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Background: Health care staff should be given the opportunity to participate in research, but recruiting clinicians via their employing organisation is not always straightforward or quick in the UK. Unlike many countries outside the UK, very low-risk survey, interview or focus group studies can be subject to some of the same governance approval procedures as interventional studies. An exemplar study carried out by the NIHR funded Palliative Care Research Partnership North West Coast is used to highlight the challenges still faced by researchers and health care organisations when setting up a low-risk staff study across multiple NHS and non-NHS sites. Methods: A study database was created and information was collected on the first point of contact with the clinical site, Health Research Authority (HRA) and local organisational approval times, time from trust or hospice agreement to the first survey participant recruited and overall site survey recruitment numbers. Descriptive statistics (median, range) were used to analyse these data. Results: Across participating NHS trusts, it took a median of 147.5 days (range 99–195) from initial contact with the local collaborator to recruitment of the first survey participant and hospice sites mirrored these lengthy timescales (median 142 days, range 110–202). The lengthiest delays in the HRA approval process were the period between asking NHS trusts to assess whether they had capacity and capability to support the research and them granting local agreement. Local approval times varied between trusts and settings which may indicate organisations are applying national complex guidance differently. Conclusions: There is the potential for HRA processes to use more NHS resources than the research study itself when recruiting to a low-risk staff study across multiple organisations. There is a need to reduce unnecessary administrative burden and bureaucracy to give clinicians and research staff more opportunities to participate in research, and to free up NHS R&D departments, research nurses and clinicians to focus on more demanding and patient focused research studies. Hospices need standardised guidance on how to assess the risk of being involved in low-risk research without adopting the unnecessarily complex systems that are currently used within the NHS. [ABSTRACT FROM AUTHOR]

Background: Participant non-response is a source of bias in all research, especially in randomised controlled trials. Participants followed up remotely can have high non-response rates. Four such trials have been conducted of a cover letter with content informed by behaviour change theory to overcome hypothesised barriers to responding to a mailed questionnaire. Pooled results to date have suggested further research to be worthwhile. We conducted an embedded randomised study within a trial of such cover letters in the hope that we would improve response rates to our postal quality of life questionnaires. Methods: One hundred forty-eight participants in the CODIFI2 diabetic foot ulcer sampling trial were randomised 1:1 to receive one of two different cover letters at follow-up timepoints: either a standard cover letter accompanying their postal follow-up questionnaires or to an 'enhanced' (theory-informed) cover letter. Questionnaires were mailed at 39, 52 and (for some participants) 104 weeks post randomisation. Outcome measures were response to mailing at each timepoint. Analysis was restricted to those for whom a questionnaire and letter was issued. Owing to limited recruitment, a reduced analysis plan, comprising solely observed response rates and 95% confidence intervals for difference in response rates was followed. Post hoc, we added our week 52 results to an already-published meta-analysis. Results: Sixty-seven out of 74 enhanced cover letter group (Enhanced) and 67/74 standard cover letter group (Standard) participants who had not already died or withdrawn were sent their first mailing at 39 weeks. The 39-week response rates were 47/67 (70.1%) and 39/67 (58.2%) for Enhanced and Standard participants, respectively. At week 52, the response rates were 45/64 (70.3%) and 35/63 (55.6%) for Enhanced and Standard participants, respectively. At week 104, the response rates were 24/33 (72.7%) and 19/33 (57.6%) for the Enhanced and Standard participants, respectively. Adding our week 52 results to a published meta-analysis increased the pooled estimate of differences in response rates to 0.04 (− 0.01 to 0.09) favouring enhanced letters. Conclusion: While this embedded randomised controlled trial observed greater response rates at all times among those randomised to the enhanced letter, the reduced sample size meant that these results are imprecise. Trial registration: ISRCTN registry ISRCTN74929588. Registered on 5 March 2019. [ABSTRACT FROM AUTHOR]

Background: This in vitro study investigated whether full-guided (FG) or half-guided (HG) implant placement is more suitable for beginners and to what extent the use of the coDiagnostiX (CDX) (10.5, Straumann Group, Basel, Switzerland) implant planning software proves useful in teaching. Methods: Twenty students planned implant positions with CDX which were then placed in a model using printed drill templates in the sense of FG implantation (group 1) and HG implantation (group 2). The implant positions could be compared with those of the reference model, and deviations could be determined. The results were tested for significance using the t-test for independent samples for groups 1 and 2. A total of 32 students subsequently completed a questionnaire about the software. Cronbach's α was also calculated to check the reliability of the questions for the individual subject areas. Results: In both groups the greatest deviation occurred along the y-axis in the vestibular direction. It measured 1.390 mm in group 1 and 1.570 mm in group 2. Comparing both groups, there were significant deviations along the y-axis (p =.013), along the z-axis (p =.049), and in the total deviation (p =.031). The questionnaire was evaluated in design, with 95% positive answers. In contrast, the evaluation of the area of time and effort resulted in only 55% positive responses. Overall, experience with the software was rated as positive by 74%. Conclusions: Group 1 achieved more accurate results, especially along the y-axis in the vestibular direction. In both groups, the implants were placed too deep. The questionnaire indicated a software with high usability and is therefore very suitable for teaching. If clinically feasible, beginners should prefer full-guided implant placement. [ABSTRACT FROM AUTHOR]

Background: Preoperative emotional distress has been linked to adverse health outcomes, diminished quality of life, increased symptom burden after surgery, and poorer postoperative outcomes. Therefore, this study aimed to assess the impact of perioperative emotional distress on the long-term outcomes of patients undergoing colorectal surgery. Methods: We conducted a follow-up study of a previously conducted observational study of colorectal surgery patients who underwent surgery at the University Medical Centre Freiburg, Germany, between April 2018 and February 2020. Initially, all the patients completed a multidimensional mood questionnaire (MDMQ) preoperatively and on postoperative days 3, 6, and 9. From June to November 2021, these patients were contacted again to capture the results of MDMQ at least one year after surgery and to assess the rate of late complications, quality of life, dietary changes, and overall health. Results: Of the original 80 patients, 51 took part in the follow-up study (55% female, on average 59 years old), on average 30 months after the operation. The average mood results of the surgical patients returned to those of the normal population. Most patients (80%) did not feel that their quality of life was affected by the surgery. Satisfaction with the surgical outcome averaged 8.5 out of 10, while current health was rated at 6.8 out of 10. Emotional distress levels varied over time, with mood and arousal improving significantly postoperatively. Late complications were reported by 28% of the patients, but there were no significant differences in the MDMQ scores, health status, or satisfaction between those with and without complications. Conclusions: The results indicate that there is no association between the emotional strain measured by the MDMQ and the occurrence of late postoperative complications. [ABSTRACT FROM AUTHOR]

AbstractAimMethodsResultsConclusionThis study aimed to develop the Participation Questionnaire for Preschoolers (PQP) and validate its psychometric properties as a disability-specific tool designed to assess participation in preschool-aged children with autism spectrum disorder (ASD).This cross-sectional study recruited caregivers of 412 children, including those diagnosed with ASD and those at risk for neurodevelopmental disorders. Participants were recruited from child development facilities, medical institutions, and developmental support websites across Japan. Data from 287 children diagnosed with ASD were analyzed for item reduction, followed by exploratory factor analysis and the calculation of Cronbach’s alpha to evaluate internal consistency. Five hypotheses were tested to assess construct validity.Item reduction resulted in the removal of seven items and the identification of four factors: Friendship and Education, Family Satisfaction, Daily Living and Independence, and Leisure and Community Life. Cronbach’s alpha values for these factors ranged from 0.74 to 0.88, indicating acceptable internal consistency. Three of the five hypotheses related to construct validity were supported, aligning with expectations.The PQP exhibited structural validity, internal consistency, and construct validity. However, further longitudinal studies are needed to validate its measurement properties over time. [ABSTRACT FROM AUTHOR]

