Longitudinal Monitoring of Clinician-Patient Video Visits During the Peak of the COVID-19 Pandemic: Adoption and Sustained Challenges in an Integrated Health Care Delivery System.

BACKGROUND: Numerous prior opinion papers, administrative electronic health record data studies, and cross-sectional surveys of telehealth during the pandemic have been published, but none have combined assessments of video visit success monitoring with longitudinal assessments of perceived challenges to the rapid adoption of video visits during the pandemic. OBJECTIVE: This study aims to quantify (1) the use of video visits (compared with in-person and telephone visits) over time during the pandemic, (2) video visit successful connection rates, and (3) changes in perceived video visit challenges. METHODS: A web-based survey was developed for the dual purpose of monitoring and improving video visit implementation in our health care system during the COVID-19 pandemic. The survey included questions regarding rates of in-person, telephone, and video visits for clinician-patient encounters; the rate of successful connection for video visits; and perceived challenges to video visits (eg, software, hardware, bandwidth, and technology literacy). The survey was distributed via email to physicians, advanced practice professionals, and clinicians in May 2020. The survey was repeated in March 2021. Differences between the 2020 and 2021 responses were adjusted for within-respondent correlation across surveys and tested using generalized estimating equations. RESULTS: A total of 1126 surveys were completed (511 surveys in 2020 and 615 surveys in 2021). In 2020, only 21.7% (73/336) of clinicians reported no difficulty connecting with patients during video visits and 28.6% (93/325) of clinicians reported no difficulty in 2021. The distribution of the percentage of successfully connected video visits ("Over the past two weeks of scheduled visits, what percentage did you successfully connect with patients by video?") was not significantly different between 2020 and 2021 (P=.74). Challenges in conducting video visits persisted over time. Poor connectivity was the most common challenge reported by clinicians. This response increased over time, with 30.5% (156/511) selecting it as a challenge in 2020 and 37.1% (228/615) in 2021 (P=.01). Patients not having access to their electronic health record portals was also a commonly reported challenge (109/511, 21.3% in 2020 and 137/615, 22.3% in 2021, P=.73). CONCLUSIONS: During the pandemic, our health care delivery system rapidly adopted synchronous patient-clinician communication using video visits. As experience with video visits increased, the reported failure rate did not significantly decline, and clinicians continued to report challenges related to general network connectivity and patient access to technology.

Energy drink consumption among medical students in Jordan - prevalence, attitudes, and associated factors: a cross-sectional study.

Background: Energy drinks (ED) are popular beverages that contain high levels of caffeine, sugar, and other supplements, such as vitamins, which are marketed to enhance mental alertness and physical performance. Studies have shown that energy drink consumption is prevalent among medical students. Therefore, this study aimed to assess the prevalence, attitudes, and factors associated with energy drink consumption among medical students in Jordan. Materials and methods: A cross-sectional study was conducted among medical students from six public universities in Jordan. A total of 307 students were included in the study, and data were collected using an expert-validated questionnaire. The collected data were analyzed using SPSS version 25. Results: The study found that 50% of the sample had consumed ED, half of them started consuming them at the age of 16-18, and learned about them from friends. The primary reasons for consuming ED were to stay awake at night and the majority of them increase their consumption during exams to increase alertness. Regular energy drink consumption was significantly associated with being a student at the university located in the south governorate of Jordan (P=0.021), living alone (P=0.000), drinking alcohol (P=0.049), drinking coffee daily (P=0.043), and consuming more than 10 cans of soft drinks weekly (P=0.001). However, sex, age, academic achievement, and smoking status had no significant association with regular energy drink consumption. Students with regular energy drink consumption experienced daytime sleepiness, decreased concentration, fatigue, and reduced performance more than students with no regular energy drink consumption. Conclusion: The prevalence of energy drink consumption among medical students in Jordan is high, with factors such as social influences, lifestyle behaviors, and academic pressure being significant contributors. This study highlights the need for interventions to promote healthy behaviors and raise awareness about the potential harms of ED among medical students.

Attitude towards Spirituality and Spiritual Care among Nurses of Bharatpur Hospital.

