Background:Internet healthcare has become a key part of China's hospital-centered health system. Driven by "Internet Plus Healthcare", Healthy China 2030, and public-hospital high-quality development policies, it has evolved from remote consultation experiments into regulated online-offline care pathways. This review traces its development from the first documented remote medical practice in 1986 to the present, focusing on policy, institutional models, clinical evidence, governance challenges, and reform. Methods:We conducted a structured narrative review of English- and Chinese-language sources on internet healthcare in Chinese public hospitals. PubMed/MEDLINE, Web of Science Core Collection, China National Knowledge Infrastructure (CNKI), and official policy sources were searched. Eligible sources addressed internet hospitals, telemedicine, online follow-ups, remote monitoring, e-prescriptions, insurance payments, digital governance, clinical outcomes, patient safety, equity, or implementation barriers in mainland China. Results:Internet healthcare progressed through early telemedicine, institutional network expansion, internet-hospital development, and pandemic-driven normalization. The 2018 regulatory framework positioned internet hospitals as extensions of licensed physical medical institutions, thereby permitting online follow-ups for common and chronic diseases while preserving offline accountability. During COVID-19, online consultation, e-prescriptions, drug delivery, and insurance payments rapidly expanded. Evidence suggests benefits for chronic disease management, medication adherence, cardiovascular secondary prevention, and reduced travel burden. However, evidence remains limited for diagnostic accuracy, adverse events, emergency escalation, and long-term outcomes. Persistent barriers include quality variation, workload, cybersecurity, data fragmentation, artificial intelligence (AI) accountability, reimbursement design, regional inequity, and digital exclusion among older adults. Conclusion:China's model may be understood as a hospital-centered extension of public-hospital functions rather than a stand-alone virtual-care system. Future development should prioritize outcome-based evaluations, safety governance, equitable access, data interoperability, and accountability for internet-based and AI-assisted care.
Background:Nursing care involves both cognitive and emotional aspects, significantly impacting nurses' professional quality of life (ProQOL). This systematic review investigated the factors affecting nurses' professional quality of life in Europe. Methods:This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting framework and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD420251133948). Searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and EBSCOhost from inception to August 2025. Eligible peer-reviewed quantitative studies from European Union countries utilized the ProQOL instrument, reporting on all three dimensions: compassion satisfaction, burnout, and secondary traumatic stress. Two reviewers independently screened records, extracted data, and appraised methodological quality using the Joanna Briggs Institute critical appraisal tool. Results:A total of 3407 records were initially identified, and 35 studies were ultimately included, comprising 8580 nursing staff across diverse clinical settings, predominantly hospitals, with 13 studies conducted during the coronavirus disease period in 2019. Most studies reported moderate levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. Higher compassion satisfaction was generally associated with greater age and professional experience, relevant education and training, work engagement, supportive work environments, better perceived control over workload, and stronger psychosocial resources, including resilience, psychological flexibility, self-compassion, mindfulness, and social support. Higher burnout and secondary traumatic stress related to indirect exposure were consistently linked to a high workload, overtime, rotating schedules, job stress, workplace violence, employment in high-intensity clinical areas, and adverse psychological states, including persistent stress, fear related to the coronavirus disease, and moral distress. Conclusions:Professional quality of life among European nursing staff is influenced by a combination of demographic, occupational, and psychosocial factors. Multilevel strategies addressing organizational stressors while strengthening individual and team-based resources are warranted to improve compassion satisfaction and reduce burnout and secondary traumatic stress.