Aims: To test the Triangle of Human Ecology by examining associations between unipolar depression and different measures of human biological factors, health behaviour, and the physical environment. Methods: Data originate from the third wave of the Nord-Trøndelag Health Study (2006–2008). The survey was based on a random sample of 50,000 Norwegians (response rate: 54%). Logistic regression was performed, using unipolar depression, measured with the Hospital Anxiety and Depression Scale score, as outcome variable and 38 explanatory variables. Results: Biological factors including older age and male gender were associated with higher odds of depression, as were behavioural factors including drinking behaviour and having a neurotic personality. Reduced odds were associated with units of alcohol consumed, extrovert personality and physical activity. Social networks were an environmental factor with reduced odds at both personal and neighbourhood levels, as was warmer outdoor temperatures. Conclusions: Using the Triangle of Human Ecology provides a holistic insight into how behaviour, biology and the environment influence mental health. [ABSTRACT FROM AUTHOR]

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Background: The number of validated questionnaires that assess the level of breastfeeding competence of primary care professionals who attend lactating mothers is limited. Research Aim: To validate the CAPA (Competència en l'Atenció Primària sobre Alletament [Breastfeeding Competence in Primary Care]) questionnaire into Spanish in collaboration with professionals from the primary care services of the Comunidad de Madrid (Spain). Methods: In this multicentric study, four bilingual healthcare professionals translated the CAPA questionnaire into Spanish and back-translated it into Catalan. The cross-cultural adaptation included a discussion by an expert committee, a review by a philologist, and a pilot study that involved 13 healthcare residents. We randomly selected professionals from specialties involved in breastfeeding. The re-test was conducted 3 weeks later, aiming to avoid changes in the studied population. We performed a factor analysis to identify underlying constructs and hypothesis-testing to assess the validity of the questionnaire and estimated the Cronbach Alpha and intraclass correlation coefficient (ICC) to assess its reliability. Results: A total of 198 professionals participated by responding to the questionnaire. Factorial analysis showed that the questionnaire was unidimensional. Hypothesis testing showed that, of all the considered professional groups, midwives achieved the highest mean score (M = 131.7, SD = 10.9, p < 0.001). Amongst the other professionals, only 26.5% achieved a basic level of breastfeeding competence. The Cronbach alpha and ICC were 0.852 (95% CI [0.821, 0.880]) and 0.890 (95% CI [0.800. 0.937]). Conclusions: The Spanish CAPA questionnaire is a valid and reliable tool for assessing breastfeeding basic competence among primary care professional groups who attend lactating mothers. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusions Judicious antimicrobial use is essential for the continued treatment of infections in small and mixed animal veterinary medicine. To better support Washington (WA) State veterinarians in antimicrobial stewardship, we surveyed licensed small and mixed animal veterinarians and led group conversations regarding antimicrobial prescription practices.Survey questions included demographic information, factors influencing prescription practices and clinical cases. Responses were summarised and logistic regressions were performed to identify factors associated with antibiotic treatment choices. Group conversations, led by a licensed veterinarian, focused on resource gaps for veterinarians, management of clinical scenarios and interpretation of minimum inhibitory concentrations (MICs) and breakpoints. A systematic qualitative analysis of conversation transcripts identified key themes such as common barriers to stewardship.Among 53 responses to clinical scenarios, veterinarians selected the most appropriate treatment choice, according to a veterinary microbiologist, 62% of the time. Variability was observed in culture and susceptibility practices and antibiotic choices. Survey respondents reported an influence of the client ability to medicate (92%), considerations of resistance (91%), client finances (75%) and availability of antimicrobials (75%) on their prescription decisions. There were no significant associations between opinions about contributing factors to antimicrobial resistance (AMR) or guidelines used and treatment choices in clinical scenarios. Among 15 veterinarians interviewed in group conversations, a systematic qualitative analysis of conversation transcripts revealed key themes, including reliance on human medicine as a resource and a lack of support for veterinarians in interpreting MICs and breakpoints.The variability in veterinary antibiotic treatment decisions in this study suggests a need for further dissemination of standardised antimicrobial stewardship resources for veterinarians. Client‐related challenges and the cost of culture and susceptibility are major barriers to stewardship. To address these barriers, it is necessary to provide standardised, easy‐to‐access guidance for veterinarians in interpreting MICs and breakpoints, as well as develop antimicrobial use resources for clients. [ABSTRACT FROM AUTHOR]

Aim: Patients with metastatic breast cancer (MBC) may be vulnerable to changes in healthcare management, safety standards and protocols that occurred during the COVID-19 pandemic. Materials & methods: The REthink Access to Care & Treatment (REACT) survey assessed USA-based patient perspectives on COVID-19-related impacts to their MBC treatment experience between 27 April 2021 and 17 August 2021. Results: Participants (n = 341; 98.5% females, mean age 50.8 years) reported that overall oncology treatment quality was maintained during the pandemic. Delayed/canceled diagnostic imaging was reported by 44.9% of participants while telemedicine uptake was high among participants (80%). Conclusion: Overall, MBC care was minimally affected by the pandemic, possibly due to the expanded use of telemedicine, informing MBC management for future public health emergencies. Plain Language Summary The COVID-19 pandemic has forced healthcare providers to change the way that healthcare is delivered. These changes could particularly affect people with metastatic breast cancer (MBC), an advanced stage of cancer that has spread to other parts of the body. The authors of this study used a web-based survey to ask 341 volunteers with MBC how the pandemic has affected their cancer treatment. The authors found that people with MBC thought that the quality of their care stayed the same during the pandemic. Most people (80%) surveyed were able to use telemedicine, the remote delivery of care by phone or computer, to replace in-person visits to their doctor. However, almost half of people surveyed reported delays or cancellation of their diagnostic imaging appointments. Overall, this study shows that the COVID-19 pandemic did not affect peoples' opinions of their MBC care. Increased use of telemedicine may have contributed to the lack of disruption in care. These findings will help guide MBC care during future public health emergencies. Tweetable abstract A survey of patient perspectives on their care for metastatic breast cancer during the COVID-19 pandemic has shown consistent quality of care. Care delivery adaptations such as telemedicine may be key to maintaining cancer care quality during future public health emergencies. Substantial changes in healthcare management, safety standards and protocols occurred during the COVID-19 pandemic. Patients with metastatic breast cancer (MBC) are particularly at risk of pandemic-related negative consequences due to the need for clinical visits, multimodal therapies, potential immunosuppression and compromised support services. This cross-sectional study used a two-part REthink Access to Care & Treatment (REACT) survey to assess the perspective of patients with MBC on the effects of COVID-19 with regards to their MBC treatment experience. Data from 341 validated participants (98.5% females; mean age 50.8 years) revealed that patient-reported overall quality of oncology treatment remained about the same during the pandemic. Telemedicine uptake was high among participants (80%); replacement of in-person visits with telemedicine was the most reported change to regular clinical checkups and mental health visits due to the pandemic. However, 44.9% of participants reported that diagnostic imaging appointments were either delayed or canceled. During the pandemic, 48.1% of participants reported disease progression. Overall, participants perceived that the management and treatment of their MBC were minimally disrupted by the pandemic, likely due in part to the utilization of telemedicine. While these findings can inform MBC management decisions during future public health crises, future studies should solicit perceptions of care from more diverse patient populations. [ABSTRACT FROM AUTHOR]

