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ObjectiveCOVID-19 risk perceptions are discussed to be volatile and have been shown to be connected to the adoption of preventive public health behaviors. This study aimed to investigate changes in COVID-19 concerns and influencing factors as a function of season among the German public.MethodsSixty-three waves of cross-sectional telephone surveys with German participants aged 14 years and older conducted at least monthly between June 2020 and April 2023 provided the data basis (N = 63,471). After pooling participants of different waves by season (spring, summer, fall, winter), data were analyzed with regard to changes in physical health, mental health, economic, and social COVID-19 concerns. Individual characteristics (e.g., age), COVID-19 behavior (e.g., hygiene practices), and related perceptions (e.g., controllability of risk) were considered as predictors of composite concerns in different seasons.ResultsResults showed a higher between-seasons than within-seasons variability in concerns, with rises in physical and mental health and social concerns during fall. Multivariate regressions revealed being female, lower education, adopting protective measures, and higher perceived probability of infection in both public and private settings to be consistent predictors of higher COVID-19 concerns. Coefficients of these predictors remained comparatively stable over seasons and years.ConclusionResults indicate re-occurring changes in concerns during a prolonged crisis, with distinct characteristics being consistently associated with higher reported concerns. To ensure the application of protective measures, communicators should consider that risk perceptions are subject to fluctuations, but that certain groups of individuals tend to develop them and therefore deserve particular focus.

The public perspective on genetically modified foods (GMFs) has been intensely debated and scrutinized. Often, discussions surrounding GMF tend to revolve solely around the potential health risks associated with their consumption. However, it is essential to acknowledge that public perceptions of genetically modified foods are multifaceted, encompassing environmental concerns, ethical considerations, and economic implications. This paper studies the factors predicting GMF acceptance employing the representative sample of the Czech population (N = 884, aged 18–90 years, M ± SD: 48.17 ± 17.72; 53.40% women, 18.04% with higher education). The research relies on the Behavioral Change Model and the Health Belief Model. We employ hierarchical ordinal regressions to study the effects of information, environmental concerns, perceived health risks, food habits, purchasing habits, and socio-demographics on GMF acceptance. The results suggest that the (un)willingness to purchase GMF is primarily driven by the health risks - the environmental concerns were largely unimportant. The impact of information provision on GMF acceptance proved positive, suggesting information and education to be the main channels of creating public acceptance. The intrinsic interest regarding information related to GMF had an adverse impact on the perception of GMF morality. The benefits of the GMF proved unrelated to the GMF acceptance, indicating the gap in the information campaign. The research provides valuable insights for policymakers, public health professionals, and market researchers to communicate the GMF agenda effectively to the general public.

BackgroundZoonotic diseases such as anthrax, rabies, brucellosis, and Rift Valley fever pose a direct threat to health and undercut livelihoods in the communities in which they occur. A combination of anthropogenic and animal activities like migration and interaction with wildlife and their respective parasites and vectors drives the emergence and re-emergence of zoonotic diseases. Consequently, One Health interdisciplinary approaches that incorporate social scientists can provide key insights into complex local perceptions. The approach calls for collaboration between the human and animal health sectors, including the sharing of disease surveillance data necessary to alleviate disease impacts. Livestock traders interact closely with livestock, which puts them at elevated risk of infection and creates conditions by which they may spread zoonotic disease. It is thus essential to examine practices among actors involved in the livestock trade to understand the most appropriate ways to mitigate these risks.MethodsA qualitative study was conducted among the actors in the livestock trade in Busia County on their knowledge and perceptions of zoonotic diseases and practices that may contribute to the spread, control, and prevention of zoonotic disease transmission. A thematic analysis framework was used to categorize and synthesize data from in-depth interviews (IDIs), key informant interviews (KIIs), and structured observations.ResultsWhereas participants could list livestock diseases, they could not identify which ones were zoonoses, demonstrating insufficient knowledge of zoonosis. They identify sick animals by checking for dropped ears, excess mucus production, diarrhea, bloody urinal discharge, and general animal activity levels. To prevent the spread of these diseases, they wash their animals, isolate sick animals from the rest of the stock, and vaccinate their animals. They seek help from animal health professionals for sick animals as part of curative practices. This shows that they perceive the diseases as serious and that they need to be attended to by professionals. The results also show that they perceive animals from outside the region to be more vulnerable to diseases compared to those from within. The actors in the livestock trade engage in practices like skinning dead animals before burying them; to them, this is a normal practice. Some also consume dead carcasses. These increase the risk of zoonotic disease transmission.ConclusionThe actors involved in the livestock trade are critical in the prevention and elimination of zoonotic diseases; hence, they need to be involved when developing intervention programs and policies for animal health extension services. Training them as a continuum of animal health workers blends lay and professional knowledge, which, alongside their intense contact with large numbers of animals, becomes a critical disease surveillance tool. Increasing awareness of zoonoses by using multi-disciplinary teams with social scientists is urgently needed so that practices like skinning dead animals before disposing of them and consumption of dead carcasses can be minimized.

BackgroundInter-Professional Learning (IPE) is based on mutual respect, and it improves collaboration and teamwork, and satisfaction among students and professionals.ObjectiveThis study aimed to assess the perceptions of IPE among Nursing students in Saudi Arabia.MethodsThis is a cross-sectional survey-based study conducted among students from three different universities in Saudi Arabia, among nursing students over 6 months from May 2021 to October 2021. Descriptive analysis was used to assess the perceptions of IPE and inferential testing was used to assess the association of perception scores among variables using a statistical package for social science version 26 (SPSS).ResultsA total of 517 participants responded to the questionnaires. A higher proportion (n = 281, 54.4%) of the participants were females and were between 21 and 24 (n = 350; 67.7%) years old. The mean age of the participants was 21.35 (SD = 1.46). The majority of them were from King Saud University (n = 273, 52.8%), followed by King Khalid University (n = 127, 24.6%). Of the participants (80.4 %) agreed learning with other students will help them to become more effective members of a healthcare team. The mean overall score for RIPLS was 70.85 (SD = 6.611). The mean score for teamwork and collaboration was 37.19 (SD = 4.79), professional identity, 23.23 (SD = 2.89), roles and responsibilities 10.42 (SD = 2.20). The mean score is significantly associated with the university type (p = 0.0001), and previous knowledge of IPE (p = 0.0001).ConclusionThe majority of the students had positive perceptions of understanding IPE and a good level of preparation for IPE. This means that if IPE is conducted among Saudi students, students will benefit from it, and it has the potential to improve their capacity to deliver holistic nursing care to their patients.

