Using Social Media and Snowball Sampling as an Alternative Recruitment Strategy for Research

Analysis of the retention of women in higher education STEM programs

Gender equity and quality education are Sustainable Development Goals that are present when a culture of equity and inclusion is pursued in society, companies, and institutions. Particularly in undergraduate programs in Science, Technology, Engineering, and Mathematics (STEM), there is a noticeable gender gap between men and women. The objective of this study was to find out the causes of permanence in STEM careers of women, as well as the possible causes of career abandonment towards another STEM or non-STEM career. This was done by analyzing historical data for admission to STEM careers and using an instrument (survey) for data collection carried out in a private university in Mexico. Historical data indicates that only 17% of the total population were women choosing a STEM career. A survey was carried out for 3 months to obtain information on the factors that affect the decision to opt for a STEM career or to remain in it. It was found that men and women prefer inspiring Faculty who motivate them to continue their careers. Factors such as the competitive environment and the difficulty of teaching with less empathetic Faculty were negative and decisive aspects of decision-making. School achievement did not influence the dropout rate of women in STEM careers. The factors of choice and desertion of women in STEM careers were determined, and actions of educational innovation such as mentoring and timely monitoring of already enrolled female students, digital platforms for students and Faculty, awareness workshops for Faculty, and talks with successful women in STEM areas were proposed.

Working conditions and well-being in UK social care and social work during COVID-19

Summary

Stress and mental health are among the biggest causes of sickness absence in the UK, with the Social Work and Social Care sectors having among the highest levels of stress and mental health sickness absence of all professions in the UK. Chronically poor working conditions are known to impact employees' psychological and physiological health. The spread of the COVID-19 pandemic has affected both the mode and method of work in Social Care and Social Work. Through a series of cross-sectional online surveys, completed by a total of 4,950 UK Social Care and Social Workers, this study reports the changing working conditions and well-being of UK Social Care and Social Workers at two time points (phases) during the COVID-19 pandemic.

Findings

All working conditions and well-being measures were found to be significantly worse during Phase 2 (November-January 2021) than Phase 1 (May-July 2020), with worse psychological well-being than the UK average in Phase 2. Furthermore, our findings indicate that in January 2021, feelings about general well-being, control at work, and working conditions predicted worsened psychological well-being.

Applications

Our findings highlight the importance of understanding and addressing the impact of the pandemic on the Social Care and Social Work workforce, thus highlighting that individuals, organizations, and governments need to develop mechanisms to support these employees during and beyond the pandemic.

Moral distress during COVID-19: The importance of perceived organizational support for hospital nurses

Moral distress, or the inability to act congruent with moral beliefs, has been of concern for healthcare professionals especially since the COVID-19 pandemic. Hospital nurses are particularly affected in their roles with mounting administrative pressures and demands. We examined whether general and COVID-specific support in employing healthcare organizations predicted moral distress in a sample of inpatient hospital nurses. A total of 248 nurses completed the Measure of Moral Distress for Healthcare Professionals, Survey of Perceived Organizational Support, COVID Organizational Support survey, and the Hospital Ethical Climate Scale. We found that general and COVID-related organizational support were predictors of moral distress after controlling for age, gender, working in an intensive care unit setting, and ethical climate. Findings support the need for a comprehensive strategy to address moral distress, including institutional efforts to convey support and commitment. Strategies moral distress may be experienced differently based on gender identity.

The Relationship among Anxiety, Worry, Perceived Stress, Defense Mechanisms, and High Levels of Post-Traumatic Stress Symptoms: A Discriminant Analytic Approach

Post-traumatic stress disorder (PTSD) is a pathological condition that may lead to a significant deterioration in the quality of life over time. Therefore, the study of the elements that can characterize the disorder could be considered of great clinical interest and relevance. The aim of the present research was to empirically discriminate the influence of perceived stress, state anxiety, worry, and defense mechanisms (mature, neurotic, and immature) at different levels of post-traumatic stress symptoms. A sample of 1250 participants (69.5% women, 30.5% men; M_age = 34.52, SD = 11.857) completed an online survey including the Impact of Event Scale-Revised, Ten-Item Perceived Stress Scale, Penn State Worry Questionnaire, Forty Item Defense Style Questionnaire, and State-Trait Anxiety Inventory-Form X3. Data were analysed by implementing MANOVA and discriminant analysis. Results showed significant differences in the levels of perceived stress, state anxiety, and worry, as well as neurotic and immature defenses based on the levels of post-traumatic stress symptoms: F(12,2484) = 85.682, p < 0.001; Wilk's Λ = 0.430. Furthermore, these variables discriminate significant accuracy between participants who reported a mild psychological impact and those with a probable presence of PTSD, with perceived stress, which was found to be the best predictor. Classification results indicated that the original grouped cases were classified with 86.3% overall accuracy. Such findings may provide useful insight for clinical practice.