Background: Evidence-based medicine is defined as searching for medical information, reviewing and comparing it to each patient's situation, and then judging the optimal decision. We aimed to measure the psychometric properties of the Evidence-Based Performance Profile (EBP2) Questionnaire among the students of health-related fields at Shiraz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2021. The EBP2 questionnaire, which includes 74 five-Likert-scale items, was translated into the Persian language using the forward-backward translation method. A panel of five experts approved the face, content, and structural validity of the questionnaire. The Cronbach's alpha and McDonald's Omega coefficients were utilized to assess the questionnaire's internal consistency. Furthermore, both confirmatory and exploratory factor analyses were used to assess the questionnaire's construct validity. SPSS software version 25 and LISREL software version 8.8 were used for statistical analysis. Results: Overall, 339 students participated in this study. The cultural adaptability, linguistic equivalence, and content validity of the Persian version of the EBP2 questionnaire were approved by a five-member team of medical experts. In addition, the results showed excellent internal consistency of the Persian version of the EBP2 questionnaire (Cronbach's alpha = 0.962, McDonald's Omega (ML) = 0.963). Moreover, all domains had acceptable reliability (> 0.7), except the Practice domain which had a marginally acceptable Cronbach's alpha coefficient equal to 0.686. Exploratory factor analysis discovered six domains for the questionnaire. Moreover, the confirmatory factor analysis demonstrated that all indices except the comparative fit index (CFI) and adjusted goodness of fit (AGFI) confirmed the validity of the EBP2 questionnaire. Conclusion: The study's findings indicate that the Persian translated of the EBP2 questionnaire exhibited satisfactory validity and reliability for assessing students' evidence-based performance in health-related fields. [ABSTRACT FROM AUTHOR]

Introduction Aim Methods Results Conclusions The Child Hemophilia Treatment Experience Measure (Child Hemo‐TEM) was developed to capture the treatment burden experience of children with haemophilia (CwH).Describe the development of this novel haemophilia‐specific measure.Interviews were conducted with clinical experts, CwH and CwH's caregivers. Interviews were analysed according to adapted grounded theory principles. Based on the analysis, a preliminary measure was developed and debriefed. Psychometric analyses were performed according to an a priori analysis plan using data collected in a cross‐sectional web survey and a final measure was generated.Interviews with four clinical experts, 25 CwH ages 8 to <12 years, and 25 caregivers of CwH <12 years were conducted. Concepts endorsed by ≥10% of CwH and caregivers were: adherence, ease of use, emotional impacts, physical impacts, treatment concerns, and interference with daily life. Cognitive debriefing assessments were conducted to ensure participant understanding and item relevance. Caregivers found the measure to be understandable, comprehensive, and relevant. However, several issues with CwH completing the measure were identified and it was decided to only develop an observer‐reported outcome version. Data for psychometric validation was collected in a web survey (N = 187). Item reduction dropped 12 items. Factor analysis generated a single, 7‐item, internally consistent (α = .855) factor, which consisted of items covering all relevant a priori concepts. The majority of a priori convergent and all known groups validity hypotheses were confirmed.The study findings provide evidence that the Child Hemo‐TEM is a brief, well‐designed, and valid and reliable measure of haemophilia treatment burden. [ABSTRACT FROM AUTHOR]

In order to assess the perceptions and expectations of the radiology staff about artificial intelligence (AI), we conducted an online survey among ESR members (January–March 2024). It was designed considering that conducted in 2018, updated according to recent advancements and emerging topics, consisting of seven questions regarding demographics and professional background and 28 AI questions. Of 28,000 members contacted, 572 (2%) completed the survey. AI impact was predominantly expected on breast and oncologic imaging, primarily involving CT, mammography, and MRI, and in the detection of abnormalities in asymptomatic subjects. About half of responders did not foresee an impact of AI on job opportunities. For 273/572 respondents (48%), AI-only reports would not be accepted by patients; and 242/572 respondents (42%) think that the use of AI systems will not change the relationship between the radiological team and the patient. According to 255/572 respondents (45%), radiologists will take responsibility for any AI output that may influence clinical decision-making. Of 572 respondents, 274 (48%) are currently using AI, 153 (27%) are not, and 145 (25%) are planning to do so. In conclusion, ESR members declare familiarity with AI technologies, as well as recognition of their potential benefits and challenges. Compared to the 2018 survey, the perception of AI's impact on job opportunities is in general slightly less optimistic (more positive from AI users/researchers), while the radiologist's responsibility for AI outputs is confirmed. The use of large language models is declared not only limited to research, highlighting the need for education in AI and its regulations. Critical relevance statement: This study critically evaluates the current impact of AI on radiology, revealing significant usage patterns and clinical implications, thereby guiding future integration strategies to enhance efficiency and patient care in clinical radiology. Key Points: The survey examines ESR member's views about the impact of AI on radiology practice. AI use is relevant in CT and MRI, with varying impacts on job roles. AI tools enhance clinical efficiency but require radiologist oversight for patient acceptance. [ABSTRACT FROM AUTHOR]

Background/Aims NOVAponin, a functional health food derived from Dolichos lablab Linne extract improves gastric mucosal injury and increases regeneration and proliferation. This study aims to investigate the efficacy and safety of NOVAponin in individuals with mild functional dyspepsia (FD). Methods In this single-center, double-blind, randomized clinical trial, 131 patients with FD meeting the Rome IV criteria were enrolled. Changes in the gastrointestinal symptom rating scale (GSRS), FD-related quality of life (FD-QoL), gastrointestinal symptom (GIS) scores, inflammatory and anti-inflammatory markers, and adverse effects before and after administration were compared. Results After 12 weeks of administration, GSRS upper abdominal symptom scores were significantly improved in the test group compared to the control group (–5.30 ± 0.60 vs –2.35 ± 0.56, P < 0.001). GSRS upper abdominal symptom scores (–5.13 ± 0.55 vs –1.92 ± 0.44, P < 0.001), GSRS total scores (–7.02 ± 0.91 vs –3.33 ± 0.73, P < 0.001), GIS total scores (–11.21 ± 0.53 vs –6.65 ± 0.70, P < 0.001) after 6 weeks of administration, GSRS total scores (–7.54 ± 0.94 v. –3.31 ± 0.85, P < 0.001), GIS total scores (–11.90 ± 0.52 vs –7.61 ± 0.73, P < 0.001), and FD-QoL total scores (–11.41 ± 1.75 vs –5.55 ± 1.20, P = 0.007) after 12 weeks of administration also showed significant differences between groups. The differences were slightly more pronounced in epigastric pain syndrome subtypes and in females than the others, although more females were assigned to the test group. There were no significant changes in inflammatory and anti-inflammatory markers or adverse reactions. Conclusion NOVAponin significantly improved mild FD symptoms especially in epigastric pain syndrome subtype and in females, and was found to be safe. [ABSTRACT FROM AUTHOR]

Background/Aim. Despite the demanding nature of their roles in community pharmacies and their critical importance to patient safety, healthcare professionals, including pharmacists, are often not covered by the Resilience Scale. Therefore, the aim of the study was to develop and validate a resilience scale specifically tailored for pharmacists working in community pharmacies. Methods. The study involved the development and validation of a scale aimed at assessing psychological resilience among community pharmacists. The domains and items of the scale were considered from the aspect of reviewing the available literature. Content validation by subject matter experts and subsequent computation of the content validity index ensured the scale's content validity. Face validity assessment ensured alignment with the intended construct. The final scale was distributed to a sample of 504 community pharmacists, after which the scale was analyzed using statistical methods such as factor analysis, multiple regression, and reliability analysis. Additionally, test-retest reliability analysis was performed on 80 community pharmacists. Results. During the brainstorming sessions and focus groups, 95 items were generated within five domains -- Confidence, Agility, Coping with stress, Interpersonal relations, and Developmental thinking. Following expert review and rigorous content and face validity analyses, 30 items with Content Validity Index and Face Validity Index values surpassing 0.80 were retained. The scale exhibited strong internal consistency, with Cronbach's alpha exceeding 0.9. Factor analysis confirmed the five-factor structure, with each component displaying high factor loadings and significant variable loadings on only one component. Conclusion. The Resilience Scale emerged as a promising tool for assessing community pharmacists' resilience, demonstrating robust psychometric properties. The study contributed validity evidence concerning content and internal structure, thereby enhancing the scale's credibility in evaluating resilience domains within the pharmacy profession. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) have gained increased importance in assessing outcomes after reconstructive surgery. This also applies to the reconstruction of vulvoperineal defects after resection of gynecological or colorectal cancers in women. The objective of this study is to analyze the current state of PROM tool use within this patient population. Methods: By systematic literature searches in Embase, Medline, and Web of Science, English-language studies published after 1980, including randomized controlled trials, cohort studies, and case series reporting on vulvoperineal defect reconstruction, which were included if they also analyzed quality of life (QoL) and/or PROMs. The PROM tools used by each study were extracted, analyzed, and compared. Results: The primary search yielded 2576 abstracts, of which 395 articles were retrieved in full text. Of these, 50 reported on vulvoperineal defect reconstruction, among which 27 studies analyzing QoL were found. Of those, 17 met the inclusion criteria for this systematic review. After full-text screening, 14 different PROM tools and 5 individual, non-standardized questionnaires were identified. Only 22% of studies used a validated PROM tool. Conclusion: Far too few studies currently use PROM tools to assess outcomes in oncological vulvoperineal defect reconstruction. Less than half of the used PROMs are validated. No PROM was designed to specifically measure QoL in this patient population. The standardized implementation of a validated PROM tool in the clinical treatment of this patient population is an essential step to improve outcomes, enable the comparison of research, and support evidence-based treatment approaches. [ABSTRACT FROM AUTHOR]