While growing attention has been given to moral distress and work-related psycho-emotional trauma among practicing midwives, few researchers have explored how midwifery academic educators understand, identify, and manage these phenomena in students. This paper presents a study protocol on the exploration of midwifery academic educators' experiences and knowledge in managing students' moral distress and psycho-emotional trauma related to clinical placement. A qualitative research design using focus group interviews with academic educators involved in undergraduate and postgraduate midwifery education will be adopted. Participants will be purposively recruited according to predefined inclusion and exclusion criteria. Focus groups will consist of 6-8 participants. Two focus group discussions will initially be conducted in each country in the host country's native language. Following preliminary data analysis and identification of major-and subcategories, a second round of focus group confirmatory discussions will be conducted with the same participants. Data will be collected through semi-structured discussions focusing on participants' direct or indirect experiences regarding midwifery students' moral distress and trauma, pedagogical approaches academic educators' use to address these issues, strategies for identifying and managing students' distress, and practices that facilitate students' disclosure and psychological safety. Data will be analysed using the inductive content analysis approach. The study is expected to provide insight into current educational practices, perceived challenges, and gaps in academic educators' preparedness to address moral distress and psycho-emotional trauma among midwifery students. Findings are anticipated to inform the development of targeted pedagogical strategies, continuing education initiatives, and supportive interventions aimed at enhancing students' well-being and resilience during clinical placement. By highlighting academic educators' perspectives, this study seeks to contribute to the advancement of midwifery education through the promotion of psychologically safe learning environments and evidence-informed approaches to managing moral distress and trauma in academic and clinical training contexts.
Background: Antibiotics are crucial for treating bacterial illnesses; however, overuse and abuse of these drugs, together with improper consumption, have led to selection pressure and the rise of resistant bacteria. Aim: To investigate the knowledge and attitudes of outpatients in a healthcare setting regarding antibiotic consumption and antimicrobial resistance. Methods: This exploratory survey was conducted among 120 outpatients visiting a public primary healthcare setting in Greece, from February to March 2024. Data were collected via a 38-item self-administered questionnaire covering three domains: antimicrobial resistance (AMR) knowledge, antibiotic knowledge, and consumption practices. Statistical analysis was performed using SPSS (ver.29), employing Mann-Whitney and Kruskal-Wallis tests to identify demographic correlates (p < 0.05). Results: A total of 120 individuals participated in the study, 72 of whom were women (60.0%); 37.5% resided in an urban center, and 30.8% were lyceum graduates. Most of the sample knew that AMR signifies resistance of microbes to antibiotics (75.0%), that it constitutes a significant public health problem in the country (70.0%), and that it is due to the inappropriate use of antibiotics in humans (67.5%). 74.2% disagreed with stopping antibiotic treatment earlier, while 40.0% of respondents stated that taking antibiotics is only useful for fighting bacterial infections. 27.5% thought antibiotics were necessary for viral illnesses with fever, and 35.8% thought they speed up recovery from a cold. Remarkably, 52.5% of respondents acknowledged keeping antibiotics for later use, and 56.7% reported using non-prescription antibiotics in the past. Antibiotic knowledge scores were statistically significantly higher for women and people living in urban and semi-urban areas (p < 0.05). People with less education knew less about antibiotics, antimicrobial resistance, and antibiotic consumption practices (p < 0.005). Conclusions: Although primary health care recipients demonstrate a generally satisfactory awareness of antimicrobial resistance, significant knowledge gaps and misconceptions about antibiotics persist, leading to inappropriate antibiotic use practices.
In the context of Global Health, massive administrative datasets have become indispensable tools for health surveillance. However, the sheer scale of Big Data can mask systemic selection biases that standard mathematical adjustments may not fully mitigate. In this study, I propose a methodological audit of a recent large-scale cohort (N = 2,975,035) concerning COVID-19 vaccination and oncological outcomes. By benchmarking the cohort's architecture against national demographic and epidemiological gold standards through single-proportion Z-tests, we identified notable structural divergences. The first inferential test yielded a Z-score of -260.39 (p < 10⁻⁵⁰), suggesting a structural under-sampling of the elderly population (32.2% deficit) relative to the reference population. The second test identified a statistically inconsistent cancer incidence deficit in the non-vaccinated control group (Z = -15.23, p < 10⁻⁵⁰). These findings indicate that the reported statistical signals may emerge as a computational consequence of structural selection bias, where an artificially deflated baseline in the control group potentially inflates Hazard Ratios. Within a One Health approach, ensuring the structural integrity of data is crucial for effective prevention and control measures. We conclude that large-scale surveillance studies could be inferentially validated against demographic benchmarks to ensure that public health conclusions are grounded in baseline equivalence, thereby safeguarding the reliability of global health monitoring.
