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Context: This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery. Design and Methods: Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg, session frequency). Results: Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program. Conclusions: This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals. [ABSTRACT FROM AUTHOR]

Background: Although menstruation is a monthly biological phenomenon, it is shrouded in stigma and shame which directly impacts health, education, gender equality, decent work, and economic growth. However, there is scarce evidence on how personal agency, an individual's ability to access resources, may act as a protective factor to adequate menstrual health and hygiene practices. Therefore, we assess the association between attitudes toward menstruation and personal agency among very young adolescent girls. Methods: We use cross-sectional data from the Global Early Adolescent Study in São Paulo, Brazil, among 10- to 14-year-old girls who have experienced menarche (n = 325) and completed a home-based self-administered questionnaire in 2021. "Attitudes toward menstruation" was created based on five indicators on a Likert scale, with a higher score indicating more positive attitudes. The main covariate was personal agency, comprised of three scales and modeled as three continuous variables: voice, decision-making power, and freedom of movement. Data were analyzed using multivariable linear regression. Results: Attitudes toward menstruation mean score was 12.5 (range 5–19). Older adolescents (12–14 years-old) had higher mean scores (more positive) than younger adolescents (10–11 years-old) on attitudes toward menstruation, whereas no other sociodemographic or menstrual health indicator (knowledge or access to products) were associated with attitudes toward menstruation. In the multiple regression model, older age and higher freedom of movement remained positively associated with attitudes toward menstruation (βadjust = 0.5; 95%CI 0.1 to 0.8). Conclusion: Positive attitudes toward menstruation are associated with higher freedom of movement among very young Brazilian adolescent girls. The promotion of personal agency should be recognized as key strategies to accelerate young girls' positive approaches to their own menstruation and, consequently, well-being. Plain language summary: Menstrual Health and Hygiene Attitudes are associated with Personal Agency Our results show that positive attitudes toward menstruation among very young adolescent girls are associated with personal agency, measured through freedom of movement. This information can inform strategies to accelerate young girls' positive approaches to their own menstruation and, consequently, well-being. [ABSTRACT FROM AUTHOR]

Studies investigating autistic community research priorities indicate a mismatch between what autism research focuses on and what autistic people want to see researched. Furthermore, there has not been a research priority-setting exercise specifically with autistic people in Scotland, where there are unique cultural, political and social contexts. Using a community-based participatory design, we aimed to identify the research priorities of autistic adults living in Scotland. Autistic and non-autistic researchers designed and conducted a survey where 225 autistic adults rated and ranked research topics in order of importance and provided qualitative feedback on issues and questions important to them. The top five research priorities were mental health/well-being, identification and diagnosis of autistic people, support services, knowledge and attitudes towards autistic people and issues impacting autistic women. There were differences in priorities according to different intersections of identity, and qualitative responses indicated a desire for research to focus on support and understanding. The bottom three priorities concerned genetics, treatments and interventions and causes. These findings emphasise the need to address the gap between what autism research focuses on and the everyday lives of autistic people. Although research has the potential to improve autistic people's lives, lots of funding goes towards research looking at topics which autistic people say has little impact in their everyday lives. Autistic people's lives can be different depending on where they live, and Scotland is a unique country in many ways. We wanted to find out which topics autistic people in Scotland want to see research on. Our team of autistic and non-autistic researchers (including university-based and community researchers) created a survey where 225 autistic adults rated and ranked the importance of possible research topics and shared their thoughts on what topics mattered to them. The five most important topics were mental health and well-being, identifying and diagnosing autistic people, support services (including healthcare and social care), non-autistic people's knowledge and attitudes and issues impacting autistic women. The three least important topics were genetics or biological aspects of autism, autism treatments/interventions and causes of autism. Our findings indicate that autistic people in Scotland want research to focus on things that matter to their day-to-day lives. Also, the Scottish government says they will be listening to autistic people in their latest policy plans, and we believe that considering autistic people's research priorities is an important part of this. Our findings also add to growing calls for change to happen in how and what autism researchers do research on. [ABSTRACT FROM AUTHOR]

Background: The experiences and perceptions of Community Health Workers toward mental illness are vital for tailoring interventions, reducing stigma, improving access to services, and fostering community engagement in mental health initiatives. Aims: This study investigates the experiences of community health worker and their perception of mental illness. Methods: A multi-settings cross-sectional study was conducted among 487 Community Health Workers. Their experience and perception toward mental illness were studied with questionnaires, which examined their general perception, religious-related perception, cause, treatment, and expectation for mental treatment. Results: Most participants concurred that serving as a community health worker enhances their communication abilities (90.4%), strengthens connections with community health center staff (84.8%), boosts self-confidence (84.6%), and refines their capacity to identify signs of mental disorders (77%). Most notably, they consider their fellow community health workers essential to their extended family. Furthermore, a notable proportion associates' mental illness with religious elements, with 19.5% believing it can result from a lack of religious worship and a minority attributing it to witchcraft or black magic (3.5%). In terms of treatment, 14.2% think Ruqyah can cure mental illness, 6.4% believe in treatment by religious scholars, and a similar percentage (6.4%) think no medication or treatment is necessary for mental problems. Conclusion: Participants overwhelmingly recognize the positive impact of serving as community health workers, citing improvements in communication, relationships with health center staff, self-confidence, and mental disorder identification. The strong bond among community health workers, likened to an extended family, emphasizes their collective importance. Additionally, the majority advocates for compassionate treatment of individuals with mental illness. These findings underscore the complex interplay of professional, communal, and cultural elements in addressing community mental health. [ABSTRACT FROM AUTHOR]

Psychological distress in women represents a critical aspect; however, few studies have comprehensively addressed how health management strategies, consideration of future consequences (CFC), cognitive reappropriation, and self-efficacy may influence this phenomenon, especially in contexts that require a comprehensive approach to women's mental health. This study aimed to evaluate the effects of future consequence consideration, cognitive reappraisal, and self-efficacy in health management on psychological distress in American women, as well as to demonstrate their equivalence according to age. Data from 2788 women responding to the 2019 Health Information National Trends Survey 5, cycle 3 were used. A predictive model was considered using structural equation modeling (SEM). Cognitive reappraisal and self-efficacy in health management (SEHM) have a significant mediating effect between CFC and psychological distress. In addition, the invariance of the SEM model was presented as a function of age. The findings underscore the importance of incorporating cognitive components into mental health interventions for women, focusing on modifying thoughts and perceptions about the efficacy of health care to mitigate negative emotions. [ABSTRACT FROM AUTHOR]

Simple Summary: Skin cancer rates in Canada are rising quickly, with about one-third of Canadians likely to be affected in their lifetime. Despite this alarming trend, government actions to reduce skin cancer are limited. Our study, conducted in Manitoba, found that many residents have risky sun exposure habits and lack awareness about skin cancer. Over 65% reported a history of sunburns, more than half had used tanning beds, and a large majority recently tanned for pleasure. Misconceptions are common, with over 50% believing that tans are healthy or a sign of beauty. Moreover, sun protection practices are inadequate, with less than 60% using protective clothing and under 50% using sunscreen. These findings highlight the need for targeted public health campaigns to improve awareness and promote better sun protection behaviors to prevent future skin cancers in Manitoba. The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine college student perceptions related to institutional vaccine mandates. We utilized qualitative data (n = 2,212) from five open-ended questions in a cross-sectional study of students enrolled or intending to enroll in an institute of higher education in California in fall 2021. Data were collected between June and August 2021. Thematic analysis was employed to analyze student beliefs, and four themes were developed from the data: (1) Polarizing views and language, (2) deciding who to trust, (3) conveying rights and risk, and (4) staying focused on education. The themes represented vaccinated and nonvaccinated student perspectives, capturing views about trust, rights, and risk. Many responses were polarizing and included language that was emotional and political. Despite the range of responses, most students expressed appreciation and approval of the vaccination mandate on college campuses. Findings illustrate the important contributions of qualitative research and suggest opportunities for public health practitioners to lead and engage in critical dialogue about science and public health practices as we aim to promote public perceptions of vaccination programs and health promotion practice. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To understand and describe attitudes toward general health checkups, breast health knowledge, cultural beliefs, and health-promoting behaviors among Myanmar American immigrant women in the United States. SAMPLE & SETTING: 267 women participated in the study. 10 women were excluded because of missing data, so the total sample size was 257 participants. METHODS & VARIABLES: A descriptive, crosssectional survey design was used to describe and investigate breast health perceptions and behaviors. RESULTS: Nearly 75% of the study sample reported having negative attitudes toward general health checkups and were found to have less accurate breast health knowledge and more fatalistic views about breast cancer. Only 29% of older women adhered to mammogram recommendations. Younger women reported more barriers to mammograms, and older women reported fewer barriers to mammograms. IMPLICATIONS FOR NURSING: This study demonstrated the need for additional research focusing on unique perspectives when investigating breast health practices among Myanmar American immigrant women. The findings highlight the essential need to build a strong partnership with stakeholders to combat breast health disparities and address the complex nature of acculturation. [ABSTRACT FROM AUTHOR]