COVID‐19 infection among pregnant women results in more severe symptoms and higher mortality rates. No comprehensive health literacy for protection against COVID‐19 among pregnant women has been available for general use in Thailand. This cross‐sectional study aimed to develop and examine an instrument for measuring health literacy of prevention COVID‐19 infection among pregnant women (HLS‐P). A total of 321 pregnant women aged older than 20 years were participated in this study, Selected through multistage cluster sampling, between September 2021 and January 2022. Data were collected using structured questions that included sociodemographic characteristics and the health literacy scale for protecting against COVID‐19 (HLS‐P) developed by the researchers. The content and construct validity of the health literacy scale were examined. Exploratory factor analysis performed with principal component analysis and Varimax rotation. Confirmatory factor analysis was conducted using IBM SPSS AMOS 26. The model fitting was evaluated using several indices namely root mean square error of approximation, normed fit index, comparative fit index, and goodness‐of‐fit index. The reliability of the scale was evaluated using Cronbach's alpha and item total correlation. As a results of exploratory factor analysis of the scale, 31 items were loaded which indicated a 6‐factors for the scale that collectively explained 62.59% of total variance. Confirmatory factor analysis also indicated a good fit to the six latent structures with root mean square error of approximation 0.03, normed fit index 0.94, comparative fit index 0.97, and goodness‐of‐fit index 0.91. Internal consistency reliability was satisfactory with Cronbach's alpha coefficient of 0.94 and the item‐total correlation between 0.34 and 0.86. The overall scale was sufficiently reliable. As a result, the HLS‐P is a reliable and relevant measure for assessing health literacy in pregnant women. Thus, this scale is profoundly used as an evaluation tool for measuring health literacy among pregnant women, providing critical information for healthcare professionals and policymakers about the health literacy needs and capacity of service receivers. [ABSTRACT FROM AUTHOR]

Objective: This study examined patient and healthcare provider (HCP) perspectives on the impact of unmet social needs on healthcare barriers for patients with vasculitis. Methods: Two surveys were developed to gather perspectives from patients with vasculitis, and HCPs specializing in vasculitis care. The patient survey also included a 20-question social needs assessment. The data were analyzed using descriptive statistics. Results: One hundred patients and 31 HCPs completed the surveys between September 2022 and June 2023. Fifty-six percent of patients reported unmet social needs, with poor social and mental health (30%) being the most common. Sixty-three percent of patients with vasculitis perceived unmet social need(s) as barriers to healthcare access. Financial insecurity (30%), poor mental health (29%), and poor health knowledge (25%) were the most common barriers identified. Overall, HCPs perceived SDOH have a greater impact on healthcare access than the patients surveyed. Most patients (82%) and HCPs (90%) believed rheumatologists should help in the management of SDOH, specifically health knowledge and mental health. Few HCPs (10%) felt well-positioned to address patients' mental health. Suggested interventions that address social needs and improve healthcare access included referrals to community-based resources, providing educational materials, and virtual visits. Conclusion: Through patient and HCP perspectives, the impact of SDOH on healthcare access for patients with vasculitis was explored. Understanding the positive experiences and challenges faced by patients is crucial for developing targeted interventions to enhance healthcare access. These findings underscore the importance of ongoing efforts to improve the healthcare experience for patients with vasculitis. Key Points • The impact of unmet social needs on healthcare access for patients with vasculitis, illustrates the complex relationship between SDOH and healthcare outcomes. • Unmet social needs among patients with vasculitis, included poor social and mental health, financial and food insecurity, and a lack of health literacy, which may exacerbate challenges leading to poor health outcomes. • The differences in perspectives between patients and healthcare providers regarding the impact of certain SDOH on healthcare access, necessitates the importance of co-production in the development of interventions to improve healthcare delivery. • The importance of patient-centered care and tailored solutions was highlighted by the need for various interventions to address social needs and improve healthcare access, such as referrals to community-based resources, educational materials, and interprofessional collaboration. [ABSTRACT FROM AUTHOR]

Background & Objective: Mentorship is essential for medical undergraduates' professional and personal development to enhance soft skills, knowledge, and academic performance. The present study analyzed the mentee's feedback about the program. Material & Methods: The present cross-sectional (retrospective) study, approved by the ethics committee, was conducted between January and March 2022. One hundred fifty feedback forms (open and closed-ended questions) of 2016-2019 MBBS students (at the end of one and a half years of implementation) were analyzed. Data were represented as mean ± SD and median. Qualitative data was coded and analyzed descriptively. Results: 58% and 50.66% of mentees agreed on easy approachability and communication with mentors. 52.67 % agreed strongly, and 52% agreed that mentors listened actively to their problems and provided constructive feedback. 68.67% agreed and 56.67% agreed strongly that important lessons about personal, college, and career life were learned. 78.66% agreed that research motivation was provided. 71, 33%, and 60% agreed that mentoring helped improve academics and develop a conceptual learning style. 70% and 51.33% agreed that mentors helped them solve medical life problems and develop skills (communication, interpersonal, and humane values). 46.66% agreed that mentors encouraged them to participate in sports or extracurricular activities. 52% agreed strongly that their mentors had a professional attitude, 47.33% agreed mentors were beneficial to them, and 46.67% agreed strongly to recommend their mentors for future professional and personal development activities. Open-ended analysis showed that, in decreasing order, the most beneficial developmental activities performed with their mentors were problem-solving (40.56%), guidance, counseling (34.26%), and soft skill development (13.85%). Menttes considered time constraints a hurdle and suggested scheduled, regular meetings and the use of social media for the program's effectiveness. Conclusion: Regular feedback, evaluation, and perceptions of mentees are vital for the mentorship program. [ABSTRACT FROM AUTHOR]

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations. Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects women of childbearing age and has been reported to cause sexual dysfunction in women. Although there are articles on sexual function in women with SLE, the number of articles is small, and the factors affecting sexual function in women with SLE are controversial. Based on this, this study aimed to investigate the prevalence of sexual dysfunction in Chinese female SLE patients and to explore the factors that influence it. The study design was a cross-sectional study conducted from December 2023 to April 2024 in the Department of Rheumatology and Immunology of a tertiary hospital in Hefei, Anhui Province. A total of 293 female patients diagnosed with SLE were enrolled using face-to-face questionnaires and online questionnaires. The questionnaire consisted of four parts: general information questionnaire, fatigue severity scale (FSS), depression-anxiety-stress scale (DASS-21), and female sexual functioning index (FSFI) scale. A total of 173 (59.04%) patients had sexual dysfunction, including 251 (85.67%) with decreased libido and 186 (63.46%) with difficulty in sexual arousal. There was a correlation between the patients' total FSFI scores and age (p = 0.028), marital satisfaction (p < 0.001), own education level (p = 0.008), partner's education level (p = 0.003), place of residence (p = 0.039), monthly household income (p < 0.001), family financial satisfaction(p < 0.001), menstrual status (p = 0.003), hormone use (p = 0.021),immunosuppressant use (p = 0.042), disease activity (p = 0.016), FSS score (p < 0.001), stress score (p < 0.001), anxiety score (p < 0.001) and depression score (p < 0.001)were correlated. The results of stepwise regression analysis showed that marital satisfaction (b = 2.011, t = 3.797, p < 0.001), monthly household income (b = 0.854, t = 2.316, p = 0.021), menstrual status (b = 1.218, t = 2.350, p = 0.019), fatigue scale score (b = − 0.069, t = − 2.302, p = 0.022), and depression score (b = − 0.117, t = − 2.910, p = 0.004) were the influencing factors of FSFI total score, and the difference was statistically significant. The incidence of sexual dysfunction in Chinese female SLE patients is high, and medical personnel should pay more attention to patients' sexual problems, to provide theoretical and practical bases for further prevention, treatment, and care of sexual dysfunction in female SLE patients. [ABSTRACT FROM AUTHOR]