BACKGROUND: Understanding spirituality and spiritual care is a prerequisite for holistic care in nursing. Spirituality is an important dimension of human existence with a crucial role in health promotion. The objective of this study was to assess the level of attitude towards spirituality and spiritual care among nurses. METHODS: A cross-sectional analytical study design was used among 208 nurses to assess attitude toward spirituality and spiritual care among nurses of Bharatpur Hospital. A pretested semi-structured, self-administered questionnaire was used to collect data from the respondents. The instrument spirituality and spiritual care rating scales were used. Collected data were coded and entered in Microsoft office excel and SPSS version 22 was used for analysis. RESULTS: The finding of the study revealed that, out of 208 respondents, the majority (74.0%) of respondents were of age 20-29 years with a mean and SD of 28.2±5.510. Among all, 125(60.1%) respondents had a moderate attitude score of 32-62, 83(39.9%) had a high level of attitude score of 63-92, whereas 0.5% had a low level of attitude towards spirituality and spiritual care score (0-31).There is no statistically significant relationship between the level of attitude and socio-demographic variables. CONCLUSIONS: It is concluded that most of the respondents had a moderate level of attitude. In-service education and awareness on providing spiritual care among nurses needs to be focused.

Knowledge, attitude and practice of physiotherapists about lymphedema: A Turkish perspective.

BACKGROUND: Physiotherapists are important members of the healthcare team in the management of lymphedema. Therefore, the level of knowledge and awareness of physiotherapists on this disease is substantial. This study was planned to investigate knowledge, attitude, and practice of physiotherapists about lymphedema in Turkey. METHOD: This study was a qualitative, prospective, and cross-sectional research. Data were collected with the web-survey which consisted of the demographical characteristics information, evaluation of their own knowledge and practice in lymphedema management, and current knowledge of physiotherapists about lymphedema based on the current literature. RESULTS: Two hundred seventy-four physiotherapists (174 Female: 100 Male; mean age: 29.87 ± 6.9 years) completed the web-survey. From 274 physiotherapists, 52.60% of them had no education about lymphedema, 13.90% of them had never seen any patient with lymphedema, and 57.70% of them had not taken part in the management of a patient with lymphedema. 71.90% of the physiotherapists did not think they have enough knowledge about lymphedema. It was identified that physiotherapists' general and risk factors knowledge about lymphedema was sufficient. However, physiotherapists showed a lack of knowledge on the evaluation, treatment, and recommendations for lymphedema. CONCLUSION: Physiotherapists' education and experience in lymphedema management are crucial as they are important members of the multidisciplinary team. To raise qualified physiotherapists in this field, from undergraduate education, special training programs about lymphedema should be added to their lifelong learning process.

Farm Animal Welfare-From the Farmers' Perspective.

Improvements in the welfare of animals in the intensive production industries are increasingly being demanded by the public. Scientific methods of welfare improvement have been developed and are beginning to be used on farms, including those provided by precision livestock farming. The number of welfare challenges that animals are facing in the livestock production industries is growing rapidly, and farmers are a key component in attempts to improve welfare because their livelihood is at stake. The challenges include climate change, which not only exposes animals to heat stress but also potentially reduces forage and water availability for livestock production systems. Heat-stressed animals have reduced welfare, and it is important to farmers that they convert feed to products for human consumption less efficiently, their immune system is compromised, and both the quality of the products and the animals' reproduction are adversely affected. Livestock farmers are also facing escalating feed and fertiliser costs, both of which may jeopardise feed availability for the animals. The availability of skilled labour to work in livestock industries is increasingly limited, with rural migration to cities and the succession of older farmers uncertain. In future, high-energy and protein feeds are unlikely to be available in large quantities when required for the expanding human population. It is expected that livestock farming will increasingly be confined to marginal land offering low-quality pasture, which will favour ruminant livestock, at the expense of pigs and poultry unable to readily digest coarse fibre in plants. Farmers also face disease challenges to their animals' welfare, as the development of antibiotic resistance in microbes has heralded an era when we can no longer rely on antibiotics to control disease or improve the feed conversion efficiency of livestock. Farmers can use medicinal plants, pro-, pre- and synbiotics and good husbandry to help maintain a high standard of health in their animals. Loss of biodiversity in livestock breeds reduces the availability of less productive genotypes that survive better on nutrient-poor diets than animals selected for high productivity. Farmers have a range of options to help address these challenges, including changing to less intensive diets, diversification from livestock farming to other enterprises, such as cereal and pseudocereal crops, silvopastoral systems and using less highly selected breeds. These options may not always produce good animal welfare, but they will help to give farm animals a better life.

Community Pharmacist's Awareness, Knowledge and Attitude Towards use of Vitamin Supplements in Pimpri-Chinchwad Municipal Corporation (PCMC) Area of Pune, India: A Descriptive Cross Sectional Study.

