Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis

AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.

Farmers′ Perception to Farmland Conversion: A Questionnaire Survey in Xining City, Qinghai Province, China

China is experiencing a fast process of farmland conversion which is conducted mainly by local governments to fuel economic development.Social tension is aroused and policy makers take great concerns on coordinating interests among different stakeholders,especially for increasing farmers′ interest.The purpose of this study is to get some insights related to land acquisition institution by exploring farmers′ perception to farmland conversion.Participatory Rural Appraisal(PRA) was applied for the investigation in peri-urban area,of Xining City,Qinghai Province,China.The total of 519 householders from 15 villages completed valid questionnaire survey from July to November,2012.The results indicate that farmland conversion has several impacts on farmers′ life.Most farmers are gradually adapting to city life.Higher living expenses and more income are perceived by farmers with average score of 4.21 and 2.69,respectively.The average scores of 2.38 and 2.46 are for improvement of life security and more job opportunities.Farmers expect to get some stable ways of compensation in addition to lump-sum compensation in cash.Stable subsidies every year and obtaining same number of land received strong proposal.And these two options are cited by 49.6% and 43.9% of respondents.Farmland conversion brings about cleaner living condition and more amenities,but lower air visibility and drier air.Results reflect landless farmers′ economic and life pressures and various demands.Local government should pay more attention to increase farmers′ income and improve rural security system.

Adjuvant therapy for hormone receptor-positive breast cancer: Perspective from a survey on breast cancer physicians' acceptance of practice-changing data

A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.

Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Investigation of the Oral Health Status of Patients Based on Rehabilitation Nursing

Objective: To investigate the current situation of knowledge, attitude, and practice (KAP) of oral health among rehabilitation nursing patients, and provide some reference for implementing oral health intervention measures for rehabilitation nursing patients. Method: A total of 231 nursing patients in the rehabilitation department of a tertiary hospital in this city from January 2023 to October 2023 were selected as the research subjects. Their oral health knowledge, attitudes, and behaviors were investigated, and the oral health behavior habits of patients with different genders, education levels, and disease situations were compared. Result: The total awareness rate of oral health knowledge among patients was 73.16%, and the average score of oral health knowledge was 6.58 ± 1.25 points. The overall positive rate of oral health attitude among patients is 55.70%, and the average score of oral health attitude is 5.01 ± 1.04 points. The average score for oral health behavior is 16.87 ± 5.23 points. Only 8.48%, 3.3%, 1.3%, 2.6%, and 0.87% of patients seek timely medical treatment for bleeding tooth roots, gum swelling and pain, gum bleeding, tooth pain, and dental calculus, respectively;Only 5.19% of people change their toothbrush every 3 months, and only 10.39% use the vertical brush method to brush their teeth. The scores of oral health knowledge, attitudes, and behaviors of patients are related to age, educational level, disease type, and smoking situation. The oral health knowledge and attitude scores of elderly patients were lower than those of younger patients, and the difference was statistically significant (P P P P P < 0.05). Conclusion: The oral health status of rehabilitation nursing patients is not optimistic, with a moderate level of oral health knowledge, weak awareness of oral health, and a low qualification rate of oral health behaviors. Strengthening oral health education for rehabilitation nursing patients and incorporating oral health care procedures into rehabilitation nursing procedures is of great significance.

Research and Exploration of Ideological and Political Education in the Course of Pathophysiology

Course based ideological and political education (CIPE) is an important way to improve the quality of ideological and political work and talent cultivation. This study explores for the first time the implementation of ideological and political education in the teaching of pathophysiology courses, and also analyzes the evaluation of student psychological status and the importance of mental health education in the implementation of IPE courses. A survey was conducted on 211 students at Yangtze University to understand their motivation and behavior towards learning ideological, political, and pathophysiological courses. In addition, a questionnaire survey was used to explore the relationship between pathophysiology and ideological and political courses, as well as the importance of their satisfaction with the implementation of ideological and political courses in pathophysiology and mental health education. The research results indicate that factors such as educational background and gender differences affect the learning of CIPE. Graduate students are more interested in ideological and political courses, while female students find it difficult to study pathophysiology;In addition, the results of one-way ANOVA indicate that the implementation effect of IPE in pathophysiology courses depends on the level of interest in IPE and pathophysiology courses, the level of consideration for the importance of professional courses, the professional gains after studying pathophysiology, and the level of understanding of the relationship between IPE and CIPE. 81.04% of students believe that in the CIPE process, telling stories by teachers themselves is the most popular way of communication and education. This reflects the importance of mental health education from the perspective of CIPE. In addition, this study also indicates that PBL and flipped classroom teaching models are popular teaching models in CIPE. This study is beneficial for promoting the improvement and implementation of CIPE and mental health education in higher education curricula, thus providing valuable insights for educational decision-makers.