Age in the Acceptance of Mobile Social Media

This paper focuses on determining the age-based differences among consumers in terms of the acceptance of mobile social media. In doing so, the younger age group is represented by Generation Y and the elderly by Baby Boomers. Further, the famous UTAUT2 model is applied, and relationships mentioned in it are evaluated for the two age groups. For this purpose, a sample of 249 respondents was obtained from the online survey conducted in the state of Punjab in India. The statistical technique of multi-group path analysis using structural equation modelling (SEM) is applied to the generated data. The findings of the study reveal that the young age and elderly groups differ significantly in terms of the impact of effort expectancy, facilitating conditions, hedonic motivation on behavioral intention, and facilitating conditions on use behavior. It may provide important implications for future research related to internet marketing and mobile social media.

The InterFace of Social Media Recruitment and Nursing Education Research

This study describes using social media in recruiting a large and hard-to-reach national sample of family nurse practitioner students in the United States enrolled in their final clinical course and the impact on survey response targets. Social media recruitment was initiated when sample targets were not met using traditional, direct email invitations. A cross-sectional, observational, complex-samples survey design was used to collect data from students enrolled in accredited programs. When inviting participants via emails to schools of nursing and program administrators was only moderately successful, direct recruitment via social media sites was used. Targeted study advertisements were shown 602 389 times to 77 410 unique Facebook users over 14 months. In the final sample of 3940 study participants, 46% (n = 1811) were recruited through social media. Survey responses for health education research are typically 50% or less of the target. Using Facebook was successful for recruiting a large, geographically disperse and representative student sample necessary to ensure findings were representative and generalizable. This recruitment strategy could be effectively used for a myriad of research in areas where social media use exists to gain access to participants who might otherwise not be accessible.

Unity strengthens and inhibits development: A focus group interview with volunteer adults in support programs for bereaved children and their family

This article illuminates (inter)actions and group dynamics of adult volunteers in programs for bereaved children and parents. A focus group interview with seven volunteers in Swedish was conducted. A latent, thematic analysis was conducted, inspired by Braun and Clarke, and Goffman. Two themes were constructed: Personal despair as a motivation for establishing and consolidating voluntary involvement and The volunteers acted as an extended family. Group dynamics within the group contributed to uphold volunteers' adherence to formal and informal guidance related to the program. Strong engagement among volunteers and internal recruitment strategies contributed to uphold and consolidate the program's implementation.

Validation of the illustrated questionnaire on eating and sedentary behaviors (QUICAS) for seven to ten-year-old children

The Illustrated Questionnaire on Eating and Sedentary Behaviors (QUICAS) was developed and validated for schoolchildren seven to ten years old. It used previous day recall and was illustrated with ten eating behaviors (referring to the act of eating without distractions, with company, on a regular basis, the type of food eaten, and participation in tasks involved in meal preparation) and five sedentary behaviors (related to the use of television, computer, tablet, cell phone, and video game). The instrument was validated in four stages: (1) Its content was developed based on literature review and expert evaluation; (2) Items were validated by comparing the responses of children and their parents, through a questionnaire on Google Forms. At this stage, a convenience sample was adopted, consisting of 145 parent-child dyads. High sensitivity (average of 90.7%); high specificity (mean of 87.9%); low number of false positives (mean of 12.1%); low number of false negatives (mean of 9.3%); almost perfect agreement between the child's and the parent's reports (k = 0.81); and low disagreement (≤22%) were found. In addition, the child's gender and age did not significantly influence the child's report. (3) The illustrations were validated in a focus group with 18 children, who satisfactorily described all the eating and sedentary behaviors of the illustrations. (4) In the pretest of the questionnaire on Google Forms, with the participation of 15 children, the majority (86.7%) judged the questionnaire as excellent or good. Therefore, the QUICAS is valid to assess eating and sedentary behaviors in schoolchildren seven to ten years old.

