Search Results (2,203)

Background: Globally, community pharmacists worldwide have prescribed more over-the-counter systemic antibiotics, posing significant issues for international organizations tackling antibiotic-resistant bacteria, a major global threat, due to the accessibility in pharmacies. Objectives: This study aimed to examine the Jordanian pharmacists’ antibiotic selection and over-the-counter antibiotic prescriptions. Methods: A total of 244 community pharmacists participated in an online standardized survey, which examined five essential domains including sources and trust of pharmacy antibiotic prescription information, category and frequency of permitted antimicrobials, prescription-free antimicrobials, interactions, antimicrobial prescription issues for pharmacists, and pharmacy staff’s knowledge of non-prescription antimicrobial questions and answers. Results: This study found that 1—pharmacists are confident in prescribing antibiotics and they use various tools to improve their skills. 2—Antibiotics were the most sought antimicrobials without a prescription, followed by antifungals and antivirals. 3—Throat, urinary tract, chest, and otitis media are the most common infections that require antibiotics. Pharmacists prescribe penicillin for 75% of throat infections, Fluoroquinolones for 48.2% of urinary tract infections, and cephalosporins for 35.9%. Macrolides are the most prevalent otitis media treatment (43.2%). 4—Some people obtain antimicrobial prescriptions without a valid reason or diagnosis. 5—Many pharmacists (171/244, 70%) agree or strongly believe that antibiotic prescription information is difficult to obtain. 6—Many pharmacists (183/200, 91.5%) aimed to educate patients on the risks and correct use of antimicrobials without prescriptions. Conclusions: These results show that Jordanian community pharmacists follow clinical antibiotic prescribing guidelines and conduct antimicrobial stewardship, yet they demand antimicrobials without prescriptions and lack decision support tools. Antibiotic classes address most diseases, and pharmacists emphasize antimicrobial misuse. Full article

Over the past 30 years, Romanian Educational Research (RER) has strived to enhance its global visibility. This study examines the evolution and structure of RER through a bibliometric analysis of 10,396 publications indexed in the Web of Science Core Collection from 1975 to 2024. The results reveal fluctuating productivity, with growth driven by national and international initiatives, and challenges during the COVID-19 pandemic. Conference papers dominate research output, while articles and reviews are less frequent. Although domestic sources offer valuable publication opportunities, increasing visibility in high-impact journals is essential for international recognition. Universities across various regions contribute significantly, with research intensive institutions producing the bulk of articles and reviews. Five primary research clusters emerged, including studies on student performance factors, digital transformation in education, curriculum development and students’ skills, competency-based education, and teacher training, as well as advancements in teaching, learning, and assessment practices. The study highlights the importance of international collaborations, particularly with institutions in Europe, the United States, Canada, and Australia, to boost the worldwide impact of Romanian research. These findings provide insights into the current state of RER and suggest that fostering international partnerships and leveraging local strengths can enhance its global presence and contribute to academic diversity. Full article

Objectives: The aim of this study was to evaluate the level of knowledge and awareness among parents regarding oral hygiene habits in two different national groups and to raise awareness among parents about oral hygiene education. Methods: A sample of 640 parents from Rome (Italy) and Valencia (Spain) was collected. The survey involved children between 0 and 18 years of age. An online questionnaire was administered to gather information regarding demographic data, the level of knowledge about dental caries and its transmission, proper oral hygiene habits of parents with regard to their children, mothers’ attitudes towards their own oral health before or during pregnancy, awareness of risk behaviors, such as the use of pacifiers or baby bottles, sharing cutlery, the use of the same toothbrush in the entire family, the role of schools, and oral health prevention techniques. Results: The comparison between the two groups shows that Spanish parents are more attentive to oral hygiene measures compared to Italian parents, especially about the knowledge of dental caries and its transmission, oral health check-ups during pregnancy, and proper oral hygiene habits. In both groups, there is still little knowledge about oral prevention methods. Conclusions: From the results of our survey, we can conclude that the knowledge regarding oral hygiene among parents from both countries is not yet optimal when compared to international health objectives. It is necessary to promote oral health prevention programs both in schools and within families in order to improve children’s oral health. Full article

