Importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, Ucayali, Perú / Cultural importance of the flora used by the Asheninka Sheremashe native community, Ucayali, Peru

The cultural significance of the flora used by the native Asheninka Sheremashe community in Ucayali, Peru was determined. To do this, a fieldwork of over 4 months was conducted, involving semi-structured interviews with 106 residents through non-probabilistic convenience sampling. The community utilizes 139 plant species in their daily lives, belonging to 120 genera and 52 families, with the most abundant being Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae, and Rutaceae. Furthermore, 25.9% of the species are of significant importance to theinhabitants according to the Cultural Index (CI), such as Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, among others. It can be concluded that the flora plays a prominent role in the life of the community, with the categories reporting the highest number of species being: food (29.35%), medicine (28.36%), culture (9.95%), construction (9.45%), lumber (6.97%), commerce (3.48%), craftsmanship (2.49%), toxic (2.49%), and other uses (7.46%)

Se determinó la importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, en Ucayali, Perú. Para ello, se realizó un trabajo de campo de más de 4 meses, donde se aplicaron entrevistas semiestructuradas a 106 habitantes mediante un muestreo no probabilístico por conveniencia. La comunidad emplea 139 especies vegetales en su día a día, pertenecientes a 120 géneros y 52 familias; siendo las más abundantes las Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae y Rutaceae. Además, el 25.9% de las especies tiene gran importancia para los pobladores según el Índice Cultural (IC): Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, entre otras. Se concluye que la flora tiene un rol preponderante en la vida de la comunidad, siendo las categorías que presentaron mayor reporte de especies: alimentación (29.35%), medicina (28.36%), cultura (9.95%), construcción (9.45%), aserrío (6.97%), comercio (3.48%), artesanía (2.49%), tóxico (2.49%) y otros usos (7.46%)

Ethnobotanical knowledge on non-conventional food plants and medicinal plants in Extractivist Reserve in the Brazilian Amazon / Conocimiento etnobotánico sobre plantas alimenticias no convencionales y plantas medicinales en una Reserva Extractivista en la Amazonía Brasileña

Information on the knowledge and ways of using food and medicinal plants by traditional populations, family farmers and Brazilian native population in the Amazon is essential to guarantee the food sovereignty of these groups. This study was conducted using semi-structured interviews applied to local respondents. A total of 269 species of both non-conventional food plants and medicinal plants were identified, distributed in 83 botanical families and 198 genera. The Arecaceae and Lamiaceae families had the highest species richness (11 and 7, respectively). The Shannon-Wiener (H') and Pielou (J') diversity indices were considered high (5.02 and 0.9, respectively) when compared to other ethnobotanical works. In the environment in which these families are found, these species become the only food and medicinal resources available.

La información sobre los saberes y formas de uso de las plantas alimenticias y medicinales por parte de las poblaciones tradicionales, agricultores familiares e indígenas brasileños en la Amazonía es fundamental para garantizar la soberanía alimentaria de estos grupos. Este estudio se realizó utilizando entrevistas semiestructuradas aplicadas a encuestados locales. Se identificaron un total de 269 especies tanto de plantas alimenticiasno convencionales como de plantas medicinales, distribuidas en 83 familias botánicas y 198 géneros. Las familias Arecaceae y Lamiaceae tuvieron la mayor riqueza de especies (11 y 7, respectivamente). Los índices de diversidad de Shannon-Wiener (H') y Pielou (J') fueron considerados altos (5,02 y 0,9, respectivamente) en comparación con otros trabajos etnobotánicos. En el ambiente en que se encuentran estas familias, estas especies se convierten en los únicos recursos alimenticios y medicinales disponibles.