Multi-center investigation of breast reconstruction after mastectomy from Chinese Society of Breast Surgery:A survey based on 31 tertiary hospitals(CSBrS-004)

Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.Methods:A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1,2018 and December 31,2018.Information was collected on tumor characteristics,treatment,mesh application,nipple-areola complex(NAC)preservation,postoperative complications,bilateral reconstruction,patient satisfaction and local recurrence.The overall rate of breast reconstruction was assessed,and the characteristics were compared across patient groups with different reconstruction approaches.Results:A total of 1,554 patients underwent breast reconstruction after total mastectomy,with a reconstruction rate of 9.6%.Among them,1,190 were implant-based,and 262 underwent autologous reconstructions,while 102 cases underwent a combination of both.Patients who underwent implant-based reconstruction were younger than those who received autologous reconstruction(40.1±4.6 vs.45.0±5.9,P=0.004).Compared to patients with autologous reconstruction,mesh application(25.5%vs.6.5%),NAC preservation(51.8%vs.40.5%)and reconstruction failure(1.8%vs.0)were more frequently reported among those with implant-based reconstruction.There was no significant difference in general satisfaction across three reconstruction approaches,though patients with autologous reconstruction reported the highest aesthetic satisfaction among the three groups(P=0.044).Conclusions:Implant-based breast reconstruction remains the dominant choice among patients,while autologous reconstruction was associated with higher aesthetic satisfaction.Our multi-center investigation based on the findings of the tertiary hospitals of Chinese Society of Breast Surgery may guide a future series of clinical studies on breast reconstruction in China.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

Development and validation of a self-management ability questionnaire for patients with chronic periodontitis

Objective: This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis.Methods: A questionnaire was developed through theoretical research,literature review,semistructured interview,and expert consultation.A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling.Validity and reliability were analyzed.Results: The questionnaire consisted of 24 items.Exploratory factor analysis identified three principal factors,which explained 66.949% of the total variance.The item-level content validity was between 0.800 and 1.000,and the scale-level content validity was 0.969.The coefficient of correlation between the gold standard and the whole questionnaire was 0.869.Cronbach's α of the whole questionnaire was 0.931,and the test-retest reliability coefficient was 0.825.Conclusion: The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity.It is useful for clinical work to measure self-management among patients with chronic periodontitis.

Reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire for patients with head and neck cancer and their caregivers

Objectives:This study aimed to assess the reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire(HaNiQ).Methods:The HaNiQ was translated into a Chinese version using internationally recognized forwardand back-translation procedures.The reliability and validity of the HaNiQ were measured using Cronbach’s a coefficient,split-half reliability,exploratory factor analysis,and Pearson correlation analysis.Results:A total of 207 patients in different head and neck cancer(HNC)stages and 174 caregivers completed the Chinese version of the HaNiQ.Internal consistencies varied between good and very well(Cronbach’s α coefficient 0.74-0.90);the split-half coefficient and the content validity index(CVI)of the questionnaire were 83.5%and 83.33%,respectively.The cumulative contribution rates of the 5 subscales in patients with HNCand their caregivers were 62.41%and 61.19%,respectively.However,there are some differences between the Chinese questionnaire for caregiver and the original questionnaire regarding the attribution of items.Items 22,23,and 27 in the Psychosocial subscale of the English version were assigned to the Survivorship subscale in the Chinese version for caregivers.Conclusions:The results demonstrated that the Chinese version of the HaNiQ is a reliable and valid instrument for measuring the information needs of patients with HNC and that of their caregivers.Though the structure of the Chinese versionwas different from the English version for caregivers of HNC patients,the Chinese version of the HaNiQ appears to be reliable and would benefit from further testing.