Background: The effects of climate change have been evident throughout all domains of health such as physical, social, environmental, and mental. However, the lack of perception made it a grey topic among the public. The aim of the study was to determine the perception of climate change on physical, environmental, and mental domains of health and to find the association between the physical, environmental, and mental effects of climate change and its basic characteristics. Materials and Methods: This study was conducted in a cross-sectional design among the general population above 30 years in the field practice area [urban and rural] of tertiary care hospital Perambalur for a period of three months. The data were collected using a semi-structured questionnaire and the interviewer method, which includes sociodemographic characteristics along with questions on the perception of climate change effects on mental, physical, and environmental aspects. The regression models were used to analyze the odds of perception among the subjects with respect to the various domains of characteristics. Results: The study included 877 participants, where the majority of subjects perceived the effects of climate change on physical, mental, and environmental domains of health. The odds of having a higher perception were significant in regression analysis among people with higher/school education, agriculture occupation, and rural residence (P < 0.05). Conclusion: Most of the study participants had an increased perception of climate change effects, making the subjects better candidates to impart adaptive strategies. Community-based programs have to be promoted to develop better comprehension and factual perception of climate change. [ABSTRACT FROM AUTHOR]

This cross-sectional analysis aimed to describe beliefs about antiretroviral therapy (ART) in young people living with perinatal HIV (PHIV) in England, and the association between these beliefs and adherence to ART. The Beliefs About Medicine Questionnaire (Highly Active Antiretroviral Therapy version), was used to measure participants' beliefs in the necessity of ("Necessity score") and concerns regarding ("Concerns score") ART. Participants were classified as having high/low total scores using midpoints of the score scales. Associations between beliefs and being Last Month Adherent (LMA; self-reported not missing more than 2 consecutive ART doses in the month prior to the interview) were analysed using logistic regression, adjusting for sociodemographic, clinical, and psychosocial variables. Of 247 PHIV (median age = 18.6 years), 158 (64%) were LMA. 224 (91%) had a high Necessity score and 54 (22%) a high Concerns score. There was no association between high Necessity score and LMA in multivariable analysis (adjusted odds ratio (aOR) = 1.34, 95% confidence interval (CI) = 0.34–5.28, p = 0.679); however, high Concerns score was independently associated with a reduced odds of being LMA (aOR = 0.19, CI = 0.07–0.47, p < 0.001). Interventions to address the concerns young people living with PHIV have about ART should be explored as a strategy to improve their adherence. [ABSTRACT FROM AUTHOR]

This study examined relations between political ideology, religiosity, individual characteristics, personal belief in a just world, and attitudes towards asexuals' parenting rights, aiming to understand the complex roots of sexual prejudice better. An exploratory cross-sectional study was conducted via an online survey in Greece between May 2 and 30 July 2021. Two hundred and four participants were recruited for this study. A between-subject, correlational design was employed. Bivariate correlation was generated to explore the associations between variables of interest. Next, a bootstrapping analysis for simple mediation models was conducted. Also, a multiple regression model was employed to predict attitudes towards asexuals' parenting rights from the study measures. This study suggests that religious opposition to asexuals' parenting rights is attributable, at least in part, to political ideology. In addition, gender is also a significant factor influencing the formation of attitudes towards asexuals' parenting rights. In light of the current debates regarding expanding sexual and gender minority rights in several countries, this study presents a timely investigation into the underpinnings of opposition to asexuals' parenting rights. Research data in this scarcely researched field may support the efforts of advocacy groups to promote social justice. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths with high mortality rates worldwide. Accessible screening methods have facilitated its early diagnosis. In Iran, as in many Asian countries, an important barrier to CRC screening is the insufficient knowledge of healthcare providers, including physicians, and the lack of advice from them. Available data on this subject are insufficient, and more surveys are needed in this country. Objectives: This study aimed to investigate Iranian physicians' knowledge about CRC signs and symptoms, risk factors, and screening. Additionally, the association between their knowledge and their characteristics was assessed to provide more data for further interventions. Methods: This cross-sectional study was conducted on 150 family physicians selected by convenience sampling from rural areas in Hamadan province, Iran, from June to September 2017. A self-administered, semi-structured questionnaire was used. Data were analyzed using SPSS 21, with a significance level set at P < 0.05. Results: The mean total knowledge score about CRC was 25.11 ± 4.64 (64.3%) out of 38 questions. The average scores for knowledge about CRC signs and symptoms, risk factors, and the screening program were 7.1 ± 0.81 (out of 8), 10.29 ± 1.83 (out of 13), and 7.77 ± 3.43 (out of 18), respectively. Family physicians had the highest accuracy in answering questions about CRC signs and symptoms (88.7%) and the lowest accuracy in answering questions about the screening program (43%). Since the Kolmogorov-Smirnov test rejected the normal distribution of the data, nonparametric tests were used to compare physicians' knowledge scores according to different variables. The study revealed a statistically significant reverse correlation between physicians' knowledge of CRC and their age (r = -0.342, P < 0.001), years since graduation (r = -0.228, P = 0.005), and work experience (r = -0.247, P = 0.002). However, after multiple regression analysis, only higher age significantly predicted lower total knowledge scores (P = 0.002). No significant relationship was found between participants' knowledge scores and their gender (P = 0.929) or place of employment (P = 0.399). Conclusions: Family doctors had insufficient knowledge regarding CRC screening programs. To address this issue, health education programs should be designed to enhance their knowledge of CRC screening guidelines. [ABSTRACT FROM AUTHOR]

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Men who have sex with men are at an increased risk of acquiring sexually transmitted infections, and although behavioral and contextual interventions have improved, infections continue to spread. Therefore, a new focus on recent trends in sexual health in this population is needed. The aim of this study was to describe the relationship between sociodemographic and behavioral characteristics according to Grindr usage patterns, the prevalence of sexually transmitted infections (STIs), and attitudes toward HIV testing. In January 2020, a cross-sectional study was conducted using a sample of 881 men who have sex with men (MSM) who completed an online questionnaire. We evaluated their Grindr use patterns (moderate or intensive) and explored the associations of these with sociodemographic behavioral characteristics, STIs, and attitudes toward HIV testing. Of 881 participants in total, 587 (66.6%) were intensive Grindr users. Compared to moderate users, these participants reported significantly higher numbers of casual sexual partners (76.2% vs. 23.8%; p < 0.001), were more likely to participate in Chemsex (77.3% vs. 22.7%: p = 0.031), and had a higher self-reported number of STIs (69.9% vs. 30.1; p = 0.046). They also demonstrated better attitudes toward HIV testing (69.7% vs. 30.3%; p = 0.045) and perceived themselves to be at moderate risk of HIV (71.2% vs. 28.8%: p = 0.048). Moreover, intensive Grindr users were 1.36 times more likely than moderate users to test positive for STIs (95%CI = 1.15–1.91; p = 0.048). With some limitations, age, sexual partners, intensive Grindr users, and PrEP uses were associated with the risk of STIs in the sample of Spanish Grindr users studied. As Grindr users are vulnerable to sociodemographic and behavioral factors that determine STIs and HIV infection, mainly among intensive users, it is necessary to highlight the importance of new trends such as online dating apps, PrEP use, substance use in sex, and Chemsex, and these need to be incorporated into online public health strategies. [ABSTRACT FROM AUTHOR]