Introduction: Muscle biopsy plays an important role in the diagnostic evaluation of individuals with suspected idiopathic inflammatory myopathies (IIM). However, variability in biopsy practices may result in a heterogenous patient experience. The existing literature offers limited insights into the experiences and perspectives of patients undergoing muscle biopsy. Methods: This study employed a 27-item online survey to comprehensively characterise the experience of muscle biopsy among Australian patients, including their concerns, beliefs about procedure utility, information sources, physical sensations, perceived complications and recovery. Results: A total of 111 Australian individuals who reported a diagnosis of IIM completed the survey, with data collected from March to June 2023. Most participants had inclusion body myositis (76/111, 68.5%) and had undergone one biopsy procedure (87/111, 78.4%) as part of their IIM work-up. Nine of the 111 respondents did not undergo a muscle biopsy. The procedure was well-tolerated by many respondents, however, a notable number of respondents experienced post-procedural pain lasting > 72 h (27/102, 26.5%), increasing weakness post-biopsy (13.7%), numbness at the biopsy site (18/102, 17.6%) and a recovery time beyond 3 days (36/102, 35.3%). A substantial minority (30/111, 27%) felt they were inadequately informed about the risks and benefits of the procedure. Conclusions: This survey highlights that although muscle biopsy is often well-tolerated, there are considerable patient concerns that are often inadequately addressed. Our findings underscore the need for improved patient-doctor communication and support throughout the biopsy process. [ABSTRACT FROM AUTHOR]

Sexual dysfunction (SD) has been associated with worse quality of life and higher disease activity in patients with rheumatic diseases, yet it is still not regularly addressed during routine rheumatologic evaluations. This study aimed to determine the prevalence of sexual dysfunction in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and evaluate their perception of their sexual health. We performed a retrospective study in an outpatient rheumatology clinic to evaluate patients over 18 years old with a diagnosis of RA or SLE through the Spanish version of the Arizona Sexual Experiences Scale (ASEX) and the Sexual Health Perception Survey (SHEPS), a questionnaire of 6 items designed in our clinic. Additionally, we applied the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F version 4) and the Hospital Anxiety and Depression Scale (HADS). A total of 567 patients were evaluated with SHEPS, most of whom were women with a median age of 50 years (IQR: 34) and a median disease duration of 5 years (IQR: 9). Through the ASEX, we found that 67% of the patients with RA and 60% of the patients with SLE experienced SD. Patients reported the level of sex drive, arousal, and the ability to achieve orgasms as the areas with the most difficulties. Most patients did not know their disease could affect their sexuality and had never addressed these issues with their rheumatologists, but almost all of them were willing to. Our findings highlight the importance of addressing sexual health issues regularly during rheumatologic evaluations. [ABSTRACT FROM AUTHOR]

This study analyzed the status of medical information acquisition through social media (SM) and its impact on healthcare utilization among patients with rheumatic diseases (RDs) who visited the rheumatology department of a tertiary hospital. We consecutively evaluated 102 patients with RDs in this single-center cross-sectional survey. Using a face-to-face survey, patients were asked about the sources they used to acquire medical information, factors influencing their visits to tertiary hospitals, and the potential impact of acquiring medical information on RDs through SM. SM refers to YouTube, Facebook, Instagram, Kakao Channel, Naver Band, and X. The mean age was 42.3 years and 39% were female. The most common disease was ankylosing spondylitis (45.1%), followed by rheumatoid arthritis (20.6%). The most frequent method for acquiring medical information regarding RDs, except for rheumatologists, was internet portal sites (47.8%), followed by SM (40.2%). The most important factor influencing the decision to visit a tertiary hospital was medical doctors (51%); only 1% of the patients responded that SM was the most crucial factor in determining their visit. Most patients (77.5%) responded that acquiring medical information through SM would help them manage their diseases. Our data revealed that a substantial proportion of patients with RDs obtained medical information through SM. However, the impact of SM on visiting a tertiary hospital was minimal, suggesting that SM has become a mainstream source of medical information, yet the reliability of SM remains relatively low. Rheumatology societies should establish SM platforms capable of providing high-quality medical information. [ABSTRACT FROM AUTHOR]

This study examined how track cycling coaches, practitioners, and athletes: develop knowledge and practices; value performance areas; and, implement research into practice. Cross-sectional survey. An online REDCap survey of track cycling coaches, practitioners, and athletes was conducted involving questions related to demographics, performance area importance, knowledge acquisition and application, research relevance, and research direction. A total of 159 responses were received from coaches (n = 55), practitioners (n = 29), and athletes (n = 75). Participants' highest track cycling competition level involvement ranged from local/regional (12.7%) to Olympic/Paralympic (39.9%). Respondents primarily develop practices by observing 'the sport' or 'others competing/working in it' (both 85.8%). Practitioners develop practices through self-guided learning (96.4%). The primary reason for practice use was prior experience (84.9%), whilst individuals were least likely to use practices resulting in marginal gains with potentially negative outcomes (27.3%). Areas of greatest perceived importance were Aerodynamics, Strength & Conditioning, and Tactics (all > 96% agreed/strongly agreed). Scientific evidence for Tactics (30%) and Mental Skills (26%) was perceived to be lacking, resulting in greater reliance on personal experience (74% and 62%, respectively) to inform training decisions. The main barrier to implementing research into practice was athlete buy-in (84.3%). Within track cycling, informal learning was most popular amongst respondents. Greater reliance on personal experience within evidence-based practice for many performance areas aligns with limited existing research. Most respondents reported multiple barriers affecting research implementation in practice. [ABSTRACT FROM AUTHOR]

Periodontal diseases have been reported to be lifestyle-related and associated with metabolic syndrome (MetS). The introduction of dental checkups in a health checkup program may create a synergistic effect and aid the prevention of MetS. In Japan, a chewing function questionnaire has now been introduced into the national health checkup program. The purpose of this study was to investigate whether the questionnaire reflects dental and oral conditions and whether it helps improve general and oral health. A total of 6599 subjects who underwent health checkups or guidance specified by the National Health Insurance of Japan for two consecutive years were included. A single comprehensive question to evaluate masticatory function was asked. Medical and dental examinations and insurance data were collected and used for analysis. In terms of masticatory function during chewing, 82.3% of subjects experienced no problems, 17.3% experienced some difficulty, and 0.4% experienced severe problems. There was a significant relationship between the questionnaire response and dental examinations results for several items of examination. The overall dental consultation rate after health screening was 42.3%. Improvement in periodontal disease was achieved in those who reported some problems with chewing function. Improvement in blood pressure was also observed in those who reported some problem with chewing function and subsequently had a dental consultation. The results of this study indicate that questionnaires on masticatory function reflect the status of dental and oral health. In addition, the results suggested that questionnaire results are potentially linked to improvement in dental and oral health status, and improvement in MetS. [ABSTRACT FROM AUTHOR]