Nursing team's perceptions on care for children and adolescents hospitalized with mental disorders

Abstract Objective to know the perceptions of the nursing team about the care of hospitalized children and adolescents with mental disorders. Method social phenomenological qualitative study whose data collection was carried out with 12 members of the nursing teams by means of phenomenological interviews. Results “Reasons why” described in two categories: the perception of the nursing team in view of the care provided and actions and care of the nursing team of the child with mental disorders. “Reasons for” expressed in the category: the recovery of the child with mental disorder and his return home. Conclusions and Implications for practice The possibility of establishing a face-to-face relationship between the team, the family, and the child to apprehend the biographical situation and the body of knowledge of the subjects involved, and then understand their real needs and demands promotes comprehensive care. Through Alfred Schutz's social phenomenology, it brings as implications for practice the possibility of understanding the perception of the nursing staff about the relevance of the face-to-face relationship in caring for children and adolescents with mental disorders.

Percepções da equipe de enfermagem sobre cuidados de crianças e adolescentes internados com transtornos mentais

Resumo Objetivo conhecer as percepções da equipe de enfermagem ante o cuidado de crianças e adolescentes com transtornos mentais internados. Método estudo qualitativo fenomenológico social cuja coleta de dados foi realizada com 12 membros das equipes de enfermagem por meio de entrevista fenomenológica. Resultados “Motivos porque” descritos em duas categorias: a percepção da equipe de enfermagem em face dos cuidados prestados e ações e cuidados da equipe de enfermagem da criança com transtornos mentais. “Motivos para” expressos na categoria: a recuperação da criança com transtorno mental e o seu retorno para casa. Conclusões e Implicações para a prática a possibilidade do estabelecimento da relação face a face entre equipe, família e criança como forma de apreender a situação biográfica e o acervo de conhecimento dos sujeitos envolvidos e, então, entender as suas reais necessidades e demandas promovem um cuidado integral. Através da fenomenologia social de Alfred Schutz, traz-se como implicação para a prática a possibilidade de compreender a percepção da equipe de enfermagem sobre a relevância da relação face a face no cuidado de crianças e adolescentes com transtornos mentais.

Does Appearance Matter during Pregnancy? A Cross-Sectional Study of Body Satisfaction from Pre-Pregnancy to Late Gestation

Few studies have explored the associations between body satisfaction and physical activity and weight gain during pregnancy, and none have been conducted in Scandinavia. Hence, the aim of the present study was to evaluate changes in body satisfaction from pre-pregnancy to late pregnancy and investigate whether this differed according to parity. We also wanted to explore the association between body satisfaction and physical activity and weight gain among pregnant women in Norway. This cross-sectional survey used an electronic questionnaire to assess physical activity level, weight gain and women's satisfaction with body weight and size. In total, 150 pregnant women answered the questionnaire. Related-samples Wilcoxon signed rank tests, Mann-Whitney U tests and chi-square tests were used to answer our research questions. The proportion of women who were dissatisfied with their body weight and shape increased from pre-pregnancy to late gestation (body weight p = 0.030 and body shape p = 0.040). Body dissatisfaction before and during pregnancy was linked to weight gain above recommendations. Characterising oneself as physically active prior to pregnancy was associated with satisfaction with body shape pre-pregnancy. Given that mothers strongly influence how a child will judge their body later in life, the results of this study underline the importance of addressing these issues during pregnancy.

Paramedics' perceptions of job demands and resources in Finnish emergency medical services: a qualitative study

BACKGROUND

Paramedics' fatigue is rising. Stress factors show increased risk for burnout, fatigue, leaving the profession, decreased performance and risk for patient safety. Meanwhile, paramedics' strong community of practice, autonomy and a sense of professional respect are important factors in forming psychological resilience. We aimed to explore Finnish paramedics' perceptions of job demands and resources.

METHODS

Our study design was descriptive, inductive with a constructivist approach. Using reflexive thematic analysis, we analyse open-ended questions, from a web-based survey and essays written by Finnish paramedic masters-degree students. The study followed the SRQR checklist.

RESULTS

We identified paramedics' job demands as stress from a high workload, environmental factors and emotional burden. Performance expectations and a sense of inadequacy were further noted, as well as an organizational culture of hardiness, presenting lack of support and sense of inequality. Paramedics' job resources were pressure management strategies, which were expressed as positive coping mechanisms, agency to affect workload and professional self-actualization, expressed as psychologically safe work community, professional pride and internal drive to professional development.

CONCLUSIONS

Finnish paramedics exhibit resources and demands related to uncertainty and emotional burden as well as cultural hardiness and psychological safety in communities.

PATIENT OR PUBLIC CONTRIBUTION

This study was done based on survey data collected and analysed by the authors. No patient or public contribution was utilized for this study.