Background and objectiveNumeracy is the branch of mathematics involved in understanding basic calculations, quantitation, estimation, reasoning, and execution of multistep operations. It is very imperative that pharmacists understand and apply numeracy skills in their routine work in the interest of their profession and patient care. This observational study was designed to assess the pharmacy student's perceptions of numeracy.MethodsA prospective observational study was conducted by the Department of Pharmacy, King Saud University, Kingdom of Saudi Arabia, between December 2021 and February 2022. All the enrolled subjects pursued a 5-year Pharma degree course at the university using a 9-item instrument, which accessed the perception of students toward numeracy. The data were analyzed using the statistical software statistical package for social science (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). Chi-square and Fisher's exact test were used to derive an association between various parameters of the study subjects. A P-value of < 0.05 was taken as statistically significant.ResultsA total of 550 pharmacy students were approached in this study, out of which 21 (3.8%) students were excluded due to incompleteness of the responses; thereupon, 529 students were included in the study. We learned that almost 90.0% of students had excellent and/or good mathematical ability, but at the same time, they were frequent users of calculators. Most of the students endorsed the importance of numeracy and showed their interest in attaining more knowledge of numeracy. Similarly rating the perceptions of mathematical ability is significantly associated with the frequency of use of a calculator for calculations (p = 0.0001).ConclusionPharmacy students showed interest in numeracy and correspondingly showed excellent perceptions toward mathematical ability. Although the role of numeracy has been well accepted, inciting changes in teaching-learning practices through mathematically focused teaching approaches throughout the pharmacy program will increase its applicability in healthcare.

Objective: COVID-19 risk perceptions are discussed to be volatile and have been shown to be connected to the adoption of preventive public health behaviors. This study aimed to investigate changes in COVID-19 concerns and influencing factors as a function of season among the German public., Methods: Sixty-three waves of cross-sectional telephone surveys with German participants aged 14 years and older conducted at least monthly between June 2020 and April 2023 provided the data basis ( N  = 63,471). After pooling participants of different waves by season (spring, summer, fall, winter), data were analyzed with regard to changes in physical health, mental health, economic, and social COVID-19 concerns. Individual characteristics (e.g., age), COVID-19 behavior (e.g., hygiene practices), and related perceptions (e.g., controllability of risk) were considered as predictors of composite concerns in different seasons., Results: Results showed a higher between-seasons than within-seasons variability in concerns, with rises in physical and mental health and social concerns during fall. Multivariate regressions revealed being female, lower education, adopting protective measures, and higher perceived probability of infection in both public and private settings to be consistent predictors of higher COVID-19 concerns. Coefficients of these predictors remained comparatively stable over seasons and years., Conclusion: Results indicate re-occurring changes in concerns during a prolonged crisis, with distinct characteristics being consistently associated with higher reported concerns. To ensure the application of protective measures, communicators should consider that risk perceptions are subject to fluctuations, but that certain groups of individuals tend to develop them and therefore deserve particular focus., 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 Janzik, Borzekowski and Böl.)

IntroductionSugar-sweetened beverage (SSB) consumption among adolescents contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health.ObjectiveTo better understand adolescents' perceptions, attitudes, and consumption behaviors around SSBs by conducting virtual workshop discussions with adolescents in NC.Materials and methodsAdolescents ages 11–17 in communities with a high proportion of Supplemental Nutrition Assistance Program (SNAP) eligible households were selected to participate in a series of virtual group workshops during summer 2021. A semi-structured discussion guide was used by a workshop facilitator. Workshop discussions centered around general health perceptions, SSB perceptions, and consumption behaviors. A thematic analysis was used to summarize knowledge, beliefs, attitudes, and perceptions around SSBs.ResultsApproximately 36 adolescents participated across four group workshops. Parents and caregivers influenced adolescents most when it came to making beverage choices. Positive SSB perceptions included liking the taste and the association with special times and social events. Negative opinions focused on associated health risks (diet-related chronic disease and poor oral health). Some adolescents acknowledged SSBs were not healthy but suggested they could be consumed occasionally. Very few participants mentioned any benefits from SSBs; those that mentioned benefits stated they provided energy, replaced electrolytes, and tasted good.ConclusionFindings provide several key insights that can contribute to the development of messages aimed at curbing SSB consumption among adolescents. For example, messages that focus on catching adolescents' attention and sharing short- and long-term health consequences of high SSB consumption resonated with adolescents, but because occasional SSB intake was not seen as consequential, messages that suggest abstinence from SSBs may not be helpful in reducing consumption.

