and younger individuals, faced high levels of mental health challenges. Marital status, educational level, and employment status also significantly influenced caregivers' well-being. Depression was the most significant factor negatively correlating with the mental component of quality of life. The magnitude of the burden experienced by caregivers highlighted the urgency for targeted social and financial support, as well as strategic treatment programs that consider caregiver well-being. Conclusions: Caregivers of individuals with mental disorders endure significant stress, anxiety, and depression, influencing their quality of life. Demographic factors such as age, gender, marital status, education, and employment status have notable impacts. Findings emphasize the need for society-wide recognition of caregivers' roles and the creation of comprehensive support and intervention programs to alleviate their burden, particularly in the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Highly active antiretroviral therapy (HAART) has improved the life expectancy of people living with HIV (PLWH) and has increased the risk of chronic non-communicable diseases. Comorbid HIV and diabetes mellitus (DM) significantly increase cardiovascular disease and mortality risk. This study aimed to determine the prevalence of type 2 diabetes mellitus among HIV-positive patients receiving HAART in Zimbabwe and its associated risk factors. Methods: This cross-sectional study was conducted at eight primary healthcare facilities in Harare, Zimbabwe, between January 2022 and March 2023. Non-probability convenience sampling was used to recruit adult HIV-positive patients undergoing HAART attending the facilities. Data were captured on clinical history and socio-demographic and behavioral characteristics, and analyzed using descriptive statistics to determine DM prevalence rates. Additionally, bivariate and multivariate logistic regression models were employed to examine factors associated with HIV and DM comorbidities. Results: A total of 450 participants were included in this study, of which 57.6% (n = 259) were female. The majority were married (73.8%) and older than 35 years (80.2%). Most participants had completed high school (87.6%) and 68.9% were employed either formally or self-employed. The prevalence of diabetes mellitus (DM) was 14.9%. HIV/DM comorbidity was more prevalent in patients who were female, self-employed, and smoked (p < 0.05). Multivariate logistic regression analysis revealed that the factors associated with DM-HIV comorbidity were gender, age, education, marital status, employment status, smoking, physical activities, duration of HAART, and diet. Age, level of education, marital status, and occupation were not associated with HIV-DM comorbidity. Obesity (body mass index > 30 kg/m2), smoking, and alcohol consumption were associated with an increased risk of DM. Regular physical activity is associated with a reduced risk of DM. Conclusion: A substantial burden of DM was found in PLWH. The intersectoral integration approach is advocated, and active screening for DM is recommended. Gender-specific interventions are necessary to target diseases and health behaviors that differ between men and women. These interventions should be customized to the specific diseases and behaviors of each group. [ABSTRACT FROM AUTHOR]

Background: Families with children diagnosed with ADHD often experience elevated levels of stress compared to families with typically developing children. This stress manifests in various forms including family conflicts, disciplinary challenges, financial strain, parental depression, and difficulties in marital relationships. Objectives: The objective was to assess parenting stress, coping, and resilience among parents of children with ADHD, as well as the psychosocial problems of children with ADHD as reported by parents. Method and Materials: his descriptive cross-sectional study was conducted at the Child Guidance Clinic, Psychiatry Department, Government Medical College & Hospital, Chandigarh. It included 40 consecutive mothers of children diagnosed with ADHD according to DSM-5 criteria, aged 6 to 14 years, fluent in Hindi or English, and residing with their child. Exclusion criteria comprised major medical or psychiatric illnesses, specific learning disabilities (SLD), and comorbid disabilities in children, as well as significant psychiatric or medical illnesses, disabilities, or substance dependencies (excluding nicotine) in mothers, and multiple family members with major disabilities. Assessment tools used were the Socio-demographic and Clinical Data Sheet, Chandigarh Parent Related Stress Scale (CPRSS), Bref-COPE, The Connor-Davidson Resilience Scale (CD-RISC), Screening Tool for Assessment of Psychosocial Problems (STAPP), and Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS). Result: The study revealed high levels of stress among mothers of children with ADHD, who employed a range of coping strategies including instrumental support, active coping, and planning, as well as emotional support, acceptance, positive reframing, and religious coping. Some also used maladaptive strategies like behavioural disengagement, venting, and self-blame. Participants showed a moderate level of resilience, with mild overall problems noted. Issues related to financial resources and high expressed emotion were most prevalent, followed by challenges with medication/treatment compliance and social support. Conclusion: This study underscores the need for increased focus on supporting parents in ADHD management, informing the development of comprehensive psychosocial intervention programs. [ABSTRACT FROM AUTHOR]