Elite female footballers in England: an exploration of mental ill-health and help-seeking intentions

OBJECTIVES

Mental health research in sport is almost entirely focused on elite male athletes. However, recent research suggests that elite female athletes are at higher risk for mental ill-health when compared to their male counterparts. Given the recent growth of women's football in England and lack of research surrounding mental health in this population, this study sought to explore the prevalence of, and factors associated with depression, anxiety, and eating disorder symptoms in females competing in the top two tiers of English football.

METHODS

An anonymous online questionnaire pack, which measured personal and player characteristics and included the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder scale (GAD-7), Brief Eating Disorder Questionnaire (BEDA-Q), and General Help-Seeking Questionnaire (GHSQ), was completed between November 2020 and March 2021 by elite female footballers competing in the Women's Super League (WSL) and Women's Championship.

RESULTS

A total of 115 players completed the questionnaire (63 from the WSL; 52 from the Women's Championship). 36% displayed eating disorder symptoms (BEDAQ) 11% displayed moderate to severe anxiety symptoms (GAD-7), and 11% displayed moderate to severe depression symptoms (PHQ-9). Significant associations emerged between starting status, want for psychological support, student-athlete status, help-seeking intentions score, and mental ill-health symptoms.

CONCLUSION

In summary, elite female footballers in England reported significant mental health symptoms, particularly disordered eating symptoms. Further research should explore the experiences of mental ill-health in this population, focusing on the factors that were important in this study.

Beyond challenges and enrichment: a qualitative account of cross-cultural experiences of nursing patients with an ethnic minority background in Norway

BACKGROUND

Substantial mass migrations to the Scandinavian countries have made them heterogeneous and multicultural societies. Migration has also influenced the workforce, especially the healthcare system that has had to accommodate a culturally diverse population. This qualitative study aimed to explore nurses' experiences in caring for patients with an ethnic minority background.

METHODS

Focus group interviews with a total of 21 nurses were conducted. Thematic analysis was performed on the transcribed and translated interviews.

RESULTS

The findings of this study revealed three major themes: various experiences concerning language barriers and the use of interpreters, the impact of religious and cultural values, and caring for patients with an ethnic minority background is professionally interesting but demanding.

CONCLUSIONS

Caring for culturally diverse patients offers both challenges and opportunities to enhance cultural competence and cultural sensitivity among nurses. Various culturally divergent needs of patients such as family visits, food preferences, expression of pain, and gender sensitivity are interlinked and depend on effective communication during encounters with nurses and the healthcare system at large.

The Impacts of Work-Life Balance on the Emotional Exhaustion and Well-Being of College Teachers in China

UN Sustainable Development Goal 3 states that “Ensuring healthy lives and promoting well-being at all ages is essential to sustainable development.” The sustainable well-being of college teachers deserves attention. Currently, college teachers in China are facing enormous challenges and pressures, which may increase their emotional exhaustion (EE) and hinder the sustainable development of their well-being (WB). Therefore, this study examined Chinese college teachers’ well-being in relation to their work-life balance (WLB) and EE. An online survey was conducted. The valid subjects included 586 college teachers (367 females, 62.6%). We assessed their WLB, EE, and WB. The results revealed that among the Chinese college teachers, (1) WLB was negatively correlated with EE, but positively correlated with WB; EE was negatively correlated with WB; (2) EE partially mediated the relationship between WLB and WB; and (3) College teachers who are male, class tutors, and in public colleges scored higher on EE and lower on WLB and WB than those who are female, non-class tutors, and in private colleges, respectively. The findings indicated that WLB is an important factor for the sustainable development of the well-being of college teachers, and special attention should be paid to college teachers who are male, class tutors, and in public colleges in China.

Rethinking work: How approach and avoidance features of cognitive crafting are linked with job crafting behaviors and work engagement

Responding to the call for more research on cognitive crafting, this study focuses on employees' reframing of their job characteristics to assign higher importance to job resources and downplay the relevance of costly job demands. Furthermore, it examines how these proactive cognitive strategies are embedded in an overall job crafting process, including both cognitive and behavioral aspects, and linked with work engagement. Preliminary results (n = 247) support the conceptualization of cognitive crafting encompassing approach and avoidance aspects targeting resources and demands, respectively. Moreover, three-wave data (n = 84) show that employees' cognitive efforts to highlight the centrality of job resources influence work engagement over time. Importantly, proactively organizing work leads to higher work engagement by prompting cognitive reframing of the relevance of job resources as central to one's work. Differently, cognitive efforts to downplay the relevance of hindering job demands are unrelated to following proactive behaviors and work engagement.

