Search Results (2,140)

Proficiency in history-taking is foundational to safe clinical practice, yet traditional teaching methods offer infrequent opportunities for deliberate practice. This study evaluated whether an AI-powered virtual patient chatbot with a custom knowledge base could improve history-taking competence among fifth-year medical students during general medicine rotations. A mixed-method, quasi-experimental, non-equivalent control group design was used. The experimental group (N ≈ 157) engaged with four custom knowledge-based chatbot scenarios, while a control cohort (N ≈ 156) followed traditional training within the same curriculum. Assessment was performed using a validated Objective Structured Clinical Examination across two standardized cases, and user perceptions were gathered using an adapted Technology Acceptance Model survey from 105 students, with qualitative feedback from 32 trained students in a focus group. Compared to the control group, the experimental group demonstrated significant improvements in direct assessments (79.2% vs. 74.8%, p = 0.002) and indirect assessments (81.2% vs. 79%, p = 0.026). Participants reported a high user-perception score (80%) across usefulness, ease, attitude, and behavior. Focus group findings highlighted the chatbot’s value as a safe, flexible, feedback-rich tool. The chatbot-based training improved students’ performance and satisfaction and should serve as a supplementary aid rather than a substitute for real patient interactions. Full article

Background: Schools are widely recognized as key settings for promoting healthy eating behaviors and supporting childhood obesity prevention. In recent years, increasing attention has been devoted to experiential and interactive nutrition education strategies designed to actively engage children and adolescents in food-related learning processes. These approaches move beyond traditional didactic teaching and include practical and participatory formats, such as cooking activities, school gardening, digital or app-based learning tools, workshops and educational camps, and game-based learning interventions. Objective: This narrative review aims to provide an overview of experiential school-based nutrition education interventions, describing the main types of programs implemented in school settings and summarizing their reported effects on nutrition knowledge, attitudes, and eating behaviors among children and adolescents. Results: Across intervention studies and systematic reviews, hands-on and interactive educational models, including cooking classes, gardening programs, digital learning tools, workshops or camps, and board game-based interventions, frequently report improvements in nutrition knowledge, attitudes toward food, food-related skills, and self-efficacy. These programs seek to strengthen food literacy by combining experiential learning with educational content delivered within the school environment. Evidence regarding changes in dietary intake, diet quality, and anthropometric outcomes is more heterogeneous, with some studies reporting improvements in eating behaviors and others showing more modest or short-term effects. Program outcomes appear to be influenced by several contextual factors, including intervention duration, curriculum integration, teacher involvement, and the availability of resources supporting implementation. Conclusions: Experiential and interactive approaches represent an increasingly adopted strategy in school-based nutrition education. Their effectiveness appears to depend on the quality of implementation, the degree of integration within the school curriculum, and the broader educational context. Future research should further explore how different experiential formats can be optimally integrated into school systems to support the development of food literacy and sustainable healthy eating behaviors among children and adolescents. Full article