Background: Urban slum dwellers face significant challenges, including overcrowded living conditions, inadequate access to basic necessities, and limited socio-economic opportunities, which adversely affect their mental health. Despite the high prevalence of mental health issues in slum populations, there is a dearth of research addressing this aspect of well-being. Aim: This study aimed to investigate the social determinants and predictors of mental health among urban slum dwellers in Rohtak, Haryana, India. Material and Methods: The study employed a cross-sectional design to examine mental health status and predictors among urban slum dwellers in District Rohtak, Haryana. Using simple random sampling, 301 subjects from the slum area were selected, ensuring demographic representation. A socio-demographic data sheet, the Modified Kuppuswamy scale, and the Mithila Mental Health Status Inventory were administered. Results: The findings revealed a moderate level of mental health challenges among urban slum dwellers, with age, gender, education, occupation, family income, and socioeconomic status identified as the strongest predictors of mental health (F = 7.69, p < .001), accounting for 29.9% of the variance. The remaining variance is attributed to variables not included in the study. Conclusion: This study sheds light on the social determinants and predictors of mental health among urban slum dwellers in Rohtak, Haryana, India. The findings underscore the significant impact of socio-demographic factors such as age, gender, education, occupation, family income, and socioeconomic status on mental health status. [ABSTRACT FROM AUTHOR]

Purpose: The phenomenon of social withdrawal, known as the hikikomori-like idiom of distress (HLID), has been reported in many countries. This study aimed to explore profiles of Omanis who have HLID. Design/methodology/approach: A cross-sectional online survey of 673 out of 1,529 Omanis identified with HLID using the Hikikomori Questionnaire (HQ-25) score of 42+. Findings: Two profile groups were determined through cluster analysis according to socio-demographic and HQ-25 outcomes. Subjects in cluster 1 (n = 168, 24.9%) are significantly younger (p < 0.001) and more educated (p = 0.019), spend more time online (p < 0.001) and are living alone (p < 0.001) than subjects in cluster 2 (n = 505, 75.1%). More subjects in cluster 1 had a past mental illness (p = 0.037) but less previous childhood physical/emotional abuse (p = 0.029) than subjects in cluster 2. In contrast, subjects in cluster 2 had a low lack of socialization (p < 0.001), less active isolation (p < 0.001) and total HQ-25 scores (p < 0.001) than cluster 1. Subjects in Cluster 1 have more serious social withdrawal issues than those in Cluster 2, especially on a lack of socialization and isolation. Research limitations/implications: One limitation that might influence the results of this online study was that information was collected via self-report, and a cross-sectional design limits its results because it cannot assess causal inference. This study has contributed valuably to exploring different profile groups of HDLD, especially in the Arabian Gulf. The authors' findings facilitate the development by creating innovative interventions strategically tackling different hikikomori groups. Originality/value: While social withdrawal characterized by HLID has been reported proliferating in different parts of the world, little research has been forthcoming from Arabian Gulf countries. These findings suggest that there are two orthogonal clusters of HLID among Omanis. This study provides a foundation for further research on HLID, which has recently been reported in different parts of the world. [ABSTRACT FROM AUTHOR]