ObjectiveOrganizational responses that support healthcare workers (HCWs) and mitigate health risks are necessary to offset the impact of the COVID-19 pandemic. We aimed to understand how HCWs and key personnel working in healthcare settings in Melbourne, Australia perceived their employing organizations' responses to the COVID-19 pandemic.MethodIn this qualitative study, conducted May-July 2021 as part of the longitudinal Coronavirus in Victorian Healthcare and Aged Care Workers (COVIC-HA) study, we purposively sampled and interviewed HCWs and key personnel from healthcare organizations across hospital, ambulance, aged care and primary care (general practice) settings. We also examined HCWs' free-text responses to a question about organizational resources and/or supports from the COVIC-HA Study's baseline survey. We thematically analyzed data using an iterative process.ResultsWe analyzed data from interviews with 28 HCWs and 21 key personnel and free-text responses from 365 HCWs, yielding three major themes: navigating a changing and uncertain environment, maintaining service delivery during a pandemic, and meeting the safety and psychological needs of staff . HCWs valued organizational efforts to engage openly and honesty with staff, and proactive responses such as strategies to enhance workplace safety (e.g., personal protective equipment spotters). Suggestions for improvement identified in the themes included streamlined information processes, greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce.ConclusionsThis study provides in-depth insights into the challenges and successes of organizational responses across four healthcare settings in the uncertain environment of a pandemic. Future efforts to mitigate the impact of acute stressors on HCWs should include a strong focus on bidirectional communication, effective and realistic strategies to strengthen and sustain the healthcare workforce, and greater investment in flexible and meaningful psychological support and wellbeing initiatives for HCWs.

BackgroundThe Canada's Food Guide (CFG) is recognized as the most prominent authoritative guideline for healthy eating in Canada. In 2019, Health Canada released the latest iteration of the CFG with substantial changes to its messaging and format from the previous 2007 CFG.ObjectiveThis study compared the awareness, use, knowledge, and opinions of the 2007 and 2019 CFGs among parents with children aged 18 months to 5 years who are participants in a family-based intervention trial, the Guelph Family Health Study.MethodsThe sample consisted of 327 parents (59% women) who responded to questions about the 2007 CFG and 177 parents (60% women) who responded to questions about the 2019 CFG. Parents' awareness and knowledge of the 2007 and 2019 CFGs were compared using Pearson's Chi-Square, while parents' opinions of the two CFGs were compared using Wilcoxon Rank-Sum tests. To describe and provide context about how parents used the 2007 and 2019 CFG descriptive analysis was used. To analyze the open-answer comments parents provided for the 2007 and 2019 CFGs thematic coding was used.ResultsAwareness of the 2007 and 2019 CFGs was high with 94.5 and 90.4% of parents reported having heard about the 2007 and 2019 CFGs, respectively. Knowledge of the plate proportion recommendations in the 2019 CFG was significantly higher than knowledge of the recommended number of servings in the 2007 CFG with 93.4% of parents identifying the Vegetable and Fruit Plate Proportions in the 2019 CFG. Parents identified that the 2019 CFG was a helpful and trustworthy resource, and that it was easier to follow and understand, and more representative of their culture and traditional foods than the 2007 CFG.ConclusionOur results suggest that parents' knowledge of the 2019 CFG recommendations was higher than for the 2007 CFG recommendations. Parents also had more positive opinions about the 2019 CFG as compared to the 2007 CFG. Future research is needed to explore whether these higher levels knowledge of the 2019 CFG recommendation translate to healthier eating patterns among Canadian families.

Work in agriculture is a significant area of research that highlights the problem of the integration of young people in the former, in particular, in the recent period. Work in agriculture is hard and not prestigious, and young people tend to leave rural areas in the search for alternative activities in urban areas. The study addresses the problem of how the youth should be integrated into agricultural workforce by focusing on identification of the reasons behind the (un)willingness to work in agriculture. The aim of the study is to assess the reasons behind the youth's (un)willingness of work in agriculture, using Lithuania as the case study. The data were collected by means of a questionnaire designed to investigate the perception and opinions toward work in agriculture. The Binary Logistic Regression was used to identify the factors affecting the youth's opinion about (un)willingness to work in agriculture. The study analyzed 430 young people 's responses to the questionnaires survey. The BLR has revealed that youth's unwillingness to work in agriculture is mostly affected by gender, area of residence and youths' beliefs that work in agriculture does not provide any opportunities for self-realization. In summary, this paper argues that the major motivation to work in agriculture is associated with having parents who are engaged in agricultural activities, love of animals and natural environment, and the availability of specialized training. The findings have confirmed the need to attract young people to work in agriculture. Its results are necessary for the scientific community, policy makers, farmers, and practitioners exploring the possibilities for integration of the youth into the agricultural workforce.

BackgroundCOVID-19 vaccination is a key public health measure to mitigate the crippling effects of the pandemic. COVID-19 vaccination began in adults and targeted adolescents at a later stage. However, medical decision-making on its uptake among the latter was unknown, which could be affected by their literacy and concerns about the vaccine. The study aimed to elucidate the awareness, concerns and barriers of adolescents toward the COVID-19 vaccine.MethodsA cross-sectional online survey using a self-developed questionnaire was conducted between June to November 2021. The adolescent participants were students from institutes of post-secondary education who were recruited via convenience sampling. The data were collated from an officially approved electronic platform, audited and analyzed. Continuous and categorical variables were expressed as mean (standard deviation) and percentages, respectively.ResultsA total of 460 adolescents participated in the study (mean age: 16.99 ± 0.99; 73% female). Most of them (91.5%) were aware of the COVID-19 vaccines. The main barriers to vaccination were uncertainty about long-term health risks (38.6%) and vaccine efficacy (37.3%). Regarding the potential vaccine side effects, they were concerned about: anaphylactic shock (73.2%), low blood pressure (58.3%) and fast heartbeat (58.0%). Only 58% expressed willingness for repeated COVID-19 vaccination.ConclusionDespite high COVID-19 vaccine awareness, the adolescents were concerned about the potentially severe but rare side-effects. The study identified apprehension regarding vaccine efficacy and the potential long-term health impact as the main barriers to vaccination. Future studies should address these concerns to scale vaccination programs among adolescents.

