UNASSIGNED: Older age and female sex are risk factors for osteoarthritis and osteoporosis (OP). This study evaluated the knowledge, attitudes, and practices of patients with knee osteoarthritis (KOA) in China regarding OP and its prevention. This cross-sectional, questionnaire-based study enrolled patients with KOA at four grade-A tertiary hospitals in Shandong Province between 1st September and 20th November 2022.
UNASSIGNED: The administered questionnaire contained 55 items across four dimensions (demographic information, knowledge, attitude, and practice). Logistic regression analyses were performed to identify factors associated with an overall questionnaire score ≥70% of the maximum possible score. SPSS 26.0 was used for the analyses; P<0.05 was considered significant.
UNASSIGNED: The analysis included 434 participants (261 females). The median knowledge, attitude, and practice scores were 7 (interquartile range: 5-10) (possible range, 0-17 points), 44 (interquartile range: 42-49) (possible range, 11-55 points), and 43 (interquartile range: 38-47) (possible range, 13-65 points), respectively. Multivariable logistic regression indicated that female sex (odds ratio [OR], 2.421; 95% confidence interval [95% CI] 1.558-3.762; P<0.001), age 56-65 years-old (OR, 4.222; 95% CI, 1.763-10.109; P=0.001 vs ≤55 years-old), age >65 years-old (OR, 4.358; 95% CI, 1.863-10.195; P=0.001 vs ≤55 years-old), middle/high/technical secondary school education (OR, 1.853; 95% CI, 1.002-3.428; P=0.049 vs primary school or below), and having KOA for 4-5 years (OR, 2.682; 95% CI, 1.412-5.094; P=0.003 vs ≤3 years) were independently associated with a high KAP score.
UNASSIGNED: There is room for improvement in the knowledge and practices of patients with osteoarthritis in China regarding OP. The findings of this study may facilitate the design and implementation of education programs to increase awareness about OP prevention among patients with KOA.

Health care challenges in remote rural municipalities (RRMs) emphasize the importance of primary health care (PHC) and require an expanded scope of practice. Doctors are key actors in this context. The aim of this study was to explore the level of integration of doctors in RRMs and working practices. We conducted a qualitative study involving semi-structured interviews with 46 PHC doctors working in 27 RRMs in Brazil. Content analysis was performed, resulting in the identification of categories of analysis grouped under three core dimensions: doctor training and experience; comprehensive care and timely access; and the community-based approach. Doctors working in RRMs were mainly recent graduates with limited experience who had undertaken their degree outside Brazil, and care was focused on the individual. The findings also revealed weak sociocultural adaptation and a harsh working environment and issues related to social status that reinforced prejudice against rurality and poverty. Practice was limited in scope and care tended to be oriented towards acute problems, disease-centered and focused on the biomedical model of medicine. Barriers to the delivery of comprehensive care include both structural constraints, such as poor facilities and centralization of services in administrative centers, and the lack of professional competencies necessary for PHC in these areas. The findings point to the need to promote an expanded scope of practice in PHC delivery in RRMs, with major public investment in the promotion of training and strengthening career pathways in these areas.

UNASSIGNED: Childhood stunting poses serious long-term risks to cognitive development, education, and adult productivity. While research has explored stunting\'s causes and effects, there is a lack of focus on maternal knowledge of nutrition-focused nurturing care for stunted children. This gap limits the ability to design effective interventions that target improved caregiving practices.
UNASSIGNED: This study aimed to assess maternal knowledge of nutrition-focused nurturing care and explore associated factors, including child gender, maternal age, education, income, and prior exposure to nurturing care information, among mothers of stunted children aged 6-23 months in Indonesia.
UNASSIGNED: A cross-sectional study was conducted with 73 mothers in Kulon Progo, Yogyakarta. Data were collected from February to March 2024 using a validated self-assessment questionnaire covering four domains: responsive caregiving, early learning opportunities, safety and security, and supportive caregiver well-being. Statistical analyses, including t-tests and one-way ANOVA, were performed.
UNASSIGNED: Overall maternal knowledge of nurturing care was high, with a mean score of 25.15 (SD = 4.72). Factors significantly associated with higher knowledge included having male children (p = 0.017), being aged 30-34 years (p = 0.035), possessing higher education levels (p = 0.002), and prior exposure to nurturing care information (p <0.001). Family income significantly influenced knowledge in the domain of early learning opportunities (p = 0.006), though not in other areas.
UNASSIGNED: Maternal knowledge of nutrition-focused nurturing care was influenced by child gender, maternal age, education, income, and prior exposure to nurturing care information. These findings emphasize the importance of focused educational interventions in nursing practice to enhance maternal knowledge. Addressing these factors can help align nursing strategies better to support the healthy growth and development of children.