Social Support as a Mediator of the Relationship between Identity Fusion and Psychological Well-Being in South-South Migrant Populations

The present study provides evidence of how perceived social support is a mechanism by which identity fusion with the country of origin is associated with psychological well-being in a migrant population. The study design was cross-sectional. We use intentional sampling based on the accessibility of the participants and using the snowball strategy through an online survey. This study included 323 Venezuelan migrants, of whom 176 (54.5%) were women, all residents of the city of Santiago, Chile. The variables assessed were perceived social support, identity fusion, and psychological well-being. Structural equation modeling was used to estimate the proposed mediation model. The estimation method used was robust weighted least squares estimation. The estimated models indicated that perceived social support has a mediating effect on the positive relationship between identity fusion and psychological well-being of Venezuelan migrants residing in Chile. According to these results, feeling a sense of fusion with the country of origin and the perception of having sources of care and protection are factors that may help to improve the psychological well-being of Venezuelan migrants living in Chile. Implications and limitations of these results are discussed.

Mental Health, Support System, and Perceived Usefulness of Support in University Students in Hong Kong Amidst COVID-19 Pandemic: A Mixed-Method Survey

BACKGROUND

This study explored the association of students' mental health with their support system, identified the preferred ways and sources of support, investigated the perceived usefulness of available university support, and recommended actionable strategies to enhance students' mental health.

METHOD

An online questionnaire survey and semi-structured focus group interviews were conducted in 2021.

RESULTS

Among 1121 university students, 39.4% reported anxiety symptoms, which were less common in Chinese students and those pursuing medical and health programmes. Overall, 32.6% reported depression symptoms, which were more common in undergraduates. Both anxiety and depression symptoms were less common in students with higher resilience and support system and more common in students with family distress. Students with higher resilience had a better support system and less family distress. Perceived support from universities was lower than from peers and families. Peer support and phone contacts were the most preferred sources and ways of support. The most useful available university support was updated university guidelines, and the least useful was the emotional hotline service from universities The qualitative findings corroborated the quantitative results.

CONCLUSION

We suggested that a holistic care approach and more proactive student-oriented university support would help students face adversity and enhance mental health.

Healthcare professionals’ knowledge, attitude and practice towards National Centralized Drug Procurement policy in central China: A cross-sectional study

Background: National Centralized Drug Procurement (NCDP), an ongoing government-led policy starting in 2019 in China, aimed at reducing drug costs. During the implementation of NCDP, healthcare professionals (HCPs) still have a certain degree of concern about the policy, which affects the clinical use of related drugs.

Objective: This study aims to assess the level of knowledge, attitude and practice (KAP) of HCPs towards NCDP policy, together with the associated factors that determine their KAP.

Methods: A cross-sectional study was conducted between September and November of 2021 in 30 hospitals in Hubei province in Central China. A self-designed online questionnaire including KAP towards NCDP policy was administered to HCPs. Logistic regression analysis was adopted to identify the factors associated with KAP.

Results: A Total of, 742 HCPs completed the questionnaires. 43.4% of HCPs had good knowledge, 24.7% had a positive attitude, and 23.7% held good practice. Through multivariate logistic regression analysis, HCPs who are males, pharmacists, with senior professional titles and 6–10 years of professional working experience contributed to a higher knowledge level. Pharmacists and HCPs with good knowledge were more likely to have positive attitudes, while HCPs with higher education were less likely to have positive attitudes. Pharmacists, HCPs who had 11–20 years of professional working experience, worked in medium-size urban areas or had good knowledge were more likely to have good practice. Good practice is also associated with the positive attitude towards the efficacy of centralized-purchased medicines and impacts of NCDP policy.

Conclusion: Only a small percentage of HCPs had good KAP towards NCDP policy. Pharmacists showed better KAP than physicians. The positive attitude towards the efficacy of centralized-purchased medicines and impacts of NCDP policy contributed to better practice. High-quality clinical evidence on the therapeutic effects and safety of the centralized-purchased drugs is needed.