Talla baja asociado a errores de refracción ocular en escolaresde Muquiyauyo, Perú / Short stature associated with ocular refractive errors in schoolchildren in Muquiyauyo, Peru

Objetivo: Determinar la asociación entre talla baja y erro-res de refracción ocular en escolares de Muquiyauyo. Metodología: El tamaño de la población estuvo constituidapor 250 escolares y el tamaño muestral (n) para el nivel deconfianza 99.99% fue de 215 escolares, el estudio fue analí-tico observacional transversal, y la técnica utilizada para la re-colección de datos fue de observación y encuesta medianteuna ficha con datos de medición antropométrica y refracciónocular (medida de vista con autokeratorefractometro). Resultados: De los 215 niños evaluados 158 presentanerrores de refracción ocular, a quienes se les realizó la medidade vista con autokeratorefractometro; presentando 17 niñosmiopía, 9 hipermetropía, 21 astigmatismo, 32 miopía y astig-matismo y 79 hipermetropía y astigmatismo. Con respecto al análisis bivariado de talla baja y miopía, astigmatismo, hiperme tropía se encontraron que los niños que tienen tallabaja se asociaron significativamente con el astigmatismo p = <0.0000965, la razón de prevalencia =2.33 IC (1.44,3.78); es decir, que los que presentan talla baja tienen dosveces más el riesgo de presentar astigmatismo. Los niños que presentaron talla baja se asocian significati-vamente con refracción ocular P=<0.01 razón de prevalencia6.81 IC (2.57,18.1). Conclusión: Los escolares de Muquiyauyo con talla bajatienen 6 veces más riesgo de presentar alteraciones en la re-fracción ocular.(AU)

Objective: To determine the association between shortstature and ocular refractive errors in schoolchildren inMuquiyauyo. Methodology: The population size consisted of 250 scho-olchildren and the sample size(n) for the 99.99% confidencelevel was 215 schoolchildren. The study was a cross-sectionalobservational analytical study, and the technique used fordata collection was observation and survey using an anthro-pometric measurement and ocular refraction data sheet (eyemeasurement with autokeratorefractometer). Results: Of the 215 children evaluated, 158 had ocular re-fractive errors, and their eyesight was measured with an au-tokeratorefractometer; 17 children had myopia, 9 had hypero-pia, 21 had astigmatism, 32 had myopia and astigmatism and79 had hyperopia and astigmatism. With respect to the biva-riate analysis of short stature and myopia, astigmatism andhyperopia, it was found that children with short stature weresignificantly associated with astigmatism p = <0.0000965,prevalence ratio =2.33 CI (1.44, 3.78); that is, those withshort stature have twice the risk of presenting astigmatism. Children with short stature are significantly associated withocular refraction P=<0.01 prevalence ratio 6.81 CI (2.57,18.1). Conclusion: Muquiyauyo school children with short statureare 6 times more likely to have ocular refractive disorders.(AU)

Influence of physician and clinical dietitian on the use of dietary supplements among Polish patients with ulcerative colitis – pilot study / Influencia del médico y dietista clínico sobre el uso de suplementos dietéticos entre pacientes polacos con colitis ulcerosa – estudio piloto

Introduction: Patients with ulcerative colitis are a group of patients who are particularly vulnerable to nutritional deficiencies. Supplementation, prescribed by a physician or clinical dietitian, is therefore important in these patients. Materials and methods: The study was carried out by means of a questionnaire on a group of 106 people diagnosed with colitis and in remission. Results: More than 92% recommended the use of dietary supplements. Vitamin supplements were most common among people with ulcerative colitis (82.7%). The physician as a source of knowledge positively influenced the use of vitamin and mineral supplements (r=0.23, p=0.0213) while dietitians as a source of knowledge showed no significant effect on patients' supplementation choices. Conclusion: In Poland, the physician is the main source of supplementation knowledge than the clinical dietitian. This may be due to the unregulated nature of the dietitian profession in the Polish health care system. . It is therefore necessary to integrate dietitians in Poland into the medical profession, which will allow for better results in the treatment of not only IBD patients.(AU)

Protocolo de la DDHealth: Justificación, diseño y realización de una encuesta transversal de salud sociodemográfica, alfabetización sanitaria y brecha digital en 2.000 adultos de cincuenta a setenta y nueve años residentes en España en 2022 / DDHealth Protocol: Justification, design and implementation of a cross-sectional survey of sociodemographic health, health literacy and digital divide in 2,000 adults aged fifty to seventy-nine residing in Spain in 2022