Deforestation in the municipality of Puerto Guzmán, located in the Colombian Amazon, has increased significantly in recent years with negative consequences for the region’s ecosystems. This paper article aims to explore local perceptions of the causes and actors of deforestation in Puerto Guzmán through a qualitative approach. Semi-structured interviews and documentary review were used as data collection techniques. A total of 25 interviews were conducted with different stakeholders between June and October 2022. ATLAS.ti 9 software was used for data processing. The study found that the main perceived causes of deforestation in Puerto Guzmán are extensive cattle ranchers, illegal mining and illicit crops. The main actors of deforestation include businesspeople and raising cattle in Caquetá, as well as local armed groups involved in illicit crop cultivation and illegal mining, which generate violence and intimidation in the community. Almost all of the actors belong to the local community, with the exception of some members of the armed groups who come from other regions. The various actors interviewed identified education as possible alternative solution and suggested improvements to the illicit crops substitution programmes. It was concluded that there is a loss of trust among the actors living in Puerto Guzmán, particularly in relation to the management of international cooperation funds intended to support efforts to reduce deforestation. The communities are aware of these resources and claim that they belong to them and therefore expect them to be given directly to them. Full article

Background: Diabetes mellitus is one of the greatest public health challenges worldwide and one of the major conditions contributing to a poorer quality of life. The main factors that may deteriorate quality of life among patients with diabetes include age, financial status, educational background, quality of healthcare services and presence of disease complications. This study aimed to assess the quality of life among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province, taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among participants of the “Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolReD” (“Stop Diabetes! Polish Diabetes Registry (PolRed)”) project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the 36-Item Short Form Survey (SF-36). Results: The overall study group had the highest level of quality of life assessment in the domains of social functioning (M = 69.48; SD ± 28.07), physical functioning (M = 64.54; SD ± 31.57) and role limitations due to emotional problems (M = 62.40; SD ± 45.21), and the lowest level of quality of life in the domain of general health perceptions (M = 42.21; SD ± 12.77). Age was found to be negatively correlated in all quality of life domains analysed (r = −0.438; p < 0.001)—quality of life decreased with age in all investigated domains. Men had a statistically significantly (p < 0.05) higher quality of life in each analysed domain (M = 43.52–74.08; SD ± 12.68–44.09) compared to women (M = 41.18–65.88; SD ± 12.76–46.08). Place of residence also exhibited a statistically significant (p < 0.05) differentiated quality of life in terms of physical functioning. Conclusions: The assessment of quality of life among patients with type 1 and type 2 diabetes and those diagnosed with prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The assessment of quality of life among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. Respondents with type 1 diabetes have a higher quality of life in terms of role limitations due to physical health, role limitations due to emotional problems, pain (bodily pain) and general health compared to respondents with type 2 diabetes. Full article

Background/Objectives: Universities, particularly in nursing education, have evolved to incorporate University Social Responsibility (USR) into their curricula, emphasizing ethical, social, and sustainable competencies, which align with the Sustainable Development Goals (SDGs) to enhance healthcare and education. The study examines socially responsible behaviors, ethical competencies, and sustainability values among nursing students in private universities in Santiago, Chile, and their relation to sociodemographic variables. Methods: The study measures social responsibility in nursing students at private universities, accredited and co-financed by the State in Santiago, Chile, using the ICOSORE-U questionnaire, with statistical analyses such as EFA and CFA to validate the scale and evaluate correlations with sociodemographic variables. Results: The study validated the ICOSORE-U-10 scale for social responsibility in Chilean nursing students through both exploratory and confirmatory factor analysis. The results revealed a two-factor structure and an acceptable internal reliability (α = 0.841), with no significant differences related to sociodemographic variables. The findings confirmed that socially responsible behaviors are positively correlated with the development of ethical competencies and sustainability among these students. Conclusions: the socially responsible behaviors of nursing students are mainly determined by their orientation towards University Social Responsibility (USR) and not by sociodemographic variables. This orientation favors the development of ethical and professional competencies, improving their ability to address social and ethical challenges in the health field. Integrating the principles of USR in university education is key to training professionals committed to social justice, equity and sustainability in health care. Full article