Background: Malaysian preschool children continue to exhibit a high prevalence of dental caries and poor oral hygiene. There is a need to gain an in-depth understanding of oral hygiene habits and design suitable interventions to improve oral hygiene in early childhood. Objective: To cross-culturally adapt and determine the psychometric properties of the Malay-translated Parenting and Child Tooth Brushing Assessment questionnaire (M-PACTA). Methodology: This cross-sectional study involved face and content validation, and forward and back-translation of PACTA. The M-PACTA was then tested for reliability and construct validity on 150 Malaysian parents of children aged 5 to 6 years old. Results: Face validity indicated that the M-PACTA items were clear and easy to understand. For content validity, some words had to be modified in accordance with the recommendations of the expert committees to make it more coherent to Malaysians. Some statements in the parental knowledge scales were modified according to the guidelines applicable in Malaysia. The content comparison of the back translation with the adapted PACTA revealed that all items were semantic and linguistically equivalent. Exploratory factor analyses of M-PACTA suggested a two-factor structure for three scales including child behaviour scale ('non-compliance' and 'avoidance behaviour'), parental attitudes ('lack of concern' and 'attitude of care'), and parental knowledge ('general tooth brushing knowledge' and 'awareness of tooth brushing care') while for the parental strategy scale, three-factor structure was extracted including 'routine positive methods', 'uncommon positive methods', and 'negative methods'. Internal consistencies for all scales were good (α > 0.9). Conclusion: M-PACTA did not replicate the construct of the original PACTA. Nonetheless, M-PACTA demonstrated good construct validity, internal consistency reliability, and test-retest reliability within Malaysian context. [ABSTRACT FROM AUTHOR]

This study aimed to understand how psychological factors affect regular exercise in older adults, hypothesising that trait self-control mediates the relationship between motivation types (intrinsic, extrinsic, and amotivation) and exercise time. In this cross-sectional study, 430 older adults (mean age = 68.8 ± 6.72) completed questionnaires regarding their perceived trait self-control, motivation towards leisure activities, and level of physical activity. A Bayesian mediation analysis was performed, controlling for demographics. We documented positive direct (c′ = 0.021, 95%CI [0.001, 0.043]) and indirect (ab = 0.028, 95%CI [0.014, 0.043]) effects of intrinsic motivation on exercise, a fully mediated indirect effect of extrinsic motivation on exercise (ab = 0.027, 95%CI [0.011, 0.046]), and negative direct (c′ = −0.281, 95%CI [−0.368, −0.194]) and indirect (ab = −0.161, 95%CI [−0.221, −0.105]) effects of amotivation on exercise. There was no direct association between extrinsic motivation and exercise (c′ = 0.013, 95% CI [−0.013, 0.037]). In conclusion, trait self-control mediates motivation to influence exercise behaviour in older adults. Intrinsically motivated individuals resist sedentary living and show higher self-control, while extrinsically motivated ones rely on self-control and are more susceptible to non-adherence during mental fatigue. High amotivation is linked to less exercise and reduced self-control, suggesting potential non-compliance with structured exercise interventions. [ABSTRACT FROM AUTHOR]

Background: Longevity increases pose public health challenges, especially in managing falls and their psychological impacts on older adults. Limited evidence exists on the relationship between a fear of falling (FOF), previous falls, and depressive symptoms among community-dwelling older adults. Objective: To evaluate the association between falls, FOF, and depressive symptoms in community-dwelling older adults. Methods: This cross-sectional study, conducted in 2018, included 400 older adults from a Basic Health Unit in São Paulo, Brazil. The Geriatric Depression Scale (GDS-15) and the International Falls Efficacy Scale (FES-I) were used, along with self-report questionnaires on fall history. Linear and logistic regression were used to analyze the relationships between variables. Results: The mean age was 75.2 (SD = 8.53) years, with 63.2% being female. Depressive symptoms were observed in 18.3% of the participants, while 90.5% reported a fear of falling (FOF). More than half (63.0%) experienced falls, with 49.5% occurring in the last year. Factors such as the female gender, negative health perceptions, and functional dependence were associated with depressive symptoms. Adjusted analyses indicated that both a fear of falling (FOF) (B = 0.043; p = 0.012) and a history of falls (B = 0.725; p = 0.015) were associated with depressive symptoms. Conclusions: Falls, FOF, and depressive symptoms are interlinked among older adults, underscoring the need for targeted interventions to improve their mental and physical health. [ABSTRACT FROM AUTHOR]

Access to online medical records (OMRs) can help enhance cancer patient engagement and improve their health outcomes. This study investigates disparities in OMR access among cancer survivors and examines the association between OMR access and health perceptions. We conducted a cross-sectional analysis using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) from 2017 to 2022. The sample included 4713 cancer survivors. We employed regression analysis to assess the associations between the different factors. Overall, 18.78% of participants accessed their OMRs once or twice, while 36.69% accessed them three times or more. Gender minority groups (β = −0.0038, p = 0.01), older adults (β = −0.1126, p < 0.001), and racial minority groups (β = −0.059, p < 0.001) were less likely to access their OMRs. Additionally, higher education levels (β = 0.274, p < 0.001), insurance coverage (β = 0.365, p < 0.001), and higher incomes (β = 0.115, p < 0.001) were associated with increased OMR access. Positive health perceptions were significantly associated with OMR usage, including perceived good health (β = 0.148, p < 0.001), quality of care (β = 0.15, p = 0.026), and self-efficacy (β = 0.178, p = 0.002). Disparities in OMR access among cancer survivors are influenced by socio-economic factors and health perceptions. Interventions targeting vulnerable groups, enhancing digital health literacy, and improving health perceptions could promote equitable OMR usage. [ABSTRACT FROM AUTHOR]