Métodos: DDHealth pretende abordar dos aspectos innovadores y oportunos que se ha postulado que contribuyen a las desigualdades socioeconómicas en salud. El primero es la brecha digital socioeconómica, que se refiere a que las capacidades y posibilidades de acceder a la tecnología y usar internet son mayores entre las clases sociales altas en comparación con las bajas. La segunda es la alfabetización sanitaria, que se refiere a la capacidad de los individuos para satisfacer y comprender las complejas demandas de promoción y mantenimiento de la salud en la sociedad moderna. El estudio llevó a cabo más de 2.000 entrevistas entre residentes en España de entre cincuenta y setenta y nueve años de edad entre marzo y abril de 2022, utilizando un enfoque de entrevista telefónica asistida por ordenador (CATI). El cuestionario tiene cuatro módulos diferentes: sociodemográfico; brecha digital; salud; alfabetización sanitaria. Los datos anonimizados están disponibles a través del enlace: https://dataverse.csuc.cat/dataset.xhtml?persistentId=doi:10.34810/data765.Consideraciones éticas y discusión: La DDHealth permite abordar dimensiones innovadoras acerca de los determinantes sociales de la salud en España. Los datos de la DDHealth están disponibles para investigadores externos con fines científicos previa solicitud de una propuesta de investigación razonable.(AU)

Background: Socioeconomic inequalities in health persist in Spain. The DDHealth project aims to address two timely innovative aspects that have been postulated to contribute to socioeconomic inequalities in health. Methods: DDHealth aims to address two innovative and timely aspects that have been proposed to contribute to socioeconomic health inequalities. The first one is the socioeconomic digital divide, which refers to the greater capabilities and opportunities to access technology and use the internet among higher social classes compared to lower ones. The second aspect is health literacy, which refers to individuals’ capacity to meet and understand the complex demands of health promotion and maintenance in modern society. The study conducted over 2,000 interviews among residents in Spain aged between fifty and seventy-nine years old from March to April 2022, using a computer-assisted telephone interviewing (CATI) approach. The questionnaire comprises four different modules: sociodemogra-phic; digital divide; health; health literacy. The anonymized data are available through the following link: https://dataverse.csuc.cat/dataset.xhtml?persistentId=doi:10.34810/data765ETHICAL Considerations and Discussion: DDHealth enables addressing innovative dimensions concerning the social determi-nants of health in Spain. The data are available to external researchers for scientific purposes upon request of a reasonable research proposal.

The Effect of Melatonin on Increasing the Health Related Quality of Life in Non-Metastatic Breast Cancer Patients: Three-Year Follow up a Clinical Trial.

INTRODUCTION: Although breast cancer is common worldwide, if diagnosed early and treated on time, the probability of recovery is high and patients often experience a long life. Reducing the quality of life is a common side effect in patients. Melatonin may have an important role in fatigue, sleep disorders and, as a result, the health-related quality of life (HRQoL) in people. About 184 patients with breast cancer were enrolled in 2 groups: intervention with daily melatonin intake of 18 mg for 3 years (93 patients) and the control group with placebo intake (91 patients). Health-related quality of life and the effect of melatonin on increasing that were evaluated with the EORTC QLQ-C30 questionnaire, third edition at the beginning, 2 months later and 3 years after the beginning of the study. RESULTS: The general score of the HRQoL was significantly different both in the passage of time and in the comparative study of the 2 groups, and it was better in the melatonin group (P < .05). CONCLUSION: Long-term use of 18 mg of melatonin for 3 years in patients with non-metastatic breast cancer can lead to an increase in the patients' quality of life.

Therapeutic radiographer prescribing practices in the United Kingdom: Questionnaire survey.

INTRODUCTION: Non-medical professionals in the United Kingdom (UK) have been granted prescribing rights to improve patient care quality and cost-effectiveness. There is limited evidence on how therapeutic radiographer prescribers have impacted medicine management or patient services. METHODS: An online survey was conducted amongst non-medical prescribing therapeutic radiographers in the UK between 2019 and 2022. The study teams initially analysed the individual data sets, subsequently combined, and secondary analysis was performed to provide a UK perspective, to understand the services provided and identify areas for improvement. Data was analysed using descriptive statistics from Microsoft Excel® and SPSS®. RESULTS: 74 non-medical prescribing therapeutic radiographers who were predominantly over 40 years old and in full-time work participated. The main job categories were consultant radiographers (n = 23, 31.1%) and advanced practice practitioners (n = 18, 24.3%). Many use their prescribing qualifications (87.5%, n = 62), issuing a mean of 15 independent and seven items by supplementary and prescribing per week. Most received assessment and diagnostic skills training before prescribing courses (91.6%, n = 67). Respondents prescribed from a median of six areas, with the highest being in GI (82%), skin (68%), infections (58%), urinary tract disorders (55%) and ear, nose, and oropharynx conditions (54%). CONCLUSION: This study presents the first report on therapeutic radiographers prescribing in the UK, offering insights into current practices and highlighting the success of non-medical prescribing. Therapeutic radiographers' roles continue to expand into advanced practice and medicine-prescribing responsibilities, contributing to holistic and patient-centred care. IMPLICATIONS FOR PRACTICE: The results are relevant for nations grappling with oncology workforce shortages and contemplating similar roles for therapeutic radiographers. The study can be a valuable resource for policymakers and healthcare organisations worldwide.