This study aimed to explore physicians\' and pharmacists\' knowledge, attitudes, and practice (KAP) regarding the prevention and treatment of cardiovascular toxicity associated with cancer treatment. A multicenter cross-sectional study included physicians and pharmacists between April 2023 and June 2023. The study included 918 participants (514 physicians and 404 pharmacists). The average scores of knowledge, attitudes, and practice were 11.6 ± 3.39, 24.7 ± 2.6, and 26.3 ± 6.8 points. Sufficient knowledge was significantly associated with age ≥ 41 years (odds ratio (OR) = 2.745, 95% confidence interval (CI) 1.086-6.941, P = 0.033), male (OR = 2.745, 95% CI 1.150-2.223, P = 0.005), bachelor\'s degree (OR = 0.084, 95% CI 0.013-0.533, P = 0.009), master\'s degree and above (OR = 0.096, 95% CI 0.015-0.609, P = 0.013), physician occupation (OR = 7.601, 95% CI 1.337-43.207, P = 0.022), pharmacy department (OR = 18.858, 95% CI 3.245-109.57, P = 0.001), oncology department (OR = 4.304, 95% CI 2.426-7.634, P < 0.001), cardiology department (OR = 3.001, 95% CI 1.387-6.492, P = 0.005), hospitals located in Eastern China (OR = 1.957, 95% CI 1.120-3.418, P = 0.018), and hospitals located in Western China (OR = 3.137, 95% CI 1.783-5.518, P < 0.001). Positive attitudes were significantly associated with a senior professional title (OR = 2.989, 95% CI 1.124-7.954, P = 0.028) and hospitals located in Eastern China (OR = 0.424, 95% CI 0.257-0.698, P = 0.001), Western China (OR = 0.231, 95% CI 0.136-0.394, P < 0.001), and Southern China (OR = 0.341, 95% CI 0.198-0.587, P < 0.001). Proactive practice was significantly associated with male (OR = 1.414, 95% CI 1.029-1.943, P = 0.033), senior professional title (OR = 3.838, 95% CI 1.176-12.524, P = 0.026), oncology department (OR = 3.827, 95% CI 2.336-6.272, P < 0.001), and cardiology department (OR = 2.428, 95% CI 1.263-4.669, P = 0.008). Both physicians and pharmacists had positive attitudes toward the prevention and treatment of cardiovascular toxicity associated with cancer treatment, while their knowledge and practice were not as proactive.

This cross-sectional survey study aimed to assess the attitudes and knowledge of children\'s guardians in Poland towards tick-borne encephalitis (TBE) and its vaccine, as well as to compare these attitudes to those regarding other infectious diseases and their vaccines. Data were collected through anonymous questionnaires, both paper-based and online, from 3030 respondents across Poland, with the majority being from TBE-endemic areas. The survey included questions on demographic characteristics, general vaccination beliefs, and specific perceptions of TBE and its vaccine. Statistical analysis revealed significant associations between willingness to vaccinate against TBE and factors such as general vaccination attitudes, information sources, vaccine safety ratings, and perceptions of disease severity. Results indicated that guardians from larger cities and those with fewer children were more likely to vaccinate. Additionally, parents who supported general vaccinations were significantly more willing to vaccinate against TBE. The study concludes that enhancing public awareness about the safety and importance of the TBE vaccine, especially in endemic regions, is crucial for improving vaccination rates. Targeted public health interventions addressing misconceptions and providing accurate information are essential strategies to increase TBE vaccine uptake and protect children from this serious disease.