Antibiotic Prescribing Practices for Treating COVID-19 Patients in Bangladesh

Although national and international guidelines have strongly discouraged use of antibiotics to treat COVID-19 patients with mild or moderate symptoms, antibiotics are frequently being used. This study aimed to determine antibiotics-prescribing practices among Bangladeshi physicians in treating COVID-19 patients. We conducted a cross-sectional survey among physicians involved in treating COVID-19 patients. During September-November 2021, data were collected from 511 respondents through an online Google Form and hardcopies of self-administered questionnaires. We used descriptive statistics and a regression model to identify the prevalence of prescribing antibiotics among physicians and associated factors influencing their decision making. Out of 511 enrolled physicians, 94.13% prescribed antibiotics to COVID-19 patients irrespective of disease severity. All physicians working in COVID-19-dedicated hospitals and 87% for those working in outpatient wards used antibiotics to treat COVID-19 patients. The majority (90%) of physicians reported that antibiotics should be given to COVID-19 patients with underlying respiratory conditions. The most prescribed antibiotics were meropenem, moxifloxacin, and azithromycin. Our study demonstrated high use of antibiotics for treatment of COVID-19 patients irrespective of disease severity and the duty ward of study physicians. Evidence-based interventions to promote judicious use of antibiotics for treating COVID-19 patients in Bangladesh may help in reducing an overuse of antibiotics.

Social Media Use for Research Participant Recruitment: Integrative Literature Review

BACKGROUND

Social media tools have provided health researchers with the opportunity to engage with communities and groups in a nonconventional manner to recruit participants for health research. Using social media to advertise research opportunities and recruit participants facilitates accessibility to participants from broad geographical areas and diverse populations. However, little guidance is provided by ethics review boards for researchers to effectively use this recruitment method in their research.

OBJECTIVE

This study sought to explore the literature on the use of social media for participant recruitment for research studies and identify the best practices for recruiting participants using this method.

METHODS

An integrative review approach was used to synthesize the literature. A total of 5 health sciences databases, namely, EMBASE (Ovid), MEDLINE (Ovid and EBSCOhost), PsycINFO (Ovid), Scopus (Elsevier), and CINAHL Plus with Full Text (EBSCOhost), were searched using predefined keywords and inclusion and exclusion criteria. The initial search was conducted in October 2020 and was updated in February 2022. Descriptive and content analyses were applied to synthesize the results, and the findings are presented in a narrative and tabular format.

RESULTS

A total of 96 records were included in this review, 83 (86%) from the initial search and 13 (14%) from the updated search. The publication year ranged between 2011 and 2022, with most publications (63/96, 66%) being from the United States. Regarding recruitment strategy, 45% (43/96) of the studies exclusively used social media, whereas 51% (49/96) used social media in conjunction with other strategies. The remaining 4% (4/96) provided guidelines and recommendations for social media recruitment. Notably, 38% (36/96) of these studies involved hard-to-reach populations. The findings also revealed that the use of social media is a cost-effective and efficient strategy for recruiting research participants. Despite the expanded use across different populations, there is limited participation of older adults in social media recruitment.

CONCLUSIONS

This review provides important insights into the current use of social media for health research participant recruitment. Ethics boards and research support services in academic institutions are encouraged to explicitly provide researchers with guidelines on the use of social media for health research participant recruitment. A preliminary guideline prepared based on the findings of this review is proposed to spark further development in this area.

Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study

Background

Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered.

Objectives

The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers.

Methods

This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations.

Results

Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19- infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86).

Conclusion

Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.

Eating Competence and Aspects Related to a Gluten-Free Diet in Brazilian Adults with Gluten-Related Disorders

This cross-sectional study aims to assess eating competence (EC—an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who “never/almost never” felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment.

COVID-19 Vaccine Uptake in the Context of the First Delta Outbreak in China During the Early Summer of 2021: The Role of Geographical Distance and Vaccine Talk

Purpose

Vaccination is essential to control the prevalence of COVID-19. However, vaccine hesitancy has been a major issue globally. Some studies have suggested that community outbreaks might boost vaccine uptake. Consistent with that idea, vaccination rates increased dramatically during the first outbreak of the COVID-19 Delta variant in Guangdong, China, in June 2021. Based on the risk perception attitude theory, this study attempted to explore the joint effect of geographical distance to the outbreak and the frequency of talking about the COVID-19 vaccine (vaccine talk) on people’s COVID-19 vaccine uptake.

Methods

An anonymous self-report online questionnaire was completed by citizens living in Guangdong Province, China, from June 6 to 11, 2021, during the Delta variant outbreak in that region. The relationship between COVID-19 vaccine uptake, geographical distance to the epicenter of the outbreak, and vaccine talk was analyzed using logistic regression analysis.

Results

Data from 350 respondents were included in the final analysis. Results showed a negative association between geographical distance and COVID-19 vaccine uptake. Furthermore, the relationship was moderated by vaccine talk. Specifically, when individuals infrequently discussed vaccine talk with others, close distance to the epicenter of the outbreak served as a motivator for getting vaccinated, whereas for people who frequently discussed the vaccine, geographical distance might have played less of a role in motivating them to get vaccinated.