Academic institutional repositories in China:A survey of CALIS member libraries

Purpose: China Academic Library & Information System(CALIS) planned to launch an institutional repository(IR) project to promote IR development and open access at colleges and universities in China. In order to get to know the current state of IRs in academic institutions, with the help of Peking University Library, CALIS Administrative Center conducted this survey.Design/methodology/approach: We conducted an online survey of CALIS member libraries.Findings: Firstly, the development of IRs at China's colleges and universities is still in its infancy. Secondly, the Chinese colleges and universities have reached a consensus on the objective for having an IR. Thirdly, they are having high expectations of IR functions. Fourthly,they prefer to establish a centralized IR system at a minimum cost. Finally, there are both similarities and differences between the Chinese academic institutions and their counterparts in other countries in the state of IR development.Research limitations: The questionnaire needs to be improved because there is a lack of enough questions for those who do not plan to build an IR. Comparatively lower rate of valid questionnaire return can affect the accuracy of the results. It is hard to go into an in-depth discussion only based on the data collected from this questionnaire survey, and consequently,the findings from the survey can hardly present an accurate and comprehensive picture of the current state of IR development in the academic sector in China.Practical implications: The survey results provide essential foundation for CALIS IR project,and meanwhile the research can serve as a reference source for the future studies of the development of IRs at China's colleges and universities.Originality/value: It is the first national survey focused on the development of IRs in academic institutions in China.

A survey study on motivations for citation:A case study on periodicals research and library and information science community in China

A large number of theoretical and empirical studies on citation behavior have been conducted internationally. Although some theoretical studies on such topic have been carried out in China, few studies have focused specifically on this area from an empirical perspective, resulting in the lack of literature on the findings of actual surveys. To address this challenge, we conducted two questionnaire surveys to understand the motivations of the researchers on citation. One survey covers the authors who published articles in Chinese Journal of Scientific and Technical Periodicals, while the other targets the most productive and most cited Chinese authors in library and information science. The results show that citation behavior is not only motivated by rational factors, but also by other social factors.

Survey and Analysis on the Students Satisfaction with Undergraduate Teaching Management in Local Agricultural Colleges and Universities:A Case Study of Tianjin Agricultural University

Local agricultural colleges and universities undertake the important task of training rural revitalization talents suitable for regional characteristics.Only by mastering students'satisfaction with teaching management can we find the problems existing in teaching management.Taking Tianjin Agricultural University as an example,this paper analyzes the undergraduates'satisfaction with teaching management by questionnaire and SPSS24.0.The results show that undergraduates can actively and actively participate in undergraduate teaching management,but their satisfaction is not high.There are significant differences in teaching evaluation management satisfaction among students of different majors and grades.It is suggested to improve the level of teaching management from the aspects of guiding and cultivating a new concept of management and education,establishing and perfecting a scientific and rigorous teaching management system,strengthening the information-based construction of teaching management and strengthening personnel training.

A Survey for Exploring Personality Traits of Excessive Online Game Users in Japan

For the aim at exploring differences on personality traits between excessive online game users and non-excessive users in Japan, an online survey was conducted using psychological scales measuring addictive tendencies for online gaming, depressive tendencies, aggression, and self-concealment. The results revealed that excessive online game users having addictive tendencies in Japan had lack of self-esteem as one of depressive tendencies, high aggressive tendencies, and low tendency of self-disclosure, in contrast with non-excessive users. Moreover, it was suggested that these users had a confidence in the society based on contributive behaviors in multi-player groups of online gaming.

Survey and Analysis on Present Situation of Biological Experiment Teaching in Some Middle Schools in Yangjiang Area

Experimental teaching is an important part of biology teaching in middle school.In the form of questionnaire,this paper conducts a survey on some leading teachers of biology in the middle schools in the Yangjiang area about the biological experiment teaching in the implementation of the new curriculum,and analyzes the results of the survey.The problems and deficiencies in the implementation of biological experiment teaching in some middle schools in this area are found,and the relevant reform measures and suggestions are put forward in order to promote the better development of biological experiment teaching in middle schools.