BACKGROUND: Reading nutritional labelling helps consumers select healthier food, thereby benefitting their oral health. The purpose of this study was to describe the knowledge, attitudes, and practices (KAPs) of parents and carers of children and preteens, associated with reading nutritional labelling, selecting sweetened ultra-processed foods, and their impact on oral health.
METHODS: This was a descriptive cross-sectional study in which a validated questionnaire was administered to 298 parents and caregivers of children aged 1-12 years from different districts in Villavicencio, Colombia. Participants\' scores, based on the number of correct answers, were used to classify their level of KAP as low, medium, or high. In addition, the frequency of responses, the KAP levels, and the median scores were analysed. Finally, associations were determined using the chi-square test.
RESULTS: Most participants reached a medium level in terms of knowledge (41.6%) and attitudes (49.3%) and a low level in terms of practices (43.3%). An association was found between participants\' level of KAPs and their socioeconomic and educational level (p < 0.05).
CONCLUSIONS: The study findings reveal inadequate KAPs associated with nutritional labelling, adequate food selection, and the importance of oral health.

UNASSIGNED: This study sought to understand how university student\'s academic discipline relates to sleep factors including attitudes, hygiene, quality, and duration.
UNASSIGNED: Using a cross-sectional approach, a 30-min survey was advertised to students at two Canadian universities in March of 2022. Sleep measures included the Dysfunctional Beliefs and Attitudes Scale, the Sleep Hygiene Index, the Pittsburgh Sleep Quality Index, and the Insomnia Severity Index. Academic discipline was categorized into four groups: Health, Arts, Sciences, and Engineering. Multiple linear regressions were used to investigate (1) the effect of academic discipline on sleep measures, and (2) the effect of academic discipline, dysfunctional sleep attitudes, and sleep hygiene practices on insomnia, sleep quality and duration.
UNASSIGNED: 1,566 students completed the survey (69.4% women; 80.3% undergraduates). Compared to Health students, Art students had worse dysfunctional sleep attitudes, hygiene, quality, and insomnia severity (p < 0.001). This relationship disappeared after controlling for differences in mental health (p ≥ 0.05). Art students had longer sleep durations (p < 0.01), whereas Engineering students had shorter sleep durations (p < 0.05). When dysfunctional sleep attitudes and hygiene were included in the model, both academic discipline (p < 0.05) and sleep hygiene (p < 0.001) were associated with sleep duration. Sleep hygiene and attitudes were also associated with sleep quality and insomnia severity (p < 0.001), while academic discipline was not (p ≥ 0.05).
UNASSIGNED: These results suggest differences in sleep quality across academic discipline are impacted by dysfunctional sleep attitudes, sleep hygiene, and mental health, whereas differences in sleep duration appear to be independent of these factors. Overall, students in different academic disciplines have unique relationships with sleep and thus may require targeted approaches to improve their sleep. Future interventions should focus on supporting sleep hygiene and attitudes to improve students\' sleep and well-being.

