4 articles
Surgery exposes professionals to significant physical and psychological risks, including intense exertion, prolonged static postures, and repetitive gestures, often leading to musculoskeletal pain. International studies report prevalence rates above 90%, linked to long procedures and poor ergonomics, alongside exposure to biological and chemical hazards, radiation, toxic smoke, and chronic stress. In the Republic of Moldova, occupational health in the medical sector is underexplored, with no tools tailored to surgeons. This study aims to develop and validate the first nationally standardized questionnaire to assess these risks and support public health policies.
The study used a sequential mixed-methods design: a qualitative phase to identify domains and indicators, followed by a quantitative phase for psychometric testing. Four domains were defined: working conditions, occupational factors, general health, and psycho-emotional state. The questionnaire was refined from 70 to 47 items after expert review and validation, with internal consistency (Cronbach’s α) and content validity (I-CVI, modified Kappa) assessed. It was pre-tested on 52 surgeons, and data were analyzed using SPSS 27 (p<0.05).
Content validation revealed S-CVI/Ave values ranging from 0.934 to 1.00 and S-CVI/UA values from 0.738 to 1.00, with all domains exceeding the accepted threshold for relevance and clarity, except for one domain, which fell slightly below the recommended level for unanimous agreement. I-CVI values ranged from 0.857 to 1.00 (relevance) and 0.847 to 1.00 (clarity), while κ* indices were all rated as "excellent". Based on expert feedback, 24 questions were revised and 15 were removed. Overall internal consistency was very good (α = 0.808), with section values ranging from 0.769 to 0.864, the highest being for "Psycho-emotional state" (α = 0.864). The pre-test sample comprised 52 surgeons, mostly male (57.7%), with a mean age of 44.92 years, predominantly from urban areas (92.3%). Respondents generally found the questions clear but noted some lengthy formulations, repetitiveness, and sensitive items. These observations contributed to optimizing the final version of the instrument.
The final questionnaire meets the initial theoretical dimensions and shows strong psychometric properties, with high validity and internal consistency. The tool is comparable to established instruments and suitable for assessing surgeons’ health and occupational risks, with potential for wider use.
Even if boron is not yet recognized as an essential element for the human body, its insufficient intake is considered harmful, especially for the osteoarticular system. A daily intake of at least 3 mg of boron can fortify bone mass and prevent the onset of osteoarthritis, rheumatoid arthritis, and osteoporosis. This research aims to assess the morbidity caused by rheumatoid arthritis and inflammatory polyarthropathies in the population from regions with different boron concentrations in deep drinking water of the Republic of Moldova.
Two full-length descriptive observational studies were conducted: one on osteoarticular morbidity caused by rheumatoid arthritis and inflammatory polyarthropathies (incidence and prevalence), and one on boron concentrations in deep drinking water (public wells and artesian wells). Following national regulations, the Republic of Moldova was divided into three distinct boron-related areas, and in each of them, the boron trend overlapped with the morbidity trend.
In the below-the-limit boron area, the research hypothesis was confirmed in two out of three districts, by overlapping osteoarticular morbidity with boron concentrations in deep drinking water and their trendlines. In the limit-level boron area, boron concentrations in drinking water do not appear to influence the studied osteoarticular morbidity in either district. In the above-the-limit boron area, unlike in previous research, trends for boron concentrations in public wells and artesian wells were opposite to those of the incidence and prevalence of rheumatoid arthritis and inflammatory polyarthropathies, confirming the research hypothesis.
Out of the three studied areas, the expected phenomenon of low morbidity and high boron concentrations, and vice versa, was observed in two below-the-limit boron districts and two above-the-limit boron districts. The results can be expanded upon in further research in the field.
In the context of increasing global consumption of bottled water, assessing its chemical composition and impact on public health becomes essential. Although perceived as a safe alternative, bottled water exhibits variability in its chemical composition, and advanced filtration methods can remove essential minerals. Consumers opt for bottled water due to its taste and convenience, yet awareness of associated risks remains limited. This study proposes the development and validation of a questionnaire to evaluate public perceptions of bottled water quality and its health impact, providing a valuable tool for public education and regulatory policies.
The questionnaire was developed to analyze consumer attitudes and behaviors regarding bottled water. Structured into four sections (socio-demographic data, consumption habits, perceptions of quality, and health impact), it underwent multiple validation stages. A panel of experts assessed the relevance of the questions, and a pilot study was conducted with a sample of 32 adults (aged 24-62) to evaluate validity and internal consistency using the Cronbach's alpha coefficient. Final validation was based on the feedback collected and statistical analysis performed using SPSS Statistics 27.
S-CVI/Ave and S-CVI/UA are indicators of questionnaire content validity, calculated based on item validity scores and the percentage of agreement among evaluators. The S-CVI/Ave and S-CVI/UA values exceeded the minimum standard of 0.80, while the I-CVI index ranged between 0.83 and 1.00, demonstrating excellent item validity. Following respondent feedback, 18 questions were revised, and 6 were removed, resulting in a second version with 61 items. The validity sample comprised 84.4% women and 15.6% men, aged 24 to 62 years. Most respondents considered the questions clear and easy to understand, although suggestions were made to improve clarity and avoid redundancy. Internal consistency was confirmed through the Cronbach's alpha coefficient, which was acceptable for most domains, except one, where the coefficient was below 0.70 but was retained due to the validity of the questions.
The questionnaire for assessing bottled water consumption was successfully validated, demonstrating content validity and internal consistency. Face validity ensured the clarity of the questions.
Osteoporosis remains a major public health issue, particularly affecting the elderly, and is characterized by decreased bone mass and deterioration of bone structure, increasing the risk of severe fractures. The development of specific and precise tools that allow for the identification and estimation of the influence of modifiable factors on the development of osteoporosis is an important step in early intervention for at-risk individuals.
The initial version of the questionnaire was created to identify modifiable factors contributing to the development of osteoporosis, including the type and frequency of drinking water consumption, water quality, knowledge about its mineral composition, dietary preferences, alcohol and tobacco use, physical activities, and stressful situations. The questionnaire initially contained 65 questions, organized into three sections. Five experts reviewed the content validity, evaluating the clarity, cultural and linguistic relevance, structure, and coherence of the questions. The feedback led to adjustments, reducing the questionnaire to 52 questions. A pre-test was conducted with 30 adults from the Republic of Moldova, confirming the validity and internal consistency of the questionnaire, with a Cronbach’s Alpha coefficient of 0.768.
To ensure content validity, experts evaluated the questionnaire, and based on their comments and suggestions, semantic and syntactic reformulations and modifications were made. As a result, 13 questions were eliminated, reducing the second version of the questionnaire to 52 questions. During the pre-testing stage, the order and content of the questions were deemed appropriate by the respondents. The average time required to complete the questionnaire was 14.19 minutes (SD ± 1.567), with a minimum of 11.90 minutes and a maximum of 17.33 minutes. The sample used in the pre-testing stage included 30 respondents, the majority of whom (93.3%) were women. The respondents’ ages ranged from 25 to 72 years, with a mean age of 50.37 ± 2.6 years. The distribution of respondents was balanced between urban (53.3%) and rural (46.7%) areas. Regarding education level, 56.6% had higher education, 26.7% had secondary vocational education, and 16.7% had no higher education.
The study demonstrated that the new questionnaire is a valid and reliable instrument for assessing the impact of modifiable risk factors on morbidity due to osteoporosis. Ongoing research is necessary to refine and further validate the questionnaire within the broader population.