This study investigated the ethical landscape of aging research amid the increasing global focus on extending the human lifespan and health span. Our global survey of 180 researchers across 38 jurisdictions revealed divergent perceptions of aging, a consensus regarding the feasibility of delaying aging, and multiple perspectives regarding lifespan extension. The present findings underscore a paradigm shift toward inclusive and ethically sound research, emphasizing the need for an approach that strikes a balance between basic and clinical research. In addition, this study highlighted key ethical concerns in aging research, including the effects of misleading advertising, potential inequality in access to aging interventions, and risks pertaining to the extrapolation of research findings from lower-model organisms to humans. The insights presented in this paper call for an integrated approach for overcoming the complex ethical and societal challenges in aging research to ensure responsible and equitable advancements in this burgeoning field. [ABSTRACT FROM AUTHOR]

Introduction: Artificial Intelligence (AI) is becoming an essential part of modern radiology. However, available evidence highlights issues in the real-world applicability of AI tools and mixed radiologists' acceptance. We aimed to develop and validate a questionnaire to evaluate the attitude of radiologists toward radiology AI (ATRAI-14). Materials and Methods: We generated items based on the European Society of Radiology questionnaire. Item reduction yielded 23 items, 12 of which contribute to scoring. The items were allocated into four domains ("Familiarity", "Trust", "Implementation Perspective", and "Hopes and Fears") and a part related to the respondent's demographics and professional background. As a pre-test method, we conducted cognitive interviews with 20 radiologists. Pilot testing with reliability and validity assessment was carried out on a representative sample of 90 respondents. Construct validity was assessed via confirmatory factor analysis (CFA). Results: CFA confirmed the feasibility of four domains structure. ATRAI-14 demonstrated acceptable internal consistency (Cronbach's Alpha 0.78 95%CI [0.68, 0.83]), good test–retest reliability (ICC = 0.89, 95% CI [0.67, 0.96], p-value < 0.05), and acceptable criterion validity (Spearman's rho 0.73, p-value < 0.001). Conclusions: The questionnaire is useful for providing detailed AI acceptance measurements for making management decisions when implementing AI in radiology. [ABSTRACT FROM AUTHOR]

Purpose: Understanding patients' motives for undergoing metabolic and bariatric surgery (MBS) is key to managing postoperative expectations. We aimed to translate and validate the 14-item European Obesity Academy Questionnaire on Expectations about Surgical Treatment (EOAQ-EST) to Brazilian Portuguese for research and clinical use. Materials and Methods: This study included a total of 198 candidates for MBS at a reference academic hospital in Brazil from January 2021 to February 2022. We followed Beaton and Bombardier's guidelines for translation and cultural adaptation, including translation, back-translation, comparative analysis, expert review, pilot testing, and the creation of the final version of the questionnaire. Reliability was tested with McDonald's omega, and internal validity was assessed using confirmatory factor analysis (CFA). Results: The final version was applied to 161 patients, 85% female, with a mean age of 46.4 ± 10.3 years and a mean BMI of 48.3 ± 8.2 kg/m2. Validity was supported by a bifactorial model (95% CI 0.044–0.104, p = 0.08), excluding one item (improved fertility) due to a floor effect. The reliability analysis showed that the 13 remaining items were internally consistent, with a McDonald's ω of 0.625. Conclusions: The Brazilian-Portuguese version of EOAQ-EST proved to be user-friendly, consistent, and reliable. This questionnaire may assist multidisciplinary teams in effectively addressing patients' expectations concerning metabolic and bariatric surgery (MBS) outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion Socioeconomic deprivation is a known risk factor for head and neck cancer (HNC). Despite this, there is no current way to acknowledge this in two‐week wait (2WW) referrals. 2WW HNC referrals have continually risen, and a self‐reporting questionnaire was trialled with referrals to the ear, nose and throat (ENT) department with suspected HNC, allowing additional triage information not included in referrals to be obtained.Patients referred through the 2WW pathway for HNC between February 2021 and March 2022 were asked to complete an electronic self‐reporting symptom questionnaire. The vetting process resulted in the referral being accepted or regraded to less urgent referral streams. Scottish Index of Multiple Deprivation (SIMD) quintiles were derived using the online postcode checker tool.A total of 984 2WW referrals were retrospectively reviewed. The questionnaire was completed by 717 (72.9%) patients. Regrading of urgency resulted in 292 (29.7%) 2WW appointments not required. Of those regraded, 264 (90.4%) patients completed the questionnaire. A significantly greater number of patients (p = 0.03) from SIMD 4 and SIMD 5 were regraded (33.3%) compared to SIMD 1 and SIMD 2 (26.4%). Patients who did not complete the questionnaire had a higher median age (61.0 years, range: 17–96, IQR: 25.0) compared to those who completed the questionnaire (56.0 years, range: 17–88, IQR: 23.5, p < 0.001).A self‐reported symptom questionnaire can help rebalance urgent appointments to those with genuine red flag symptoms. This in turn reduces social inequality in 2WW referrals and reduces the number of inappropriate 2WW appointments. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionsThe Activities-specific Balance Confidence Scale was developed for testing the balance confidence of elderly individuals, and it has been used extensively for evaluating various patients. No such scale has been adapted for the Hungarian population.To translate and culturally adapt the Activities-specific Balance Confidence Scale and test the reliability and validity of the Hungarian version.The study included 167 independently mobile subjects, of whom 39 filled in the questionnaire twice, 1 week apart. Beaton’s six-step principle was applied for cross-cultural adaptation. Reliability was assessed by internal consistency measured by Cronbach's alpha and through test–retest analysis. Types of validity evaluated were concurrent validity using the Berg Balance Scale and cross-cultural validity.Excellent internal consistency was shown by Cronbach’s alpha = 0.977. Test–retest analysis resulted in an Intra-Class Correlation Coefficient of 0.962 (0.865–0.961, 95% CI, p < .001) for the whole test; no floor or ceiling effects were found. The convergent validity of the scale was tested by Spearman’s rank correlation analysis using the Berg Balance scale for external validation and showed a strong positive correlation (Rho = 0.755, p < .001). Receiver Operating Characteristic curve analysis showed an Area Under the Curve of 0.821 (CI 95% 0.75, 0.892). Mean detectable change based on the 95% confidence interval was 10.49% on the scale ranging from 0 to 100%.The Hungarian version of the Activities-Specific Balance Confidence Scale provides a valid and reliable picture of the patients’ self-assessed balance. It is recommended both for clinicians and for clinical studies. [ABSTRACT FROM AUTHOR]

This study aimed to assess medical students' knowledge and attitudes towards artificial intelligence (AI) models and their potential role in medical education and healthcare. A cross-sectional study was conducted among 398 students of Ondokuz Mayıs University Medical Faculty using an online questionnaire administered through Google Forms. Participants' awareness of AI applications, their usage patterns, and their opinions on AI's role in medical education were evaluated. The study found extensive awareness of AI applications among participants, with ChatGPT being the most recognized (%95). The majority of students believed that AI models could benefit medical education and assist in diagnosis and treatment when collaborating with doctors. However, concerns were raised regarding the potential for incorrect results, patient safety, and ethical issues. While students recognized the potential of AI-supported education to enhance learning motivation, they expressed concerns about its impact on creativity. Significant differences were found between classes regarding the acceptance of the proposition that artificial intelligence models will take over our profession in the future (p=0.001). Participants aware of AI applications exhibited a higher agreement rate with the proposition that AI-assisted education is more advantageous than traditional methods (p=0.022). Medical students recognize the potential benefits of AI models in clinical practice and medical education but also highlight concerns about ethical considerations and potential limitations. These findings emphasize the importance of a balanced approach to integrating AI into medical education and practice. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the trend in human papillomavirus (HPV) vaccination rates in Japan before and after a policy change in 2022, involving resumption of active recommendation and start of catch‐up vaccination. Methods: From 2021 to 2023, a web‐based questionnaire survey was administered to newly enrolled female college students in Yokohama, Japan. The questionnaire included items such as age, HPV vaccination status, HPV vaccine awareness, and awareness of catch‐up vaccination. We compared knowledge about the HPV vaccine and cervical cancer in 2021 and 2023, before and after resumption of the national vaccination program. Results: The HPV vaccination rates were 5.4% in 2021, 7.5% in 2022, and 35.3% in 2023, with a significant upward trend (p < 0.001). A similar upward trend was observed for HPV vaccine awareness (p < 0.001). Comparing 2022 and 2023 after the start of catch‐up vaccination, there was no significant difference in awareness of catch‐up vaccination (p = 0.669), but there was a significant increase in awareness of free vaccination tickets (p < 0.001). After resumption of the national vaccination program with adoption of the catch‐up vaccination program, there was no difference in knowledge of cervical cancer, but there was a difference in knowledge of the HPV vaccine. Conclusions: Although the HPV vaccination rate has increased after the policy change, it has not recovered to the level before the suspension of active recommendation. It is important for healthcare providers and school educators to actively communicate the safety and effectiveness of the HPV vaccine. [ABSTRACT FROM AUTHOR]