This study examines how Japanese Generation Z, “digital natives” currently in higher education, engage in cross-cultural learning and develop global skills. In the modern digital era, encountering and studying international topics, cultures, and languages is no longer limited to the traditional physical movement of people to acquire new experiences. We seek to investigate a modernized educational model for intercultural exchange, learning, and internationalization that emphasizes the technological information, platforms, and tools that the digital native generation uses daily. We use survey data from 123 Japanese higher-education students to investigate this subject and help reveal how they can operate and learn global skills in an increasingly digital landscape. Our findings indicate a strong desire to gain intercultural competence through digital sources, remote communications, and interactions with inbound international students. Digital information provides a significant opportunity for students to gain foundational international knowledge and competencies without the level of investment and limited accessibility of traditional study-abroad programs. We consider the pros and cons of integrating digital information into future academic endeavors. Full article

Background: Interdialytic weight gain (IDWG), defined as the accumulation of salt and water intake between dialysis sessions, is a critical parameter of fluid management and a marker of adherence to dietary and fluid restrictions in hemodialysis patients. Excessive IDWG has been strongly associated with increased cardiovascular risk, including left ventricular hypertrophy, cardiac dysfunction, and cerebrovascular complications. Additionally, it necessitates more aggressive ultrafiltration, potentially compromising hemodynamic stability, impairing quality of life, and escalating healthcare costs. Despite international guidelines recommending an IDWG target of <4–4.5% of body weight, many patients struggle to achieve this due to barriers in adhering to dietary and fluid restrictions. This review explores the current state-of-the-art strategies to mitigate IDWG and evaluates emerging diagnostic and therapeutic perspectives to improve fluid management in dialysis patients. Methods: A literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science to identify studies on IDWG in hemodialysis. Keywords and MeSH terms were used to retrieve peer-reviewed articles, observational studies, RCTs, meta-analyses, and systematic reviews. Non-English articles, case reports, and conference abstracts were excluded. Study selection followed PRISMA guidelines, with independent screening of titles, abstracts, and full texts. Data extraction focused on IDWG definitions, risk factors, clinical outcomes, and management strategies. Due to study heterogeneity, a narrative synthesis was performed. Relevant data were synthesized thematically to evaluate both established strategies and emerging perspectives. Results: The current literature identifies three principal strategies for IDWG control: cognitive–behavioral interventions, dietary sodium restriction, and dialysis prescription adjustments. While educational programs and behavioral counseling improve adherence, their long-term effectiveness remains constrained by patient compliance and logistical challenges. Similarly, low-sodium diets, despite reducing thirst, face barriers to adherence and potential nutritional concerns. Adjustments in dialysate sodium concentration have yielded conflicting results, with concerns regarding hemodynamic instability and intradialytic hypotension. Given these limitations, alternative approaches are emerging. Thirst modulation strategies, including chewing gum to stimulate salivation and acupuncture for autonomic regulation, offer potential benefits in reducing excessive fluid intake. Additionally, technological innovations, such as mobile applications and telemonitoring, enhance self-management by providing real-time feedback on fluid intake. Biofeedback-driven dialysis systems enable dynamic ultrafiltration adjustments, improving fluid removal efficiency while minimizing hemodynamic instability. Artificial intelligence (AI) is advancing predictive analytics by integrating wearable bioimpedance sensors and dialysis data to anticipate fluid overload and refine individualized dialysis prescriptions, driving precision-based volume management. Finally, optimizing dialysis frequency and duration has shown promise in achieving better fluid balance and cardiovascular stability, suggesting that a personalized, multimodal approach is essential for effective IDWG management. Conclusions: Despite decades of research, IDWG remains a persistent challenge in hemodialysis, requiring a multifaceted, patient-centered approach. While traditional interventions provide partial solutions, integrating thirst modulation strategies, real-time monitoring, biofeedback dialysis adjustments, and AI-driven predictive tools represent the next frontier in fluid management. Future research should focus on long-term feasibility, patient adherence, and clinical efficacy, ensuring these innovations translate into tangible improvements in quality of life and cardiovascular health for dialysis patients. Full article