Background: Workplace gaslighting is an alarming issue. However, the negative consequences of workplace gaslighting in nurses are unknown. In this context, our aim was to examine the association between workplace gaslighting and nurses' mental health and work life. Methods: We conducted an online cross-sectional study in Greece during December 2024. We employed a convenience sample of nurses. We used the Gaslighting at Work Scale (GWS) to measure levels of workplace gaslighting among our nurses. We used the Patient Health Questionnaire-4, the Quiet Quitting Scale, and the Utrecht Work Engagement Scale-3 to measure anxiety-like symptoms, depressive-like symptoms, quiet quitting, and work engagement, respectively. Results: The study population included 369 nurses with a mean age of 37.86 years. We found a positive association between workplace gaslighting, anxiety-like symptoms, and depressive-like symptoms in our nurses. After adjustment for confounders, we found a positive association between GWS scores and anxiety-like symptoms (adjusted b = 0.758, 95% CI = 0.606 to 0.909, p < 0.001), and depressive-like symptoms (adjusted b = 0.720, 95% CI = 0.555 to 0.885, p < 0.001). Moreover, our multivariable models showed a positive association between GWS scores and quiet quitting (adjusted b = 0.258, 95% CI = 0.186 to 0.330, p < 0.001). Also, we found a negative associationbetween GWS scores and work engagement (adjustedb = -0.353, 95% CI = -0.512 to-0.195, p < 0.001). Conclusions: Our findings suggest that nurses who experience higher levels of gaslighting from their supervisors have more anxiety-like symptoms and depressive-like symptoms. Moreover, workplace gaslighting is associated with quiet quitting and work engagement. However, considering the cross-sectional nature of our study and the study limitations, further research should be conducted to extract more valid results.
Mesoamerican nephropathy (MeN) has emerged as a critical yet often overlooked occupational and environmental health crisis. Primarily affecting young, otherwise healthy agricultural workers in Central America, this disease leads to rapid progression to kidney failure without traditional causes like diabetes or hypertension. While the central drivers are recurrent heat stress and chronic dehydration, emerging research reveals a multifactorial pathogenesis. This includes synergistic nephrotoxic insults from agrochemicals, heavy metals, chronic endotoxin exposure, and mycotoxins (e.g., ochratoxin A). Morphologic studies point to shared pathways of tubular injury, characterized by mitochondrial dysfunction and lysosomal abnormalities. Furthermore, gut-kidney crosstalk and genetic susceptibility, particularly among individuals with Native American ancestry, may amplify renal inflammation and injury. Although targeted interventions, such as enhanced hydration, rest, and access to shade, show promise, their efficacy in halting disease progression remains limited. As global temperatures rise, similar disease patterns are now being reported among outdoor laborers in other hot regions, signaling a broader climate-linked public health threat. Addressing MeN demands a concerted, multidisciplinary effort encompassing rigorous pathogenesis research, enforceable occupational protections, and global recognition of heat-associated kidney disease as a growing epidemic. This perspective synthesizes recent insights into MeN and calls for urgent, actionable measures to confront this silent crisis.
In this study, an assessor-blinded randomized trial with concealed allocation was conducted. Thirty women aged 25-35 years with chronic ankle instability (CAIT score ≤ 24 on the affected ankle) were randomly assigned (1:1) to perceptual balance (PB) training with floss bands (FB group, n = 15) or PB training alone (n = 15). Both groups completed a 6-week program (3 sessions/week), progressing from static to dynamic and plyometric tasks. FBs were applied at perceived occlusion pressure of 5-7/10 (0-10 scale); no adverse events occurred. Outcomes (assessed on the affected limb only) included static balance (single-leg stance time), dynamic balance (Y-balance test-normalized reaches in anterior, posteromedial, and posterolateral directions and composite score), ankle proprioception [joint position sense (JPS) error at 20° plantarflexion], and functional performance (single-leg hop and triple-hop for distance). A 2 × 2 mixed ANOVA (time × group) was used, with Bonferroni post hoc tests. Effect sizes were partial η² (ANOVA interactions) and Cohen's dz (repeated-measures within-group changes with 95% CI). Both groups improved significantly (p < 0.01). The FB group showed greater improvements in static balance (25.7 ± 2.9 s vs. 22.3 ± 2.8 s, p = 0.015), dynamic balance (composite and all directions, p < 0.015), JPS (4.2 ± 1.1° vs. 6.1 ± 1.3°, p = 0.022), single-leg hop (1.80 ± 0.15 m vs. 1.65 ± 0.18 m, p = 0.032), and triple-hop (5.10 ± 0.30 m vs. 4.70 ± 0.35 m, p = 0.039). Interaction effect sizes (dz) ranged from 0.143 to 0.234 (large). These findings suggest that floss band augmentation may provide additional short-term benefit to PB training in women with CAI, although mechanisms remain speculative, and larger, longitudinal trials are needed.