Rift Valley fever (RVF) is a viral zoonosis endemic in Madagascar, threatening human and animal health as well as the economy. Trade-related livestock movements are a major factor in the spread of RVF virus. While previous RVF research in Madagascar has focused on farmers or general ecology, this study is the first to specifically target livestock traders, the primary drivers for long-distance viral spread, in the Alaotra Mangoro endemic hotspot. This study aimed to assess the level of knowledge, prevailing attitudes and current practices regarding RVF among people engaged in livestock trade in the Alaotra Mangoro region, as well as the factors associated with these KAPs. A descriptive and analytical cross-sectional survey was conducted among 406 livestock traders in five districts of the Alaotra Mangoro region, using a structured questionnaire. A multi-stage sampling approach was employed, utilising purposive selection of markets followed by snowball sampling to reach informal traders often missed by traditional surveys. Generalised linear mixed models were used to analyse factors associated with KAPs regarding RVF. Awareness of RVF was very low (only 18.5% respondents had heard of it), with significant regional disparities (0% in Anosibe An’Ala versus 51.6% in Moramanga). Veterinarians (15.5%), family (12.8%), radio (9.6%) and neighbours (9.6%) were the main sources of information. Understanding of symptoms and modes of transmission (particularly mosquito bites) was limited. Higher levels of education (OR = 181.6; 95% CI: 29.9–1123.7; p < 0.001) and older age (50–60 years) were associated with better knowledge. Proactive attitudes were scarce (21.4%), although more than half (53.4%) believed that RVF is a real disease. Perception of personal risk and the contribution of livestock trade to the spread of the disease was low. However, confidence in animal vaccination was relatively high (60.3%). Preventive practices were highly inadequate. The majority did not wear protective equipment when handling sick animals (94.6%) and rarely avoided touching aborted foetuses (12.6%). Less than half (48.3%) expressed a willingness to report sick or dead animals, and nearly half admitted to having sold or purchased sick livestock (49.5%). Cooking meat (95.1%) and using mosquito nets (74.1%) were the only well-established practices. More than half of respondents (57.9%) lived more than 5 km from veterinary services, and cost was the most frequently cited barrier to consultation. Participation in awareness campaigns was virtually non-existent (5.4%). Results revealed critical gaps in KAP that may contribute to the persistence of RVF. A “One Health” approach is imperative, integrating human, animal and environmental health. Full article

Background/Objectives: To assess the knowledge, attitudes, and practices of ophthalmologists in Saudi Arabia towards genomic medicine and genetic testing, in light of the growing significance of genomics in ophthalmology and the national transition towards precision medicine. Methods: A cross-sectional, questionnaire-based survey was conducted among ophthalmologists, including consultants, specialists, fellows, and residents, across Saudi Arabia. The questionnaire included four domains: demographics, knowledge of genomic principles and gene therapy, self-rated confidence in genetic tasks (scored 1–10), and attitudes toward genetic testing. Data were analyzed using descriptive and inferential statistics, with subgroup comparisons performed using chi-square tests and t-tests/ANOVA. Results: A total of 115 ophthalmologists participated (46% male, 54% female; mean age 34 years; mean post-board experience 4 years). Most were consultants (40%) and practiced in Riyadh (52%). Knowledge was variable: 92% correctly identified human chromosome count, and 99% recognized autosomal recessive inheritance, but only 9% answered DNA base-pairing correctly, and 54% recognized mitochondrial inheritance. Confidence was highest for referral to specialists (mean 7.3/10) and lowest for test selection and counseling (4.7/10). The internet was the primary knowledge source among our sample (65%). The majority of individuals had positive attitudes towards genomic medicine: 90% believed testing was beneficial, 89% considered it enhanced health outcomes, and 89% indicated they would undergo testing themselves. On the other hand, 77% indicated difficulty in access, 91% strongly concurred on the significance of privacy and confidentiality, and more than half expressed concerns regarding misuse and bias. Conclusions: Ophthalmologists in Saudi Arabia acknowledge the importance of genetics. Yet, there are substantial gaps in knowledge and familiarity with genomic medicine and genetic testing. To overcome these challenges, it is essential to integrate genetics into ophthalmology curricula. Full article

The Farmer-to-Farmer (FtF) methodology has demonstrated effectiveness in promoting sustainable agriculture through horizontal knowledge exchange; however, its implementation in territories with emerging peasant organizational bases remains understudied. This study examines the profile and training performance of eight rural promoters in FtF encounters focused on plantain cultivation and agroecological practices in southern Casanare, Colombia. Performance was evaluated across four dimensions (communication and mediation, inclusion and attitude, methodology, and cultural belonging) using three complementary instruments: an expert evaluation matrix, a self-evaluation form, and an attendee perception survey (Likert scale 1–5). High overall performance was observed (median: 4.32), with medium scores in expressive capacity, enthusiasm and motivation, and session planning. Three promoter groups emerged based on agroecological transition level and global performance. Groups 1 and 2 achieved high scores (>4.0), while Group 3 showed opportunities for methodological strengthening. Expert evaluations revealed variability not captured by self-evaluation or community perceptions, underscoring the value of complementary evaluation approaches. These findings suggest that promoter effectiveness may depend less on formal education than on practical knowledge, community recognition, and relational competencies, and that targeted evaluation tools can support the pedagogical strengthening of farmer promoters. Full article