Teachers’ sense of efficacy (TSE) is a crucial construct for evaluating the quality of pre-service teachers. While the Teachers’ Sense of Efficacy Scale (TSES) is the most widely used and promising instrument for measuring TSE, there is no existing literature assessing the appropriateness of the TSES for early childhood pre-service teachers in China. This study aimed to adapt the English version of the TSES for the Chinese early childhood education contexts, testing its factor structure, validity, measurement invariance, and reliability. The sample included 402 participants in China. The TSES was translated into Chinese using the standard back-to-back translation method. CFA results indicated that the TSES is best represented by a modified three-factor model, demonstrating strong preliminary, overall, and internal structure fit. The concurrent validity, convergent validity, criterion-related validity, internal consistency reliability, and composite reliability of the Chinese version of the TSES were robust. The measurement invariance across age and college year was also confirmed. This study addresses a gap in the literature by providing robust empirical evidence on the factor structure, validity, measurement invariance, and reliability of the Chinese version of the TSES for early childhood pre-service teachers, thereby enhancing understanding of TSE in Chinese-speaking Confucian culture and in early childhood education contexts. Full article

Introduction: The COVID-19 pandemic caused significant disruptions to medical training worldwide, particularly for junior doctors, as in-person clinical training was replaced by online education. This study aims to assess the impact of the pandemic on medical training in Greece, focusing on the perceptions of junior doctors across various specialties and exploring the implications for future clinical practice. Methods: We conducted a cross-sectional online survey of 465 junior doctors, all of whom were members of the Athens Medical Association, from 14 September to 14 October 2022. Participants completed a questionnaire assessing the perceived impact of the pandemic on their training, the effectiveness of online education, and potential consequences for clinical preparedness. Factor analysis was conducted to identify underlying patterns related to perceptions for the impact on medical training. Multiple linear regression models were used to assess potential associations among the extracted factors and participants’ sociodemographic characteristics. Results: Among the 465 participants, the mean age was 32.1 (SD = 7.0) years and 300 (64.5%) were female. Among the responders, the majority (n = 241, 51.8%) conducted training in Internal Medicine, 155 (33.3%) in a surgical specialty and 69 (14.8%) in other specialties, including Psychiatry, Radiology and Laboratory Medicine. Two out of five medical students reported that their medical training was mostly affected during the first wave of the pandemic, from March to June 2020 (n = 201, 43.2%). Factor analysis revealed the existence of two factors with high reliability and acceptable validity, interpreted as “perceptions towards online training” and “perceptions for the consequences of the pandemic on medical training”. Age and medical specialty were found to be significantly associated with both factors. Conclusion: Training was severely disrupted, with potential long-term implications for clinical competence; therefore Government and Universities should consider the lessons learned from the pandemic and compensate for the time and opportunities lost. Measures must be taken to safeguard medical education and training in the event of such outbreaks in the future. Full article

Aberrant responding poses a significant challenge in measurement and validity, often distorting well-established relationships between psychological and educational constructs. This study examines how aberrant response patterns influence the relationship between student–teacher relations and students’ perceptions of school safety. Using data from 6617 students from the Saudi Arabia Kingdom from the 2022 Programme for International Student Assessment (PISA), we employed the cusp catastrophe model to evaluate the nonlinear dynamics introduced by aberrant responses, as measured by the U3 person-fit index and the number of Guttman errors. Theoretical and empirical support for the cusp model suggests that aberrance functions as a bifurcation parameter, shifting the relationship between student–teacher relations and perceived school safety from predictable linearity to chaotic instability when exceeding a critical threshold in aberrant responding. Results indicate that both the U3 index and the number of Guttman errors significantly contribute to response distortions, confirming the cusp model’s superiority over traditional linear and logistic alternatives. These findings suggest that ignoring aberrant responding risks misinterpreting data structures, while properly accounting for it through catastrophe models provides a more nuanced understanding of nonlinear system behavior in educational assessment. The study highlights the importance of person-fit statistics in psychometric evaluations and reinforces the predictive utility of nonlinear models in handling response distortions in large-scale assessments. Full article