Understanding the attitudes of medical staff contributes to shaping a culture of safety in health care. The aim of this study was the measurement of attitudes of nurses and midwives towards reporting clinical adverse events. Various research tools were used, including the Reporting of Clinical Adverse Events Scale (RoCAES; Polish: P-RoCAES), the Justice Sensitivity Inventory, the Feelings in Moral Situations Scale, the Perceived Stress at Work Scale and the Author's Survey Questionnaire. The cross-sectional survey was conducted from October 2022 to April 2023. The study used assessment-based sampling. The study included 745 midwives and nurses working in internal medicine—surgical wards in nine hospitals in a large provincial city in Poland. One-way analysis of variance ANOVA, post hoc test (Fisher's NIR), and r-Spearman correlation test were used. The level of significance (p) did not exceed 0.05. Respondents did not differ in terms of sensitivity to justice, moral feelings, and perceived stress at work, all of which variables were at moderate levels. Respondents' attitudes towards reporting clinical adverse events in the P-RoCAES were positive (surgical nurses 71.10; internal medicine nurses 72.04; midwives 71.26; F(2.741) = 1.14, p = 0.319), especially those with a master's degree, longer work experience and older age. Respondents with a master's degree were most likely to perceive a benefit from reporting adverse events (P-RoCAES subscale) (F(2.737) = 8.45, p = 0.001). The longer employment tenure (F(3.716) = 4.63, p = 0.003) and having a master's degree (F(2.737) = 3.10, p = 0.045) were associated with a higher feeling of guilt among the respondents (P-RoCAES subscale). The longer the participants worked, the more positive their attitude became towards the importance of transparency in procedures (F(2.741) = 3.56, p = 0.029), but the more negative their attitude was towards the benefits of reporting adverse events (P-RoCAES subscale) (r(686) = −0.08, p = 0.037). Individual attitudes of nurses and midwives as well as their age, length of service or education can influence the formation of a culture of safety in health care (including the reporting of clinical adverse events). Attitudes can motivate corrective action, can be reinforced and shaped by educational programs, good quality management and monitoring system solutions. [ABSTRACT FROM AUTHOR]

Purpose: Schools have long been perceived as an ideal setting to support the healthy eating behaviours of children. The aim of the study was to examine the views of Australian primary school parents regarding school food and nutrition, including education, practices and policy. Design/methodology/approach: An online survey was conducted among 787 parents in March 2021, which included closed and open-ended questions. Findings: The results indicated the inconsistent implementation of policies and/or varying practices among different schools. Parents' views were slightly associated with some demographic and personal measures including their SES levels, education, age, the main language spoken at home and universalism values. Parents viewed healthy food provision through canteens, policies and informing parents, fruit and vegetable breaks and kitchen and garden programs as the main contributors to the promotion of healthy eating. They believed unhealthy options in canteens, school fairs, events and birthdays are the major contributors to the formation of unhealthy eating habits among children at schools. Results revealed the efforts to establish health promoting school food environments in Australian primary schools; however, inconsistencies and discrepancies among schools should be addressed to ensure equity among all children. Practical implications: The findings may provide directions for policymakers and school managers and can inform future reforms and initiatives in Australian primary schools and elsewhere. Originality/value: This is the first study that has examined Australian parents' views of school food policy, practices and environments using a mixed-methods design. [ABSTRACT FROM AUTHOR]

Introduction: Identifying patterns of human immunodeficiency viruses (HIV) transmission and factors affecting it can help to prevent and control the disease. The present study aimed to identify the latent classes of HIV risk factors in Iran. Material and methods: This cross-sectional study was conducted among 32,168 HIV patients. We fitted latent class analysis by considering 11 indicators. Models with 2 to 5 classes were fitted, and the best-fitted model was chosen based on Acaik information critical (AIC), Bayesian information criterion (BIC), entropy, and interpretability of the results. Additionally, multinomial logistic regression model was applied to assess relationships between the covariates and latent class membership. Results: We identified 3 latent classes, including low-risk (41.35%), high-risk (50.28%), and moderaterisk (8.37%) classes. The moderate-risk class was most likely prison history (69.09%) and addiction (67.37%). The high-risk class included addiction (99.68%), injection drugs users (IDUs) (99.06%), prison history (86.27%), and sharing needles (79.64%). Older age and being single increased the odds of membership in high-risk class (OR: 1.021, 95% CI: 1.017-1.024%; OR: 1.34, 95% CI: 1.20-1.50%), respectively, while older age increased the odds of membership in classes of moderaterisk (OR: 1.028, 95% CI: 1.023-1.033%) compared with low-risk group (p < 0.05). The odds of membership in classes of high-risk (OR: 0.011, 95% CI: 0.010-0.013%) and moderate-risk (OR: 0.113, 95% CI: 0.098-0.131%) were significantly lower in women than in men compared with low-risk group (p < 0.05). Conclusions: Injection drugs users, drug addiction, sharing needles, and prison history are related to HIV infection in Iran. Moreover, older age, female gender, low education, and being single increase the odds of membership in high-risk classes. These findings highlight the need for preventive interventions and harm reduction programs for people at risk. [ABSTRACT FROM AUTHOR]