Universities operate in an environment characterized by complexity, unpredictable challenges, rapid change and stakeholder demands. University employees are a key resource to achieve the strategic goals of the institution, linked to this complexity. Therefore, a conducive environment that fosters employee engagement in the university is critical. Employee engagement as a concept which encompasses employees’ positive attitude towards the organization and its values, whereby employees continuously improve how they perform their duties to improve organizational effectiveness. Organizational effectiveness is the ability of the organization to proactively adapt and adopt new ideas to continuously improve its operations. The purpose of the study was to explore the application of systems thinking as a strategic approach to foster employee engagement across functional boundaries in universities of technology (UoTs). Employee engagement is central to achieving the strategic goals of Universities of Technology. The problem is a lack of an overarching philosophy to foster employee engagement across the institution. To achieve the objectives of this study, a qualitative research methodology was used, underpinned by a constructivism philosophical worldview. A total of 15 participants were purposively selected from the employees of two universities of technology. Semi-structured face-to-face interviews were used to collect data. Thematic analysis was applied to analyze data. The findings revealed that systems thinking would create a conducive environment to foster employee engagement across functional boundaries in the UoTs. In addition, the findings revealed the prevalence of silo practices in universities of technology. Without systems thinking in the institution, departments generally operate in silos and there is no institutionalized philosophy to foster employee engagement, collaboration and knowledge sharing within and beyond functional boundaries. Full article

Automobile spray painters in small informal workshops in developing countries face high occupational exposure to organic solvents. Although health effects are well known, the influence of workers’ knowledge, attitudes, and practices (KAP) on these effects is less well understood. This study examined spray painters’ KAP regarding organic solvents and health symptoms and assessed workplace safety compliance. A cross-sectional study in Region F, Johannesburg, collected data among 152 spray painters across 47 workshops using a questionnaire and checklist. KAP scores were analysed with multivariable logistic regression to identify associations with eye, skin, respiratory, and CNS symptoms, while controlling for confounders. Workplace controls were inadequate: 64% of workshops conducted spray painting outdoors, while only 17% had a functioning spray booth. Although knowledge scores were high (45.29/50 ± 6.025), practice scores remained low (9.01/20 ± 5.275). After adjustment, higher knowledge was significantly associated with reduced odds of eye (AOR = 0.846), skin (AOR = 0.915), and respiratory symptoms (AOR = 0.890). Better practice scores also correlated with fewer skin symptoms (AOR = 0.891). No KAP construct was linked to CNS symptoms. In the absence of engineering controls, workers’ knowledge is strongly linked to lower reporting of solvent-related symptoms affecting the eyes, skin, and respiratory system. However, knowledge does not appear to influence CNS symptoms, which are probably driven by ambient solvent concentrations that individual behavioural measures cannot effectively manage. Therefore, knowledge acts as a supplementary, rather than a substitute, safeguard where engineering controls are lacking. Interventions should include education and enforceable regulations to empower workers and ensure the use of engineering controls, especially in spray booths. Full article

Objective: This study aimed to assess practicing dentists’ knowledge, attitudes, and self-confidence regarding knowledge about oral manifestations of haematological disorders and interpretation of blood count (BC) tests. Materials and Methods: An online survey was sent to all practicing dentists via email addresses registered with the Dental Chamber. The questionnaire collected sociodemographic data and assessed knowledge of hematological diseases, their oral manifestations, and BC interpretation, as well as dentists’ attitudes toward interdisciplinary collaboration and perceived need for continuing education. In the knowledge section, some questions required a single correct answer, while most allowed multiple selections. For multiple-choice items, any incorrect choice made the response incorrect; responses were partially correct if accurate but incomplete and fully correct only when all correct options were selected. Statistical analysis was performed with p < 0.05. Descriptive statistics, Shapiro–Wilk, Kruskal–Wallis H, Mann–Whitney U, and independent-samples t-tests were used. Results: A total of 308 dentists responded, representing only 7.6% of the national dental workforce. While most recognized the relevance of BC tests and systemic disease indicators in oral health, knowledge gaps were substantial. The mean score on knowledge items was low (2.81 ± 1.52 out of 11), with only 1.3% dentists achieving seven or more correct answers. Interestingly, dentists with higher self-reported confidence in interpreting BC tests had lower knowledge scores, suggesting a potential Dunning-Kruger effect. Knowledge did not differ by specialization or postgraduate education, likely reflecting limited curricular coverage, but was more strongly associated with clinical experience, practice location, and patient load. Most respondents (96.1%) expressed strong interest in further education on the topic. Conclusions: Targeted education and interdisciplinary collaboration are essential to overcome gaps and enhance knowledge and diagnostic accuracy in oral manifestations of blood diseases and BC interpretation. Full article