Background: Abortion-related complications remain a main cause of maternal mortality. There is little evidence on the availability and quality of post-abortion care (PAC) in humanitarian settings. We assessed the quality of PAC in two hospitals supported by an international organization in Jigawa State (Nigeria) and Bangui (Central African Republic, CAR). Methods: We mapped indicators corresponding to the eleven domains of the WHO Maternal and Newborn Health quality-of-care framework to assess inputs, processes (provision and experience of care), and outcomes of PAC. We measured these indicators in four components of a cross-sectional multi-methods study: 1) an assessment of the hospitals' PAC signal functions, 2) a survey of the knowledge, attitudes, practices, and behavior of 140 Nigerian and 84 CAR clinicians providing PAC, 3) a prospective review of the medical records of 520 and 548 women presenting for abortion complications and, 4) a survey of 360 and 362 of these women who were hospitalized in the Nigerian and CAR hospitals, respectively. Results: Among the total 27 PAC signal functions assessed, 25 were available in the Nigerian hospital and 26 in the CAR hospital. In both hospitals, less than 2.5% were treated with dilatation and sharp curettage. Over 80% of women received blood transfusion or curative antibiotics when indicated. However, antibiotics were given to about 30% of patients with no documented indication. Among discharged women in CAR, 99% received contraceptive counseling but only 39% did in Nigeria. Over 80% of women in Nigeria reported positive experiences of respect and preservation of dignity. Conversely, in CAR, 37% reported that their privacy was always respected during examination and 62% reported short or very short waiting time before seeing a health provider. In terms of communication, only 15% felt able to ask questions during treatment in both hospitals. The risk of abortion-near-miss happening ≥ 24h after presentation was 0.2% in Nigeria and 1.1% in CAR. Only 65% of women in the Nigerian hospital and 34% in the CAR hospital reported that the staff provided them best care all the time. Conclusion: Our comprehensive assessment identified that these two hospitals in humanitarian settings provided lifesaving PAC. However, hospitals need to strengthen the patient-centered approach engaging patients in their own care and ensuring privacy, short waiting times and quality provider-patient communication. Health professionals would benefit from instituting antibiotic stewardships to prevent antibiotic-resistance. Plain English summary: In humanitarian contexts, abortion complications are a leading cause of maternal mortality. Providing quality post-abortion care (PAC) is therefore an important part of needed services. We assessed the quality of PAC in two hospitals supported by an international organization in Jigawa State (Nigeria) and Bangui (Central African Republic). We measured quality indicators in four components: 1) an assessment of the equipment and human resources available in hospitals, 2) a survey of the knowledge, attitudes, practices, and behavior of clinicians providing PAC, 3) an assessment of the medical care provided by clinicians to women presenting with abortion complications and, 4) a survey of a subgroup of these women who were hospitalized. Both hospitals had almost all the equipment and human resources necessary to provide post-abortion care. Less than 2.5% of women received a non-recommended method to evacuate their uterus in both hospitals. More than 80% of women received a blood transfusion or antibiotics when they needed them. However, 30% of women received antibiotics without written justification and only 15% of women reported being able to ask questions about their treatment. Overall, only 65% of Nigerian women and 34% of Central African women said that the staff provided them with the best care all the time. The fact that less than 2% of women experienced a very severe complication 24 hours or more after their arrival at the two hospitals suggests that the care provided was lifesaving. But they urgently need to adopt a better patient-centered approach as well as to improve the rational management of antibiotics. [ABSTRACT FROM AUTHOR]

Elderly individuals are more likely to suffer from both short and long-term consequences of COVID19, including exacerbation of existing illnesses, psychological issues, and increased risk of death. This study aimed to understand the medical, perceived psychological, and social health problems faced by the elderly due to the COVID-19 pandemic. This hospital-based study included 225 elderly patients (aged >60 years) with chronic health conditions. Hypertension (70.2%) and diabetes mellitus (64.0%) were the most common morbidities among the study participants. At least 34.7% of the participants had one or more symptoms suggestive of psychological problems due to COVID-19 pandemic. Among the participants, 56.9% had difficulty with routine activities, 10.2% had trouble accessing medications and 8% faced issues in receiving routine medical care. There is a need to protect the interests of the elderly and suggest potential preventive measures and solutions for their medical, social and psychological problems. [ABSTRACT FROM AUTHOR]

Recombinant zoster vaccine has been recommended by the US Advisory Committee on Immunization Practices (ACIP) for the prevention of herpes zoster (HZ) in immunocompetent adults aged at least 50 years since 2018. In January 2022, this was extended to immunodeficient/immunosuppressed adults aged at least 19 years. Key study objectives were to assess specialists' knowledge of the ACIP HZ vaccination recommendations, their attitudes toward HZ vaccination, and HZ vaccination practices/barriers. This cross-sectional, web-based survey (conducted in March 2022) included US dermatologists, gastroenterologists, infectious disease specialists, oncologists, and rheumatologists who treat patients with psoriasis, inflammatory bowel disease, human immunodeficiency syndrome, solid tumors/hematological malignancies, and rheumatoid arthritis, respectively. Although most of the 613 specialists correctly identified the ACIP HZ vaccination recommendations for adults aged at least 50 years (84%) and immunodeficient/immunosuppressed adults aged at least 19 years (67%), only 29% knew that recombinant zoster vaccine is recommended for individuals who have previously received zoster vaccine live, and only 18% knew all current ACIP recommendations. For patients with the diseases listed, 84% of specialists thought that HZ is a serious risk, 75% that HZ vaccination is extremely/very important, and 69% were extremely/very likely to recommend HZ vaccination. Only 36% administer vaccines themselves, mainly because patients receive vaccinations from others. Barriers to vaccination included more urgent/acute issues, insufficient time, and lack of patient motivation/willingness. Full knowledge of the ACIP HZ vaccination recommendations among the surveyed specialists was low. There may be a need to educate specialists to improve adherence to these recommendations. [ABSTRACT FROM AUTHOR]

Health care workers are at increased risk for mental health issues due to high psychological and physical job demands. According to a recent study, stress beliefs (i.e., believing stress to be detrimental to one's health) might influence physicians' mental health in response to a naturalistic stressor (COVID‐19 hospital working conditions). Due to a small sample size and high alpha error inflation, the suggested association needs to be interpreted with caution. The current study aims to replicate those findings in a larger sample. A cross‐sectional survey among N = 418 (64.1% female; Median age = 30–39 years) physicians and nurses of a large German medical centre was conducted during the COVID‐19 pandemic (May/June 2021). Perception of pandemic related increase of work stress was assessed via self‐report. Stress beliefs were assessed with the Beliefs About Stress Scale, and mental health symptoms were assessed with the 21‐item Depression Anxiety Stress Scale. Stress beliefs moderated the association between increased work stress and mental health symptoms. Increased work stress was associated with increased depressive, anxiety and distress symptoms only in health care workers with medium (simple slope = 2.22, p <.001; simple slope = 1.27, p <.001; simple slope = 3.19, p <.001) and high (simple slope = 3.13; p <.001; simple slope = 1.66, p <.05; simple slope = 4.33, p <.001) negative stress beliefs. Among health care workers with low negative stress beliefs increased work stress was not associated with increased depressive, anxiety and distress symptoms. This confirms negative stress beliefs as variable of interest in research on the impact of stress on mental health in health care workers. [ABSTRACT FROM AUTHOR]

Objective: Campus recreational sport activities impact college student health and well-being in a variety of domains. This multi-institutional study examined the participation of students in campus recreation during the pandemic and explored the relationship between student participation and their demographic markers, COVID-19 experience, and perceptions of risk, health and safety. Methods: Results from a survey of 1,815 American college students indicated the presence of statistical differences in sport participation based on Gender, Race, State, Personal COVID-19 Experience, Campus Safety Efforts, and Risk Perception Score within various areas of analysis. Results: The impact and meaning of these cross-sectional results are discussed with reference to the ongoing pandemic and student health. Recommendations are presented within the context of this vital programming area both during and beyond the current crisis. Conclusion: These results are especially important given the health benefits associated with participation in recreational sport as tools to mitigate against the unprecedented consequences of the pandemic. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study examined the weight bias attitudes and obesity beliefs of health science (HS), nursing, and pre-medicine undergraduate students. Methods: Using snowballing and convenience sampling strategies, students (N = 139) completed an online survey, including a 24-item Antifat Attitudes Scale (AFAS) and eight-item Belief About Obese Persons (BAOP) scale. Results: HS students have higher weight bias than nursing and pre-medicine students combined (M = 43.45, SD = 10.75), t(137) = −2.45, p =.016). A negative correlation exists between AFAS and BAOP suggesting high weight bias influences a belief that obesity is controllable. Gender positively predicted weight bias attitudes (ß = −11.43, t = −4.33, p <.001) and obesity beliefs (ß = 3.75, t = 3.01, p =. 003). Conclusions: Findings confirm that HS students have weight bias attitudes. This supports undergraduate curricular changes on obesity etiology that may improve treatment plans of individuals who are obese. [ABSTRACT FROM AUTHOR]

