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Background: Chronic insomnia is a common yet often overlooked issue in primary health care. This study investigated the knowledge, attitude, and practices of chronic insomnia management among general practitioners (GPs). Methods: A cross-sectional online survey was conducted among GPs providing routine care to adults with insomnia in health facilities at all levels in Sichuan Province, China. Additionally, we designed an online questionnaire that included basic information and knowledge, attitudes, and practices regarding chronic insomnia management. Results: We included 420 GPs, 66.2% of whom were female and 58.1% were from community health service centers. Total 198 (47.1%) GPs had received specific training and only 2 GPs (0.5%) correctly answered the knowledge-related questions. Furthermore, only 44 GPs (10.5%) demonstrated excellent practice behaviors, while most GPs (70.2%) expressed high demand for training in insomnia management. Insomnia training experience was associated with higher practice scores (β = 3.318, p < 0.001). Conclusion: This study established an association and correlation between knowledge, attitude, and practice scores in treating insomnia and the sociodemographic characteristics of GPs in China. Although knowledge and practice performance in this field need to be improved, they mostly displayed a positive attitude towards insomnia management. Thus, offering continuing education opportunities to GPs would be highly beneficial. [ABSTRACT FROM AUTHOR]

Abstract Background Chronic insomnia is a common yet often overlooked issue in primary health care. This study investigated the knowledge, attitude, and practices of chronic insomnia management among general practitioners (GPs). Methods A cross-sectional online survey was conducted among GPs providing routine care to adults with insomnia in health facilities at all levels in Sichuan Province, China. Additionally, we designed an online questionnaire that included basic information and knowledge, attitudes, and practices regarding chronic insomnia management. Results We included 420 GPs, 66.2% of whom were female and 58.1% were from community health service centers. Total 198 (47.1%) GPs had received specific training and only 2 GPs (0.5%) correctly answered the knowledge-related questions. Furthermore, only 44 GPs (10.5%) demonstrated excellent practice behaviors, while most GPs (70.2%) expressed high demand for training in insomnia management. Insomnia training experience was associated with higher practice scores (β = 3.318, p

Background With the change of disease spectrum and the development of modern medical model, traditional Chinese medicine (TCM) is playing an important role in disease prevention, health care and rehabilitation. It is necessary to further promote the development of prevention of disease in TCM and vigorously promote the unique role of TCM in maintaining and promoting people's health. However, popularization and education of the concept of prevention of disease in TCM among community residents remains unclear. Objective To understand the overall awareness, trust, and adoption behavior of prevention of disease in TCM of community residents in Guangzhou, and explore the influencing factors of community residents' trust in prevention of disease in TCM services. Methods From April to August 2022, a stratified cluster sampling method was used to interview 652 community residents from 12 streets in 4 administrative regions of Guangzhou city based on geographic location (central city, urban-rural areas, and suburbs) and economic factors by questionnaires. The survey included residents' basic information, awareness and access to knowledge of prevention of disease in TCM, as well as their demand, utilization and trust in it. The influencing factors of community residents' trust in prevention of disease in TCM services were explored by binary Logistic regression analysis. Results Among the 652 community residents, 67.79% (442/652) were aware of prevention of disease in TCM, 77.91% (508/652) trusted prevention of disease in TCM services, 69.63% (454/652) had received traditional TCM physiotherapy, and only 6.59% (43/652) had received prevention of disease in TCM services more than 4 times in the past year. Univariate correlation analysis showed that age (χ2=9.218), household type (χ2=19.356), marriage status (χ2=2.490), occupation (χ2=17.889), and medical insurance payment type (χ2=13.516) were influencing factors of residents' trust in prevention of disease in TCM services. Binary Logistic regression analysis showed that household type (non-agricultural, agricultural to resident, and non-agricultural to resident) was an influential factor for community residents' trust in prevention of disease in TCM services (OR=2.646, 5.593, 10.502) . Conclusion The overall awareness (67.79%) and trust (77.91%) of prevention of disease in TCM among community residents in Guangzhou are relatively high, but the actual number of services received is insufficient, with a phenomenon of knowledge-attitude-practice separation. Community residents with non-agricultural household type have a higher level of trust, while those with agricultural household type have a lower level of trust. During popularization and services of prevention of disease in TCM, it is necessary to fully utilize the residents' preferred forms, as well as to target specific groups, so as to cultivate the health habits of prevention of disease in community residents.

Background: Many ICUs worldwide are striving to integrate early mobilization as part of critical care rehabilitation. However, ICU nurses, who are essential contributors to the early mobilization of critically ill patients, still lack comprehensive surveys assessing their knowledge, beliefs, and practices regarding the early mobilization of mechanically ventilated patients. Aim: To analyse the knowledge, attitudes, and practices of intensive care unit (ICU) nurses regarding the early mobilization of mechanically ventilated patients and to explore the effects of these practices. Study Design: A multicentre cross‐sectional study. ICU nurses in five tertiary hospitals in Zhejiang Province, China, were selected by convenience sampling and invited to complete an online questionnaire between 1 June 2021 and 15 June 2021. Sociodemographic data and the knowledge, attitudes, and practices of ICU nurses regarding early mobilization. Results: A total of 296 valid questionnaires were collected, for a response rate of approximately 77.5%. The average scores for knowledge, attitudes, and practices of ICU nurses regarding the early mobilization of mechanically ventilated patients were 42.7 ± 7.4, 34.3 ± 6.5, and 47.1 ± 6.5, respectively, which were good scores. Quantile regressions showed that at the 25% and 50% quartiles, increases in knowledge and attitude scores resulted in increases in practice scores (p <.001); however, at the 75% quartile, increases in knowledge scores did not result in practice score increases (t = 0.000, p =.999); moreover, there was still a 0.5‐point increase in practice scores per 1‐point increase in attitude scores (t = 0.500, p <.001). Conclusions: The knowledge, attitudes, and self‐reported practices of ICU nurses were good, although there is room for improvement. Considering that the influence of attitudes on practice improvement is more important than knowledge, ICU managers should promote knowledge transformation, strengthen attitudes, and adopt comprehensive measures to promote the early mobilization of mechanically ventilated patients in the ICU. Relevance to Clinical Practice: To optimize the early mobilization of mechanically ventilated patients in the ICU, introducing multipronged support strategies based on the knowledge and attitudes of ICU nurses is recommended to promote the implementation of such practices. [ABSTRACT FROM AUTHOR]

BackgroundAntimicrobial resistance (AMR) is one of the biggest threats to global public health systems. This study aimed to assess the knowledge, attitudes and practice about AMR, antimicrobial stewardship programs (ASPs) and multidrug-resistant (MDR) bacteria.MethodsA web-based questionnaire survey was conducted among the residents of Isfahan University of Medical Sciences from May to November 2023. Data analysis was done using SPSS version 24.0 software.ResultsOverall, 400 out of 450 medical residents responded to the questionnaire, giving a response rate of 88.9%. The participants’ ages ranged from 26 to 54 years, and the majority were female (227/400 56.8%). Average scores for knowledge, attitudes, and practices were 53.70 ± 15.88, 36.97 ± 5.89 and 24.69 ± 4.24, respectively. In terms of knowledge, only 26.8% had heard the term “ASPs” and knew what it was. Most incorrect answers appeared to the treatment of infection caused by MDR bacteria including ESBL-producing Escherichia coli (27.8%) and carbapenem-resistant Klebsiella pneumoniae (30.8%), as well as the atypical bacteria (45.5%). Approximately, 50 and 71.7% said they had received no specific training in the fields of microbiological sampling methods and the appropriate time to prescribe antibiotics, respectively. Surprisingly, regarding practice, 81.8% of the respondents stated that antibiotics are used to treat flu or the common cold.ConclusionResidents considered their training on important issues including ASPs, MDR bacteria and the spectrum of antibiotics insufficient. This result highlights the need for targeted training interventions about antibiotic prescription in the curriculum at the university with more emphasis on ASPs to limit the development of resistance.