Background: US FDA defines: dietary supplements is a product that intended to supplement a person's diet, it's generally consist of at least one or more of the following dietary ingredients, vitamin, minerals, a herb or other botanical and amino acid by increasing the daily consumptions of an extract metabolite concentration, constitute or combinations of these medication. Excessive and inappropriate use of medicines has been recognised as a public health problem resulting in increased likelihood of adverse drug event, drug interaction, and inappropriate drug prescribing and increased cost. Material and Methods: This was the cross-sectional study conducted in year 2022 at Pimpri Chinchwad (Pune). The total 250 questionaires are distributed and from that 226 response were received. Target population consist of community pharmacists working in the drug store in this area (n=226). Results: Data was represented in three domains of study i. e. awareness, knowledge and attitude. Correlation coefficient using Pearson's method were determined to evaluate strength of correlation between awareness-knowledge, Knowledge-attitude and awareness-attitude. Correlation coefficient were calculated by comparing most relevant and equal number of questions. Conclusion: The study demonstrated positive attitude among surveyed community pharmacists in Pune, India. There is lacuna in accurate and adequate awareness, knowledge and attitude of vitamin deficiency, efficiency, recommended daily allowance (RDA), toxicity and interactions among pharmacist as one of the stakeholders of healthcare in India. Few of the remedies viz. framing of guidelines, inclusion in formal education syllabus, continuous education, updation exams etc. may be of use.

Factors Influencing Use of Medicinal Herbs.

In countries with a long tradition of folk herbal medicine that is not integrated into the health system, consumer interest in medicinal herbs has increased. Considering the lack of knowledge about the factors influencing the use of medicinal herbs, the aim of this study was to identify the most important factors of herbal use in Slovenia. Factors were assessed in June 2023 using a nationwide sample (N = 508). Results show that almost half of the respondents are not familiar with medicinal herbs, however, 86% use them at least a few times a year. The "familiarity with medicinal herbs" had the strongest direct effect on the use of medicinal herbs, followed by the "social impact of the herbalist" and the "perceived usefulness of medicinal herbs." There is a need to create a new approach to integrative medicine policy and the use of medicinal herbs in Slovenia by developing educational programs, training professionals, establishing guidelines for the safe and effective use of herbs, and advocating for reimbursement by health insurance companies.

Beyond pillbox: a national cross-sectional study on the attitudes, practices, and knowledge of community pharmacists regarding complementary and alternative medicine.

BACKGROUND: While community pharmacists are uniquely positioned to promote the safe and effective use of complementary and alternative medicine, their potential role remains largely untapped. The objective of this study was to assess the knowledge, attitudes, and practices related to complementary and alternative medicine products among community pharmacists in the United Arab Emirates and explore the correlates of knowledge in the study sample. METHODS: Using a stratified random sampling frame, a national survey of community pharmacists was conducted in the United Arab Emirates. In a face-to-face interaction, participants completed a multi-component questionnaire consisting of four sections: sociodemographic and general characteristics; knowledge of complementary and alternative medicine products and usage; attitudes towards complementary and alternative medicine and practices related to complementary and alternative medicine. Based on participants' answers, scores were calculated with higher scores indicating more positive knowledge, attitudes, and practices. RESULTS: 373 community pharmacists participated in the study (response rate: 83%). For the knowledge questions, more than 50% of community pharmacists correctly answered the functions of complementary and alternative medicine, however lower percentages were noted for the side effects and drug interactions questions. Most community pharmacists had positive attitudes towards complementary and alternative medicine, except for particular aspects such as efficacy, where 40% agreed that complementary and alternative medicine is only effective in treating minor complaints. As for practices, while more than 70% of participants counseled patients on complementary and alternative medicine use, only 47% reported the toxic effects when encountered. Multiple linear regressions showed that community pharmacists working in independent pharmacies, those with fewer years of experience, and those who did not receive complementary and alternative medicine education during their academic degree had lower knowledge scores (p < 0.05). CONCLUSIONS: The findings of this study showed that community pharmacists in the United Arab Emirates have good knowledge of complementary and alternative medicine functions and generally positive attitudes and practices, with few gaps identified in each. Together, these findings provide critical evidence for the development of targeted interventions to promote the role of community pharmacists towards safe and effective complementary and alternative medicine use in the country.

Effect of COVID-19 Pandemic on Knowledge, Attitude and Practices Towards Antenatal Care Among Antenatal Women: A Study From a Tertiary Care Hospital in Delhi, India.