To assess the relationship between knowledge of long-acting reversible contraception (LARC) and intention to use LARC among female students. Participants consisted of a convenience sample of 292 female undergraduate and graduate students at a large midwestern university. We conducted a cross-sectional in-person survey and multivariate analysis of LARC knowledge and intention to use LARC. Total response rate was 84.9%. Among contraceptive users, 13.3% were using a LARC method. On average, respondents scored 4.8/10 (SD 2.5) on a 10-item LARC knowledge assessment. Higher levels of LARC knowledge were associated with the intent to use LARC in the future in our multivariate analysis (RR 1.7, 95% CI 1.14–2.54: p =.01). Common reasons for LARC hesitancy were a need for more information, safety concerns, and risk of undesirable side effects. Low LARC knowledge and students' self-identified need for further LARC information represent an opportunity for campus contraceptive interventions which empower students to make informed reproductive decisions. [ABSTRACT FROM AUTHOR]

Background: Women with diminished ovarian reserve (DOR) have fewer eggs than would be expected at their age. It is estimated that 10% of women seeking fertility treatment are diagnosed with DOR. However, the success rate of medically assisted reproduction (MAR) is significantly lower in women with DOR, thus many seek additional approaches. Aim: To explore the health needs of women with DOR, treatment options and experience of treatment including traditional complementary integrative medicine (TCIM). Methods: Anyone with a diagnosis of DOR, living in Australia or New Zealand, aged over 18 were invited to complete an online survey distributed via fertility support networks and social media platforms from April to December 2021. Results: Data from 67 respondents were included. The main aspects of health that were impacted by DOR were fertility (91.0%) and mental health (52.2%). The main treatment recommended was MAR with most women either currently using MAR (38.8%) or having previously used MAR (37.3%). TCIM was widely used with 88.1% of women utilising supplements, 74.6% consulting with TCIM practitioners, and 65.7% adopting self‐care practices. The main reasons for using TCIM were to improve fertility or support pregnancy, and to support general health and well‐being. Conclusions: Women with DOR have additional health needs apart from infertility, most notably mental health support. The main form of treatment utilised is MAR, despite DOR being challenging for fertility clinicians. TCIM was widely used, and respondents perceived benefits related to improving fertility, supporting pregnancy, or improving well‐being through use of acupuncture, meditation, naturopathy, massage, yoga. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between control beliefs about stress and post‐traumatic growth among Chinese nurses during the COVID‐19 pandemic and to examine the mediating role of basic psychological needs satisfaction and optimism in this relationship. A total of 692 Chinese nurses participated in this online study, who completed the Beliefs about Stress Scale, Post‐Traumatic Growth Inventory, Positive Psychological Capital Questionnaire, Basic Psychological Needs Satisfaction Scale and demographic variables between September and October 2020. Results indicate that 48.8% (N = 388) of nurses reported significant post‐traumatic growth related to the COVID‐19 pandemic. Moreover, control beliefs about stress were positively related to post‐traumatic growth (r = 0.38, p < 0.001), basic psychological needs satisfaction (r = 0.44, p < 0.001) and optimism (r = 0.47, p < 0.001). In addition, basic psychological needs satisfaction and optimism were both independent and serial mediators of the relationship between control beliefs about stress and post‐traumatic growth. Nurses and hospital administrators should focus on increasing nurses' control beliefs about stress and thereby enhancing their post‐traumatic growth after experiencing events such as the COVID‐19 pandemic. To support this process, programs should be designed to meet nurses' basic psychological needs and increase their optimism. [ABSTRACT FROM AUTHOR]

Intermittent claudication is the most common symptom of Peripheral Arterial Disease (PAD) and is associated with decreased quality of life (QoL) due to walking impairment. The level of threat attributed to the disease affects QoL and physical activity. This study explores beliefs and illness drawings, and their relationship with quality of life and physical activity in patients undergoing conservative treatment for PAD. A cross-sectional study was carried out including 119 patients with PAD and Intermittent Claudication, in which patients were asked to freely draw their disease and 33 agreed to participate. The profile of beliefs about PAD is characterized by a low level of threat. Belief in the emotional impact of the disease, representations about the consequences and concern about the disease were associated with worse quality of life; the belief of having a high personal control over the disease was associated with more physical activity. The analysis of the disease drawings revealed three categories: extension of the disease (category 1), location and representations of the disease (category 2), and level of detail and complexity of the drawings (category 3). Greater disease extent was associated with more disease symptoms (IPQ 6) (rs = 0.399, p =.021). It is necessary to address beliefs and representations about the disease in consultations with patients with PAD. Patient drawings are a useful, practical, and free tool that does not require a lot of time and can facilitate the approach of health professionals to patient training and education. [ABSTRACT FROM AUTHOR]

Objective: Onset of the Coronavirus Disease 2019 (COVID) pandemic has increased students' perceived burdens. The current study aimed to examine COVID‐related changes and to identify potential factors that contribute to students' stress. Method: Adopting a cross‐sectional cohort‐study design, we examined perceived stress and depressive and anxiety symptoms with a specific focus on the role of study‐related variables such as perceived study‐related demands, study‐related resources, academic procrastination, and stress‐enhancing beliefs. Two cohorts (Npre‐COVID = 2,175; NCOVID = 959) were recruited at the same university and matched with regard to their propensity score (age, gender, semester). Results: Compared with the pre‐COVID cohort, university students in the COVID cohort reported more perceived stress, more depressive and anxiety symptoms, more academic procrastination due to fear of failure, more stress‐enhancing beliefs, more distress due to the housing situation, and more perceived study‐related challenges (Cohen's d = 0.15–0.45). A stepwise regression analysis identified depressive symptoms, procrastination due to fear of failure, general self‐efficacy, increased study demands, perceived difficulties with self‐organized learning, distress due to housing, and stress‐enhancing beliefs as predictors of perceived stress in the COVID cohort. Discussion: Findings suggest that the switch to online‐only education increased the study‐related burden for students, primarily due to exams being replaced by a greater amount of regular coursework and imposing demands on self‐organized learning. Possibly, stress‐enhancing beliefs and procrastination due to fear of failure might have been elevated due to less opportunity for social referencing and lack of felt social support by peer students. Conclusion: Experienced increased burden in students during the COVID pandemic was mostly accounted for by a lack of perceived individual resources rather than by an increase in objective study‐related demands. [ABSTRACT FROM AUTHOR]

There is emerging evidence that post-traumatic growth is a relevant concept in addiction recovery. However, existing measures, such as the post-traumatic growth inventory, were designed to measure post-traumatic growth in general trauma populations. It is unclear if the post-traumatic growth inventory is suitable for individuals in recovery from substance-related addiction. The current study aimed to qualitatively assess the content validity of the post-traumatic growth inventory for individuals in addiction recovery. The think-aloud method was applied, and semi-structured interviews utilized, to collect data from 20 individuals in recovery from unhealthy alcohol and/or drug use. Reflexive thematic analysis was used to analyze data in relation to item interpretation and experience of post-traumatic growth. Qualitative assessment supported three out of five subscales on the post-traumatic growth inventory (new possibilities, personal strength and appreciation of life). Modifications were suggested on some items from the relating to others domain and responses to the spiritual change domain possibly reflected a cultural influence. There was an identified need to include items that account for positive changes in health behavior. The current study highlights domains of post-traumatic growth for those in addiction recovery and how the post-traumatic growth inventory may understate some forms of positive life change. Future research should focus on validating a revised version of the post-traumatic growth inventory for this population. [ABSTRACT FROM AUTHOR]

As the opioid epidemic continues, availability of evidence-based strategies for harm reduction and treatment in communities is critical to reduce overdose and other consequences of opioid use disorder. Community members' support of harm reduction and treatment services is needed for new programs and to maintain existent programs. This study sought to understand beliefs and attitudes associated with support for three community-based strategies to address opioid misuse and addiction: naloxone, needle exchange, and medication-assisted treatment. We conducted a cross-sectional online survey with 545 adults. Results of the survey showed that participants supported all three strategies, with the strongest support for medication-assisted treatment. Multiple regression showed that stigma and perceived stigma were significant predictors for all three strategies, with inverse relationships. Stigmatizing beliefs predicted less support while perceiving stigma among others was associated with greater support for the strategies. Normative beliefs also significantly predicted support for all three strategies, such that stronger belief that others were supportive of each strategy was associated with greater support for that strategy. Other predictors varied across the three strategies. Support for harm reduction and treatment programs in communities affected by the opioid epidemic may be bolstered by reducing stigma and increasing normative beliefs. Stronger support for medication-assisted treatment may be leveraged and extended to harm reduction strategies. Results of our study contribute insights for bolstering community support for harm reduction and treatment, which is vital for adoption and maintenance of these important programs. [ABSTRACT FROM AUTHOR]