Objectives: The aim of this study is to investigate the knowledge, attitudes and practices of Italian intensive-care physicians and nurses with respect to antibiotic resistance. Methods: A multicenter cross-sectional survey was conducted of 20 Italian intensive care units, supported by an online validated questionnaire. Results: A total of 143 participants took part, mainly nurses (79.7%). Most respondents were between 26 and 45 y old (62.9%), with more than 6 y of service (about 71%). Some 90% of those who took part stated that they were aware of the problem of antibiotic resistance and had easy access to guidelines and information materials on the subject. On the other hand, a high level of disagreement, mostly among nurses, emerged in relation to knowledge of the existence of national plans for the fight against AMR (62.9%) or the presence of international information campaigns (80%). A majority (76%) said they had received no specific training in the past 12 months. Most physicians (70%-90%) showed faith in their ability to prescribe, trusted guidelines, and recognized their role in antibiotic resistance by considering it while prescribing antimicrobial therapy. Conclusions: The study highlights the need for targeted training interventions, especially for nurses, and the importance of involving all healthcare professionals in the fight against antibiotic resistance.

To explore the knowledge, attitudes and practice (KAP) status of preventing pressure injury among clinical nurses working in paediatric ICU, and to examine factors affecting nurses' KAP. A questionnaire survey was conducted among 1906 paediatric ICU nurses in 18 children's hospitals by convenience sampling method. The survey tools were self‐designed general data questionnaire, KAP questionnaire for the prevention of pressure injury and the influencing factors were analysed. A total of 1906 valid questionnaires were collected. The scores of overall KPA, knowledge, attitudes, and practice were 101.24 ± 17.22, 20.62 ± 9.63, 54.93 ± 5.81and 25.67 ± 6.76, respectively. The results of multiple linear regression analysis showed that education background, professional title, age and specialist nurse were the main influencing factor of nurses' knowledge of preventing PI; education background and specialist nurse were the main influencing factors of nurses' attitudes of preventing PI; knowledge, attitudes and education background were the main influencing factors of nurses' practice of preventing PI. Paediatric ICU nurses have a positive attitude towards the prevention of PI, but their knowledge and practice need to be improved. According to different characteristics of nurses, nursing managers should carry out training on the knowledge of prevention of PI to establish a positive attitude, so as to drive the change of nursing practice and improve the nursing practice level of ICU nurses to prevent of PI. [ABSTRACT FROM AUTHOR]

Abstract Background Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception. Methods A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse’s workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected. Results Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses’ workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses’ workplace violence (B = -0.278, P

Background: Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception. Methods: A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse's workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected. Results: Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses' workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses' workplace violence (B = -0.278, P <.001), attitude dimension (B = -0.241, P <.001), behavior dimension (B = -0.216, P <.001) and the violence climate perception's organizational management (B = -0.177, P <.001), organizational training (B = -0.175, P <.001), organizational support (B = -0.143, p <.001) and the violence handling (B = -0.165, P <.001). Conclusion: The incidence of workplace violence among obstetric nurses in the new situation is high. However, the overall violence prevention knowledge-attitude-practice and climate perception levels are low. Therefore, nursing managers should take targeted measures according to the relevant influencing factors and the characteristics of obstetrics to improve the level of obstetric nurses' violence prevention knowledge-attitude-practice and climate perception to reduce workplace violence among obstetric nurses. [ABSTRACT FROM AUTHOR]

Objective To observe the effect of health education based on the theory of knowledge-attitude-practice(KAP)on mental health and quality of life in patients with newly diagnosed primary liver cancer. Methods Totally80 patients with primary liver cancer were selected as the study object, and 80 patients were randomly divided into control group (n=40) and the observation group (n=40). All patients received routine care and health guidance during the treatment, and patients in the observation group received KAP-based health education. A self-designed questionnaire was used to evaluate the patients’ knowledge, attitude and practice about disease. Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) were used to measure the psychological status of patients. The World Health Organization Quality of Life assessment (WHOQOL-BREF) was used to assess the patient quality of life. Results Dimensional scores of knowledge, attitude and practice in the observation group were higher than those in the control group after intervention( P＜0. 01). The SAS and SDS scores in the observation group were lower than those in the control group after intervention( P＜0. 01). Scores of physical, psychological and social dimension in the observation group were higher than those in the control group after intervention( P＜0. 01). Conclusion KAP-based health education can effectively improve the mental health and quality of life of patients with newly diagnosed primary liver cancer. (目的 观察基于知信行理论的健康教育对首次诊疗原发性肝癌患者心理状态及生活质量的影响。方法 选取2022年5月—2023年5月在医院首次就诊治疗的原发性肝癌患者80例为研究对象, 随机分为对照组(n=40)和观察组(n=40)。治疗期间, 对照组接受常规护理和健康教育指导, 观察组在对照组基础上联合知信行健康教育。采用自制问卷调查患者疾病知信行水平, 采用抑郁自评量表(SDS)和焦虑自评量表(SAS)评估患者心理状态, 采用世界卫生组织生存质量测定量表( WHOQOL -BREF) 评价患者生存质量。结果 干预后, 观察组知信行问卷量表知识、态度和行为评分均高于对照组, 差异有统计学意义(P＜0. 01)。干预后, 研究组患者SAS、SDS评分均低于对照组, 差异有统计学意义(P＜0. 01)。干预后, 观察组患者WHOQOL－BREF量表生理、心理和社会关系维度者评分均高于对照组, 差异有统计学意义(P＜0. 01)。结论 基于知信行理论的健康教育能有效改善首诊原发性肝癌的心理状态, 提高生活质量。)

Background: The success of battle against COVID 19 depends on public adherence towards infection control measures, which is greatly affected by their knowledge, attitude, and practices towards the COVID 19 pandemic. Objectives: Among the residents in the rural field practice area of a teaching hospital in Mangaluru:- 1) To assess knowledge, attitude, practice regarding preventive measures of COVID 19. 2) To assess stigma and risk perception of COVID 19. Methodology: A community based cross sectional study, by house-to-house visit was conducted among 323 participants residing in the rural field practice area of A.J. Institute of Medical Sciences & Research Centre, Mangaluru. Multistage sampling was adopted. Details regarding socio-demographic characteristics; knowledge, attitude, practice regarding preventive measures of COVID 19; risk perception and stigmatizing behavior was collected. Analysis was done using SPSS trial version 28. Results: 61% of participants were male; 27% had primary education and 33.1% were unemployed. Mass media was the most common source of COVID 19 related information. The knowledge of preventive measures of COVID 19 was good in 97.5% of the participants. 98.1% had positive attitude towards the preventive measures of COVID 19. The practice of preventive measures of COVID 19 good in 63.5%. 87.6% had taken two dose of COVID 19 vaccine. Low risk perception was seen in 96% and 83.6% had low stigmatizing behavior towards COVID 19. Gender was significant predictor of attitude scores. Age, gender, educational status, occupation status, type of family was the significant predictor of practices scores. Conclusion: Majority of the participants had good knowledge, positive attitude and good practice of preventive measures of COVID 19. As a result of effective IEC effort by different authorities is reaching rural part of India, people are aware of the preventive measures, has positive attitude about it and are practicing them.