Ethnobotanical survey on herbal remedies for the management of type 2 diabetes in the Casablanca-Settat region, Morocco.

BACKGROUND: Morocco faces a substantial public health challenge due to diabetes mellitus, affecting 12.4% of adults in 2023. The Moroccan population makes extensive use of phytotherapy and traditional medicine to address the difficulties this chronic condition poses. The aim of this study is to document the use of medicinal plants in traditional medicine for managing type 2 diabetes in the provinces of the Casablanca-Settat region. METHODS: The study employed a semi-structured questionnaire for data collection. A study was conducted between August 1st and September 30th, 2023, and 244 individuals diagnosed with diabetes were invited to take part in the research, all of whom used at least one medicinal plant to manage type 2 diabetes, by visiting primary healthcare facilities in Morocco. The analysis included the use of Relative Frequency of Citation (RFC) to scrutinize the data. RESULTS: A total of 47 plant species belonging to 25 families were documented. Notably, the Apiaceae, Lamiaceae, and Fabaceae families were frequently mentioned in the context of treating type 2 diabetes in Morocco. Prominent among the cited plant species were Sesamum indicum L., Lepidium sativum L., followed by Foeniculum vulgare Mill., and Rosmarinus officinalis L. Seeds emerged as the plant part most commonly mentioned, with infusion being the prevailing preparation method and oral consumption being the most frequently depicted method of administration. CONCLUSION: This research underscores the practicality of incorporating traditional medicine into the healthcare framework of the Casablanca-Settat region. The findings not only offer valuable documentation but also have a vital function in safeguarding knowledge regarding the utilization of medicinal plants in this locality. Moreover, they provide opportunities to delve deeper into the phytochemical and pharmacological potential of these plants.

Features of d-vitamin status in young children in the Kazakh population.

OBJECTIVE: Aim: The purpose of the article is to form the parameters of vitamin D status in young children in the ethnic group of Kazakh nationality with the factor of highlighting the necessary recommendations for the prevention of hypovitaminosis D. PATIENTS AND METHODS: Materials and Methods: Methods for the study of the highlighted problem are the diagnosis of young children in the parameter of clinical and anamnestic research, which includes the collection of anamnestic data of children of Kazakh nationality within the framework of the identified data based on a questionnaire of parents, an evaluation component in the child's health factor at the level of his initial state, and laboratory analysis to determine 25(OH)D to identify the content of vitamin D using the method of electrochemiluminescent immunoassay. RESULTS: Results: Analysis of vitamin D levels revealed significant differences among age groups. In the 0-28-day group, average vitamin D was 13.35 ng/ml, with 92.8% deficient. In the 1-6-month group, it was 21.47 ng/ml, with 84% deficient. In the over 6-month group, it was 33.58 ng/ml, with 40% sufficient. Formula-fed children had the lowest levels (average 15.21 ng/ml), while breastfed children had insufficiency (average 23.91 ng/ml). Children with vitamin D supplementation averaged 25.9 ng/ml, compared to 19.01 ng/ml without supplementation. CONCLUSION: Conclusions: The results point to a widespread deficiency of vitamin D and offer practical recommendations for its prevention, such as creating a unified system of timely diagnosis, implementing preventive measures in pregnant women and young children, including a balanced diet enriched with vitamin D, staying outdoors in the bright hours of the day.

Knowledge, awareness, and use of folic acid among women of childbearing age living in a peri-urban community in Ghana: a cross-sectional survey.