OBJECTIVE:  Effect of the COVID-19 pandemic on knowledge, attitude, and practices toward antenatal care among antenatal women. DESIGN:  Prospective observational study. METHOD: After taking written and informed consent, 3000 term/near-term SARS CoV2-negative antenatal women admitted to the hospital for emergency were enrolled; excluding those in advance labour or critically ill. An interview was conducted and a knowledge, attitude, and practices (KAP) questionnaire was filled out based on verbatim answers. All women were then given individualized antenatal and postnatal care as per hospital protocols and discharged accordingly. The data obtained during the study was recorded on predesigned case proforma and analysed at the end of the study using the SPSS v. 23 software, after the application of appropriate statistical tests. MAIN RESULT: All women knew about the pandemic and its signs and symptoms along with precautions to be taken. Most of the women 2652 (88.4%) thought that they were at increased risk of contracting an infection during pregnancy and 2208 (73.6%) thought that coronavirus can harm the baby and will increase the risk of pregnancy. Awareness of nearby health facilities providing antenatal care was in 71.2% and 94% were aware of functional outpatient department services but only 1.4% were aware of teleconsultation services. About 2094 women have had any ANC visits. All of them knew that taking iron, Ca and vitamin supplements and getting an ultrasound and investigations were necessary but only 1524 (50.8%) took these supplements regularly, 1752 (58.4%) got their ultrasound done and 41.6% got investigations done. Two thousand four hundred thirty-six (81.2%) women had this fear that they would contract COVID-19 infection during their visit to the hospital. All the respondents of our study wanted to have hospital delivery and knew that it was necessary to have ANC registration and none of them wanted to have home delivery. CONCLUSION: Mastering correct knowledge will foster a positive attitude among antenatal women and will not only prevent disease transmission but also improve pregnancy outcomes.

High School Athletes' Use and Knowledge of (Safe) Nutritional Supplement Use: An Exploratory Study.

The use of nutritional supplements can lead to doping risk and no data exist on high school athletes' use of certified third-party tested supplements. A cross-sectional cohort design was developed using an anonymous survey. Descriptive data for supplement use, use of third-party tested supplements, and knowledge in high school athletes were reported. A total of 225 high school athletes, ranging from 14-19 years of age, from a private high school in the western US, were included in the analysis of the results. A total of 94% (n=211) of athletes reported nutritional supplement use within the past year with an average of six (interquartile range: 3-9) individual supplements, ranging from 0-20 supplements per person. Most frequently reported were sports drinks (72%), vitamins (65%), sports bars (60%), protein powder (58%), caffeine (37%, as part of normal beverages, or 13% as a supplement), followed by creatine (23%). A total of 24% claimed to know for sure that all their supplements were third-party tested. In addition, the recognition of third-party testing organization icons was low (46% in supplement users vs. 14% in nonusers). Athletes also scored low in reporting how to find (22%) and how to order (25%) third-party tested supplements. In conclusion, almost all athletes in this study reported the use of multiple nutritional supplements annually. Only one-fourth of the athletes reported consistently using third-party tested supplements. Knowledge of where and how tested supplements could be purchased was limited in this high school athlete population.

Parents' Knowledge, Attitude, and Practice Related to Childhood Constipation in Makkah, Saudi Arabia.

Introduction Functional constipation in children is described as irregular or difficult bowel motions without underlying systemic or anatomical causes. Although constipation can have a serious negative impact on a child's health and the lives of their parents. This study aimed to assess the knowledge of parents about childhood constipation, intending to reduce morbidity and mortality through increased public health education in Makkah, Saudi Arabia. Methods The current study was a web-based, descriptive cross-sectional study. The data were obtained from May 2023 to November 2023 through an online questionnaire directed to parents in Makkah, Saudi Arabia, and analyzed using SPSS version 27.0.1 (Armonk, NY: IBM Corp.). Results A total of 796 participants were included in the present study, of which 205 (25.8%) were males and 591 (74.2%) were females. The knowledge levels among them varied, with 11.1% correctly defining constipation and 63.6% recognizing it as a symptom. Common causes like organic and functional constipation were acknowledged by 88.4% and 81.3% of participants, respectively. Regarding practices, 27.9% recommended high-fiber foods for initial home treatment, and 42.8% acknowledged that an enema is effective for fecal impaction. In the dietary recommendations, 71.7% suggested fruits and 68.8% mentioned vegetables. Concerning attitudes, 65.1% expressed fear of childhood constipation continuing into adulthood, while 30.9% feared severe medical conditions. The internet (25.5%) and friends/relatives (23.6%) were the primary sources of information. Knowledge was significantly higher among females and those with postgraduate education. Conclusion This study highlights the variability in knowledge levels among parents, with an overall moderate understanding of childhood constipation. It emphasizes a moderate level of adherence to recommended practices related to childhood constipation, with some room for improvement in Makkah, Saudi Arabia.