Abstract Background Breast cancer‐related lymphedema (BCRL) is one of the common postoperative complications that severely affects the functions of the arm and quality of life. Since lymphedema is difficult to treat and prone to recurrence, early prevention of lymphedema is crucial. Methods Patient diagnosed with breast cancer (N = 108) were randomized to the intervention (n = 52) or control group (n = 56). In the intervention group, patients were provided the lymphedema prevention program based on the theory of knowledge–attitude–practice during the perioperative period and the first three chemotherapy sessions (mainly includes health education, seminars, knowledge manuals, sports guidance, peer education, and WeChat group).The limb volume, handgrip strength, arm function, and quality of life were measured in all patients at the baseline, 9 weeks (T1), and 18 weeks (T2) after surgery. Results The incidence of lymphedema in the Intervention group was numerically lower than in the control group after implementing the lymphedema prevention program, but the difference was not statistically significant (T1: 1.9% vs. 3.8%, p = 1.000; T2: 3.6% vs. 7.1%, p = 0.744). However, compared with the control group, the intervention group showed there was less deterioration in handgrip strength (T1 [t = −2.512, p

Background Primary care physicians play a vital role in the health management of hypertensive patients. Health assessment is an important tool for screening, diagnosis, and risk prediction of hypertension. Risk assessment allows early detection of target organ damage in hypertensive patients and provides a basis for treatment planning. Currently, the national public health service specification has clear requirements for health assessment for hypertensive patients, and such assessments have been carried out in primary health care institutions, but there are few reports on the competence of primary care physicians in health assessment for hypertensive patients. Objective To understand the levels of knowledge, attitude and practice (KAP) about health assessment for hypertensive patients among primary care physicians, and to analyze their influencing factors. Methods From May to June 2022, an online questionnaire survey was conducted among a multistage stratified sample of 420 primary care physicians in northern, central and southern Shanxi Province for collecting information of their baseline demographics, levels of KAP for health assessment for hypertensive patients, and hypertension assessment devices equipped in their medical institutions. Multiple linear regression was used to identify factors associated with primary care physicians' level of health assessment for hypertensive patients. Results A total of 402 cases (95.7%) who returned responsive questionnaires were finally included. The total average score of KAP of the primary care physicians on the health assessment for hypertensive patients was (127.16±18.65) , with an average score of (53.68±8.95) on the knowledge dimension, (28.62±4.09) on the attitude dimension and (44.86±7.53) on the practice dimension. The results of multiple linear regression analysis showed that work unit, the level of highest educational attainment, specialty, participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease knowledge and skills organized by their medical institutions, and weekly hours of independent learning were associated with the knowledge dimension of hypertension health assessment among primary care physicians (P

Background: Breast cancer‐related lymphedema (BCRL) is one of the common postoperative complications that severely affects the functions of the arm and quality of life. Since lymphedema is difficult to treat and prone to recurrence, early prevention of lymphedema is crucial. Methods: Patient diagnosed with breast cancer (N = 108) were randomized to the intervention (n = 52) or control group (n = 56). In the intervention group, patients were provided the lymphedema prevention program based on the theory of knowledge–attitude–practice during the perioperative period and the first three chemotherapy sessions (mainly includes health education, seminars, knowledge manuals, sports guidance, peer education, and WeChat group).The limb volume, handgrip strength, arm function, and quality of life were measured in all patients at the baseline, 9 weeks (T1), and 18 weeks (T2) after surgery. Results: The incidence of lymphedema in the Intervention group was numerically lower than in the control group after implementing the lymphedema prevention program, but the difference was not statistically significant (T1: 1.9% vs. 3.8%, p = 1.000; T2: 3.6% vs. 7.1%, p = 0.744). However, compared with the control group, the intervention group showed there was less deterioration in handgrip strength (T1 [t = −2.512, p < 0.05] and T2 [t = −2.538, p < 0.05]), improved postoperative upper limb dysfunction (T1 [t = 3.087, p < 0.05] and T2 [t = 5.399, p < 0.05]) and less deterioration in quality of life (T1 [p < 0.05] and T2 [p < 0.05]). Conclusion: Although the investigated lymphedema prevention program improved arm function and quality of life, it did not reduce the incidence of lymphedema in postoperative breast cancer patients. [ABSTRACT FROM AUTHOR]

Water, Sanitation and Hygiene (WASH) Knowledge, Attitudes and Practices (KAP) are relevant concerns for sustained and effective implementation of WASH programs. This research was conducted in Zaria Local Government Area (LGA), Kaduna State to Assess the KAP on WASH to avail reliable data for informed interventions. 174 randomly selected households were interviewed. The result reveals four main sources of drinking water, viz borehole (31%), well (19%), pipe-borne (13.1%) and water packaged in sachet (24.7%). The result shows that 34.5% of households dispose solid waste through unauthorized waste collectors, 16.1 % use authorized collectors, 17.2% at public approved dumpsite, 16.1% at unapproved dump sites, 16.1% by burning, 4% bury their waste and 4% dispose waste in open water bodies/ways/drainages. The results shows that 30.5% of households have modern water closets, 42.8 % use pit latrine, and 11.5 % use public toilets. Based on the findings, it is evident that there is high accessibility of improved water to households, availability of improved toilet facility is also high, but waste management practice is poor. In conclusion, Zaria LGA is in need of WASH interventions especially as regards waste management. It is recommended that efforts should be made to intensify awareness about WASH. [ABSTRACT FROM AUTHOR]

As a cultural concept reflecting the relationship between humans and forests, forest culture plays an active role in sustainable forest management. Forest parks provide a wide range of ecosystem services essential for the sustainable development of society, and the relationships between forest culture, green construction and management of forest parks have practical significance. This study aimed to understand the interaction and process of forest culture influencing green construction and management in forest parks with the models Knowledge-Attitude-Practice (KAP) and Theory of Planned Behavior (TPB) by proposing a theoretical model. Four hypotheses were tested using data collected from 193 forest park employees in Heilongjiang Province, China. Our results show that forest culture had a significant influence on green construction and forest management. In addition, subjective norm and perceived behavioral control directly impacted behavior in green construction and management of the forest park, whereas attitude did not have an impact. Subjective norm had a direct effect on attitude. Results between constructs show that forest culture had an indirect effect on planning and construction, and on ecological and economic management. Consequently, it supported three of four hypotheses within the proposed model in determining the influence of forest culture on green construction and management. [ABSTRACT FROM AUTHOR]

Background: Due to the scarcity of organs available for transplantation, several patients lose their lives each year. Increased awareness and positive attitudes alone may be insufficient to increase an individual's willingness to donate (i.e., the basic tenets of the knowledge-attitude-practice/KAP model). Therefore, it is pertinent to examine other psychological determinants that are associated with engaging in the altruistic/prosocial act of organ donation. Objective: To understand the association between empathy and KAP of organ donation in an Indian population. This pilot is the precursor to a larger project which aims to develop and test an empathy intervention to promote organ donation. Methods: Using a cross-sectional design, Indians (N = 419; female = 261; mean age = 28.48 years) aged 18 years and above were recruited using convenience sampling through an online survey. Questionnaires included the Awareness, Attitudes, and Practice of Organ Donation (Chakradhar et al., 2016) and Empathy Quotient-8 (Loewen et al., 2010). Multiple regression analyses were carried out to analyze the data. Results: Results showed that empathy was related to: (i) Total KAP (β = 0.123, P = 0.014), and (ii) attitudes (β = 0.195, P < 0.001) towards organ donation. Conclusion: These pilot study findings indicate that public health messages focused on evoking empathy can use the technique of patient/donor narratives, and training clinicians on empathic communication skills can help increase individuals' KAP of organ donation. Further, this pilot elucidated the need to conduct mixed-method studies with a donor and nondonor population and clinicians prior to developing and testing a larger empathy-centered intervention aimed at promoting the KAP of organ donation.