The purpose of the current study was to evaluate the possible role of multi-user video gamepads in spreading microbial populations among users and understand how to reduce this risk. The study design involved 10 public locations in Al-Kharj city and 10 semi-public locations inside the campus of Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia. Air samples were collected from all selected places once during the study using a passive air sampling technique. Semipublic places with a good aeration system and a regular cleaning routine showed much less airborne organisms than public places with less care. Samples from the multi-user video gamepads were taken from each gamepad three times during a period of two weeks. Each time, one sample was taken before any intervention, and another sample was collected after disinfection with commercial alcohol swab pads containing 70% isopropyl alcohol. All samples were examined for the number of viable organisms. The mean microbial count ranged from 98 to 270 CFU in public locations and from 18 to 34 CFU in semi-public locations. Samples collected from semi-public places showed 3 bacterial genera and were free from fungi, while samples from public places showed 9 bacterial and 4 fungal genera. After disinfection of the multi-user video gamepads in the public places, the number of colonies reached a maximum of 8 CFU (approximately 97% reduction), while the semi-public places expressed a 91% reduction in the number of organisms. The results obtained demonstrate the importance of following hygiene measures in multi-user objects to reduce the risk of infection transmission.
Eating and feeding disorders (EDs) are a heterogeneous group of pathologies accompanied by important metabolic and psychiatric comorbidities that occur most frequently among the young but also appear in adulthood. Consequently, they can have a high impact on the quality of life and productivity. In the workplace, they are associated with traumatic events, stress, and sleep problems. Office workers who are not engaged in night shifts are an ideal sample for studying the relationship between sleep problems and EDs, since the confounding factor of night work can be excluded. This study is a survey of office workers undergoing health surveillance over a one-year period. Participants (463 out of a total of 489) completed the Short Version of the Eating Disorder Examination Questionnaire (EDE-QS) to screen for EDs, the Effort/Reward Imbalance (ERI) questionnaire for stress, the Goldberg's Anxiety and Depression Scale (GADS) for mental health, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, two items from the Stop-Bang questionnaire to screen for obstructive sleep apnea (OSA), and some questions concerning trauma, violence, motor vehicle accidents, and injuries. The prevalence of suspected EDs was 6% (CI 95% 4.1; 8.6). According to the body mass index, all suspected cases were affected by overeating. On the basis of non-smoking, regular physical activity, and adherence to appropriate alcohol and eating behaviors, only 1.9% of the cohort was classified as having a healthy lifestyle. Suspected EDs reported experiencing significantly more life trauma (OR = 4.47, CI 95% 1.99; 10.04), domestic injuries (OR = 3.89, CI 95% 1.04; 14.56), assaults (OR = 4.36, CI 95% 1.35; 14.07), and near-miss driving accidents (OR = 3.32, CI 95% 1.26; 8.76) than their colleagues in the previous year. They also reported higher levels of work-related stress than their colleagues (OR 5.38, CI 95% 2.29; 12.63), worse sleep quality (OR = 1.31, CI 95% 1.18; 1.46), and higher levels of anxiety (OR = 1.41, CI 95% 1.23; 1.62) and depression (OR = 1.55, CI 95% 1.33; 1.81). OSA symptoms were present in 25% of suspected EDs. A multivariate logistic regression model indicated that trauma and depression were most strongly associated with suspected ED cases. Health promotion in office workers should be based on sleep hygiene, stress reduction, and emotional trauma counseling.