The Effect of Mindfulness on Death Escape Acceptance in Young People: Emotion Regulation as a Mediator.

Few studies have examined young people's attitudes toward death escape acceptance and its relationship to mindfulness. This study addressed this issue and examined the mediating role of emotion regulation. In Study 1, 61 undergraduate students aged 19-22 years participated in a mindfulness intervention program, and the results showed that increasing young people's levels of mindfulness could improve their attitudes toward death escape acceptance. The Study 2, which recruited 440 young people aged 18-26 years to complete a cross-sectional survey, replicated the main effect and showed that young people's difficulty in emotion regulation fully mediated the coping effect of mindfulness. These findings suggest that individuals with high levels of mindfulness may have low levels of difficulty in emotion regulation and in turn promote healthy attitudes toward death escape acceptance.

Practice and attitude of general practitioners towards initiating isotretinoin for acne vulgaris in Fars province, Iran: cross-sectional study.

BACKGROUND: Since general practitioners manage acne-related referrals, there needs to be more information in Iran about how drugs such as Isotretinoin are prescribed and the treatment plan. Thus, this study aimed to evaluate general practitioners s' practices and attitudes in prescribing Isotretinoin for acne vulgaris in primary care. METHODS: This web-based cross-sectional descriptive study was conducted using two questionnaires designed with the target population of GPs working in Fars province in 2021 regarding the prescription of Isotretinoin. Moreover, demographic information, questions about interest in dermatology, and participation in dermatology workshops were gathered. RESULTS: A total of 308 complete questionnaires were obtained. According to our results, 85 (27.6%) GPs prescribed Isotretinoin in primary care. Based on our results, higher age (OR: 1.042; CI95%: 1.013-1.072; P-value:0.004) and attending dermatological courses (OR: 3.280; CI95%: 1.592-6.755; P-value:0.001) were significantly correlated with more frequent Isotretinoin administration. Among GPs who do not prescribe Isotretinoin, the most common causes are concerns about liver dysfunction (54.7%), teratogenic concerns (37.2%), and lack of familiarity with the drug (31.4%) respectively. CONCLUSION: The results of this study depicted the reluctance of most physicians to prescribe Isotretinoin and factors such as taking part in supplementary courses under the supervision of dermatologists and following national guidelines that could encourage them to prescribe Isotretinoin.

Flemish equine veterinarians' perceptions on the use of and client communication about complementary and alternative veterinary medicine.

BACKGROUND: Complementary and alternative veterinary medicine (CAVM) is increasingly popular in horses. As CAVM usage could have risks, client-veterinarian communication about CAVM is crucial. OBJECTIVES: Evaluating equine veterinarians' attitude towards CAVM, their CAVM usage and veterinarian-client communication about CAVM. STUDY DESIGN: Cross-sectional study. METHOD: A telephone survey was conducted among equine veterinarians providing ambulatory care on a daily or weekly basis. The first section of the survey included questions about the veterinarians' attitude towards CAVM and their CAVM usage. The second section focused on veterinary-client communication about CAVM. RESULTS: When herbs are included as CAVM modality, 83% of the participants applied CAVM. Nighty-eight percent had already communicated with horse owners about CAVM and 81% agreed to be open to talk about CAVM. However, 95% agreed that sometimes CAVM usage takes place without disclosure to the veterinarian. The majority of participants communicated about CAVM on a weekly (40%) or daily (22%) basis, most often in person during consultations (99%) or via phone (32%). The median percentage of conversations about CAVM initiated by the owner was 50% (range 50%-80%). When the veterinarian initiated the conversation, this was usually by mentioning it as a treatment option, mostly in addition to conventional treatments. Some participants directly asked about CAVM use in the information-gathering phase. MAIN LIMITATIONS: A convenience sample was used due to lack of data on the number of equine veterinarians in Flanders. Potential favourability bias with higher participation of veterinarians interested in CAVM. CONCLUSION: Equine veterinarians generally had a positive attitude towards CAVM use, although this depended on the specific modality. Veterinarian-client communication about CAVM occurs frequently in ambulatory care. An open dialogue with horse owners about CAVM is important to provide information about CAVM and thus enable them to make informed decisions concerning CAVM usage, together with their veterinarian.