BACKGROUND: Folic acid, a water-soluble B-complex vitamin, plays a crucial role in DNA synthesis and maintenance, making it particularly significant during reproduction. Its well-known ability to reduce the risk of congenital anomalies during the periconceptional period underscores its importance. The increased requirement for folate during pregnancy and lactation is essential to support the physiological changes of the mother and ensure optimal growth and development of the foetus and offspring. This study assessed the knowledge, awareness, and use of folic acid among pregnant and lactating women of reproductive age residing in Dodowa in the Shai Osu-Doku District, Accra, Ghana. METHODS: The study was a cross-sectional design that involved 388 randomly selected participants (97 pregnant and 291 lactating women). Structured questionnaires were administered to gather information on the socioeconomic demographic characteristics, knowledge, awareness, and use of folic acid of the participants. Dietary intake was assessed using a food frequency questionnaire. The data were analysed using descriptive statistics and Pearson's chi-square analysis tests and are presented as frequencies and percentages, means, standard deviations, bar graphs, and pie charts. The significance of the results was determined at a 95% confidence interval. RESULTS: The mean age of the participants was 31 ± 5.0 years. Among the study participants, 46.1% demonstrated knowledge of folic acid deficiency, while approximately 68.3% had a high awareness of folic acid supplementation. Approximately 75% of the participants indicated that they had not used folic acid supplements within the week, and 15.5% reported consuming folic acid-fortified food per week. CONCLUSIONS: The women exhibited high awareness but poor knowledge regarding the usage of folic acid supplementation during pregnancy and lactation. Consequently, this lack of knowledge influenced the low use of folic acid supplements and low intake of folate-rich foods among pregnant and lactating mothers.

Use of complementary and alternative medicine in vitiligo: a cross-sectional survey.

Vitiligo is characterized by skin depigmentation, which can lead to profound psychological effects and decreased quality of life, especially for those with skin of color. Individuals with vitiligo may utilize complementary and alternative medicine (CAM) due to limited treatment options with varying efficacy.An anonymous, multiple-choice, cross-sectional questionnaire was distributed to participants with vitiligo in the United States through online forums. Data on disease characteristics, use of prescription medications, use of topical therapies, supplements, and diets, and perceptions of CAM were collected.In total, 625 respondents completed the survey. Overall, 32.5% of participants (203/625) have tried CAM. Commonly reported CAM include supplements of vitamin D (57.7%, 116/203), vitamin B12 (46.3%, 93/203), vitamin C (27.4%, 55/203), topical Nigella sativa oil (26.4%, 53/203), oral omega-3 fatty acids (24.9%, 50/203), folic acid (22.9%, 46/203), and vitamin E (22.9%, 46/203). Frequently cited reasons for CAM use include desire to try "new" (40.4%, 82/203) or "more natural" (26.6%, 54/203) therapies, "frustration with conventional medicine" (24.6%, 50/203), and fear of "adverse side effects of conventional medicine" (23.6%, 48/203). Non-White participants were more likely than their White counterparts to report CAM use and have more positive perceptions of CAM therapies. Less than half (43.3%, 88/203) of CAM users reported that they disclosed their use of CAM with their physician.Dermatologists should be mindful of CAM and ask patients about their use. Further investigation of the role of CAM as adjuvant therapy for vitiligo is warranted to better advise patients.

Engaging internal and external audiences to develop and promote zoo-based conservation efforts.

As place-based conservation organizations, zoos are in a central position to support individuals in making small changes in their lives that will support the protection of wildlife and their habitats. This paper describes the secondary analysis of data collected from multi-phase front-end, exploratory evaluation that informed the development of a conservation action campaign in association with a non-profit, urban zoo. In phase one, internal organization staff were invited to attend workshops during which they brainstormed potential conservation actions that they felt were important for the zoo to promote. They identified and ranked 164 unique actions. In phase two, the ranking was used to narrow down the 164 actions to 20 actions which were used to develop a survey administered to visitors who opted in to receiving online surveys from the zoo. The survey asked participants to state their interest in each of the 20 conservation actions. The Transtheoretical Model of Behavior Change informed the analysis of responses. Through this approach we identified actions that people were already doing, interested in doing, and not interested in doing. The responses from this survey were used to narrow down the list further to 10 actions used in a survey in phase three. This second survey administered to zoo visitors on grounds asked participants which of the 10 actions they would be most interested in doing, and the perceived barriers and benefits of doing them. This process allowed us to use evidence-based decision making to choose which conservation actions would resonate most with the community for our conservation action campaign. We also were able to identify values visitors held that might influence environmentally friendly behaviors. Visitors who responded to this survey tended to respond in ways that aligned with self-transcendent values. The research suggests that the campaign should focus on habitat restoration and remediation and purchasing wildlife friendly coffee and other products.