Background/Aim. Quality of life (QoL) is one of the outcome measures for patients with chronic diseases. Mental health issues often impact the QoL of cancer patients. Cancer patients with a good QoL have a longer life expectancy and are able to lead a more productive and social life. The aim of the study was to determine the association of mental health with the QoL, as well as to determine significant predictors of QoL in patients with breast cancer (BC). Methods. The study included 118 patients treated at the Specialized Breast Cancer Department of the Oncology Clinic of the University Clinical Center Niš, Serbia. The study's inclusion criteria were the presence of early-stage nonmetastatic BC and completed surgical treatment. The following questionnaires were used: the general sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS), Buss-Perry Aggression Questionnaire, Early Maladaptive Schema questionnaire - short form (SQ-SF), Flanagan's Quality of Life Scale (QoLS), Holmes and Rahe Stress Scale, Berlin Social Support Scales (BSSS), Health Locus of Control. Results. A statistically significant negative correlation was found with emotional state, i.e., anxiety score, depressiveness score, total stress score, and physical aggression score, while QoL correlated positively with all subscales of the perceived social support (PSS) questionnaire. QoL was significantly different for patients with the following early maladaptive schemas: emotional deprivation, emotional inhibition, and a sense of entitlement/narcissism. Moreover, QoL differed significantly depending on partnership status, the presence of clinically significant anxiety, the presence of hormone-sensitive cancer, the presence of human epidermal growth factor receptor 2 (HER2)-positive cancer, and time since diagnosis. Multiple linear regression was performed, and depression and PSS had the highest share. Conclusion. In our study, the presence of depressiveness and PSS were the best predictors of QoL of BC survivors. [ABSTRACT FROM AUTHOR]

Background: Physiotherapists' attitudes and beliefs play a crucial role in the management and treatment outcomes of non‐specific neck pain (NSNP). Objective: To investigate the attitudes and beliefs of physiotherapists in Jordan towards NSNP, and to identify factors influencing these attitudes and beliefs. Methods: A Cross‐sectional survey of registered physiotherapists working in Jordan was conducted. A structured questionnaire was used to assess the attitudes and beliefs of physiotherapists towards NSNP. Descriptive and inferential statistics were used. Results: A total of 301 PTs completed the survey, 155 females (51.56%). Most respondents held bachelor's degrees, with an average of 9.5 ± 6.6 experience years. The total score for PABS‐PT (Z = 11.4, p < 0.001) and its BM (Z = +11.9, p < 0.001) and PS (Z = 3.6, p < 0. 001) subscales were significantly positive. The score of the biomedical subscale was more significantly positive than psychosocial subscale. The treatment orientation was positively correlated with education level, and negatively with age and experience. The most reported treatments were manual therapy followed by general exercises and electrical modalities. No significant relationship was observed between treatment orientation and treatment selection. Conclusion: This study created the initial profile for pain attitudes and beliefs in Jordan. Physiotherapists hold positive attitudes and beliefs towards the NSNP treatment orientations with a superiority of the BM approach. Engaging educational sectors and stakeholders in the current situation of PTs' attitudes and beliefs is important. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population. Methods: Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach's alpha coefficient), and test–retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales. Results: A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach's alpha values 0.60–0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61–0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms. Conclusions: The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders. [ABSTRACT FROM AUTHOR]

Priority-setting is a collective responsibility centred around inclusive engagement and alignment with the needs and desired outcomes of the community. In this study, we leveraged the collective expertise of stakeholders from the child and family service system, to identify priorities for supporting the health, education and wellbeing of children and families living in Logan, Queensland. A pragmatic approach combining a modified nominal group technique and consensus methodology was undertaken. Key system factors were identified and consolidated into 10 priority areas, which were ranked via an online questionnaire. The top three priority areas were identified by the service system as (i) early family and child support programs, (ii) support and resourcing of existing services, and (iii) recognition and support of a diverse community. These results present an opportunity to leverage the local knowledge and expertise of the service system to design solutions that address the greatest challenges for children and families in place. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the internal consistency of Stanford Social Dimensions Scale (SSDS) translated to Serbian and to test it against the Strengths and Difficulties Questionnaire (SDQ). The sample consisted of 200 patients (32% ASD) of the Institute of Mental Health in Belgrade, Serbia (68 females, 132 males, Mage=9.61, SDage=4.06). Internal consistency coefficients were within good/acceptable range for Social Motivation, Affiliation, Recognition and Unusual Approach subscales and below acceptable for Expressive Social Communication subscale. The non-autistic group scored higher on all subscales compared to the ASD group. All SSDS subscales positively correlated with SDQ Prosocial Behaviors scale. The SSDS is a valuable instrument for accessing sociobehavioral phenotype in both individuals on the autism spectrum and non-autistic individuals. [ABSTRACT FROM AUTHOR]

Background: This study developed a short version of a scale measuring attitudes toward people living with dementia, the Four‐Item Attitudes toward People Living with Dementia Scale (APDS4), that could be included in a large population survey. Methods: We used three datasets from Japan: a web panel survey, a community‐based mail survey, and data from a randomised controlled trial on dementia education. The original scale used was the Attitudes toward People Living with Dementia Scale developed by Kim and Kuroda. Test–retest reliability and item response theory analyses were used to reduce the number of items. The reliability, internal consistency, validity, and responsiveness of the short version were evaluated. Results: Six items with low test–retest reliability and four items with low discrimination parameters were removed from the 14‐item scale. The APDS4, consisting of four items, had test–retest reliability and internal consistency comparable to those of the original scale. Confirmatory factor analysis indicated that the APDS4 fit a unidimensional model. The validity of the APDS4 was confirmed by significant associations between the APDS4 scores and the original scale scores, knowledge of dementia, helping behaviour intentions toward people living with dementia, helping behaviour experience, attending the Dementia Supporter Training Course, and engagement in healthcare jobs. In a randomised controlled trial dataset, the APDS4 was more responsive to educational interventions than the original scale. Conclusion: The shortened APDS4 was established as a reliable, validated, and responsive scale. This scale can be used efficiently in population surveys to evaluate dementia‐friendly initiatives at the community level. [ABSTRACT FROM AUTHOR]