Purpose: To obtain nurses' perspectives regarding integrated interventions for substance use cessation for patients in general hospital settings. Design and Methods: (a) Quantitative survey (N = 207) (nurses' knowledge, attitude, practice, confidence regarding integrated interventions; (b) Focus groups exploring nurses' perspectives regarding integrated interventions (N = 32). Findings: Participants' scores (mean, SD): Knowledge‐112.5 (10.4) (maximum score‐198); Attitude‐30.99 (7.05) (maximum‐52); Practice‐1.66 (2.63) (maximum‐28); Confidence‐11.90 (3.82) (maximum‐24). From the focus groups, four themes were identified: Substance use patterns among patients seeking treatment at the hospitals where the nurses are employed; Nurses' role in providing integrated interventions; Nurses' training needs for providing integrated interventions; Feasibility of providing integrated interventions. Practice Implications: Findings provide clear justification for module development to train nurses in providing integrated interventions. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is one of the biggest threats to global public health systems. This study aimed to assess the knowledge, attitudes and practice about AMR, antimicrobial stewardship programs (ASPs) and multidrug-resistant (MDR) bacteria., Methods: A web-based questionnaire survey was conducted among the residents of Isfahan University of Medical Sciences from May to November 2023. Data analysis was done using SPSS version 24.0 software., Results: Overall, 400 out of 450 medical residents responded to the questionnaire, giving a response rate of 88.9%. The participants' ages ranged from 26 to 54 years, and the majority were female (227/400 56.8%). Average scores for knowledge, attitudes, and practices were 53.70 ± 15.88, 36.97 ± 5.89 and 24.69 ± 4.24, respectively. In terms of knowledge, only 26.8% had heard the term "ASPs" and knew what it was. Most incorrect answers appeared to the treatment of infection caused by MDR bacteria including ESBL-producing Escherichia coli (27.8%) and carbapenem-resistant Klebsiella pneumoniae (30.8%), as well as the atypical bacteria (45.5%). Approximately, 50 and 71.7% said they had received no specific training in the fields of microbiological sampling methods and the appropriate time to prescribe antibiotics, respectively. Surprisingly, regarding practice, 81.8% of the respondents stated that antibiotics are used to treat flu or the common cold., Conclusion: Residents considered their training on important issues including ASPs, MDR bacteria and the spectrum of antibiotics insufficient. This result highlights the need for targeted training interventions about antibiotic prescription in the curriculum at the university with more emphasis on ASPs to limit the development of resistance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kiani, Sajadi, Motamedi, Salmasi and Solgi.)

Background: The global spread of monkeypox (mpox) has raised concerns about public health preparedness, particularly among young adults. This study aimed to assess and compare the knowledge, attitudes, and practices (KAP) regarding mpox among undergraduate (UG) and postgraduate (PG) students in Gujarat, India., Methods: A cross-sectional study was conducted among 605 students (402 UG, 203 PG) from one of the tertiary hospitals (PG) and a medical colleges (UG) in Gujarat. A structured questionnaire assessed knowledge, attitudes, and practices regarding mpox. Data were analyzed using descriptive statistics, chi-square tests, and independent t-tests., Results: PG students demonstrated significantly higher knowledge scores than UG students (mean score 8.4 vs 6.5 out of 10, p<0.001). They showed greater awareness of mpox (187/203, 92.1% vs 314/402, 78.1%, p<0.001) and a better understanding of transmission routes, symptoms, and preventive measures. PG students also exhibited more positive attitudes, with a higher perception of mpox as a serious threat (152/203, 74.9% vs 241/402, 60.0%, p<0.001) and a greater willingness to get vaccinated (172/203, 84.7% vs 281/402, 69.9%, p<0.001). In terms of practices, PG students reported better adherence to preventive measures, including regular hand hygiene (127/203, 62.6% vs 201/402, 50.0% always practicing, p=0.002) and wearing face masks in crowded places (168/203, 82.8% vs 298/402, 74.1%, p=0.017)., Conclusion: Significant differences in KAP regarding mpox exist between UG and PG students, with PG students consistently demonstrating higher levels of awareness, more positive attitudes, and better preventive practices. These findings highlight the need for targeted educational interventions to enhance mpox preparedness among university students, with particular attention to undergraduate populations., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Shri Meghji Pethraj (MP) Shah Government Medical College and Guru Gobind Singh Government Hospital issued approval #222/04/2023. Ethical integrity was prioritized throughout the study, beginning with obtaining approval from the Institutional Ethics Committee before commencing any research activities. Informed consent was ensured from all participants, with a detailed explanation of the study's purpose, potential risks and benefits, and the voluntary nature of participation. Participants were informed of their right to withdraw from the study at any time without any consequences. To maintain confidentiality and anonymity, all questionnaires were coded, and personal identifiers were removed from the dataset. Data were stored securely, with access restricted to authorized research team members only. Recognizing the educational opportunity presented by this study, a brief informational session on mpox was offered to participants after data collection, ensuring they benefited from their involvement. This approach not only adhered to ethical research practices but also contributed to raising awareness about mpox among the student community. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gandhi et al.)

Background: Due to the scarcity of organs available for transplantation, several patients lose their lives each year. Increased awareness and positive attitudes alone may be insufficient to increase an individual’s willingness to donate (i.e., the basic tenets of the knowledge‑attitude‑practice/ KAP model). Therefore, it is pertinent to examine other psychological determinants that are associated with engaging in the altruistic/prosocial act of organ donation. Objective: To understand the association between empathy and KAP of organ donation in an Indian population. This pilot is the precursor to a larger project which aims to develop and test an empathy intervention to promote organ donation. Methods: Using a cross‑sectional design, Indians (N = 419; female = 261; mean age = 28.48 years) aged 18 years and above were recruited using convenience sampling through an online survey. Questionnaires included the Awareness, Attitudes, and Practice of Organ Donation (Chakradhar et al., 2016) and Empathy Quotient‑8 (Loewen et al., 2010). Multiple regression analyses were carried out to analyze the data. Results: Results showed that empathy was related to: (i) Total KAP (β = 0.123, P = 0.014), and (ii) attitudes (β = 0.195, P < 0.001) towards organ donation. Conclusion: These pilot study findings indicate that public health messages focused on evoking empathy can use the technique of patient/ donor narratives, and training clinicians on empathic communication skills can help increase individuals’ KAP of organ donation. Further, this pilot elucidated the need to conduct mixed‑method studies with a donor and nondonor population and clinicians prior to developing and testing a larger empathy‑centered intervention aimed at promoting the KAP of organ donation. [ABSTRACT FROM AUTHOR]

The knowledge deficit model proposes that more information increases public knowledge levels about a given topic and thus leads to improved attitudes and practice. However, research critiques the varying and limited ability of the deficit model. We argue that the deficit model can also produce an unintended cumulative advantage system: growing inequality between and within the knowledge-attitude-practice (KAP) gap of individuals and groups due to a wide variety of possible moderators. Over time, these effects can exacerbate gaps between individuals’ and groups’ levels of KAP. We discuss the negative effects of increasing inequality in sustainability KAP and provide recommendations for future research.