Background: Nursing students are at high risk of exposure to blood and body fluids due to limited clinical experience. Ensuring adequate knowledge and proper post-exposure protocols is vital for improving safety and post-exposure management. Aim: This study aimed to evaluate the level of knowledge, previous exposure experience, and reporting practices regarding occupational exposure incidents among nursing students at the Faculty of Health Sciences, University of Split, Croatia. Methods: A cross-sectional study was conducted among 274 nursing students using a structured self-administered questionnaire. Descriptive statistical methods were applied, along with univariate and multivariate linear regression analyses. Results: Exposure incidents were experienced by 36.3% of students, with needlestick injuries being the most common (80.1%). In terms of reporting practices, fewer than half (40.8%) of those affected officially reported the incident. While students demonstrated adequate overall performance on the knowledge assessment (median score 12, IQR: 11–14), significant gaps were identified in hepatitis B and C protocols and immediate wound care. Multivariate analysis identified full-time student status (β = 1.24; p = 0.010) and first-year students (β = 0.82; p = 0.036) as factors significantly associated with higher knowledge scores. Conclusions: Although nursing students possess solid fundamental knowledge of exposure-related risks, a significant gap remains in their practical application and incident reporting. The high incidence of needlestick injuries (80.1%) underscores the importance of moving beyond theory toward enhanced clinical supervision. To address these gaps, nursing education should prioritize targeted practical training and cultivate a robust safety culture that encourages incident reporting. Full article

Home food safety (HFS) is a major contributor to foodborne illness, often originating in domestic settings. Although population-based studies using surveys, questionnaires, and interviews are commonly used to assess consumers’ HFS-related knowledge, attitudes, and practices (KAP), methodological heterogeneity limits comparability across studies. This scoping review aimed to map studies assessing consumers’ HFS-related KAP in high-income countries, describe recurrent methodological and reporting features, and identify areas of variability. Following the Arksey and O’Malley framework and JBI guidance, the literature published between 2000 and 2023 was systematically searched across five scientific databases, as well as governmental and institutional sources for the grey literature. Data extraction and synthesis were guided by an expanded 15-feature framework refined from a previous rapid review. A total of 274 documents were included (247 scientific articles and 27 governmental and institutional reports). Across the included studies, several methodological features showed high consistency, including primary data collection (93%), predominantly cross-sectional designs (91%), the use of closed-ended instruments (71%), quantitative analytical approaches (78%), and voluntary, non-incentivised participation (68%), suggesting the presence of a common descriptive methodological core. At the same time, substantial variability was observed in sample size (62%), study aims (52%), analytical strategies (52%), modes of administration (51%), geographic coverage (47%), thematic scope (44%), and study period (54%). The coexistence of methodological convergence and context-dependent variability poses challenges in terms of evidence synthesis and comparability in HFS-related KAP research. The 15-feature framework developed in this review provides a structured, non-prescriptive tool to support transparent description and comparison of methodological and reporting practices. By pinpointing common approaches and areas of divergence, this review offers a foundation for guiding future HFS-related KAP research and supporting the development of more comparable and policy-relevant evidence. Full article