Conclusion

This research highlights the joint effect of geographical distance to the outbreak of COVID-19 and vaccine talk in COVID-19 vaccine uptake. While the findings may only be a starting point for launching a public health awareness campaign, encouraging people to engage in more conversations about vaccines may be a promising solution for future health emergencies, especially among people far from the outbreak.

Consumers' Perception and Preference for the Consumption of Wild Game Meat among Adults in Poland

Wild game meat can be a healthier, safer, and more environmentally friendly alternative to meat from farm animals. The aims of this study were to know the preferences and opinions of Polish consumers regarding game meat and its use in their diet, and to identify consumer segments based on differences in individual game meat choices, concerns, and eating habits related to game meat. The survey was conducted using the platform for online surveys among 1261 adult Poles. Six clusters characterizing the behavior of game consumers were identified (casual consumers, occasional game gourmets, indifferent consumers, occasional consumers, accidental consumers, wild game lovers) and four clusters among those who do not eat game (uninterested, restricted, dislikers, fearful). It has been found that wild game is more often eaten by hunters and their family or friends. The most common reasons for not consuming game are high prices, low availability, no family tradition, and unacceptable taste. Many positive respondents eat game because of its nutritional value but are concerned about the potential health risks and lack of cooking skills. The results of this study indicate the need for information programs for consumers about this meat. They will provide guidance to meat companies about consumer preferences for game and allow them to develop appropriate marketing strategies.

The Impact of Coronavirus Information-Seeking Behavior on Dental Care Access: A Cross-Sectional Questionnaire-Based Study

Health information-seeking behavior provides a variety of benefits, such as reducing knowledge gaps and educating individuals outside the medical office. This study aimed at evaluating if different sources used to gather information on COVID-19 could affect the willingness to undergo dental appointments. An anonymous survey was posted on social media. The 1003 respondents used several channels of communication, clearly distinguishing reliable from unreliable ones. Multiple logistic regression estimated the effect of different information channels on the probability of being strongly influenced by COVID-19 in accessing upcoming dental appointments. Newspapers were the most-used channel of information (61.2%), blogs and forums the least used (11.2%). Overall, the more an individual was informed, the higher was the risk of missing upcoming dental care appointments (OR 2.05, CI 1.45–2.90, p < 0.001). The two most reliable channels of communication were identified in journals/websites of medicine and healthcare professionals. Women proved to be more active in gathering information and relying on less secure but more personal channels, such as social media and friends and family, thus having an increased risk of being influenced by COVID-19 information regarding upcoming dental care appointments (OR 3.62, CI 0.85–15.52, p < 0.1 and OR 1.60, CI 1.00–2.58, p < 0.1, respectively). Social media should have a greater presence on the side of medical service providers to avoid distortions of information and fake news that ultimately cause fear among citizens and compromise their health. Healthcare professionals and institutions should adapt their communication channels based on the audience they want to address to optimize the education and information of the final users.

Meeting Undergraduate Nursing Students' Clinical Needs: A Comparison of Traditional Clinical, Face-to-Face Simulation, and Screen-Based Simulation Learning Environments

BACKGROUND

Nurse educators expanded replacement of traditional clinical practice and face-to-face simulation experiences with screen-based simulation (SBS) during the COVID-19 (coronavirus disease 2019) pandemic.

PURPOSE

The purpose of this research was to understand the student experience when learning in 3 types of clinical education environments.

METHODS

This quantitative descriptive survey study used the Clinical Learning Environment Comparison Survey 2.0 (CLECS 2.0) to compare prelicensure nursing students' perceptions of learning in 3 clinical learning environments.

RESULTS

The CLECS 2.0 was completed by 113 participants from 3 countries. Most scores were highest for the traditional clinical practice environment, and all were lowest for the SBS environment.

CONCLUSIONS

The findings are concerning as discussions about whether SBS can replace traditional clinical practice hours unfolds. The findings support the need for concentrated efforts to improve specific areas of the SBS experience.

Factors Associated with Mental Health among International Students during the COVID-19 Pandemic in South Korea

The purpose of this study was to investigate mental health problems among international students in South Korean universities during the COVID-19 pandemic, as well as to identify the factors that affect their mental health. A total of 488 international students living in South Korea participated in a web-based survey. The questionnaire was created using the Google Forms platform, and a link to the questionnaire was shared through social media. Multiple logistic regression analysis was conducted to analyze the data. The prevalence rates of sleep problems, anxiety, and depression among international students were 47.1%, 39.6%, and 49%, respectively. The prevalence of mental health problems was higher among participants who were male, living with someone, residents of a rural area, and earning a higher income. The following variables were found to contribute to the prevalence of mental health problems: undergraduate student status, good understanding of the Korean language, longer hours of media usage, and experiences related to COVID-19 infection. A collaborative effort between the government and universities to manage the mental health of international students could promote the mental health of these students.