The outbreak of the COVID-19 pandemic has caused increasing concern over health care, part of which involves the role of nutrition. In this study, a nutrition educational board game, featuring quantitative computation, was designed to help students acquire nutrition knowledge and improve dietary behaviors. A group of 22 students in grade 7 of a middle school in Beijing were selected as the participants. A single-group pre- and post-test quasi-experimental design was adopted. Knowledge-Attitude-Practice (KAP) questionnaires and interviews were used to investigate students' changes in dietary knowledge, attitude, and behavior. The influence of gender and body mass index (BMI) on the teaching effectiveness was also explored. The results showed that some dimensions of knowledge, attitude, and behavior significantly increased in the students. Their changes in behavior were mainly related to some aspects that were easier to adjust. In addition, the study also found that females and students with abnormal BMI were more likely to be influenced by the educational game to make positive changes in attitude and behavior. [ABSTRACT FROM AUTHOR]

Abstract Background Anthrax is the second most highly prioritized zoonotic disease in Ethiopia due to its negative impact at the household level, causing disease and production losses in livestock and severe disease in humans. This study seeks to assess the knowledge of, attitudes towards, and practices addressing (KAPs) anthrax in the communities of Eastern Tigray, Northern Ethiopia. Methods A cross-sectional survey was conducted concurrently with focus group discussions (FGDs) and key informant interviews (KIIs) between May 2019 and April 2020. A total of 862 respondents participated in the questionnaire survey. Of these, 800 were local community members while 62 were professionals working at health service institutions. In addition, qualitative data were collected using six FGDs and 11 KIIs. Results Sixty-two percent (496/800) of the community respondents said that they were aware of anthrax while 38% (304/800) of them did not. Only 9.3% (74/800) of the respondents reported that the causative agent of anthrax is germs/microbial. About 56.5% (35/62) of professional respondents said that it is bacterial. More than 60% (64.1%, 513/800) of the respondents did not know that whether the disease was zoonotic or not. Regarding clinical signs, 26.3 (210/800) and 36.8% (294/800) of the respondents could identify at least one in animals and humans, respectively, while 21.3 (170/800) and 20.1% (161/800) knew one or more transmission routes in animals and humans, respectively. Moreover, 43.4% (347/800) and 45.6% (365/800) of the respondents mentioned one or more control/prevention method(s) in animals and humans, respectively. Regarding qualitative results, some of the participants knew the disease (in animals) by their local names: Lalish and Tafia (splenomegaly), and Gulbus (abdominal cramps and shivering). Some reported that anthrax was exclusively a human disease while others recognized its zoonotic potential after the clinical signs in both animals and humans were listed. Conclusion The KAP of the participants regarding anthrax was low. There was no consistent understanding of the disease among the participants. The study also revealed that the participants did not receive consistent, adequate, and continuous education regarding the disease.

BackgroundPromoting technology diffusion and utilization is a key measure to address the great disparity in technical capacity within integrated health systems. However, even the effectiveness and appropriateness regarding technology has been widely recognized, its diffusion and utilization are still stagnant. The mechanisms that influence the technology from being recognized to being widely applied in practice remain largely unknown.PurposeTaking hepatic contrast-enhanced ultrasound (CEUS) as an example, this study aimed to investigate the comprehensive influencing mechanism of organizational atmosphere and organizational practice on the knowledge, attitude, and practice toward diffusion and utilization of hepatic CEUS in the medical alliance.MethodsBased on the integration of organizational ready for change (ORC) and knowledge-attitude-practice (KAP), a structured questionnaire was developed. A multistage random sampling method was applied to investigate physicians who directly use CEUS working at the liver disease-related departments of sampled health institutions. Structural equation modeling (SEM) was used to verify the proposed hypotheses, and determine the relationship between the factors.ResultsIn total, 292 physicians were included. SEM results demonstrated that knowledge influenced both attitude and practice, while attitude positively predicted practice. Organizational practice and organizational atmosphere associated positively with each other. Organizational atmosphere positively affected the physicians' attitude toward CEUS diffusion and utilization (β = 0.425, p < 0.001), while organizational practice positively affected corresponding knowledge (β = 0.423, p < 0.001) and practice (β = 0.275, p < 0.001). Additionally, there was a partial mediating effect between organizational practice and physicians' CEUS diffusion and utilization behavior.ConclusionBy verifying the influencing mechanism of organizational atmosphere and organizational practice on the physicians' KAP of hepatic CEUS diffusion and utilization, this study benefit tailoring strategies for promoting technology diffusion and utilization within medical alliance. It is recommended to develop an organizational atmosphere of advocating technology innovation, establish organizational support mechanism (SM) with multiple concrete supporting countermeasures, and so on.

Rural industrial land within the Beijing-Tianjin-Hebei region has undergone significant and profound changes because of the decisions of local micro-subjects. This study uses the knowledge-attitude-practice (KAP) analysis framework to analyze how farmers understand rural industrial land changes (RILC), how much farmers are willing to participate in RILC, and whether farmers have participated in RILC activities. Our results highlight that improving farmers' knowledge regarding RILC is an effective method to increase the participation of local farmers in RILC activities and projects, and the degree of impact on farmers' practice from large to small is followed by the household effect, rural effect, and concept. A structural equation model was also developed to analyze the factors influencing the KAP of farmers. Although variation exists in the significant predictors of the different KAP components, political post, residential land ownership, farmland ownership, age, and employment satisfaction are shown to be the main external factors affecting farmer KAP. The structure of farmers' knowledge should be understood in detail to improve the level of knowledge of farmers. In addition, the publicity and education regarding RILC need to be improved to increase the understanding of farmers regarding rural industrial land policies to allow them to truly grasp the positive role of RILC, form good expectations for RILC and participate in sustainable rural industrial land use activities. • The relationship among local farmers' knowledge, attitude, and practice towards rural industrial land changes was analyzed. • Knowledge of rural industrial land changes is correlated with attitude and practice. • Political post, residential land ownership, farmland ownership, age, and employment satisfaction are factors that affect KAP. • Strengthening publicity and improving understanding of rural industrial land policies are essential for RILC management. [ABSTRACT FROM AUTHOR]

Background: Metformin extended-release (XR) is a once-daily alternative conventional immediate-release (IR) tablet for adults with type 2 diabetes.Aim: This study aimed to investigate the knowledge, attitude, and practice of the use of metformin XR tablets among clinicians.Methods: We conducted a cross-sectional online survey among endocrinologists, general practitioners, and internists, who are taking routine care of adults with type 2 diabetes in health institutes at all levels in Sichuan Province, China. We designed an online questionnaire including the demographic information, knowledge, attitude, and practice about metformin XR tablets.Results: We included 158 clinicians, 67.7% of whom were females and 63.9% were from tertiary hospitals. The median age was 39.6 years (ranging between 22 and 62 years). Only 8.2% of the clinicians correctly answered the knowledge questions, 82.3% and 62.0% of the responders assumed that metformin XR had superior efficacy and tolerability to the metformin IR, respectively. Only 46.8% of the clinicians prescribed the metformin XR based on the patient’s preference for once daily frequency.Conclusion: The knowledge, attitude, and practice of metformin XR among Chinese clinicians need improving. Clinicians need credible information to support their clinical decision-making regarding metformin XR.