Background: Full pulpotomy has gained increasing attention as a conservative treatment option for managing complicated crown fractures and pulp exposures in mature permanent teeth. However, little is known about how undergraduate dental students perceive this treatment approach and which factors influence their willingness to adopt it in clinical practice. Objective: This study aimed to evaluate undergraduate dental students’ knowledge, attitudes, and preferences regarding full pulpotomy and to identify factors associated with willingness to use full pulpotomy as a definitive treatment option. Materials and Methods: A cross-sectional questionnaire-based study was conducted among fourth- and fifth-year dental students. The questionnaire evaluated participants’ treatment preferences, perceived procedural difficulties, preferred pulp capping materials, attitudes toward rubber dam use, perceived barriers to full pulpotomy adoption, and willingness to use full pulpotomy as a definitive treatment. Associations between variables were assessed using chi-square tests and multivariable binary logistic regression analysis. Results: In total, 255 undergraduate dental students participated in the study. Spontaneous pain (69.4%), prolonged pain to heat (50.6%), percussion sensitivity (46.7%), and radiographic findings (43.9%) were the most frequently reported diagnostic criteria for symptomatic irreversible pulpitis. In the standardized clinical scenario, a pulpotomy-based approach was the most preferred treatment strategy (45.1%), followed by single-visit pulpectomy with obturation (28.6%) and pulpectomy with calcium hydroxide dressing (24.7%). MTA was the most preferred pulp capping material (57.3%), followed by Biodentin (12.9%) and calcium hydroxide (8.2%). Overall, 55.7% of participants reported willingness to use full pulpotomy as a definitive treatment option. Clinical year, previous exposure to pulpotomy cases, and confidence in bleeding control were independently associated with willingness to use full pulpotomy. Previous performance of pulpotomy procedures and attitude toward mandatory rubber dam use were independently associated with greater willingness to use full pulpotomy, whereas perceived barriers and uncertainty regarding implementation were negatively associated. Conclusions: In this single-center, questionnaire-based study, undergraduate dental students generally showed a positive attitude toward full pulpotomy; however, acceptance was strongly influenced by practical experience, confidence in procedural protocols, and perceived implementation barriers. These findings may help inform future educational strategies aimed at improving confidence and supporting evidence-based adoption of conservative pulp-preserving approaches. Full article

Dairy farms are complex environments where cattle, workers, and the farm environment interact, creating opportunities for infectious disease transmission across animal, human, and environmental interfaces. During the COVID-19 pandemic, little was known about dairy farmers’ knowledge, attitudes, and practices (KAP) regarding integrated livestock biosecurity and worker biosafety. This study aimed to develop and demonstrate the application of an integrated biosecurity–biosafety KAP questionnaire and pilot test for dairy farms. A novel English and Spanish version of the questionnaire was developed using published biosecurity literature, zoonosis-related studies, expert input, and existing dairy biosecurity tools. From June 2020 to August 2021, 18 Front Range Colorado dairy farms were contacted, and 6 farms enrolled. Data were collected from 50 participants, analyzed descriptively; selected associations were examined using Chi-square or Fisher’s exact tests, odds ratios, and 95% confidence intervals. The final questionnaire captured integrated KAP on livestock biosecurity, zoonoses, biosafety, and COVID-19. Important knowledge gaps were identified, particularly regarding human-to-animal disease transmission and zoonoses training. Supervisors generally demonstrated broader knowledge than workers and organic farms showed higher knowledge levels than conventional farms. Veterinarians were highly trusted information sources. Training was associated with improved zoonosis-related knowledge, and several animal-focused and human-focused preventive practices were significant. This study demonstrates the feasibility and value of an integrated dairy farm biosecurity–biosafety KAP tool and highlights the need for tailored, bilingual, One Health-oriented training. Full article