Background: Outdoor Loose Parts Play (OLPP) has been recognized for its potential to support children's fundamental movement skills (FMS) and physical activity (PA). However, few researchers have explored its association in after-school settings or observed how different outdoor spaces may influence these outcomes. Purpose: We observed patterns of children's FMS and PA across two after-school programs with varied outdoor spaces in Nova Scotia, Canada, following an OLPP intervention. We also explored how types of loose parts and fixed features were associated with specific FMS and PA intensities. Methods: Using a multi-site case study approach, behavioral mapping was conducted with children aged 4-12 years pre/post a six-week OLPP intervention. Movements (FMS) were recorded using the Movement Observations during Play (MOP) measure, and PA intensities were recorded using the Children's Activity Rating Scale (CARS). Proportions of FMS, PA intensities, and environmental interactions (LP and fixed features) pre-post were explored using descriptive analyses and McNemar's test (p < 0.05). Logistic regression examined how interaction with LP and fixed features was associated with the likelihood of observing different movements and PA intensities. Results: Pre-post patterns differed by site. At Site A (larger, suburban, natural outdoor space, pre-existing OLPP), a higher proportion of stability skills were observed, while PA intensity remained unchanged. At Site B (smaller, urban, manufactured outdoor space, limited prior OLPP), a higher proportion of object control skills and moderate-intensity PA were observed. Across both sites, loose manufactured and loose natural materials were more likely to include object control skills, while fixed natural features were more likely to include stability skills. Conclusion: OLPP was associated with site-specific patterns. Findings suggest that LP types and fixed feature affordances may shape opportunities for different movements and PA intensities. These findings can inform educators and policymakers in designing outdoor play spaces that optimize children's movement opportunities.
Background: Despite leukemia being the most commonly diagnosed form of pediatric cancer, prior surveillance research has not linked the odds of a given pediatric cancer being leukemia to rural-urban county designations. Purpose: We sought to elucidate the patient-level role of rural-urban county designations in predicting the odds of a given pediatric cancer diagnosis being leukemia while observing the role of these county designations in conveying leukemia/non-leukemia disparities in the U.S. pediatric cancer population. Methods: The sample included pediatric cancer diagnoses from the Surveillance, Epidemiology, and End Results (SEER) 21 dataset from 2010 through 2017. The study outcome was binary; cases were leukemia and controls were non-leukemia. The focal predictor was the rural-urban county designation. The analysis used patient-and community-level covariates in a logistic regression model to identify the role of rural-urban designations in predicting a leukemia diagnosis. The model also generated case scores, which were the population probabilities of diagnoses being leukemia, and used these to conduct mediation analyses to determine the population-average associations of the rural-urban designations with leukemia. Results: In the adjusted model, rural counties adjacent to metropolitan areas (henceforth, "metros") had a significant association with leukemia cases, with 29.4% greater odds compared to the largest metro counties. In the population-level mediation via case scores, not only rural counties adjacent to metros, but also medium and small metros, had greater population-average odds of leukemia compared to the largest metros. Conclusions: While only rural counties adjacent to metros were consequential for modeling leukemia diagnoses among patients, population-average disparities in leukemia odds were also apparent in small and medium metros compared to the largest metros. This may indicate that leukemia risk exposures, existing systematically in rural counties adjacent to metros, may also be present, to lesser extents, in the small and medium metros.