Background: Metformin extended-release (XR) is a once-daily alternative conventional immediate-release (IR) tablet for adults with type 2 diabetes. Aim: This study aimed to investigate the knowledge, attitude, and practice of the use of metformin XR tablets among clinicians. Methods: We conducted a cross-sectional online survey among endocrinologists, general practitioners, and internists, who are taking routine care of adults with type 2 diabetes in health institutes at all levels in Sichuan Province, China. We designed an online questionnaire including the demographic information, knowledge, attitude, and practice about metformin XR tablets. Results: We included 158 clinicians, 67.7% of whom were females and 63.9% were from tertiary hospitals. The median age was 39.6 years (ranging between 22 and 62 years). Only 8.2% of the clinicians correctly answered the knowledge questions, 82.3% and 62.0% of the responders assumed that metformin XR had superior efficacy and tolerability to the metformin IR, respectively. Only 46.8% of the clinicians prescribed the metformin XR based on the patient's preference for once daily frequency. Conclusion: The knowledge, attitude, and practice of metformin XR among Chinese clinicians need improving. Clinicians need credible information to support their clinical decision-making regarding metformin XR. [ABSTRACT FROM AUTHOR]

Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure.Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls.Methods: We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-for-age z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively.Results: The mean hemoglobin (Hb) level was 119.7 g/L, with 44% of the adolescent girls being anemic (Hb < 120 g/L) and mean height was 151.0 cm with 25% being stunted (HAZ < -2 standard deviation [SD]). The median KAP score was 7 and ranged from 3 to 10. Low to moderate KAP scores were not significantly associated with being anemic (adjusted odds ratio [AOR] = 1.26; P = .43), however 1-point KAP score increment was associated with an increase of HAZ by 0.037 SD (P = .012).Conclusions: The KAP related to diet and healthy environments was not associated with anemia prevalence, but was positively associated with increased HAZ among adolescent girls. Strategy to reduce anemia risk in this population should combine KAP improvement with other known effective nutrition interventions. [ABSTRACT FROM AUTHOR]

The outbreak of the COVID-19 pandemic has caused increasing concern over health care, part of which involves the role of nutrition. In this study, a nutrition educational board game, featuring quantitative computation, was designed to help students acquire nutrition knowledge and improve dietary behaviors. A group of 22 students in grade 7 of a middle school in Beijing were selected as the participants. A single-group pre- and post-test quasi-experimental design was adopted. Knowledge-Attitude-Practice (KAP) questionnaires and interviews were used to investigate students’ changes in dietary knowledge, attitude, and behavior. The influence of gender and body mass index (BMI) on the teaching effectiveness was also explored. The results showed that some dimensions of knowledge, attitude, and behavior significantly increased in the students. Their changes in behavior were mainly related to some aspects that were easier to adjust. In addition, the study also found that females and students with abnormal BMI were more likely to be influenced by the educational game to make positive changes in attitude and behavior.

Objectives: The aim of this study is to investigate the knowledge, attitudes and practices of Italian intensive-care physicians and nurses with respect to antibiotic resistance., Methods: A multicenter cross-sectional survey was conducted of 20 Italian intensive care units, supported by an online validated questionnaire., Results: A total of 143 participants took part, mainly nurses (79.7%). Most respondents were between 26 and 45 y old (62.9%), with more than 6 y of service (about 71%). Some 90% of those who took part stated that they were aware of the problem of antibiotic resistance and had easy access to guidelines and information materials on the subject. On the other hand, a high level of disagreement, mostly among nurses, emerged in relation to knowledge of the existence of national plans for the fight against AMR (62.9%) or the presence of international information campaigns (80%). A majority (76%) said they had received no specific training in the past 12 months. Most physicians (70%-90%) showed faith in their ability to prescribe, trusted guidelines, and recognized their role in antibiotic resistance by considering it while prescribing antimicrobial therapy., Conclusions: The study highlights the need for targeted training interventions, especially for nurses, and the importance of involving all healthcare professionals in the fight against antibiotic resistance., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective To investigate the knowledge, attitude and practice about COVID-19 prevention and control among hospitalized pregnant women and their caregivers. Methods A questionnaire survey was conducted to hospitalized pregnant women and their caregivers. Results A total of 160 valid questionnaires were retrieved from 80 hospitalized pregnant women and 80 caregivers. Of 160 respondents, 102 respondents spent more than 2 hours to access information about COVID-19 prevention and control, and primary accesses to information resources included official Wechat and Mirco-blog. In terms of practice and psychological states, 156(97.50%) respondents chose to wear a face mask when going out, and 104 (65.00%) respondents suffered from a variety of anxiety. The compliance rate of accompany limitation was 100.00% (80/80) among caregivers. In terms of preparation for breastfeeding, the right way of choosing and wearing a face mask, hand hygiene and personal hygiene were three most concerned issues, accounting 56. 84%, 55.34% and 48.54%. Conclusion The survey found that the hospitalized pregnant women and then caregivers have a high level of knowledge, attitude and practice with COVID-19 prevention and control. Enhanced inpatients management and health education re necessary to improve the knowledge, attitude and practice among hospitalized pregnant women and their caregivers during the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

Among the existing modes of "Internet plus tree-planting" in China, the government-led mode is represented by "Internet plus national voluntary tree planting", and the enterprise-led mode is represented by "Ant Forest". Now, the public enthusiasm for participating in both modes has declined. We investigated the factors influencing public participation in "Internet plus tree-planting" activities of the two modes, with a view to providing better suggestions for solving the dilemma of public participation. This paper examines the factors that influence public participation in "Internet plus tree-planting" of these two different modes. We combine the theory of planned behavior (TPB) with Knowledge-Attitude-Practice (KAP). Structural Equation Modeling (SEM) is used to explore the formation of public intention and behavior practice for the two modes and compares the differences between them. Results show that subjective norm has the greatest effect on public participation in national voluntary tree planting but has no effect on public participation in Ant Forest. On the contrary, the total effect of outcome efficacy on public participation behavior has the least weight in national voluntary tree planting, while the conclusion is the opposite for Ant Forest. This paper contributes to researchers' understanding of the two participation behaviors. In addition, suggestions on promoting integrated forms of the two modes were proposed for policymakers: (1) Keep channels of communication open and attract emerging forces. (2) Popularize environmental knowledge and improve environmental protection literacy. (3) Enrich interactive content and improve incentive policies. (4) Create an integration platform and foster two-way linkage between government and enterprises. • Combined KAP and TPB to construct the conceptual model of two "Internet plus tree-planting" modes. • Explored the different influencing factors of public participation between two modes. • In the government-led mode, subjective norm and outcome efficacy both had mediating effect on intention, and the total effect of subjective norm was greatest. • In the enterprise-led mode, outcome efficacy had a mediating effect on intention, while subjective norm had neither any direct nor indirect effect. [ABSTRACT FROM AUTHOR]