ObjectivesThis study was conducted to evaluate COVID-19 vaccine booster dose willingness and identify predictors and factors of willingness and hesitance in the vaccinated population of Pakistan.MethodsA cross-sectional web-based survey was undertaken between January and February 2022 to highlight the public perceptions regarding the COVID-19 booster dose and evaluate the willingness to get the additional dose. Demographic information and booster dose willingness were recorded through the questionnaire. Additionally, a 5-point Likert scale was employed to explore fears and beliefs regarding COVID-19 vaccinations. Univariate and multivariate regression was performed to identify booster dose willingness and hesitance factors.ResultsOf the 787 respondents, 69.6% were females, 75.3% fell in the 18–30 years age group, 53.5% were university students or had a Bachelor's degree. Overall, a 77.8% booster dose willingness was reported. Participants showed absence or low fear levels associated with a booster dose (47.3%). 60.1% agreed it was safe to receive an additional vaccine dose, with 44.1% agreeing that boosters are effective against coronavirus variants. Independent predictors of willingness included the absence of comorbidities, whereas not being willing to pay for the booster dose was a predictor of hesitance.ConclusionThis study showed a suboptimal willingness level of booster dose uptake among the vaccinated Pakistani population. Public health policymakers must undertake necessary awareness campaigns to strategize vaccination drives and dispel myths.

BackgroundOlder adults represent the largest consumers of health care. It is, therefore, important that they receive adequate patient-centered care to empower them to be proactive in managing their health.AimsThis study examined the proportion of older community-dwelling individuals who report receiving patient-centered care during healthcare consultations.MethodsA cross-sectional study was conducted with 117 clients of an Australian aged care provider. Clients completed a survey examining their perceptions of whether they received patient-centered care (11-items) from healthcare professionals.ResultsThe mean number of patient-centered care items reported was 8.7 (±3.1). Speaking to the patient with respect was the item most often reported to be patient-centered (94%). Asking patients about treatment goals or expectations (62%) and how involved they would like to be in treatment (67%) were the items least reported to be patient-centered.ConclusionOlder adults perceived some important aspects of care were not provided with a patient-centered approach. There is a need to improve healthcare providers' elicitation of older patients' care preferences, enabling patients to determine their level of involvement in their health management.

The COVID-19 pandemic has exerted a significant influence on university student's learning, life and mental health. Using the method of inductive content analysis, this study examined the experience and perceptions of Chinese university students regarding the COVID-19 pandemic. Eighteen university students including seven males and eleven females were involved in this study. In this study, we identified five themes concerning experience and perceptions of Chinese university students regarding the COVID-19 pandemic, that is, emotional reactions toward the COVID-19 pandemic, the influence of the COVID-19 pandemic on the participant's learning, the influence of the COVID-19 pandemic on the participant's daily life, participants' positive responses to the COVID-19 pandemic, and China's moves toward the COVID-19 pandemic. This study elaborated on experience and perceptions of Chinese university students regarding the COVID-19 pandemic, which would provide us a better understanding of how university students perceive the COVID-19 pandemic and to what extent the COVID-19 pandemic has influenced their learning and daily lives.

Medical students' perceptions of the medical school learning environment (MSLE) have an important impact on their professional development, and physical and mental health. Few studies reported potential factors that influenced medical students' perceptions of MSLE. Thus, the main goal of this study was to identify influencing factors for medical students' perception levels of MSLE. The perception levels of MSLE were assessed by the Johns Hopkins Learning Environment Scale. The univariate and multivariate logistic regression analyses were performed to identify significant predictors for the perceptions of MSLE. The nomograms were established to predict medical students' perception levels of MSLE. In the multivariate logistic regression model, gender, university category, grade, mother education level, learning environment of schools, interests in medicine, and Kolb learning experience were significantly associated with medical students' perceptions of MSLE. Correspondently, the nomograms were built based on significant variables identified by the univariate logistic regression analysis. The validation of the nomograms showed that the model had promising predictive accuracy, discrimination, and accordance (area under the curve (AUC) = 0.751). This study identified influencing factors of medical students' perceptions of MSLE. It is essential to implement corresponding interventions to improve medical students' perceptions.

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose© software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency.

Background: School closures have inevitably deprived students of their traditional source of information. The objective of this study was to determine knowledge, attitudes, and safety practices about COVID-19 among high school students in Iran.Methods: This study was conducted from March 24th-April 3rd, 2020. Data were collected via an online-parent-administrative questionnaire.Results: Responses of 704 students were analyzed. Students' mean (SD) knowledge score was 21.5 (4.6) of 30. More than 90% of students knew about the cause of the disease, the routes of transmission, and the most renowned symptoms: dyspnea and cough. Social-and- audiovisual-media were the leading information source. Most students believed that people need to keep safe physical distancing, everyone should isolate themselves upon symptoms onset, people should avoid unnecessary in-person contact with family and friends, and that cities need to go under lockdowns if needed. Students' mean (SD) practice score was 20.2 (2.5) of 24. Most students did not go on a trip, and more than 80% said they would wear facemasks when going outside.Conclusions: High school students' knowledge and safety practices about COVID-19 were somewhat satisfactory, and their attitudes toward the disease were mainly positive. Nevertheless, some witnessed knowledge gaps, negative attitudes, and unsafe practices in the study highlighted the need for targeted education on the pandemic. Social and mass media's significant role and potential could be utilized to battle misinformation and deliver proper knowledge to young adolescents.