Patient Abuse, Neglect, and Exploitation: Why Physicians Need to Be Trauma-Informed.

Introduction: Many people experience trauma, and its cumulative effects throughout the life span can alter health, development, and well-being. Despite this, few publications focusing on interpersonal trauma include a holistic understanding of the nature and widespread exposure of trauma experiences for patients. We developed an educational resource to teach residents about identifying and intervening with patients who experience trauma across the life span using a trauma-informed care (TIC) perspective. Methods: We created a 4-hour educational session for residents that included didactics, a virtual visit with a domestic violence shelter, a discussion with a person who had experienced trauma, and role-playing. A pretest/posttest retrospective survey assessed resident confidence level in identifying and intervening with patients who may have experienced trauma. We used the Wilcoxon signed rank test to compare pretest and posttest scores and the Kruskal-Wallis test to compare responses by residency type and year. Free-text questions were analyzed for thematic content. Results: During the 2021-2022 academic year, 72 of 90 residents (80%) from four residency programs attended and evaluated the session. More than 90% of respondents reported the session met their educational needs and provided them with new ideas, information, and practical suggestions to use in their clinical endeavors. The results demonstrated significantly increased confidence on most of the metrics measured. Discussion: This session significantly improved residents' confidence in identifying and intervening with patients who have had trauma experiences using a TIC perspective, which may lead them to provide improved patient care to those who have experienced trauma.

Vitamin D status in active and inactive noninfectious uveitis - data from a reference university hospital in Rio de Janeiro, Brazil.

PURPOSE: This study aimed to investigate the correlation between serum vitamin D levels and disease activity in patients with noninfectious uveitis. METHODS: We conducted a prospective case-control study, assessing 51 patients with noninfectious uveitis, categorized into active (n=22) and inactive (n=29) groups, along with 51 healthy controls. Serum 25-hydroxy vitamin D [25(OH)D] levels were measured. The uveitis group also completed a questionnaire regarding sunlight exposure habits and vitamin D supplementation. RESULTS: Patients with inflammation-related uveitis exhibited low serum 25(OH)D levels in 68% of cases. The median 25(OH)D level in patients with active uveitis was 17.8 ng/mL (interquartile range [IQR], 15-21 ng/mL), significantly lower compared to the 31.7 ng/mL (IQR, 25-39 ng/mL) in patients with inactive uveitis (p<0.001) and the 27 ng/mL (IQR, 23-31 ng/mL) in the Control Group (p<0.001). Significantly, nearly all patients with uveitis taking vitamin D supplementation were in the Inactive Group (p<0.005). Moreover, reduced sunlight exposure was associated with active uveitis (p<0.003). Furthermore, patients with 25(OH)D levels below 20 ng/mL had ten times higher odds of developing active uveitis (p=0.001). CONCLUSIONS: This study revealed a prevalent 25(OH)D deficiency among patients with noninfectious uveitis and suggested a link between low 25(OH)D levels and disease activity. To prevent future episodes of intraocular inflammation, vitamin D supplementation and controlled sunlight exposure could be viable options.

National norms for the obstetric nurses' and midwives' health education competence, and its influencing factors: a nationwide cross-sectional study.

BACKGROUND: Strengthening obstetric nurses' and midwives' health education competence is the investment and guarantee for the population's future health. The purpose of study is to establish national norms for their health education competence, and explore possible influencing factors for providing an uniform criterion identifying levels and weaknesses. METHODS: An online questionnaire with a standard process was used to collect data. Three normative models were constructed, and multiple linear regression analysis analyzed possible influencing factors. RESULTS: The sample respondents (n = 3027) represented obstetric nurses and midwives nationally. Three health education competency normative norms (mean, percentile and demarcation norm) were constructed separately. Locations, hospital grade, department, marital status, training times and satisfaction with health education training influenced obstetrical nurses' and midwives' health education competence (P<0.05). CONCLUSION: This study constructed the first national standard for assessing obstetric nurses' and midwives' health education competence, providing a scientific reference to evaluate the degree of health education competence directly. These known factors could help clinical and policy managers designate practice improvement measures. In future research, Grade I hospitals should be studied with larger sample sizes, and indicators need to improve to reflect health education's effect better.