“Her Heart Matters”—Making Visible the Cardiac Pain Experiences of Women with Physical Disabilities and Heart Disease: A Qualitative Study

Background

Women with physical disabilities are faced with challenges in many aspects of life—education, work, income, relationships, as well as their general health. These women are at a greater risk of developing heart disease. This study aimed to explore the cardiac pain experiences of women with physical disabilities and heart disease within a Canadian healthcare context.

Methods

In this qualitative study, 8 women with physical disabilities and heart disease from across Canada were interviewed. They were asked about their pre-, peri-, and post-diagnostic experiences in the Canadian healthcare system. Transcripts of the interviews were analyzed using a hermeneutic phenomenological approach inspired by Ricoeur.

Results

Two main themes were uncovered in the analysis of the transcripts, as follows: (i) the diagnostic journey; and (ii) life with cardiac symptoms and a disability. The women indicated that they had experienced difficulties in utilizing the Canadian healthcare system prior to receiving a cardiac diagnosis, including long waitlists, expensive and unreliable transport, issues with accessibility, and dealing with providers’ attitudinal barriers regarding disability. Receiving a diagnosis was challenging due to poor relationships with healthcare providers; however, having a same-sex provider seemed essential to receiving adequate care. Self-managing a disability and heart disease had significant physical and psychological impact, which was lightened by financial and social supports, modified lifestyle choices, and self-advocacy.

Conclusions

Women with physical disabilities are often forgotten in discussions encompassing equity and inclusion. The participants’ experiences offer insight into what changes are needed within the Canadian healthcare system in order to improve outcomes for these women.

"Better If They Laugh with Me than at Me": The Role of Humor in Coping with Obesity-Related Stigma in Women

This study investigated the role of perceived stigmatization in the relationship between humor styles and coping with stress among young women suffering from stigma due to obesity. In the 21st century, obesity is an increasing global health issue with many physical and mental consequences for obese women. As a chronic stigmatizing disease, it requires that the affected individuals cope with social consequences; women with obesity are more prone to such consequences than men. Humor fosters the breaking of stereotypes and alleviating the consequences of stigmatization. A total of 127 young adult women (age M = 25.74, SD = 2.73) participated in the study (n = 54 with overfat and n = 73 with healthy fat). Participants filled out the Humor Styles Questionnaire, Perceived Stigmatization Questionnaire, and the Brief COPE Scale. Anthropometric data were gathered using a body composition analyzer. Results indicate that, when perceiving hostile behaviors toward themselves and using humor as a coping strategy, women with overfat select maladaptive styles of humor (i.e., self-defeating and aggressive styles). Women with overfat were also more likely to use humor as a coping strategy in difficult situations. Furthermore, none of the participants were satisfied with their body mass. At the same time, among women without obesity, a lack of compliments was not treated as a problem, even if they had high body fat.

Attitudes Towards Appearance and Body-Related Stigma Among Young Women With Obesity and Psoriasis

The goal of this study was to investigate the role of the subjective assessment of one's body image in the relationship between objective indices of appearance and perceived stigma in young women affected by obesity and psoriasis. These are chronic diseases that decrease one's physical attractiveness and are associated with stigmas related to body defects. A total of 188 women in early adulthood took part in the study (M = 25.58; SD = 2.90), including obese women (n = 54), women suffering from psoriasis (n = 57), and a control group (n = 77). The participants completed the Multidimensional Body-Self Relations Questionnaire, Perceived Stigmatisation Questionnaire, and a socio-demographic questionnaire. Anthropometric data were gathered using a body composition analyzer. Objective parameters of body shape were calculated (WHR and ICO). Subjective assessment of one's body and attitudes towards one's body were found to influence perceived stigma, independently of the condition causing the stigma and of the objective appearance of the participant. This study did not support the existence of a relationship between parameters regarding body shape and sense of stigma, even when subjective body assessment acted as a moderator. At the same time, body mass was a strong predictor of levels of perceived stigma. Women affected with obesity perceived a higher level of stigma than the other groups. The severity of psoriasis did not impact the perceived stigma. Moreover, women with psoriasis assessed their health-as a part of the assessment of their bodies-the highest, which may explain the lower perceived stigma in this group.