INTRODUCTION/CONTEXTE: La médecine complémentaire et alternative (CAVM) est de plus en plus populaire chez les équins. Comme l'utilisation de la CAVM peut entrainer des risques, la communication entre le vétérinaire et le client à propros de la CAVM est cruciale. OBJECTIFS: Évaluer l'attitude des vétérinaires équins par rapport à la CAVM, leur utilisation de la CAVM et leur communication aux clients en lien avec la CAVM. TYPE D'ÉTUDE: Étude transversale. MÉTHODES: Un sondage téléphonique des vétérinaires équins fournissant un service ambulatoire journalier ou hebdomadaire a été fait. La première partie du sondage incluait l'attitude des vétérinaires vis­à­vis la CAVM et leur usage de la CAVM. La seconde partie se concentrait sur la communication vétérinaire­client à propos de la CAVM. RÉSULTATS: Lorsque les herbes étaient incluses en tant que modalités de la CAVM, 83% des participants appliquaient la CAVM. Quatre­vingt­dix­huit pourcents avaient déjà parlé de la CAVM avec des propriétaires de chevaux et 81% étaient ouvert à l'idée d'en parler à leur client. Par contre, 95% étaient d'accord pour dire que la CAVM est parfois utilisée sans le mentionner au client. La majorité des participants parlaient de la CAVM sur une base hebdomadaire (40%) ou journalière (22%), le plus souvent durant les rendez­vous (99%) ou par téléphone (32%). Le pourcentage médian de conversations initiées par les propriétaires, à propos de la CAVM était de 50% (étendu 50­80%). Lorsque le vétérinaire initiait la conversation à ce sujet, c'était le plus souvent en mentionnant la CAVM comme option de traitement, plus particulièrement comme étant un ajout aux traitements conventionnels. Certains participants ont demandé de l'information directement à propos de la CAVM durant la phase de récolte de l'information. LIMITES PRINCIPALES: Un échantillon de convenance a été utilisé en raison du manque de données par rapport au nombre de vétérinaires équins dans les Flandres. Biais favorable possible en cas de participation plus élevée des vétérinaires intéressés par la CAVM. CONCLUSIONS: Les vétérinaires équins ont généralement une attitude positive par rapport à la CAVM, parfois dépendant spécifiquement de la modalité de traitement. Les communications vétérinaire­client à propos de la CAVM se produisent très fréquemment en pratique ambulatoire. Un discours ouvert avec les propriétaires de chevaux à propos de la CAVM est important afin de fournir de l'information sur la CAVM et de ce fait, leur permettre de faire une décision éclairée en ce qui à trait à l'utilisation de la CAVM, en accord avec leur vétérinaire.

The Relationship Between Religious Attitude, Compassion and Spiritual Care in Nursing Students: The Case of Türkiye.

In the present descriptive study, we aimed to examine the relationship between the levels of religious attitude, compassion and spiritual care perception among nursing students. Data were obtained from 135 nursing students using the Socio-Demographic Diagnosis Form, the Ok-Religious Attitude Scale, the Compassion Scale, and the Spiritual Care-Giving Scale. The data were analyzed using the Kruskal-Wallis H test, the Spearman correlation test, and the Mann-Whitney U test. A positive correlation was found between the scores of the Ok-religious attitude scale and cognition sub-dimension, emotion sub-dimension, behavior sub-dimension, god sub-dimension and compassion scale and spiritual care-giving scale scores. Furthermore, we observed that some socio-demographic, and nursing profession and spiritual care characteristics of the students affected their religious attitudes, compassion and spiritual care perception. The sub-dimension scores of compassion and awareness of sharing among female students and the mindfulness scores of students with nuclear families were high. Our data suggest that the course contents for spiritual care, which is an integral part of holistic nursing care, should be included in the nursing curriculum. Moreover, we recommend that efforts be made to maintain a high level of compassion while considering the socio-demographics of the students and their opinions on the nursing profession. Finally, the data presented here has the potential to serve as a valuable resource for the development of novel approaches to the provision of spiritual care within nursing education programs.

The Development and Efficacy of a High School Athlete Education Program for Safe Nutritional Supplement Use.