Introduction: Older adults have the poorest coronavirus (COVID-19) prognosis with the highest risk of death due to complications, making their COVID-19 experiences particularly important. Guided by the stress-appraisal-coping theoretical model, we sought to understand COVID-related perceptions and behaviors of older adults residing in the United States.Materials and Methods: We used convenience sampling to recruit persons with the following inclusion criteria: Aged ≥ 65 years, English fluency, and U.S. residency. Semi structured in-depth interviews were conducted remotely and audio recorded between April 25, 2020 and May 7, 2020. Interviews were professionally transcribed with a final study sample of 43. A low-inference qualitative descriptive design was used to provide a situated understanding of participants' life experiences using their naturalistic expressions.Results: The mean age of participants was 72.4 ± 6.7. Slightly over half were female (55.8%), 90.6% were White, and 18.6% lived alone. The largest percentages of participants resided in a rural area (27.9%) or small city (25.6%). We identified four themes, including (1) risk perception, (2) financial impact, (3) coping, and (4) emotions. Most participants were aware of their greater risk for poor COVID-19 outcomes but many did not believe in their increased risk. Financial circumstances because of the pandemic varied with largely no financial impacts, while others reported negative impacts and a few reported positive impacts. Coping was problem- and emotion-focused. Problem-focused coping included precautionary efforts and emotion-focused coping included creating daily structure, pursuing new and/or creative activities, connecting with others in new ways, and minimizing news media exposure. Overall, emotional health was negatively affected by the pandemic although some participants reported positive emotional experiences.Conclusions: Perceiving themselves as high risk for COVID-19 complications, older adults used precautionary measures to protect themselves from contracting the virus. The precautionary measures included social isolation, which can negatively affect mental health. Older adults will need to be resourceful and draw on existing resources to cope, such as engaging in creative activities and new strategies to connect with others. Our findings underscore the importance of the preservation of mental health during extended periods of isolation by taking advantage of low-to-no-cost existing resources.

Background: Adolescent population face a number of health concerns which calls for objective and comprehensive assessment of their wellness during their critical development phase. This study aimed to determine adolescent wellness and its predictors amongst adolescents in secondary schools in Fiji.Methods: This quantitative cross sectional study was conducted in four purposively selected schools in Suva and the greater Suva area, Fiji, between August and September, 2019. Students of Fijian nationality, enrolled into years 11-13 in the selected schools were purposively selected. A structured self-administered questionnaire was used to collect data on four dimensions of wellness including physical, emotional, social, and spiritual. Spearman's Rho correlation was conducted to test for associations. Descriptive and inferential statistical tests were applied to analyze the data by the SPSS software version 25. A p-value < 0.05 was considered significant.Results: A total of 350 students participated in the study. Mean raw scores for wellness dimensions were as follows: physical = 51 (out of 60), psychological = 63 (out of 80), social = 42 (out of 50), and spiritual = 34 (out of 40). For overall wellness, two significant differences were observed: students of Fijian Itaukei descent (193.68 ± 14.2) and participants with a family income of $40,000-50,000 (199.08 ± 12.60) (p = 0.04) had a higher overall wellness score. There were three significant differences observed for psychological wellness dimension; Fijians of Indian descent (64.68 ± 9.30), participants enrolled into year 13 (64.68 ± 9.30) and those with a family income of $40,000-50,000 had higher psychological score. For social wellness, a significant difference was observed: Itaukei participants had higher scores (43.34 ± 4.42) when compared to other ethnic groups (p < 0.05). In terms of spiritual wellness, a significant difference was observed for ethnicity: Itaukei participants had a higher mean score (35.59 ± 4.26) when compared to other ethnic groups (p < 0.05). Strong correlations were observed for all dimensions of wellness.Conclusions: Findings of this study highlighted different factors affecting adolescents' wellness in Fiji. It is recommended that health education and awareness program be carried out for developing adolescent wellness by considering these factors. It is also recommended that parental and family support are provided to adolescents.

Background: Containment of the coronavirus pandemic relied extensively on the combination of early implementation of quarantine and massive behavioral changes to ensure effectiveness. Decision-makers need to constantly monitor the outbreak situation and the impact of the measures implemented. Yet little is known about the factors influencing adherence and understanding of lockdown measures among the Palestinian community. This study aimed to assess the impact and factors affecting these early public health interventions.Materials and Methods: A cross-sectional web-based questionnaire was distributed throughout social media (Facebook and Instagram). We used a snowball recruiting technique to target Palestinian adult citizens during the coronavirus pandemic quarantine between 6 and 16 April 2020, which corresponded to almost the middle interval of the strict massive lockdown measures in Palestine that lasted from 22 March to 5 May 2020. Multivariate logistic regression models were developed for the outcome variables (staying home adherence, in-home precautions adherence, and quarantine understanding).Results: Our questionnaire was completed by 2,819 participants. The mean (range) age was 29.47 (18–71) years. Of them, 1,144 (40.6%), 1,261 (44.7%), and 1,283 (45.5%) reported low levels of staying home adherence, in-home precautions adherence, and quarantine understanding, respectively. Females, city residents, those with higher educational levels, and those informed by official government sources were associated significantly with higher levels of both staying home adherence and quarantine understanding. Adequate food supply was associated with a higher level of staying home adherence. Higher levels of in-home precautions adherence were noticed in the elderly and those with a high-risk group living at home. Higher monthly income was inversely associated with higher levels of in-home precautions adherence and lower levels of quarantine understanding (P < 0.05).Conclusions: The socio-economic and financial status of the general population and coordination between the major information resources (official government), social media, and the press were the major factors affecting the community in regard to quarantine adherence. For maximum effectiveness and commitment levels amongst the people to decrease the spread of infection, policymakers need to address all those factors. In addition, clear communication between policymakers and the population is essential for reassuring the people and minimizing their fears regarding the unknown future.

Introduction: Public perceptions and attitudes toward preventive and control measures are vital to ensure the success of national response strategies in combating COVID-19. This study assessed perceptions and attitudes via the importance of national response measures to COVID-19 among people under the nationwide partial lockdown of Vietnam.Methods: An online cross-sectional survey was conducted on 1382 people in Vietnam mainly public administration and health workers with relatives. Perceptions and attitudes toward seven national response measures to COVID-19 epidemics were assessed. Multivariable Tobit regression models were employed to identify factors associated with the perceptions.Results: The proportion of participants strongly agreeing with the measure “Isolate people from abroad and people in contact with people infected with COVID 19” was the highest (96.9%), following by the measure “Obligatory to wear face masks in public places” (96.8%), and “Blockade of places having new cases” (92.9%). Living in the Southern region, having a family with more than 5 people, and having post-graduate education were negatively correlated to the levels of perceived importance of “Social distancing and community screening” measures. Meanwhile, having post-graduate education (Coef. = −0.04; 95%CI: −0.07; −0.01), working as white-collar workers (Coef. = −0.04; 95%CI: −0.08; −0.01), and having fixed-term, full-time employment (Coef. = −0.07; 95%CI: −0.10; −0.03) were inversely associated with the levels of perceived importance of the “Mandatory quarantine and personal protective equipment” measures.Conclusion: This study informed highly positive perceptions and attitudes toward the national response measure to combat the COVID-19 in Vietnam. Contextualized strategies to maintain and improve these perceptions are warranted to ensure the success of preventive measures in the future.