An exploratory study to assess the knowledge, attitudes and practices of Lebanese residents towards acrylamide.

INTRODUCTION: For years, heat treatment has been an essential method for ensuring mature food that meet the desired quality and safety characteristics. However, this process could lead to the formation of harmful compounds such as acrylamide. In this study we aimed to investigate the knowledge, attitudes and practices (KAPs) of the Lebanese population toward the potential risk associated with acrylamide. MATERIALS & METHODS: An online survey (n = 598) was conducted among residents in Lebanon aged 18 years and above. The survey was divided into five sections including participants' sociodemographic characteristics, knowledge, attitude and practice sections, and some questions related to consumer's preferences. RESULTS & DISCUSSION: The results showed that the majority of the participants had low food safety knowledge regarding acrylamide. Specifically, 82.9% of the consumers had no idea about the chemical, its formation, the foods with a high risk of acrylamide formation and the health risks associated with its exposure. Despite lack of knowledge, good domestic food practices (storage, pre-treatment) were noticed among participants. Moreover, the majority of consumers (> 80%) showed positive attitude towards proper acrylamide labeling. Participants with a bachelor's degree appeared to have a more positive attitude toward food safety compared to those with no qualifications (p<0.001). CONCLUSION: Despite the high consumption of acrylamide by the consumers in Lebanon through fried potatoes, bread, and coffee, the majority have no idea about acrylamide's presence in food, its sources and its adverse health effects. Raising awareness among the public, involving policy makers in addressing the issue of clear labeling and encouraging the adoption of alternative practices to reduce acrylamide are all crucial to protect consumers' health in Lebanon and promote healthier food consumption habits.

Treatment of shoulder impingement syndrome: a survey of physical therapists in Saudi Arabia.

OBJECTIVE: Shoulder impingement syndrome (SIS) is one of the most frequent causes of shoulder pain. Evidence supported the use of conservative treatment for SIS. Clinical practice guidelines (CPGs) indicated that physical therapy interventions, including therapeutic exercises, manual therapy, patient education, and advice, were recommended for the treatment of SIS. This study's purpose was to investigate physical therapists' adherence to the CPGs for treating SIS. SUBJECTS AND METHODS: Physical therapists in Saudi Arabia were invited to participate in an online survey via the Saudi Physical Therapy Association between May and December 2022. The developed online survey consisted of 36 questions, divided into five sections: eligibility, demographics, clinical practice regarding the treatment of SIS, barriers, and facilitators for the use of CPGs. Descriptive and logistic regression analysis were employed to analyze study data. RESULTS: A total of 313 physical therapists completed the entire survey. In general, physical therapists were aligned with CPGs. Physical therapists advised their patients, utilized therapeutic exercises and manual therapy techniques, and used electrotherapy modalities despite being not recommended. Key challenges indicated by physical therapists for the use of CPGs include low patient adherence to therapists' instructions, lack of adequate knowledge, and limited clinical time. CONCLUSIONS: Overall, physical therapists in Saudi Arabia followed the CPGs for treating SIS. Therapeutic exercises combined with manual therapy were the most common treatment options. However, further research should consider exploring adherence to such guidelines over time.

Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa: a study protocol.

INTRODUCTION: Nurses are essential for implementing evidence-based practices to improve patient outcomes. Unfortunately, nurses lack knowledge about research and do not always understand research terminology. This study aims to develop an in-service training programme for health research for nurses and midwives in the Tshwane district of South Africa. METHODS AND ANALYSIS: This protocol outlines a codesign study guided by the five stages of design thinking proposed by the Hasso-Plattner Institute of Design at Stanford University. The participants will include nurses and midwives at two hospitals in the Tshwane district, Gauteng Province. The five stages will be implemented in three phases: Phase 1: Stage 1-empathise and Stage 2-define. Exploratory sequential mixed methods including focus group discussions with nurses and midwives (n=40), face-to-face interviews (n=6), and surveys (n=330), will be used in this phase. Phase 2: Stage 3-ideate and Stage 4-prototype. A team of research experts (n=5), nurses and midwives (n=20) will develop the training programme based on the identified learning needs. Phase 3: Stage 5-test. The programme will be delivered to clinical nurses and midwives (n=41). The training programme will be evaluated through pretraining and post-training surveys and face-to-face interviews (n=4) following training. SPSS V.29 will be used for quantitative analysis, and content analysis will be used to analyse qualitative data. ETHICS AND DISSEMINATION: The protocol was approved by the Faculty of Health Sciences Research Ethics Committee of the University of Pretoria (reference number 123/2023). The protocol is also registered with the National Health Research Database in South Africa (reference number GP_202305_032). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals.