Many high school athletes report using nutritional supplements. Due to a lack of education at the high school level, the use of safe for sports third-party tested nutritional supplements may be limited. To determine the impact of a short online nutritional supplement education program on safe dietary supplement behavior a cross-sectional repeated measures design was used. Therefore, a convenience sample of 106 high school athletes (14-19 years old) was recruited to measure pre-post education difference for nutritional supplement use and third-party tested (TPT) supplements. Additionally, it was analyzed if nutritional supplement related Theory of Planned Behavior (TPB) constructs were associated with athlete choices. The most popular supplements included protein powder (65%), caffeine from beverages (45%), and different types of vitamins (ranging from 38-44%). Consistent use of (safe) third-party tested individual supplements was low, ranging from 35-77% for the most frequently reported supplements. The combined TPB determinants explained 26% of the variance of the intention to use safe supplements (F3, 102 = 13.03, p < 0.001, Adj R2 = 0.26). The self-reported intention to use third-party tested supplements increased significantly (+7%-36% per individual supplement) after following the education program (Z = -3.288, p = 0.001) resulting in an intentional use of 54-94% TPT supplements. In conclusion, education resulted in more high school athletes reporting future third-party tested supplements use, and TPB construct scores did not change over time but could explain a substantial part of the variance of safe supplement use intentions.

Knowledge, attitude, and perceptions of healthcare professionals towards complementary and alternative medicine: a cross-sectional survey from twin cities of Pakistan.

BACKGROUND: The growing popularity and use of complementary and alternative medicine (CAM) products among the general public worldwide has been well documented. This study aimed to investigate the knowledge, attitude, and perceptions (KAP) of Pakistani healthcare professionals (HCP) toward CAM and to document their views on integrating CAM education with the curriculum of undergraduate health science programs. METHOD: A cross-sectional study using simple random sampling was conducted for a duration of ten months among HCPs from Pakistan's twin cities: Islamabad and RawalpindiThe data were collected using a self-administered and validated (Cronbach's alpha: 0.71) questionnaire. This questionnaire consisted of five sections, namely; demographic, attitude, perception, integration and knowledge. RESULT: The response rate was 91.20% (500/456). The participants included 160 physicians, 155 nurses,and 141 pharmacists. The majority of the respondents were females, 67.50%, and unmarried (60.50%).The majority of HCPs participating in this study agreed that CAM modalities may benefit conventional medicine system. Likewise, most HCPs perceived different CAM therapies aseffective treatment options. More than 50% HCPs suggested CAM elective courses in the curriculum of the health sciences program.Overall, 79.17% of the HCPs have poor knowledge of CAM. Physicians have the highest knowledge score 25.63%, followed by pharmacists 21.99%, and nurses 12.26%. Knowledge status was significantly associated with age, profession, and experience of practice (p = 0.001,0.001 & 0.019). CONCLUSION: This study revealed that despite the overall positive attitude of HCPs toward CAM, the score of knowledge is low. Therefore, the survey recommends evidence-based guidelines for the rationale use of CAM and updated syllabi of undergraduate health programs which will assist the future HCPs in increasing professionals' knowledge toachieve better health outcomes for the general public.

An acupuncture manipulation classification system based on three-axis attitude sensor and computer vision. / ä¸€ç§åŸºäºŽä¸‰è½´å§¿æ€ä¼ æ„Ÿå™¨å’Œè®¡ç®—æœºè§†è§‰çš„é’ˆåˆºæ‰‹æ³•åˆ†ç±»ç³»ç»Ÿ.

OBJECTIVES: To explore the action characteristics of acupuncture manipulations by combining visual and sensor technique, so as to improve the identification and classification accuracy of acupuncture manipulations and to quantificate the classifiations. METHODS: In this paper, the time domain features of acupuncture physical parameters and dynamic gesture features in the video of acupuncture manipulations are combined together to identify and classify acupuncture techniques. The acupuncture needle manipulation processes of 2 acupuncture experts and 3 young acupuncturists were selected as the study objects. The collected data included 4 basic manipulation techniques：lifting-thrusting reinforcing, lifting- thrusting reducing, twisting reinforcing and twisting reducing methods, all of which were performed by right-handed doctors. During acupuncture manipulation, a three-axis attitude sensor was used to acquire finger moving acceleration velocity and needle-rotating angle velocity, followed by analyzing the parameters of hand-moving velocity, amplitude, strength and angle. The mapping relationship among physical parameters and different manipulating methods was formed in time domain. The computer vision technology was employed to extract the spatio-temporal features of the acupuncture manipulation video images, and a hybrid model of three-dimensional convolutional neural network (3D CNN) and long- and short-term memory (LSTM) neural network were used for the recognition and classification of dynamic gestures of hand in acupuncture manipulation videos. Then the time-domain features of physical parameters were combined with the dynamic gestures in the classification process, with the manipulation classification realized. RESULTS: In performing the lift-thrusting reinforcing method, the needle insertion speed was faster and the force was larger, while the needle lifting speed was slower and the force was smaller. And in performing the lift-thrusting reducing method, the needle lifting speed was faster, the force was stronger, and the needle insertion speed was slower and the force was smaller. In the performance of twisting reinforcing, the leftward twisting force was bigger and the rotation amplitude was larger, while in performing the reducing method, the rightward twisting force was larger and the rotation amplitude was larger. When using the mean value of time of acceleration, speed, and amplitude as the basis of discrimination, the accuracy rates of lifting-thrusting reinforcing and reducing were 95.56% and 93.33%, while those of the two twisting manipulations were 95.56% and 91.11%, respectively. Compared with the classification method that only uses the sensor to obtain the manipulation information, the recognition accuracy was significantly improved. CONCLUSIONS: The acupuncture manipulation classification system can achieve quantitative analysis of physical parameters and dynamic recognition of acupuncture techniques, providing a certain foundation for the quantification and inheritance of acupuncture techniques.