A Survey of the Incidence and Consequences of Invasive Blood Pressure Measuring Errors Caused by Arterial Line Occlusion

Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were randomly distributed to the anesthesiologists who participated the 22nd annual meeting of Chinese society of anesthesiology. The main contents of this survey included the arterial line managing status, the incidence of arterial line occlusion, the effects of arterial line occlusion on the anesthesiologists’ therapy and consequences caused by arterial line occlusion. Results: Totally 294 questionnaires were collected, in which 261 questionnaires were valid. In all respondents, 28.3% expressed that they could not flush arterial line on time, and 95.4% had experienced flushing arterial line only or sometimes or occasionally when the arterial waveform was not normal. Furthermore, 93.9% had experienced partial occlusion of the arterial line, and 79.3% had experienced complete occlusion. According to the serious recall of the respondents, the incidence of partial arterial line occlusion was 17.7% ± 22.0%, and the incidence of complete arterial line occlusion was 3.6% ± 8.1%. For all the respondents, 89.7% had experienced suspecting arterial line occlusion while real hypotension occurred, 65.1% had experienced not treating hypotension timely due to this suspicion, and 31% had experienced serious consequences caused by this suspicion. Conclusion: The incidence of arterial line occlusion is high during invasive blood pressure monitoring, which is a threat to the patients’ safety. So, intensive attention should be paid to the arterial line management.

Ground level utility of Access, Watch, Reserve classification: Insights from a tertiary care center in North India

BACKGROUND The overuse and misuse of antimicrobials contribute significantly to antimicrobial resistance(AMR),which is a global public health concern.India has particularly high rates of AMR,posing a threat to effective treatment.The World Health Or-ganization(WHO)Access,Watch,Reserve(AWaRe)classification system was introduced to address this issue and guide appropriate antibiotic prescribing.However,there is a lack of studies examining the prescribing patterns of antimi-crobials using the AWaRe classification,especially in North India.Therefore,this study aimed to assess the prescribing patterns of antimicrobials using the WHO AWaRe classification in a tertiary care centre in North India.Ophthalmology,Obstetrics and Gynecology).Metronidazole and ceftriaxone were the most prescribed antibiotics.According to the AWaRe classification,57.61%of antibiotics fell under the Access category,38.27%in Watch,and 4.11%in Reserve.Most Access antibiotics were prescribed within the Medicine department,and the same department also exhibited a higher frequency of Watch antibiotics prescriptions.The questionnaire survey showed that only a third of participants were aware of the AWaRe classification,and there was a lack of knowledge regarding AMR and the potential impact of AWaRe usage.RESULTS The research was carried out in accordance with the methodology presented in Figure 1.A total of n=123 patients were enrolled in this study,with each of them receiving antibiotic prescriptions.The majority of these prescriptions were issued to inpatients(75.4%),and both the Medicine and Surgical departments were equally represented,accounting for 49.6%and 50.4%,respectively.Among the healthcare providers responsible for prescribing antibiotics,72%were Junior Residents,18.7%were Senior Residents,and 9.3%were Consultants.These findings have been summarized in Table 1.The prescriptions included 27 different antibiotics,with metronidazole being the most prescribed(19%)followed by ceftriaxone(17%).The mean number of antibiotics used per patient was 1.84±0.83.The mean duration of antibiotics prescribed was 6.63±3.83 days.The maximum number of antibiotics prescribed per patient was five.According to the AWaRe classification,57.61%of antibiotics fell under the Access,38.27%in Watch,and 4.11%in Reserve categories,suggesting appropriate antibiotic selection according to these criteria.The distribution of antibiotics prescribed according to the WHO AWaRe categories is presented in Figure 2.The difference in prescribing frequencies amongst departments can be noted.Most of the antibiotics prescribed in the Access category were from the Medicine department(75.4%),followed by Surgery(24.6%).For Watch antibiotics,Medicine had a higher proportion(63.4%)compared to Surgery(36.6%).In terms of seniority,Junior Residents prescribed the highest number of antibiotics for both Access and Watch categories in Medicine and Surgery departments.Senior residents and Consultants prescribed a lower number of antibiotics in all categories and departments.Only a few antibiotics were prescribed in the Reserve category,with most prescriptions being from the Medicine department.The study also evaluated the Knowledge and Awareness of Healthcare professionals towards the WHO AWaRe classi-fication through a questionnaire survey.A total of 93 participants responded to the survey.Among them,most parti-cipants were Junior Residents(69.9%),followed by Senior Residents(25.8%)and Faculty(4.3%).When enquired if they knew about the WHO AWaRe classification only 33.3%of the participants responded positively.Of those who were aware of the AWaRe classification,the most common source of information was the internet(31.2%),followed by the antimicrobial policy of their institution(15.1%)as seen in Table 2.The survey results on the knowledge and awareness of AMR among healthcare professionals are also presented in Tables 3 and 4.Out of the 93 participants,68(73.1%)agreed that the emergence of AMR is inevitable,while only 13(14.0%)disagreed that AWaRe usage will result in the inability to treat serious infections.Additionally,58(62.4%)agreed that it will lead to lengthier hospital stays,43(46.2%)agreed that the success of chemotherapy and major surgery will be hampered,and the majority also agreed that its use will lead to increased cost of treatment and increased mortality rates.Regarding the utilization of AWaRe in the hospital summarized in Tables 4 and 5,35.5%of the participants agreed that it should be used,while only 2.2%disagreed.Additionally,34.4%agreed that AWaRe reduces adverse effects of inappro-priate prescription.However,37.6%of the participants considered that AWaRe threatens a clinician's autonomy and 30.1%thought that its use can delay treatment.Additionally,the DDD of each drug was also evaluated.The usage of various antimicrobial drugs in a hospital setting,along with their daily doses and DDD according to the WHO's Anatomical Therapeutic Chemical classification system was calculated.Some of the important findings include high usage rates of ceftriaxone and metronidazole,and relatively low usage rates of drugs like colistin and clindamycin.Additionally,some drugs had wider ranges than others.Comparison of WHO defined DDD with Daily Drug dose(Mean)in the studied prescriptions is represented in the Clustered Bar chart in Figure 3.Finally,the Mean Daily Drug Dose for prescribed drugs was compared with WHO defined DDD for each drug using a Student’s T test.The mean daily drug dose of amoxy/clav was significantly higher than the WHO DDD(1.8 vs 1.50,P=0.014),while the mean daily drug dose of metronidazole and doxycycline were significantly lower than the WHO DDD(P<0.001 and P=0.008,respectively).The mean daily drug dose of piperacillin/tazobactam,amikacin,clindamycin,and levofloxacin did not show significant differences compared to the WHO DDD(P>0.05).CONCLUSION This research indicates an appropriate proportion of prescriptions falling under the Access category(57.61%),suggesting appropriate antibiotic selection,a significant proportion also belongs to the Watch category(38.27%),emphasizing the need for greater caution to prevent the escalation of AMR.There is a moderate level of awareness among healthcare professionals about AMR and the steps being taken to tackle it,highlighting the gap in implementation of policies and need for more steps to be taken in spreading the knowledge about the subject.However,there is a significant difference between the WHO DDD and the prescribed daily dose in the analysed prescriptions suggesting overuse and underuse of antibiotics.