Introduction: The primary purpose of this study was to examine the perceptions and utilization of spinal thrust manipulation (STM) techniques of physical therapists who treat patients with low back pain (LBP) in the State of Minnesota. A secondary purpose was to investigate differences between physical therapists who perform STM and those who do not. Methods: A cross-sectional design was utilized through the completion of an electronic survey. 74 respondents completed the survey. Descriptive measures were recorded as frequencies for categorical data or mean ± standard deviation for continuous data. For between-group comparisons, chi-square analyses were used for categorical items of nominal or ordinal data and t-tests were utilized for continuous data. The alpha level was set at p < 0.05. Result: 60.2% of respondents reported using STM when treating patients with LBP. 69.9% of respondents utilize a classification system. 76.7% of individuals answered correctly regarding the Minnesota State practice act. Of those who use STM, 81.8% utilize a Clinical Prediction Rule. Respondents who use STM were more likely to have a specialist certification (chi-square = 6.471, p = 0.011) and to have completed continuing education courses on manual therapy (chi-square = 4.736, p = 0.030). Discussion/Conclusions: Physical therapists who perform STM are more likely to have a better understanding of their state practice act, be board certified, and have completed continuing education in manual therapy. KEY POINTS: This research builds upon the understanding of clinical practice patterns of physical therapists, specific to utilization and clinical decision making for manual therapy treatment interventions for LBP. Adherence to treatment recommendations for LBP could benefit from further educational within the profession of physical therapy, mainly continuing education, promotion of clinical residency training, and/or attainment of specialist board certification. Physical therapists who perform STM are more likely to have a better understanding of their state physical therapy practice act, have further training as evidenced by board certification, and have pursued continuing education in the realm of manual therapy or manipulation techniques. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Longitudinal studies on chronic loneliness and before and during the COVID-19 pandemic are lacking in Africa. The study aimed to estimate the prevalence and associated factors of loneliness and chronic loneliness using cross-sectional and longitudinal data from middle-aged and older adults from rural South Africa. The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (analytic sample: n = 3,418, aged 40 years and older). Loneliness was assessed with a single and 3-item measure. The proportion of loneliness was 19.5% in the 2021/2022 survey, the incidence of chronic loneliness (having loneliness in wave 2 and 3, and free of loneliness in wave 1) was 18.9%, and the 7-year incidence of loneliness was 41.0%. Comparing the 2019 (pre-COVID-19) to 2021/2022 (during COVID-19 pandemic) surveys participants experienced a significant reduction of loneliness. In cross-sectional and/or longitudinal analyses, we found that younger age, living alone, food insecurity, lack of social engagement, depressed mood, poor life satisfaction, poor sleep quality, impaired cognition, poor self-rated health, functional disability, underweight, obesity, and not living with HIV were associated with a higher prevalence, incidence and/or increases in loneliness. One in five aging adults had acute or chronic loneliness. Several social, mental, and physical health factors were identified as associated with loneliness. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Nursing & Midwifery is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acupuncture is a promising treatment for common symptoms after traumatic brain injury (TBI). Our objectives were to explore knowledge, attitudes and beliefs about acupuncture, identify health service needs and assess the perceived feasibility of weekly acupuncture visits among individuals with TBI. Methods: We surveyed adults 18 years of age and older with TBI who received care at the University of Washington. Respondents were asked to complete 143 questions regarding acupuncture knowledge, attitudes and beliefs, injury-related symptoms and comorbidities, and to describe their interest in weekly acupuncture. Results: Respondents (n = 136) reported a high degree of knowledge about acupuncture as a component of Traditional Chinese Medicine, needle use and safety, but were less knowledgeable regarding that the fact that most conditions require multiple acupuncture treatments to achieve optimal therapeutic benefit. Respondents were comfortable talking with healthcare providers about acupuncture (63.4%), open to acupuncture concurrent with conventional treatments (80.6%) and identified lack of insurance coverage as a barrier (50.8%). Beliefs varied, but respondents were generally receptive to using acupuncture as therapy. Unsurprisingly, respondents with a history of acupuncture (n = 60) had more acupuncture knowledge than those without such a history (n = 66) and were more likely to pursue acupuncture without insurance (60%), for serious health conditions (63.3%) or alongside conventional medical therapy (85.0%). Half of all respondents expressed interest in participating in weekly acupuncture for up to 12 months and would expect almost a 50% improvement in symptoms by participating. Conclusion: Adults with TBI were receptive and interested in participating in weekly acupuncture to address health concerns. These results provide support for exploring the integration of acupuncture into the care of individuals with TBI. [ABSTRACT FROM AUTHOR]

Background/Objectives: Schools can play a key role in promoting health among adolescents, and Hungarian legislation gives them sufficient space to do so. In our study, we examined the impact of a multiyear school health promotion programme on pupils' health behaviour and well-being. Methods: We carried out our investigation in an intervention and a control primary school in Hungary. All 5th and 7th grade pupils were invited to participate in the questionnaire-based survey between 2017 and 2021. The effect of the intervention was quantified using univariate and multivariate logistic regression analyses. Results: Our results show that for those behaviours where pupils' personal choices had a greater influence (unhealthy eating, smoking, screen time), the health promotion programme was more effective. For those behaviours where family background and parental influence were more pronounced (healthy eating, physical activity), the intervention had less impact. Self-perceived health was better in the 7th-grade intervention group. Conclusions: Our findings are in line with the conclusion of systematic reviews that more intensive, longer-term, multi-behavioural school health promotion programmes can be effective in promoting positive behaviour. To be more effective, it would be worth using a well-structured curriculum, well-developed teaching materials, and greater involvement of teachers, parents, and various local organisations. [ABSTRACT FROM AUTHOR]

Purpose: LGBTQ people are less likely to seek support and face significant barriers in accessing affirmative family violence support services. Efforts to improve family violence service access must be grounded in the preferences of LGBTQ people themselves. Method: Data from a large nationwide Australian survey of the health and wellbeing of LGBTQ adults were analysed. 4,148 participants expressed a preference for family violence service provision. Multivariable logistic regressions were used to identify factors associated with preferences for family violence service provision, comparing mainstream services that are not known to be inclusive, mainstream services that are known to be LGBTQ-inclusive, and LGBTQ-specific services. Results: In total, 8.8% (n = 363) of participants indicated a preference for mainstream services, 57.5% (n = 2,383) for mainstream services that are known to be LGBTQ-inclusive and 33.8% (n = 1,402) for LGBTQ-specific services. Trans and non-binary identified people were more likely to prefer LGBTQ-specific services than cisgender participants, while bisexual, pansexual and asexual people were more likely to prefer mainstream LGBTQ-inclusive services. Participants with a regular general practitioner were more likely to prefer LGBTQ-inclusive services. Participants who had not felt supported the most recent time they reported an experience of family violence were more likely to prefer LGBTQ-specific services. Conclusion: Family violence and healthcare services require training in LGBTQ issues to provide inclusive and affirming care. The findings have implications for policy and practice in family violence care and illustrate an urgent need to reform the current narrative of family violence, which frequently excludes LGBTQ communities. [ABSTRACT FROM AUTHOR]