[Psychedelics and treatment of mental disorders: A survey of attitudes and knowledge among psychiatrists, general practitioners and psychologists in Iceland].

INTRODUCTION: Interest in the use of psychedelics has increased following reports of their possible therapeutic potential. However, little is known about the knowledge of and attitudes towards the substances among health care professional who provide treatment for mental disorders in Iceland. An online survey was therefore conducted among members of the Icelandic associations of psychiatrists, general practitioners and psychologists. METHODS: Respondents were 256 in total, including 177 psychologists, 38 psychiatrists and 41 general practitioners that provided information on their background, type of work, knowledge of and attitude towards different types of psychedelic substances and their views on optimal service delivery if psychedelics were approved by licencing authorities and used for treatment. RESULTS: Around half of psychiatrists reported having received questions about treatment with psychedelics in their clinical work, compared to only 14,6% of general practitioners and 17,5% of psychologists. The majority of respondents had little, or no knowledge of the substances targeted in the survey. A majority also expressed negative attitudes towards treatment with psilocybin mushrooms, but was positive towards ongoing scientific research and felt that such a treatment should be prescribed and provided by psychiatrists. Moreover, the majority view was that psilocybin treatment should be provided in specialised clinics or psychiatric units in a hospital setting. Scientific articles on the topic, discussions with colleagues and information in the media were identified as having had most influence on respondents´ attitudes towards psychedelics. Most respondents were interested in further education on psychedelics. CONCLUSIONS: Respondents among these three professions felt that the time has not yet come to use psychedelics in the treatment of mental disorders in Iceland but thought more education on psychedelics, their potential efficacy and adverse health effects is important given the increased interest in psychedelics.

Public Use of Complementary Medicine for Children in Saudi Arabia: A Questionnaire-Based Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: The use of complementary and alternative medicine (CAM) is growing among adults and children. Extensive data is available regarding the pattern and frequency of CAM used in adults in Saudi Arabia, but limited data is available for children. This study aims to examine the level of knowledge, attitude, and practice about the use of CAM in the pediatric population in Saudi Arabia. SUBJECTS AND METHODS: A cross-sectional descriptive study on the use of CAM in children was carried out in the general population of Saudi Arabia. Data was collected by non-probability consecutive sampling technique through an online-based questionnaire from 132 participants. In addition, data analysis was done using IBM's Statistical Package for the Social Sciences (SPSS). The data collected consisted of socio-demographic details, knowledge, attitude, and practice of CAM in children. RESULTS: CAM was reported in all 132 participants (100%), with 45% (N=59) using it without informing their physicians. The mean age of the children was 17 months old, 55.3% (N=73) children were males, and 44.7% (N=59) were females. The most common form of CAM used was herbal medicine, 91% (N=120), while alternative medicine was used in 16.7% (N=12) of the children. Honey was the most used herb (68.2%, N=90), followed by anise (65.2%, N=86), Zamzam water (holy water) (59.1%, N=78), and olive oil (56.8%, N=75). CONCLUSIONS: The use of CAM is very common for children in the general population of Saudi Arabia, with herbal medication being the most common. This constitutes a dire need to regulate this field and provide enough information for the public and health care practitioners to provide the best health care. In addition, future awareness campaigns are needed to bridge the communication gap between parents and physicians and provide better information about the benefits and safety of CAM use.