The public perspective on genetically modified foods (GMFs) has been intensely debated and scrutinized. Often, discussions surrounding GMF tend to revolve solely around the potential health risks associated with their consumption. However, it is essential to acknowledge that public perceptions of genetically modified foods are multifaceted, encompassing environmental concerns, ethical considerations, and economic implications. This paper studies the factors predicting GMF acceptance employing the representative sample of the Czech population (N = 884, aged 18-90 years, M ± SD: 48.17 ± 17.72; 53.40% women, 18.04% with higher education). The research relies on the Behavioral Change Model and the Health Belief Model. We employ hierarchical ordinal regressions to study the effects of information, environmental concerns, perceived health risks, food habits, purchasing habits, and socio-demographics on GMF acceptance. The results suggest that the (un)willingness to purchase GMF is primarily driven by the health risks - the environmental concerns were largely unimportant. The impact of information provision on GMF acceptance proved positive, suggesting information and education to be the main channels of creating public acceptance. The intrinsic interest regarding information related to GMF had an adverse impact on the perception of GMF morality. The benefits of the GMF proved unrelated to the GMF acceptance, indicating the gap in the information campaign. The research provides valuable insights for policymakers, public health professionals, and market researchers to communicate the GMF agenda effectively to the general public., 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 Cabelkova, Sanova, Hlavacek, Broz, Smutka and Prochazka.)

Background: Zoonotic diseases such as anthrax, rabies, brucellosis, and Rift Valley fever pose a direct threat to health and undercut livelihoods in the communities in which they occur. A combination of anthropogenic and animal activities like migration and interaction with wildlife and their respective parasites and vectors drives the emergence and re-emergence of zoonotic diseases. Consequently, One Health interdisciplinary approaches that incorporate social scientists can provide key insights into complex local perceptions. The approach calls for collaboration between the human and animal health sectors, including the sharing of disease surveillance data necessary to alleviate disease impacts. Livestock traders interact closely with livestock, which puts them at elevated risk of infection and creates conditions by which they may spread zoonotic disease. It is thus essential to examine practices among actors involved in the livestock trade to understand the most appropriate ways to mitigate these risks., Methods: A qualitative study was conducted among the actors in the livestock trade in Busia County on their knowledge and perceptions of zoonotic diseases and practices that may contribute to the spread, control, and prevention of zoonotic disease transmission. A thematic analysis framework was used to categorize and synthesize data from in-depth interviews (IDIs), key informant interviews (KIIs), and structured observations., Results: Whereas participants could list livestock diseases, they could not identify which ones were zoonoses, demonstrating insufficient knowledge of zoonosis. They identify sick animals by checking for dropped ears, excess mucus production, diarrhea, bloody urinal discharge, and general animal activity levels. To prevent the spread of these diseases, they wash their animals, isolate sick animals from the rest of the stock, and vaccinate their animals. They seek help from animal health professionals for sick animals as part of curative practices. This shows that they perceive the diseases as serious and that they need to be attended to by professionals. The results also show that they perceive animals from outside the region to be more vulnerable to diseases compared to those from within. The actors in the livestock trade engage in practices like skinning dead animals before burying them; to them, this is a normal practice. Some also consume dead carcasses. These increase the risk of zoonotic disease transmission., Conclusion: The actors involved in the livestock trade are critical in the prevention and elimination of zoonotic diseases; hence, they need to be involved when developing intervention programs and policies for animal health extension services. Training them as a continuum of animal health workers blends lay and professional knowledge, which, alongside their intense contact with large numbers of animals, becomes a critical disease surveillance tool. Increasing awareness of zoonoses by using multi-disciplinary teams with social scientists is urgently needed so that practices like skinning dead animals before disposing of them and consumption of dead carcasses can be minimized., 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 Majiwa, Bukachi, Omia and Fèvre.)

Background: Brain health is a multi-faceted concept used to describe brain physiology, cognitive function, mental health and well-being. Diseases of the brain account for one third of the global burden of disease and are becoming more prevalent as populations age. Diet, social interaction as well as physical and cognitive activity are lifestyle factors that can potentially influence facets of brain health. Yet, there is limited knowledge about the population's awareness of brain health and willingness to change lifestyle to maintain a healthy brain. This paper introduces the Global Brain Health Survey protocol, designed to assess people's perceptions of brain health and factors influencing brain health.Methods: The Global Brain Health Survey is an anonymous online questionnaire available in 14 languages to anyone above the age of 18 years. Questions focus on (1) willingness and motivation to maintain or improve brain health, (2) interest in learning more about individual brain health using standardized tests, and (3) interest in receiving individualized support to take care of own brain health. The survey questions were developed based on results from a qualitative interview study investigating brain health perceptions among participants in brain research studies. The survey includes 28 questions and takes 15–20 min to complete. Participants provide electronically informed consent prior to participation. The current survey wave was launched on June 4, 2019 and will close on August 31, 2020. We will provide descriptive statistics of samples distributions including analyses of differences as a function of age, gender, education, country of residence, and we will examine associations between items. The European Union funded Lifebrain project leads the survey in collaboration with national brain councils in Norway, Germany, and Belgium, Brain Foundations in the Netherlands and Sweden, the National University of Ostroh Academy and the Women's Brain Project.Discussion: Results from this survey will provide new insights in peoples' views on brain health, in particular, the extent to which the adoption of positive behaviors can be encouraged. The results will contribute to the development of policy recommendations for supporting population brain health, including measures tailored to individual needs, knowledge, motivations and life situations.