• Objective assessment of sleep during three trimesters in pregnancy was conducted. • Sleep efficiency was the worst in the third trimester of pregnancy. • Total sleep time was the shortest in the third trimester of pregnancy. • Positive correlation existed between sleep efficiency and back pain and leg cramps. • Sleep problems significantly increased as the pregnancy progressed. Studies on actual circumstances of sleep in pregnant women are limited to surveys of self-reported symptoms, and objective assessments are missing. Sleep disturbances due to hormonal imbalances are common during pregnancy. This study aimed to assess sleep quality by objective assessment using an actigraph and by self-reported assessment using a questionnaire for sleep during each trimester of pregnancy and to elucidate how sleep quality changed from the first to the third trimester of pregnancy. A longitudinal questionnaire survey was administered and sleep measurements using an actigraph were recorded at three time points during the first, second, and third trimesters in primiparous women who had conceived naturally. During the first trimester, "feeling of being refreshed when waking up in the morning" was not noted, and a decline was observed in mental function. During the second trimester, a positive correlation was observed between morning sickness and sleep quality. Sleep quality was the worst during the third trimester, with the shortest total sleep time and poor sleep efficiency, along with poor physical function scores. Back pain and leg cramps significantly correlated with sleep efficiency in the third trimester. Poor sleep during pregnancy begins in the first trimester. If minor problems, such as morning sickness, continue in the second trimester, sleep quality is greatly affected. Furthermore, during the third trimester of pregnancy, low back pain and leg cramps are more likely to occur due to an increase in the abdominal area and may interfere with sleep. [ABSTRACT FROM AUTHOR]

Background: Self‐reported measures of periodontitis developed for use in population surveillance are increasingly used in causal research. Numerous studies evaluate the validity of these measures against clinical parameters of periodontitis, yet few include validation parameters outside of multivariable models. Individual item validity is necessary to adequately inform use of these measures in causal research. Methods: We used data from the National Health and Nutrition Examination Survey 2011‐2014 in which dentate participants completed full‐mouth periodontal examinations (N = 6966). We evaluated six self‐report questionnaire items related to periodontal disease status against periodontitis case definitions developed by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC‐AAP). We estimated the sensitivity and specificity of individual items using severe and moderate‐to‐severe periodontitis classifications. We additionally combined items to evaluate the validity of joint measures. Results: Sensitivity was highest when measures were evaluated against severe periodontitis. Self‐rated oral health of fair/poor demonstrated the highest sensitivity for severe (0.60) and moderate‐to‐severe periodontitis (0.48). Specificity was highest when evaluated against moderate‐to‐severe periodontitis, with self‐reported history of tooth mobility as the most specific measure (0.87 for severe disease; 0.92 for moderate‐to‐severe) followed by a history of bone loss (0.88 for severe; 0.91 for moderate‐to‐severe). Combining questions generally improved specificity at the expense of sensitivity. Conclusions: Our findings related to item‐specific validity and the associated clinical profiles facilitate needed considerations for the use of self‐reported measures of periodontitis in causal research. Additionally, item‐specific validity can be used to inform assessments of misclassification bias within such investigations. [ABSTRACT FROM AUTHOR]

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences. [ABSTRACT FROM AUTHOR]

Consumer and community involvement (also referred to as patient and public involvement) in health-related curricula involves actively partnering with people with lived experience of health and social care systems. While health professions education has a long history of interaction with patients or consumers, a shift in the way consumer and community engage in health-related education has created novel opportunities for mutual relationships valuing lived experience expertise and shifting traditional education power relations. Drawing on a mixed methods design, we explored consumer and community involvement practices in the design and delivery of health-related education using the capability, opportunity, motivation and behaviour framework (COM-B). In our results, we describe educator capabilities, opportunities and motivations, including identifying barriers and enablers to consumer and community involvement in health-related education. Educators have varying philosophical reasons and approaches for involving consumers and community. There is a focus on augmenting student learning through inclusion of lived and living experience, and on mutual transformative learning through embedding lived experience and co-creating learning. How these philosophical positionings and motivations shape the degree by which educators involve consumers and community members in health-related curricula is important for further understanding these educational partnerships within universities. [ABSTRACT FROM AUTHOR]

Purpose: In several Asian countries, hepatocellular carcinoma (HCC) is a leading cause of cancer deaths. HCC risk factors in Asia differ from those elsewhere and are changing with the treatment landscape as systemic treatment options increase. This study was conducted to gain insight from physicians and patients into HCC screening, diagnosis, and treatment strategies in Indonesia, Korea, Malaysia, Singapore, Taiwan, Thailand, and Vietnam. Methods: Two cross-sectional, anonymized, online surveys were completed between July and December 2022 by physicians diagnosing and treating HCC (55 questions on risk factors, surveillance, diagnosis, and treatment) and patients ≥ 18 years old diagnosed with HCC (36 questions on disease knowledge, quality of life, and experiences of diagnosis and treatment). Results: Responses were received from 276 physicians in all 7 countries and 130 patients in Thailand, Taiwan, and Vietnam. From the physician's perspective, surveillance programs are widespread but identify insufficient HCC cases; only 18% are early-stage HCC at diagnosis. From the patient's perspective, knowledge of risk factors increases after diagnosis, but few seek support from patient associations; patients would benefit from better communication from their doctors. Treatment affordability and side effects are key issues for patients. Conclusions: Awareness of the risk factors for HCC should be raised in primary care and the general population, and surveillance should identify early-stage HCC. Because patients rely on their doctors for support, doctors should better understand their patients' needs, and patients could be supported by trained nurses or case managers. Programs are needed to increase patients' access to proven HCC treatments. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Few studies have explored music therapy (MT) in an acute aged care inpatient setting. We aimed to assess feasibility and patient/staff perceptions of an 8‐week MT program on an acute geriatric ward. Methods: An 8‐week in‐person MT program, comprising brief receptive musical interventions up to twice‐weekly. All patients admitted to the aged care ward were eligible for inclusion. A hard copy survey was used to assess patient and staff perceptions of MT. Themes raised in free‐text responses were manually coded within a thematic analysis approach. A mixed methods approach was used to obtain and analyse data relating to feasibility and patient and staff perceptions of the MT intervention. Results: The 8‐week program ran to completion and was delivered to a median of 11 patients (IQR 9–12) each session (median 8 new/day). In total, 10 patients completed surveys, mean age 81.1 (SD 7.7); 60% were women and all had cognitive impairment. Following an MT session, eight of eight responding patients reported feeling happy and eight of eight reported they would recommend MT. Staff respondents (n = 19) reported patients appeared happy (19/19), relaxed (13/19) and all would recommend MT to other patients. Common themes were that MT was followed by improved patient behaviour and mood, and stimulated patients. Conclusions: An acute aged care inpatient MT program proves feasible and well‐received by staff and patients. Future research may focus on more robust data collection in larger sample sizes, specific types of MT and more in‐depth exploration of the patient and carer experiences. [ABSTRACT FROM AUTHOR]

Objective: Patient preferences regarding thyroid nodules are poorly understood. Our objective is to (1) employ a discrete choice experiment (DCE) to explore risk tradeoffs in thyroid nodule management, and (2) segment respondents into preference phenotypes. Study Design: DCE. Setting: Thyroid surgery clinic, online survey. Methods: A DCE including 5 attributes (cancer risk, voice concerns, incision/scar, medication requirement, follow‐up frequency) was refined with qualitative patient and physician input. A final DCE including 8 choice tasks, demographics, history, and risk tolerance was administered to participants with and without thyroid disease. Analysis was performed with multinomial logit modeling and latent class analysis (LCA) for preference phenotyping. Results: A total of 1026 respondents were included; 480 had thyroid disease. Risk aversion was associated with increasing age (P <.001), female gender (P <.001), and limited education (P =.038), but not previous thyroid disease. Cancer risk most significantly impacted decision‐making. Of the total possible utility change from thyroid nodule decision‐making, 47.8% was attributable to variations in cancer risk; 20.0% from medication management; 14.9% from voice changes; 12.7% from incision/scar; and 4.6% from follow‐up concerns. LCA demonstrated 3 classes with distinct preference phenotypes: the largest group (64.2%) made decisions primarily based on cancer risk; another group (18.2%) chose based on aversion to medication; the smallest group (17.7%) factored in medication and cancer risk evenly. Conclusion: Cancer risk and the need to take medication after thyroid surgery factor into patient decision‐making most heavily when treating thyroid nodules. Distinct preference phenotypes were demonstrated, reinforcing the need for individual preference assessment before the treatment of thyroid disorders. [ABSTRACT FROM AUTHOR]