Background: The administration of anesthesia during gastrointestinal endoscopy potentially contributes to post-anesthesia cognitive dysfunction (PACD), with detrimental impacts for cognitive function. This study aimed to assess the knowledge, attitudes, and practices (KAP) towards PACD among patients undergoing gastrointestinal endoscopy in Wenzhou region. Methods: This cross-sectional study was conducted between June and August 2023, and recruited individuals undergoing gastrointestinal endoscopy. Demographic data and KAP scores were collected through questionnaires. Pearson correlation analysis was applied to evaluate correlations between KAP scores, and logistic regression was utilized to identify influential factors. Results: We collected 405 valid questionnaires, with 54.57% being male and 29.88% aged 31–40 years. Mean KAP scores were 13.99 ± 4.80, 16.19 ± 2.35, and 15.61 ± 2.86, respectively (possible range: 0–16, 0–25, and 0–25). Pearson correlation analysis demonstrated significant positive correlations between knowledge and practice (r = 0.209, P < 0.001), attitude and practice (r = 0.233, P < 0.001), and knowledge and attitude (r = 0.328, P < 0.001). Multivariate logistic regression revealed negative associations of opting for standard gastrointestinal endoscopy (without anesthesia) with knowledge (OR = 0.227, 95%CI: 0.088–0.582, P = 0.002) and practice scores (OR = 0.336, 95%CI: 0.154–0.731, P = 0.006). Additionally, the presence of cognitive-related diseases or symptoms before undergoing gastrointestinal endoscopy was negatively associated with knowledge scores (OR = 0.429, 95%CI: 0.225–0.818, P = 0.010). Conclusion: Patients undergoing gastrointestinal endoscopy demonstrated good knowledge, neutral attitudes, and moderate practices regarding PACD. Educational interventions and behavior modification are recommended, particularly for individuals with lower monthly income, undergoing standard gastrointestinal endoscopy, or experiencing cognitive-related conditions. [ABSTRACT FROM AUTHOR]

Background: Voluntary medical male circumcision (VMMC) is a method for combination HIV prevention for adolescents > 15 years in settings with generalized epidemics. In Zimbabwe, policy currently allows VMMC in adolescents > 15 years old, but there is consideration to lower the threshold to 13 years old. There is a need to understand current practices in assent/consent, and parents' requirements for assent/consent to inform policy recommendations for the VMMC programme in lowering its age threshold. Methods: Cross-sectional surveys were conducted in September 2022 using convenience sampling among three respondent groups: uncircumcised adolescents/young men (AYM) aged 13–16 years (n = 881), circumcised AYM aged 13–20 years (n = 247), and parents of uncircumcised adolescents aged 13–16 years (n = 443). Surveys asked about VMMC knowledge, experiences with mobilisers, circumcised AYM's assent/consent experiences, and parents' preferences for assent/consent processes. Results: Knowledge of VMMC was significantly lower among younger adolescents aged 13–14 than their 15–16 year-old peers. 57% (142/247) of circumcised AYM had a one-to-one discussion with their provider before having the procedure, 32% (80/247) said they were not fully informed about VMMC prior to the procedure, and 54% (134/247) wanted more information about procedure-related pain. Over half (56%, 42/75) of circumcised AYM whose parents had not provided consent in-person for them to receive the procedure reported that their parents had never been contacted to verify consent. Conclusions: There are gaps in the current assent/consent process for VMMC in Zimbabwe. Providers should be trained to give balanced information on risks and benefits of the procedure, including potential for pain. One-on-one discussions between providers and adolescents prior to the procedure, age-appropriate counselling, and tools for providers to ascertain adolescents' understanding and ability to provide assent are essential processes, especially if the age threshold is lowered to include younger adolescents. it is also imperative to improve communication with parents, particularly to verify consent for their children has been given, per national guidelines. [ABSTRACT FROM AUTHOR]

Objective This study aimed to assess beliefs and attitudes of Argentinean neonatologists and neonatal nurses regarding end-of-life care of newborn infants, including withdrawal of clinically assisted nutrition and hydration (CANH). Study Design A five-domain survey was sent to 465 neonatal health care workers, which included demographic data, general ethical concepts, participation in end-of-life decisions, beliefs about end-of-life care practices, and presentation of four clinical scenarios. Standard statistical tests were used, and a multivariable analysis was done to evaluate variables independently associated with rejecting the withdrawal of CANH. Results A total of 227 questionnaires were anonymously completed, 60% by physicians and 40% by nurses. More respondents agreed to withdraw mechanical ventilation in comparison to CANH in patients under certain circumstances (88 vs. 62%, p < 0.01). The most accepted variables when deciding to withdraw care were the quality of life perceived by parents (86%) and their religious beliefs (73%). A total of 93% agreed that parents should be included in the decision, but only 74% acknowledged they are included in real practice. Considering the scenario of a newborn with severe and irreversible neurological compromise, 46% of respondents were opposed to suspending enteral nutrition. No independent variables were found to be associated with opposing the withdrawal of CANH. Of those agreeing to withdraw enteral feeds under certain circumstances, for the severely neurologically affected neonate 58% would either refuse to limit enteral feeds or consult with an ethics committee before doing so. When given the scenario of their own severe and irreversible neurological compromise, 68% agreed to have enteral feeds withdrawn to themselves, and they were more likely to agree with withdrawing feeds for the severely compromised neonate (odds ratio: 7.2; 95% confidence interval: 2.7–24.1). Conclusion While most health care providers agreed to withdraw life-sustaining support under certain conditions, many were reluctant to suspend CANH. Many responses differed when being asked as general statements versus actual clinical scenarios. Key Points Withdrawal of assisted nutrition is supported by the American Academy of Pediatrics in certain scenarios. Many neonatal intensive care units health care providers from Argentina are reluctant to suspend assisted nutrition. There is a need to learn how to deal with complex bioethical issues. [ABSTRACT FROM AUTHOR]

Background Healthcare seeking behavior (HSB) and community perception on cholera can influence its management. We conducted a cross-sectional survey to generate evidence on cholera associated HSB and disease perception in populations living in cholera hotspots in Ethiopia. Methods A total of 870 randomly selected households (HHs) in Shashemene Town (ST) and Shashemene Woreda (SW) participated in our survey in January 2022. Results Predominant HHs (91.0%; 792/870) responded "primary health center" as the nearest healthcare facility (HCF). Around 57.4% (247/430) of ST HHs traveled <30 minutes to the nearest HCF. In SW, 60.2% (265/440) of HHs travelled over 30 minutes and 25.9% (114/440) over 4 km. Two-thirds of all HHs paid

Background: The increasing prevalence of chronic diseases in Saudi Arabia has heightened the need for organ transplantation; however, the donor pool remains insufficient. This study explored awareness and willingness towards organ donation among Riyadh residents and examined the sociodemographic factors influencing these attitudes. Methods: A cross-sectional survey using convenience sampling was conducted among adults in Riyadh. The survey assessed demographic characteristics, awareness, willingness to donate, and sociodemographic factors. Statistical analyses included descriptive statistics and logistic regression. Results: Among the 645 respondents, 56.4% were willing to donate organs, with females showing a higher propensity than males (OR 2.9, 95% CI 1.7–5.1, p < 0.001). Awareness of organ donation centers was linked to increased willingness to donate (OR 1.5, 95% CI 1.1–2.5, p < 0.001). Higher educational level was strongly associated with donor registration (OR 36.8, 95% CI 14.7–91.9, p < 0.001). Despite their high willingness, only 9.5% were registered as donors, highlighting the gap between intention and action. Conclusions: Riyadh residents showed a significant willingness to donate organs, influenced by gender, education, and awareness. Low registration rates suggest barriers such as religious beliefs and lack of information. Targeted educational campaigns and policy evaluations, including an opt-out system, are recommended to enhance registration rates. [ABSTRACT FROM AUTHOR]