Background: Gender inequalities have been identified as important derailment factors for health workforce and health system sustainability. Literature holds responsible a list of gendered barriers faced by female health workforce. However, there is a gap in the evidence based research on women leaders' own perceptions of barriers to leading positions advancement. This study aims to explore leadership barriers perceived by women healthcare leaders within country's context; research focused on Greece due to country's poor performance on gender equality index and current economic turbulence. Study supplements survey data and provides orientation for further gender sensitive research in health workforce development through country's specificity lens to better inform education and policy makers.Methods: The best-worst object case survey method was used, applying an online questionnaire designed in Qualtrics. The online questionnaire was sent to 30 purposively invited participants. Respondents were asked to tick the most and the least important barriers to women's leadership in provided choice scenarios. Descriptive data analysis was used to understand and interpret the results.Results: Women leaders perceived stereotypes, work/life balance, lack of equal career advancement, lack of confidence, gender gap and gender bias to be the barriers with the greatest relative importance in constraining opportunities for pursuing leading positions in Greek healthcare setting. Twenty more barriers were identified and ranked lower in relative importance. The results are considered exploratory and not to obtain population based outcomes.Conclusion: This exploratory study reports the perceived barriers of women leaders in pursuing leading positions within Greek healthcare context. The findings point mainly to organizational and socio-cultural related barriers potentially aggravated by country's unfortunate current economic turbulence. Further extensive research is required to establish grounded conclusions and better inform education and policy makers in developing gender sensitive strategies to sustainable health workforce development.

Introduction: To model and analyze the differences between girls' and boys' conceptions of the determinants of health and cancer, as expressed and perceived by children and adolescents., Method: A multicentric qualitative study was conducted in five schools (ages 6-11 years), four middle schools (ages 11-15 years), and three high schools (ages 15-18 years). A multi-phase protocol (phase 1 uses the e.Photoexpression© and phase 2 uses the Photonarration) enables children and teenagers to express themselves through photography and storytelling., Results: A total of 4,174 qualitative productions were produced by 1,068 children, of which 47% were girls and 53% were boys, all in the ages of 6-18 years. From the results of the productions, it can be noticed that children mentioned and were aware of 30 determinants of health and cancer. The three determinants most mentioned were "Consumption of psychotropic drugs", "Diet", and "Harmful environment". Among these 30 determinants, some were mentioned to a greater or lesser extent by girls and boys. These significant gender differences are present for 20 determinants of health and cancer. These differences evolve with age: (1) In elementary school (ages 6-11), girls gave significantly more importance ( p < 0.05) to 11 determinants, while boys attached significantly more importance ( p < 0.05) to 2 determinants. (2) In middle school (ages 11-16), girls gave significantly ( p < 0.05) more importance to 12 determinants, while boys gave significantly ( p < 0.05) more importance to one determinant. (3) In high school (ages 15-18 years), girls gave significantly ( p < 0.05) more importance to 13 determinants. There was no significant difference ( p < 0.05) in favor of boys for high school students. Girls also have a more systemic view of health determinants than boys. The increase in the number of determinants cited by girls is significant ( p = 0.017) between the ages of 6-11 and 15-18 years. This gap widens with age (+1.45 determinants) for girls and (+0.68 determinants) for boys between elementary school and high school., Conclusion: The determinants identified as predominantly female or male, as well as age-related specificities, constitute a resource for effective preventive action, as close as possible to the needs and particularities of a population. This mapping of people's conceptions could provide a decision-making aid in defining the strategic orientations of prevention policies., 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 © 2023 Gay, Deyra, Berland, Gerbaud and Pizon.)

Objective: To review satisfaction with telehealth among children and adolescents based on their own opinions during the COVID-19 pandemic., Methods: In the PubMed, CINAHL, PsycINFO, and Embase databases, we searched for peer-reviewed studies in English on satisfaction with telehealth among children and adolescents (rather than parents). Both observational studies and interventions were eligible. The review was categorized as a mini review because it focused on the limited time frame of the COVID-19 pandemic. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviewers extracted information from each study and assessed risk of bias., Results: A total of 14 studies were eligible. Studies were conducted in Australia, Canada, Italy, Israel, Poland, South Korea, the United Kingdom, and the United States. They focused on a variety of health conditions. Two of the 14 studies were interventions. Participants expressed high satisfaction with video and telephone visits and home telemonitoring while also preferring a combination of in-person visits and telehealth services. Factors associated with higher satisfaction with telehealth included greater distance from the medical center, older age, and lower anxiety when using telehealth. In qualitative studies, preferred telehealth features among participants included: a stable Internet connection and anonymity and privacy during telehealth visits., Conclusion: Telehealth services received favorable satisfaction ratings by children and adolescents. Randomized-controlled trials on the effectiveness of pediatric telehealth services compared to non-telehealth services may assess improvements in satisfaction and health outcomes., 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 © 2023 Kodjebacheva, Culinski, Kawser and Amin.)

There are health benefits to breastfeeding for both mothers and their children. The preventive health effects of breastfeeding continue into adulthood, lowering rate of various chronic illnesses. African American women, especially of lower socioeconomic status, are less likely to breastfeed in comparison to their racial and ethnic counterparts. The purpose of this study was to explore how African American women experience breastfeeding in the early stages of postpartum care. Two focus groups (N=20, 10 in each group) were conducted with African American mothers. Results revealed that participants felt that there were health benefits to breastfeeding, and organizations such as WIC provided support. However, participants stated that lack of information, negative perceptions, and unforeseen circumstances were barriers to breastfeeding. This study proposes support and interventions for this group to increase breastfeeding among this population.