Background: How weight perception influences weight-related knowledge, attitudes, and behaviors in Chinese children is unknown. We investigated self-perception of body weight and its correlates, and analyzed the relationship between weight perception and weight-related knowledge, attitudes, and behaviors in children in Guangzhou, China. Methods: We assessed self-reported weight perception, weight-related knowledge, attitudes, and behaviors in 3752 children aged 7–12 years. Underweight or overweight was defined using the Chinese criteria based on body mass index (BMI). Binary logistic regression analyses were performed to assess correlates of weight underestimation. Results: In total, 27.3% of children underestimated and 6.7% overestimated their weight status. Weight underestimation was common among normal-weight (34.1%) and overweight children (25.3%). Older age, female sex, and child BMI z-score were negatively associated with normal-weight children's underestimation, whereas older age, paternal obesity, maternal obesity, and child BMI z-score were negatively associated with overweight children's underestimation. Correct answers on weight-related knowledge questions ranged from 81.5% to 98.6% and did not differ by weight perception within BMI categories. Although negative perceivers (i.e., those who perceived themselves as underweight or overweight) had a higher intention to change weight, they behaved more unhealthily on fruit intake, breakfast, screen time, and daily moderate-to-vigorous physical activities time than counterparts. Conclusion: Weight underestimation was prevalent in normal-weight and overweight children in Guangzhou. Negative perceivers had stronger willingness to change weight but tended to behave more unhealthily on certain behaviors than positive perceivers. Childhood obesity interventions should incorporate health education and practical support to promote healthy eating and physical activity.

Context: Caregivers of sick children have to be careful with medicine dosing and giving medicines to a reluctant child can be challenging. Aim: To assess the knowledge, attitude, and practices of caregivers regarding pediatric medicine administration and health literacy allied to this task. Settings and Design: This cross-sectional study was carried out on outpatient and inpatient basis in the pediatrics department of a teaching hospital over 6 months. Subjects and Methods: Data regarding sociodemographic profile of patient and caregiver, idea regarding pediatric dosage forms, dosing of medicines, and medication errors during administration were recorded from 377 caregivers. Reconstitution of dry powder and measurement of 5 mL liquid medicine using measuring cup of the medicine phial was demonstrated by the caregivers. Statistical Analysis: Association assessed by point biserial correlation and Spearman's rank correlation. Results: Majority of the primary caregivers surveyed were young, educated, homemaker mothers. Liquid medicines were used maximally (88.9%). Majority (87.3%) of the caregivers used standardized dosing instruments to measure liquids and reconstitution (85.9%), and teaspoon measurement task (91%) was performed satisfactorily by most. Some potentially wrong practices (e.g., adding medicine to milk, redilution of reconstituted medicine, and storing beyond the recommended period) were recorded. Medication errors were reported by 44.5% caregivers, significantly more in the outpatient setting. Although the statistical correlation was weak, the chance of medication error was less, and the precision of measurement was better with increasing education of the caregiver. Conclusions: Physicians need to be aware of the limitations of knowledge and the possibility of wrong administration practices among caregivers of children. Remedial measures in this regard can reduce the risk of medication errors.

Background Dengue infection (DI) continues to rise in the Caribbean. Children are primarily affected by severe infection in this region. Parents thus play an essential role in identifying symptoms, seeking medical care, and preventing DI in their children. Grenada has been endemic to DI since 1956, and to date, no study has assessed the level of knowledge, attitude, and practices (KAP) among parents regarding DI. Objective To determine the level of parents' KAP and associated sociodemographic factors regarding DI in children in Grenada. Methods A quantitative cross-sectional study of 360 randomly selected parents attending postnatal and child-health clinics was conducted in Grenada. Parents completed a validated survey on demographic information and KAP regarding DI from September to December 2019. KAP scores were calculated and categorized as adequate or inadequate based on the percentage of correctly answered questions on the survey. Chi-square and logistic regression analyses were used to determine the level of KAP and associated sociodemographic factors among parents. Results Only 33.9% of parents had adequate knowledge regarding DI, which was independently associated with gender (p-value: 0.001, CI: 1.688-7.411), age (p-value: 0.001, CI: 0.037-0.443), occupation, education, and marital status. Nevertheless, most parents had a positive attitude toward DI prevention (56.4%) and practiced adequate prevention (73%) against DI. Higher education was independently associated with a positive attitude toward DI prevention (p-value: 0.013, CI: 0.190-0.825). However, no sociodemographic factors were associated with the prevention practices of DI. Conclusion This study revealed a low level of knowledge among parents, despite an adequate attitude and level of prevention against DI in Grenada. It identified specific groups, such as young, single parents of low educational status, as potential targets for educational campaigns to reduce DI-associated morbidity and mortality among Grenadian children., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Haniff et al.)

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Context: The improvement in neonatal care has led to more number of premature infants surviving. This has led to more number of babies requiring screening for retinopathy of prematurity (ROP). Thus, there is a need to bridge the knowledge gap between pediatricians and ophthalmologists for ROP management. Limited studies done among pediatricians across India had shown that there is a need for greater awareness and timely screening of pre-terms for ROP. No such study was carried out in Goa and adjoining Western India. Hence, the present study was undertaken. Aims: The aim of the study is to assess the knowledge, attitude, and practices about ROP among practicing pediatricians in Goa. Settings and Design: This is a cross-sectional study. Materials and Methods: A pretested pro forma was given to 58 pediatricians, which contained 19 questions related to their educational and practice profile, about the risk factors for ROP, screening protocol, referral criteria, facilities for referral, treatment options, and problems faced by them for referral of babies requiring treatment for sight-threatening ROP. Statistical Analysis Used: Percentages and proportions are used for analysis. Results: Among the 58 pediatricians, 75.86% were practicing in government hospitals including Goa Medical College and Hospital, whereas 14 (24.13%) were private practitioners. 50% had been practicing for 5–10 years. All participants had heard about ROP and were aware of the most common risk factors for ROP. 87.93% were aware of the timing of first screening of preterm infants for ROP; 84.48%were aware of referral to an ophthalmologist for screening and management of ROP. 77.58% had knowledge about the treatment modalities. 56.89% reported that they faced barriers to referral. Conclusions: There is a very high level of awareness among pediatricians in Goa about the risk factors and screening of ROP. [ABSTRACT FROM AUTHOR]

Background: Participation of private practitioners in routine disease surveillance in India is minimal despite the fact that they account for over 70% of the primary healthcare provision. We aimed to investigate the knowledge, attitudes, and practices of private practitioners in the city of Pune toward disease surveillance. Our goal was to identify what barriers and facilitators determine their participation in current and future surveillance efforts. Design: A questionnaire-based survey was conducted among 258 practitioners (response rate 86%). Data were processed using SPSS™ Inc., Chicago, IL, USA, version 17.0.1. Results: Knowledge regarding surveillance, although limited, was better among allopathy practitioners. Surveillance practices did not differ significantly between allopathy and alternate medicine practitioners. Multivariable logistic regression suggested practicing allopathy [odds ratio (OR) 3.125, 95% confidence interval (CI) 1.234–7.915, p=0.016] and availability of a computer (OR 3.670, 95% CI 1.237–10.889, p=0.019) as significant determinants and the presence of a laboratory (OR 3.792, 95% CI 0.998–14.557, p=0.052) as a marginal determinant of the practitioner's willingness to participate in routine disease surveillance systems. Lack of time (137, 55%) was identified as the main barrier at the individual level alongside inadequately trained subordinate staff (14, 6%). Main extrinsic barriers included lack of cooperation between government and the private sector (27, 11%) and legal issues involved in reporting data (15, 6%). There was a general agreement among respondents (239, 94%) that current surveillance efforts need strengthening. Over a third suggested that availability of detailed information and training about surveillance processes (70, 33%) would facilitate reporting. Conclusions: The high response rate and the practitioners’ willingness to participate in a proposed pilot non-communicable disease surveillance system indicate that there is a general interest from the private sector in cooperating. Keeping reporting systems simple, preferably in electronic formats that minimize infrastructure and time requirements on behalf of the private practitioners, will go a long way in consolidating disease surveillance efforts in the state. Organizing training sessions, providing timely feedback, and awarding continuing medical education points for routine data reporting seem feasible options and should be piloted.