Background:Burnout, anxiety, and depression among healthcare workers are associated with long-term sickness absence, reduced quality of care, and impaired patient safety. In Sweden and other Scandinavian countries, common mental disorders account for a substantial share of sickness absence, with costs borne by employers and national insurance systems (the "payee side"). Early identification of workers at elevated risk, followed by proportionate preventive support, is therefore central to sustainable hospital management and occupational health. The Empowerment for Participation (EFP) assessment is a 110-item web-based system that maps everyday participation, demands, and self-expectations and derives validated risk indices for burnout, anxiety, and depression, together with constructs such as motivation, stress, and defence routines. The EFP battery has been used as a triage tool and an outcome framework in web-based psychotherapy trials targeting burnout risk and as a component in AI-driven digital triage concepts within the My-E-Health ecosystem. Prior Swedish evidence also links burnout and stress symptoms in healthcare workers to subsequent long-term sickness absence, supporting the relevance of risk indices for occupational prevention. Empowerment-related constructs have further been shown to be responsive to interventions such as mindfulness-based treatment. Objective:To integrate empirical data from a cohort of healthcare personnel assessed with the EFP battery into a broader preventive model linking early risk identification, digital and therapist-delivered support, and the Scandinavian sick-pay context, while clarifying the methodological limits of non-randomised, real-world data. Methods:I analysed EFP data from 325 healthcare workers with baseline (T1) and follow-up (T2) assessments who, in routine practice, either (1) received no structured treatment or AI support (no structured support/control), (2) engaged in human-delivered psychotherapy (human therapy), or (3) used an AI-supported, web-based intervention grounded in the EFP architecture (AI-only support). Outcomes included the EFP Empowerment index and EFP-derived risk indices for burnout, anxiety, and depression, plus stress burden, motivation, and defence routines. Change over time was examined within groups (paired t-tests; Cohen's d_z) and explored between groups using change-score ANOVAs (η²). Because groups were not randomised and differed at baseline, between-group comparisons were interpreted cautiously as descriptive. Results:At baseline, participants who went on to use human therapy or AI-only support showed higher EFP-derived risk for burnout, anxiety, and depression and lower empowerment than those who did not engage in structured support, consistent with risk-driven help-seeking. Under naturalistic conditions, human therapy and AI-only support were associated with large within-group improvements in empowerment and substantial reductions in EFP-derived risk indices, whereas the no-structured-support group showed only small changes. Defence routines decreased far more in the human therapy group than in the AI-only group, suggesting potentially distinct mechanisms. Improvements in empowerment were strongly associated with reductions in risk indices; however, the observational design did not support causal inference. Conclusions:The EFP battery functions as a practical framework for early risk identification and change-sensitive outcome monitoring that can support scalable digital triage and stepped-care pathways. However, because allocation to support was non-randomised and sickness absence was not measured in this cohort, claims about prevention of sick leave should be treated as hypotheses to be tested in prospective studies that include baseline-balanced comparisons and registry-based sick-leave endpoints.
Mountain bike terrain parks have become increasingly popular, particularly at ski resorts where chairlifts transport riders uphill to enjoy downhill cycling. These parks feature trails of varying difficulty with artificial obstacles designed for jumps and stunts, which contribute to a unique pattern of injuries. This retrospective epidemiological study analyzed mountain biking injuries in two bike parks in western Austria during the summer seasons of 2023 and 2024. The bike parks are located within two major ski resorts, where lifts transport riders and their bikes uphill. Injury data were systematically documented by bike patrols using an online reporting tool, while exposure data (number of biker visits and number of downhill rides) from one of the bike parks enabled the calculation of an injury rate. A total of 274 injured riders (81.8% male, mean age 30.2 ± 14.6 years), predominantly from Germany (65%), were recorded. Most injuries occurred between Friday and Sunday, primarily between 10 a.m. and 4 p.m., with over 90% occurring during downhill cycling and 15% during the first ride of the day. Falls due to rider errors accounted for 77.4% of injuries, while 20.8% were linked to jump landings. The shoulder/clavicle region was the most frequently injured site (33.7%), followed by the upper extremities (26%) and the head/face region (17%). Fractures were the most common diagnosis, accounting for 52% of cases. Approximately one-quarter of injured riders required helicopter evacuation. The calculated injury rate was 4 injuries per 1000 visits or 6 injuries per 10,000 rides. In conclusion, injuries in bike parks predominantly affect men and are more frequent on weekends. Falls during downhill cycling are the leading cause, with fractures and injuries to the shoulder/clavicle region being the most common. These findings highlight the need for targeted prevention strategies and optimized emergency services to improve safety in bike parks.