Background/Objectives: Access to healthy and affordable food remains a challenge for under-resourced communities due to uneven food distribution and the need for reliable transportation. This study developed and evaluated an interactive Geographic Information System (GIS)-based food asset map for a low-income community in Windham, Connecticut to improve awareness of food resources and expand opportunities for fresh food access. Methods: Using the human-centered design (HCD) framework and the Asset-Based Community Development (ABCD) model, the map integrates food locations, transportation routes, and assistance eligibility. Internal pilot testing (n = 8) identified usability issues, leading to updates such as mobile compatibility and user guides. Usability testing (n = 74) assessed navigation performance and user feedback through task-based evaluations and surveys. Categorical map usability, sociodemographic, diet, and health characteristics were tested for participants with food security (yes/no) or digital literacy (passed/failed). Results: Food-secure participants showed higher usability success than food-insecure individuals (p < 0.05), while those relying on food assistance faced greater challenges (p < 0.05). Individuals rating their diet as “very good/excellent” were most likely to pass the map usability testing (p < 0.05), whereas younger, college-educated, employed participants and those with vehicles trended toward passing (p < 0.1). Participants generally reported the map easy to navigate, especially those with food security. Conclusions: The asset map promotes food resource awareness and addresses barriers such as limited public transportation information. Additional efforts are needed to support food-insecure users in utilizing digital food access resources. This study contributes to initiatives to improve food access, digital inclusion, and community engagement in under-resourced communities. Full article

Background/Objectives: Maternal nutrition during pregnancy exerts a significant influence on both maternal and foetal health, as well as long-term child development. Despite its importance, adherence to dietary guidelines among pregnant women remains low. The present study aimed to develop and validate the Italian Pregnancy Nutrition Knowledge Questionnaire (ItPreNKQ), based on national dietary guidelines for the pregnant Italian population, assessing its reliability and validity. Methods: The ItPreNKQ comprised 15 questions covering key topics on nutrition during pregnancy. The questionnaire was validated through item analysis (difficulty and discrimination indices), construct validity, internal consistency, and reliability tests. Results: A total of 145 pregnant Italian women participated in the study. The reliability of the questionnaire was confirmed through a Pearson’s correlation of R = 0.790 and a Cronbach’s alpha of 0.682, indicating strong temporal stability and acceptable internal consistency. Despite good overall performance, the mean knowledge score was 10.6 ± 2.5 out of 15, indicating significant knowledge gaps in specific topics. Conclusions: The ItPreNKQ has been demonstrated to be a reliable and valid tool for the assessment of nutrition knowledge among pregnant Italian women. The tool could be used for assessing nutritional knowledge in prenatal education settings and could be administered in future studies aimed at evaluating the impact of nutritional interventions among pregnant women. Full article

Teaching university students about international food and agricultural issues is paramount to preparing a globally competent workforce. Given future demands for foodstuffs needed to sustain a global populace exceeding nine billion, educators are tasked with promoting understanding of international agricultural issues. Studying students’ beliefs about international agriculture and the information sources and experiences used to form those beliefs is necessary in preparing a globally competent workforce. The purpose of this study was to explore university participants’ beliefs about international agriculture issues and the information sources and experiences used to learn about such issues using a cross-sectional design with random samples at Texas A&M University. Results showed that beliefs about international agriculture issues were strong; graduate students held the strongest beliefs. Those with an international experience, family in agriculture, or majors in agriculture held stronger beliefs about the diversity of international agriculture. Respondents with international experience(s) perceived internal and external sources and experiences as beneficial to learning about international agricultural issues. Efforts to create a more inclusive curriculum for international agricultural issues can be enhanced through specific information sources and experiences in postsecondary education. Research is needed to explore complex factors (e.g., educator–learner and peer-to-peer homophily, experience abroad) affecting beliefs about international agricultural issues. Full article

This study applies deep learning predictive networks and multi-objective decision-making algorithms to the context of innovation and entrepreneurship education, aiming to explore the characteristics of students in different majors regarding innovation and entrepreneurship. It also investigates how their inputs contribute to the enhancement of their innovation and entrepreneurship abilities, as well as the improvement of their academic performance. The researchers designed survey questions across four levels: internal and external factors, and subjective and objective factors. Longitudinal data are collected from 650 students at different grade levels. The results show a clear positive correlation between grade point innovation (GPI) and grade point average (GPA), and the relationship between students’ learning characteristics and GPI and GPA is established using a deep network of deep kernel extreme learning machines. The strategies in the questionnaire are used as control variables to obtain learning strategies for different students using a multi-objective decision-making approach based on evolutionary algorithms. This study shows the effect of different resources on the improvement of students’ innovation abilities and provides possible innovation strategy suggestions for different groups. The results of this study may contribute to the improvement of innovation and entrepreneurial curricula and educational methods. Full article