Land use is rapidly changing within the Mekong delta due to decisions of local actors. This study aims at understanding the factors influencing the understanding of inhabitants about the concepts, causes and effects of land use and cover changes (LUCC), as well as how they perceive and act about LUCC management. A Knowledge-Attitude-Practice (KAP) survey was carried out on a sample of 330 households in the Tran Van Thoi District, Ca Mau Province in the Mekong Delta, Vietnam. The respondents were surveyed on their knowledge of the conceptualization of LUCC, how LUCC are caused and what their consequences are. The results highlight the political, socio-demographic, economic and environmental causes and effects considered as meaningful by the respondents for understanding LUCC process. Multiple logistic regression (MLR) models with nested cross-validation were developed for investigating the factors influencing the knowledge, attitude and practice of individual households. Although variation exists in the significant predictors of the different K-A-P components, educational level, age, participation in group activity, access to communication mean, and occupation (farming or permanent employment) are shown to be the main influencing variables. The knowledge of the concept of LUCC, and to a lower extent of its causes and consequences, highly correlates with the Attitude and Practice regarding LUCC management, indicating the necessity of disseminating and enhancing LUCC understanding among local actors before implementing land use management projects. [ABSTRACT FROM AUTHOR]

Improving soil aeration in paddy fields using mechanical device reduces methane (CH 4) emissions, whereas it also increases the contribution of other sources (device production, agricultural inputs, etc.). Here, this study applied the life cycle assessment (LCA) method to evaluate the carbon footprint of a soil air injection device (SAID) in rice field. We further analyzed the prospects of this device in promoting carbon emission reduction in China's main rice-producing areas, which was combined with economic benefit calculation and revised knowledge-attitude-practice (KAP) model. Results showed that the reduction of net carbon emissions from paddy fields under SAID treatment was 4.51–241.95% higher than the total carbon emissions from the production, transportation, operation, and recycling of SAID. The economic output of using SAID in rice fields could just offset the cost of it. With reasonable government subsidies (142.80–349.95 yuan SAID−1 yr−1), SAID can reduce carbon emissions from Chinese rice fields by ∼ 41.60 Tg CO 2 -eq yr−1. This study suggests that using SAID in some rice planting areas in China may be an effective way to reduce carbon emissions. [Display omitted] • SAID could reduce carbon footprint of rice production system. • The limiting factor for the development of SAID is mainly low economic efficiency. • The cost of emission reduction in each region is 0.16–6.07 yuan per kg CO 2 -eq. [ABSTRACT FROM AUTHOR]

Context: Caregivers of sick children have to be careful with medicine dosing and giving medicines to a reluctant child can be challenging. Aim: To assess the knowledge, attitude, and practices of caregivers regarding pediatric medicine administration and health literacy allied to this task. Settings and Design: This cross-sectional study was carried out on outpatient and inpatient basis in the pediatrics department of a teaching hospital over 6 months. Subjects and Methods: Data regarding sociodemographic profile of patient and caregiver, idea regarding pediatric dosage forms, dosing of medicines, and medication errors during administration were recorded from 377 caregivers. Reconstitution of dry powder and measurement of 5 mL liquid medicine using measuring cup of the medicine phial was demonstrated by the caregivers. Statistical Analysis: Association assessed by point biserial correlation and Spearman's rank correlation. Results: Majority of the primary caregivers surveyed were young, educated, homemaker mothers. Liquid medicines were used maximally (88.9%). Majority (87.3%) of the caregivers used standardized dosing instruments to measure liquids and reconstitution (85.9%), and teaspoon measurement task (91%) was performed satisfactorily by most. Some potentially wrong practices (e.g., adding medicine to milk, redilution of reconstituted medicine, and storing beyond the recommended period) were recorded. Medication errors were reported by 44.5% caregivers, significantly more in the outpatient setting. Although the statistical correlation was weak, the chance of medication error was less, and the precision of measurement was better with increasing education of the caregiver. Conclusions: Physicians need to be aware of the limitations of knowledge and the possibility of wrong administration practices among caregivers of children. Remedial measures in this regard can reduce the risk of medication errors. [ABSTRACT FROM AUTHOR]

Development refers to change. The study of development is the understanding of how a subject functions at a particular age or time in life. The objective of this study was to evaluate the knowledge, attitude, and practice of pediatric healthcare personnel on the psychomotor development of the child., Methods: This was a cross-sectional study of knowledge, attitude, and practice conducted in the health areas of South Kivu., Results: Twenty-six caregivers participated in the survey. Men were the most represented (61.5%), mean age 27.62±5.07 years; median experience in pediatrics: 1 year; predominantly urban setting with 69.2%. General practitioners were more represented, with 57.7%. The overall state of knowledge was insufficient in 69.2%. Knowledge1 improves with increasing experience in pediatrics ( P =0.008), and qualification improves knowledge1 ( P =0.033) and knowledge3 ( P =0.009). Knowledge4 improved from rural to urban settings ( P =0.022).A good knowledge of the scales used in the evaluation of psychomotor development influences the use of one or the other ( P =0.000). The authors also notice that those who indicate and/or have physical therapy practiced in rehabilitation are generally those who have a good knowledge of the use of psychomotor development assessment tools ( P =0.010)., Conclusion: This study highlights the low theoretical knowledge of caregivers on psychomotor development in our study setting, resulting in late diagnosis and consequently poor treatment of psychomotor development disorders. The results of this study indicate a need for continuing education for pediatric caregivers on the psychomotor development of the child., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: This study evaluated the effect of implementing a hierarchical pharmaceutical service pattern based on the knowledge-attitude-practice (KAP) intervention theory on patients with systemic lupus erythematosus., Methods: Eligible patients were randomly divided into an intervention or control group. Pharmaceutical service classification criteria were formulated and used to provide patients with differing levels of pharmaceutical services. The classification scores and KAP levels of patients before and at various time points after the intervention were analyzed. The rates of acute attacks and adverse reactions, related clinical test indices, and disease activity were evaluated in both groups., Results: After 9 months of intervention, the proportions of first- and second-level services in the intervention group declined by 14.43% and 3.94%, respectively, compared with the control group, and the rates of acute attacks and adverse reactions declined by 18.26% and 12.43%, respectively. The KAP level, clinical test indices, and disease activity were significantly different between the groups., Conclusion: Providing patients with systemic lupus erythematosus with pertinent hierarchical pharmaceutical services based on the KAP theory was instrumental in changing patients' behavior and contributed to facilitating disease self-management, thus improving the quality of pharmaceutical services.