A Cross-Sectional Survey Study of Cannabis Use for Fibromyalgia Symptom Management.

OBJECTIVE: To assess the use of cannabis as a symptom management strategy for patients with fibromyalgia. PATIENTS AND METHODS: An electronic, cross-sectional survey was conducted among patients diagnosed with fibromyalgia and treated in Integrative Medicine & Health at Mayo Clinic, Rochester, Minnesota. The survey was constructed with the Symptom Management Theory tool and was sent anonymously via web-based software to patients with a diagnosis of fibromyalgia. RESULTS: Of 5234 patients with fibromyalgia sent the online survey, 1336 (25.5%) responded and met the inclusion criteria. Survey respondents had a median age of 48 (Q1-Q3: 37.5-58.0) years, and most identified as female. Nearly half of respondents (49.5%, n=661) reported cannabis use since their fibromyalgia diagnosis. The most common symptoms for which respondents reported using cannabis were pain (98.9%, n=654); fatigue (96.2%; n=636); stress, anxiety, or depression (93.9%; n=621); and insomnia (93.6%; n=619). Improvement in pain symptoms with cannabis use was reported by 82.0% (n=536). Most cannabis-using respondents reported that cannabis also improved symptoms of stress, anxiety, and depression and of insomnia. CONCLUSION: Considering that cannabis is a popular choice among patients for managing fibromyalgia symptoms, clinicians should have adequate knowledge of cannabis when discussing therapeutic options for fibromyalgia with their patients.

Development and validation of the patient-reported outcome for older people living with HIV/AIDS in China (PROHIV-OLD).

BACKGROUND: The involvement of quality of life as the UNAIDS fourth 90 target to monitor the global HIV response highlighted the development of patient-reported outcome (PRO) measures to help address the holistic needs of people living with HIV/AIDS (PLWHA) beyond viral suppression. This study developed and tested preliminary measurement properties of a new patient-reported outcome (PROHIV-OLD) measure designed specifically to capture influences of HIV on patients aged 50 and older in China. METHODS: Ninety-three older people living with HIV/AIDS (PLWHA) were interviewed to solicit items and two rounds of patient cognitive interviews were conducted to modify the content and wording of the initial items. A validation study was then conducted to refine the initial instrument and evaluate measurement properties. Patients were recruited between February 2021 and November 2021, and followed six months later after the first investigation. Classical test theory (CTT) and item response theory (IRT) were used to select items using the baseline data. The follow-up data were used to evaluate the measurement properties of the final instrument. RESULTS: A total of 600 patients were recruited at the baseline. Of the 485 patients who completed the follow-up investigation, 483 were included in the validation sample. The final scale of PROHIV-OLD contained 25 items describing five dimensions (physical symptoms, mental status, illness perception, family relationship, and treatment). All the PROHIV-OLD dimensions had satisfactory reliability with Cronbach's alpha coefficient, McDonald's ω, and composite reliability of each dimension being all higher than 0.85. Most dimensions met the test-retest reliability standard except for the physical symptoms dimension (ICC = 0.64). Confirmatory factor analysis supported the structural validity of the final scale, and the model fit index satisfied the criterion. The correlations between dimensions of PROHIV-OLD and MOS-HIV met hypotheses in general. Significant differences on scores of the PROHIV-OLD were found between demographic and clinical subgroups, supporting known-groups validity. CONCLUSIONS: The PROHIV-OLD was found to have good feasibility, reliability and validity for evaluating health outcome of Chinese older PLWHA. Other measurement properties such as responsiveness and interpretability will be further examined.