Introduction Non-communicable diseases (NCDs) have a significant impact on health concerns. The transition from school to college coincides with various stressors, affecting student health. The objective was to assess the prevalence of unhealthy lifestyles among college-going students and examine the association of composite lifestyle scores with selected demographic variables. Methods All undergraduate colleges of Rishikesh were included in the study. Cluster sampling with a population proportionate to size was used to select the participants. A structured questionnaire was administered using Google Forms or pen and paper. Index values for each lifestyle activity were added together to get a lifestyle composite score. An unhealthy lifestyle was considered with a score below 40. Association with risk factors was analyzed using a chi-square test and logistic regression. Results Among 742 participants, 166 (22.4%) lived an unhealthy lifestyle with a lifestyle score of <40. The majority of participants were either underweight or above normal weight. An unhealthy lifestyle was prevalent among fourth-year professional students (7; 58.5%), medical (33; 32%), dental (27; 34.6%), hosteller (79; 36%), and BSc Nursing (21; 56.8%) students. BSc Nursing course (AOR: 11.09; 95% CI: 1.17-104.74) and favorable attitude (AOR: 0.74; 95 % CI: 0.59- 0.93) were significant correlates of unhealthy lifestyles. Conclusion The current study indicates that nearly one-fourth of college students have unhealthy lifestyles. Four factors, i.e., health science stream, advancing professional year, hosteller, and unfavorable attitude toward health, were significantly associated with unhealthy lifestyles after adjusting for covariates.

A secondary data analysis of the 2022 Philippine National Demographic and Health Survey (PNDHS) was conducted to explore the underlying structure of knowledge regarding communicable and noncommunicable diseases using multilevel confirmatory factor analysis (CFA). The PNDHS data consist of two levels: level-1 represents within-household data (household questionnaire), and level-2 represents between-household data (primary sampling unit (PSU)). Therefore, a two-level CFA and two-level variance CFA were performed. Furthermore, a multigroup analysis assessed the structural differences between males/females and urban/rural groups. In the PNDHS survey, 30,372 household interviews were completed. Knowledge levels for cancer, heart disease, diabetes, dengue fever, TB, and COVID-19 were 96.7%, 94.9%, 97.8%, 98.4%, 96.7%, and 92.8%, respectively. The two-level CFA indicated that the coefficient loadings of each item for both levels were statistically significant (Z-test, P < 0.001). Regarding two-level variance CFA, the variance at level-1 was higher than that at level-2 (13 and 6.7, respectively). The multigroup analysis revealed that the model was non-invariant (not equal) across gender and residence (likelihood ratio test; P < 0.001, P < 0.001, respectively). In conclusion, level-1 has greater effect than does level-2 because the variance in level-1 is greater than that in level-2, the knowledge of COVID-19 has the lowest loading compared to other items, and rural/urban areas and females/males exhibit different levels of health knowledge.

UNASSIGNED: The Global Specialist Digital Health Workforce Census is the largest workforce survey of the specialist roles that support the development, use, management, and governance of health data, health information, health knowledge, and health technology.
UNASSIGNED: This paper aims to present an analysis of the roles and functions reported by respondents in the 2023 census.
UNASSIGNED: The 2023 census was deployed using Qualtrics and was open from July 1 to August 13, 2023. A broad definition was provided to guide respondents about who is in the specialist digital health workforce. Anyone who self-identifies as being part of this workforce could undertake the survey. The data was analyzed using descriptive statistical analysis and thematic analysis of the functions respondents reported in their roles.
UNASSIGNED: A total of 1103 respondents completed the census, with data reported about their demographic information and their roles. The majority of respondents lived in Australia (n=870, 78.9%) or New Zealand (n=130, 11.8%), with most (n=620, 56.3%) aged 35-54 years and identifying as female (n=720, 65.3%). The top four occupational specialties were health informatics (n=179, 20.2%), health information management (n=175, 19.8%), health information technology (n=128, 14.4%), and health librarianship (n=104, 11.7%). Nearly all (n=797, 90%) participants identified as a manager or professional. Less than half (430/1019, 42.2%) had a formal qualification in a specialist digital health area, and only one-quarter (244/938, 26%) held a credential in a digital health area. While two-thirds (502/763, 65.7%) reported undertaking professional development in the last year, most were self-directed activities, such as seeking information or consuming online content. Work undertaken by specialist digital health workers could be classified as either leadership, functional, occupational, or technological.
UNASSIGNED: Future specialist digital health workforce capability frameworks should include the aspects of leadership, function, occupation, and technology. This largely unqualified workforce is undertaking little formal professional development to upskill them to continue to support the safe delivery and management of health and care through the use of digital data and technology.