Introduction:The intensive care unit (ICU) is a stressful environment where anxiety can increase human errors, affecting patient safety. Professional commitment can improve care quality and reduce such errors. In alignment with SDG 3 (Good Health and Well-being) and SDG 8 (Decent Work and Economic Growth), we explored the relationship between professional commitment, anxiety, and human errors among ICU nurses in two government hospitals in Riyadh and Tabuk, Saudi Arabia. Methods:This descriptive cross-sectional study was conducted among ICU nurses in two governmental hospitals in Riyadh and Tabuk, Saudi Arabia. Convenience sampling was used. Data were collected using a demographic questionnaire, the Spielberger Trait Anxiety Questionnaire, a professional commitment scale, and a researcher-made questionnaire on human errors in the ICU. Statistical analysis was performed using SPSS software, applying descriptive statistics, the Pearson correlation coefficient, and multiple linear regression. Results:A significant negative relationship was found between professional commitment and human errors, and a significant positive relationship between anxiety and human errors among ICU nurses (r = -0.148, p = 0.015; r = 0.174, p = 0.006, respectively). A multiple linear regression model containing both predictors was significant [F(2,151) = 9.84, p < 0.001] and explained 11.5% of the variance in human error scores (R² = 0.115). Conclusion:There is a significant association between professional commitment, anxiety, and human errors among ICU nurses. Reducing anxiety and improving professional commitment can help minimize human errors, improve patient safety, and contribute to the achievement of SDG 3 and SDG 8.
Background: Antimicrobial resistance (AMR) is a growing global health concern, with inappropriate antibiotic use in dentistry significantly contributing to this problem. While regional studies have examined dental students' antibiotic-related knowledge and practices, comprehensive evidence from Iraq remains limited. Objective: The objective of this study is to evaluate the level of knowledge and awareness of antimicrobial stewardship principles and prescribing practices among Iraqi dental students and interns. Methods: A cross-sectional, questionnaire-based study was conducted among dental students in the clinical phase of education (fourth and fifth years) and dental interns from multiple Iraqi universities. The survey was distributed from October 2023 to June 2025 to assess the knowledge of antibiotics, awareness of prudent antibiotic use, and self-reported prescribing practices. Correlation analyses were performed to examine associations between knowledge, awareness, and practice domains. Results: The participants (n = 569) demonstrated strong theoretical knowledge of antibiotics and a high awareness of prudent antibiotic use. However, a consistent gap between knowledge and clinical practice was identified. Knowledge and awareness domains were positively correlated, while both were inversely associated with practice scores, thus indicating a more cautious prescribing behavior among students with higher knowledge levels. A limited access to prescribing guidelines, insufficient practical training, and variability in institutional support were identified as key factors that influence the prescribing behavior. Differences between universities highlighted the significant role of educational environment and curriculum structure (p < 0.05). Conclusion: Although Iraqi dental students possess adequate knowledge and awareness regarding antibiotic use and AMR, translating this understanding into consistent clinical practice remains challenging. Higher knowledge levels were associated with restrained prescribing, thus reflecting responsible antimicrobial stewardship rather than poor practice. These findings underscore the need to integrate structured antimicrobial stewardship training, standardized prescribing guidelines, and practical decision-making support into dental education. Strengthening these components is essential to bridge the knowledge-practice gap and prepare future dental practitioners to contribute effectively to combating AMR through responsible, evidence-based prescribing.
This study aimed to investigate the sex-specific differences in smartphone addiction, physical activity levels, and cognitive functions among university students. A cross-sectional survey was conducted with 256 university students aged 18-25. Participants completed questionnaires using the Smartphone Addiction Scale Short Version to assess their level of smartphone addiction. The working memory and selective attention domains of cognitive function were evaluated, and the International Physical Activity Questionnaire was used to determine participants' self-reported physical activity levels. The results revealed significant sex differences, with male students exhibiting higher levels of smartphone addiction (male = 46.42 ± 9.37; female = 38.27 ± 7.63) and greater physical activity (male = 3752 ± 1876; female = 3447 ± 1748) than their female counterparts. Additionally, female students demonstrated superior performance on selective attention tasks, including reaction time (female = 463.00 ± 50.53; male = 457.34 ± 59.31) and accuracy (female = 92.26 ± 6.53; male = 89.60 ± 8.39) across varied conditions, whereas no significant sex differences were observed in working memory or overall reaction time. These findings suggest that sex-specific factors may influence differences between male and female participants in smartphone use, cognitive function, and physical activity.