A healthy lifestyle is a key determinant of health, especially for people with chronic diseases such as diabetes or hypertension. The health behaviours which contribute to a healthy lifestyle include the following: regular physical activity, preventive examinations, maintaining a proper diet and avoiding the consumption of alcohol or cigarettes. They have a significant impact on the disease process, controlling symptoms and preventing complications. The aim of this study was to examine the health behaviours related to diet, physical activity and prevention among Polish primary health care patients and to identify predictors of health behaviours. For this reason, the standardized Health Behaviour Scale (HBS) questionnaire was used. The study was conducted among 269 patients (including 61.71% women) in primary health care facilities. The mean age of participants was 52.89 years (±17.76). The mean HBS score was 36.93 ± 9.66. A statistically significant association was found between HBS scores and such sociodemographic variables as education (p = 0.0061, r = 0.17), body mass index (p = 0.0018, r = −0.20, β = −0.36) and self-assessed economic status (p = 0.0094, r = 0.16). Women's health behaviours as measured by HBS were significantly better than men's (p < 0.001, β = −6.82). A special focus should be given to the groups manifesting poorer health behaviours (e.g., men, older people and persons with low socioeconomic status) by offering them tailored health-promoting interventions. [ABSTRACT FROM AUTHOR]

Background: With efforts increasing worldwide to understand and treat paranoia, there is a pressing need for cross-culturally valid assessments of paranoid beliefs. The recently developed Revised Green et al., Paranoid Thoughts Scale (R-GPTS) constitutes an easy to administer self-report assessment of mild ideas of reference and more severe persecutory thoughts. Moreover, it comes with clinical cut-offs for increased usability in research and clinical practice. With multiple translations of the R-GPTS already available and in use, a formal test of its measurement invariance is now needed. Methods: Using data from a multinational cross-sectional online survey in the UK, USA, Australia, Germany, and Hong Kong (N = 2510), we performed confirmatory factory analyses on the R-GPTS and tested for measurement invariance across sites. Results: We found sufficient fit for the two-factor structure (ideas of reference, persecutory thoughts) of the R-GPTS across cultures. Measurement invariance was found for the persecutory thoughts subscale, indicating that it does measure the same construct across the tested samples in the same way. For ideas of reference, we found no scalar invariance, which was traced back to (mostly higher) item intercepts in the Hong Kong sample. Conclusion: We found sufficient invariance for the persecutory thoughts scale, which is of substantial practical importance, as it is used for the screening of clinical paranoia. A direct comparison of the ideas of reference sum-scores between cultures, however, may lead to an over-estimation of these milder forms of paranoia in some (non-western) cultures. [ABSTRACT FROM AUTHOR]

BACKGROUND: Healthcare professionals deliver pain education, yet their perception of pain experiences is not well understood, which can affect their interactions with patients in pain. OBJECTIVE: This study explored Korean healthcare professionals' perceptions of the usefulness of assessing pain concepts and beliefs and the importance of domains identified in the pain literature. METHODS: This descriptive cross-sectional study employed an online survey administered to nurses, physical therapists, and physicians, including the Neurophysiology of Pain Questionnaire, Tampa Scale for Kinesiophobia, and related optional open-ended questions. RESULTS: Most participants acknowledged the importance and usefulness of assessing understanding of pain concepts but anticipated patients' difficulty comprehending items assessing biological mechanisms underlying pain. Participants questioned the items' accuracy, indicating their limited pain knowledge and the necessity of reducing literacy demands. The critical domains of pain education were learning about pain, external factors influencing pain, and pain as a form of protection. CONCLUSION: Participants had suboptimal pain knowledge but emphasized decreasing literacy demands of pain neurophysiology items. Additionally, it is necessary to develop and implement a pain education program to improve pain-related knowledge and provide educational content for healthcare professionals encountering patients in pain. [ABSTRACT FROM AUTHOR]

Poor awareness and stigmatising experiences influence menstrual attitudes. The study compared menstruators' cognitive attitudes towards menstrual health (MH) in public and private schools. A three-stage sampling identified respondents and outcomes reported by descriptive and inferential statistics (p < 0.05). Negative feelings (20.3% vs. 12.2%), Openness (7.3% vs. 17.2%) and living with menstruation (38.% vs. 63.9%) were significantly different, while positive feelings (36.2% vs 30.6%), menstrual symptoms (22.6% vs. 30.0%) and menarche acceptance (28.% vs. 35.6%) were similar. Negative attitude predominates (87.4%) and is negatively predicted by Yoruba ethnicity (77.9%). Overall, menstruators exhibited negative menstrual attitudes. Puberty education through ethnic constructs is recommended to improve attitudes. [ABSTRACT FROM AUTHOR]

Purpose: This article explored Licensed Clinical Social Workers (LCSWs) beliefs, attitudes, and knowledge of Complementary and Alternative Interventions (CAI). Method: We utilized a cross-sectional online survey among a sample of 193 LCSWs. Results: Approximately 60% of LCSWs assessed for and utilized CAI professionally, and 90% personally utilized CAI. LCSWs had moderately positive beliefs, neutral attitudes, and high baseline knowledge of CAI. Age and years of practice were the only significant correlates, and the only significant predictor for assessment and utilization of CAI was positive attitudes. Discussion: As the largest group of mental health providers, we found that it is vital for LCSWs to have a solid understanding of CAI to provide effective and safe services to the clients they serve. It is hoped that the results of this study will serve as a starting point for future research on CAI among social workers, with the goal of enhancing client-centered practice. [ABSTRACT FROM AUTHOR]

Background and aims: Varenicline is one of the most effective smoking cessation treatments. Its supply in England was disrupted in July 2021 due to nitrosamine impurities found by its supplier, Pfizer. This study measured the impact of this disruption on smoking cessation in England. Design, setting and participants: The study used repeated cross‐sectional surveys conducted monthly, from June 2018 to December 2022. Set in England, it comprised a total of 3024 adults who reported smoking during the past year and had made at least one serious attempt to quit in the past 6 months. Measurements: Generalized additive models analyzed the association of the varenicline supply disruption with the trend in self‐reported varenicline use in the most recent quit attempt. We used these results to estimate the population‐level impact of the disruption on smoking cessation. Findings Before July 2021, the proportion of past 6‐month quit attempts using varenicline was stable at approximately 3.9% [risk ratio (RR)trend = 1.034, 95% confidence interval (CI) = 0.823–1.298]. The trend in varenicline use has changed sharply since the supply disruption (RRΔtrend = 0.297, 95% CI = 0.120–0.738), with prevalence falling by 69.3% per year since; from 4.1% in June 2021 to 0.8% in December 2022. Convergently, National Health Service general practitioner prescribing data reported that just 0.1% of prescriptions for smoking cessation treatments in December 2022 were for varenicline. Assuming that varenicline does not return to the market, we estimate that this could result in ~8400 fewer people stopping smoking for at least 6 months, ~4200 fewer long‐term ex‐smokers and ~1890 more avoidable deaths each year. Conclusions: In England, the disruption in supply of varenicline since 2021 has coincided with a substantial fall in the use of varenicline in attempts to quit smoking. [ABSTRACT FROM AUTHOR]

Depression is common in adolescence, and subthreshold symptoms even more so. Untreated, it is disabling. Yet, upscaling traditional clinic-based provision would be prohibitively expensive. We aimed to investigate frontline, non-specialist professionals' use of and attitudes towards technology to increase the availability of early help. Method: Cross-sectional survey of a convenience sample of professionals in the UK (N = 115, including low intensity practitioners, GPs, education staff, school nurses). The survey included rating scales and free text boxes. Quantitative data were analysed descriptively, and we used reflexive thematic analysis for the qualitative data. Results: Frontline professionals rate their technological competence as good and have favourable attitudes towards using technology to support adolescents with depression symptoms. They rated online resources as most useful with mild-moderate symptoms, compared to severe symptoms (t (110) = 14.54, p <.001, Cohen's d = 1.49). Technology was viewed as important to bridge the needs-access gap and professionals were interested in learning about online SSIs due to usefulness (r =.32, p <.001). Conclusion: Technology, such as SSIs, are of interest to mental health professionals and may be useful for supporting adolescents with depression. Future research should explore the use of SSIs for treating adolescent depression. [ABSTRACT FROM AUTHOR]