COVID-19 Downgraded Already Impaired Mental Health of Medical Undergraduates during the Pandemic Years

Background: Measures to contain the COVID-19 transmission reached teaching routines of universities worldwide with possible mental health consequences for anxiety. This study assessed prevalence and risk factors for stress, depression, and anxiety (SDA) in medical students during quarantine by COVID-19. Methods: A cross-sectional observational study of medical students by means of the DASS-21 questionnaire. Risk factors for SDA were assessed based on epidemiologic questions related to COVID-19. Receiver Operating Characteristics (ROC) curves were calculated for each predictor, as well as sensitivity and specificity. Results: This survey reached 1009 responses. A prevalence of 77.5% for some SDA disorder was found, 63% being severe. Previous diagnosis of psychiatric disorder was a factor of risk for anxiety (OR 2.78 CI95% 1.44 - 14.25, p = 0.044), as well as for depression (OR 3.37 CI95% 1.98 - 6.02, p Conclusion: Psychiatric conditions as well as chronic illnesses were risk factors for high prevalence of anxiety, depression and stress during the COVID-19 pandemic among medical students.

A Study on the Utility of an Electroencephalogram-Based Stress Analysis Method for Seaside and Road Space

Modern society is called the stress society, there has been a growing interest in comfortable living space. Therefore, a lot of studies using biological information have been done to quantitatively assess the effects on the human body in recent years. This study verified quantitatively difference between healing effect and stress reduction effect of sea space and general street space using an inexpensive EEG (Electroencephalogram) machine. The purpose of this study is to verify quantitatively healing effect and stress reduction effect of sea space using the EEG measurement from the psychological analysis by questionnaire survey and the SD (Semantic Differential) method. As a result, EEG and questionnaire results, psychological analysis results can be seen to match, and the effectiveness of the EEG measurement was confirmed.