Background/Objectives: Oral health is integral to the overall well-being and quality of life of older adults. For institutionalized older residents who depend on staff for daily care, the knowledge, attitudes, and practices (KAP) of healthcare providers directly influence oral health outcomes. This study aimed to assess oral care KAP among healthcare providers in Macao’s residential care facilities and to examine the relationships between KAP and personal characteristics. Methods: A cross-sectional study was conducted from September to December 2023 using a structured KAP questionnaire. Data were collected from 225 healthcare providers across four nursing homes in Macao. Results: Significant positive correlations were found among KAP (Spearman’s γ = 0.293–0.419; p < 0.001). Mean scores were 15.60 (SD = 2.27)/19 for knowledge, 52.13 (SD = 5.75)/65 for attitudes, and 45.87 (SD = 5.93)/55 for practices. Denture care was the major knowledge deficit. Knowledge was associated with age 18–20 (p = 0.002), age 31–40 (p = 0.015), and university education (p = 0.003). Attitudes were associated with age 18–20 (p = 0.002), female gender (p = 0.005), and primary education (p = 0.044). Practice was associated with training programme attendance (p = 0.006) and female gender (p = 0.016). All associations involving the age 18–20 subgroup (n = 3) and male gender (n = 16) should be interpreted with caution due to very small sample sizes. Conclusions: Oral care KAP among HAs and PCWs in Macao’s residential care homes are positively but modestly correlated. Most providers acquired knowledge through induction training with verified competency outcomes and personal experience. These findings highlight the need for structured, repeatable training and suggest that Macao’s data can contribute to international efforts to improve oral care in institutionalized aging populations. Future research should employ longitudinal or observational designs and include all elderly care facilities in Macao. Full article

Background: The rapid evolution of dental adhesive systems presents both opportunities and challenges for clinical practice, particularly regarding the translation of emerging evidence into routine use. Aim: This study aimed to assess the knowledge, attitudes, and self-reported practices related to modern adhesive systems among Romanian dentists and to explore factors associated with their clinical decision-making. Materials and Methods: An observational cross-sectional study was conducted between November 2025 and February 2026 using a 115-item online questionnaire. A convenience sample of 372 Romanian dentists participated. Statistical analysis included descriptive statistics, chi-square and Kruskal–Wallis tests, and multivariate models (multiple linear regression, binary logistic regression, and multinomial logistic regression). Internal consistency of the knowledge scale was assessed using Cronbach’s alpha. Results: The knowledge scale demonstrated good reliability (Cronbach’s α = 0.873). Although 68.0% of respondents reported familiarity with universal adhesives, a discrepancy between awareness and reported clinical application was observed for several key concepts, including MMP inhibitors and hydrolytic stability. Notably, 14.8% of participants were unaware whether their preferred adhesive system contained 10-MDP. Continuing education frequency was the only independent predictor of higher knowledge scores (β = 1.63, p = 0.024), while greater clinical experience was inversely associated with rubber dam use (OR = 0.550, p = 0.024). Conclusions: The findings suggest a discrepancy between theoretical knowledge and the clinical implementation of modern adhesive concepts. Structured continuing education plays a critical role in improving knowledge and may help bridge this gap in clinical practice. Full article

Introduction: Syphilis is a preventable sexually transmitted infection (STI) with severe health outcomes, yet it is not included in Saudi Arabia’s national premarital and antenatal STI screening programs. This study assessed knowledge, attitudes, and practices (KAP) toward syphilis in Saudi Arabia and identified predictors of acceptance for including syphilis testing in such programs. Methods: A cross-sectional online survey was conducted among 935 participants aged ≥20 years. Data included sociodemographic characteristics and measures of KAP and screening acceptance. Continuous variables were summarized as medians (IQR) and categorical variables as frequencies and percentages, with bivariate and multivariate logistic regression used to identify predictors of screening acceptance. Results: Knowledge and preventive practices were low, while attitudes were predominantly neutral (median attitude score: 34 IQR 32–38). Although intentions for personal testing were low (17%), support for syphilis testing in premarital (60.8%) and antenatal (48.9%) programs was considerable. Employment in the health sector, older age, and positive attitudes predicted acceptance of screening policies. Knowledge and practice showed a weak correlation (r = 0.14), whereas knowledge and attitude were moderately correlated (r = 0.55). Conclusion: KAP toward syphilis is influenced by specific sociodemographic factors. Although acceptance of screening is high at the policy level, individual-level preventive behaviors remain low. Full article