Background: Inter-Professional Learning (IPE) is based on mutual respect, and it improves collaboration and teamwork, and satisfaction among students and professionals., Objective: This study aimed to assess the perceptions of IPE among Nursing students in Saudi Arabia., Methods: This is a cross-sectional survey-based study conducted among students from three different universities in Saudi Arabia, among nursing students over 6 months from May 2021 to October 2021. Descriptive analysis was used to assess the perceptions of IPE and inferential testing was used to assess the association of perception scores among variables using a statistical package for social science version 26 (SPSS)., Results: A total of 517 participants responded to the questionnaires. A higher proportion ( n = 281, 54.4%) of the participants were females and were between 21 and 24 ( n = 350; 67.7%) years old. The mean age of the participants was 21.35 (SD = 1.46). The majority of them were from King Saud University ( n = 273, 52.8%), followed by King Khalid University ( n = 127, 24.6%). Of the participants (80.4 %) agreed learning with other students will help them to become more effective members of a healthcare team. The mean overall score for RIPLS was 70.85 (SD = 6.611). The mean score for teamwork and collaboration was 37.19 (SD = 4.79), professional identity, 23.23 (SD = 2.89), roles and responsibilities 10.42 (SD = 2.20). The mean score is significantly associated with the university type ( p = 0.0001), and previous knowledge of IPE ( p = 0.0001)., Conclusion: The majority of the students had positive perceptions of understanding IPE and a good level of preparation for IPE. This means that if IPE is conducted among Saudi students, students will benefit from it, and it has the potential to improve their capacity to deliver holistic nursing care to their patients., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer WS declared a shared affiliation with the author to the handling editor at the time of review., (Copyright © 2023 Bashatah.)

Background and Objective: Numeracy is the branch of mathematics involved in understanding basic calculations, quantitation, estimation, reasoning, and execution of multistep operations. It is very imperative that pharmacists understand and apply numeracy skills in their routine work in the interest of their profession and patient care. This observational study was designed to assess the pharmacy student's perceptions of numeracy., Methods: A prospective observational study was conducted by the Department of Pharmacy, King Saud University, Kingdom of Saudi Arabia, between December 2021 and February 2022. All the enrolled subjects pursued a 5-year Pharma degree course at the university using a 9-item instrument, which accessed the perception of students toward numeracy. The data were analyzed using the statistical software statistical package for social science (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). Chi-square and Fisher's exact test were used to derive an association between various parameters of the study subjects. A P -value of < 0.05 was taken as statistically significant., Results: A total of 550 pharmacy students were approached in this study, out of which 21 (3.8%) students were excluded due to incompleteness of the responses; thereupon, 529 students were included in the study. We learned that almost 90.0% of students had excellent and/or good mathematical ability, but at the same time, they were frequent users of calculators. Most of the students endorsed the importance of numeracy and showed their interest in attaining more knowledge of numeracy. Similarly rating the perceptions of mathematical ability is significantly associated with the frequency of use of a calculator for calculations ( p = 0.0001)., Conclusion: Pharmacy students showed interest in numeracy and correspondingly showed excellent perceptions toward mathematical ability. Although the role of numeracy has been well accepted, inciting changes in teaching-learning practices through mathematically focused teaching approaches throughout the pharmacy program will increase its applicability in healthcare., 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 © 2022 Alrabiah, Arafah, Rehman, Syed, Babelghaith, Alwhaibi, Alghadeer, Alhossan and Al Arifi.)

This study assessed perceptions and support among the Indian populace about plain packaging for all tobacco products.12 focus group discussions (n=124), stakeholder analysis with 24 officials and an opinion poll with 346 participants were conducted between December 2011 - May 2012 , Delhi. Plain packages for tobacco products were favoured by majority of participants (69%) and key stakeholders (92%). The majority of participants perceived that plain packaging would reduce the appeal and promotional value of the tobacco pack (>80%), prevent initiation of tobacco use among children and youth (>60%), motivate tobacco users to quit (>80%), increase noticeability and effectiveness of pictorial health warnings on tobacco packs (>90%),reduce tobacco usage (75% of key stakeholders). Majority of participants favoured light grey colour for plain packaging. This study provides key evidence to advocate with Indian Government and other countries in South Asia region to introduce plain packaging legislation for all tobacco products.

Objective: Organizational responses that support healthcare workers (HCWs) and mitigate health risks are necessary to offset the impact of the COVID-19 pandemic. We aimed to understand how HCWs and key personnel working in healthcare settings in Melbourne, Australia perceived their employing organizations' responses to the COVID-19 pandemic., Method: In this qualitative study, conducted May-July 2021 as part of the longitudinal Coronavirus in Victorian Healthcare and Aged Care Workers (COVIC-HA) study, we purposively sampled and interviewed HCWs and key personnel from healthcare organizations across hospital, ambulance, aged care and primary care (general practice) settings. We also examined HCWs' free-text responses to a question about organizational resources and/or supports from the COVIC-HA Study's baseline survey. We thematically analyzed data using an iterative process., Results: We analyzed data from interviews with 28 HCWs and 21 key personnel and free-text responses from 365 HCWs, yielding three major themes: navigating a changing and uncertain environment, maintaining service delivery during a pandemic , and meeting the safety and psychological needs of staff . HCWs valued organizational efforts to engage openly and honesty with staff, and proactive responses such as strategies to enhance workplace safety (e.g., personal protective equipment spotters). Suggestions for improvement identified in the themes included streamlined information processes, greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce., Conclusions: This study provides in-depth insights into the challenges and successes of organizational responses across four healthcare settings in the uncertain environment of a pandemic. Future efforts to mitigate the impact of acute stressors on HCWs should include a strong focus on bidirectional communication, effective and realistic strategies to strengthen and sustain the healthcare workforce, and greater investment in flexible and meaningful psychological support and wellbeing initiatives for HCWs., Competing Interests: KL (APP115500) and CH (APP1173271) were supported by National Health and Medical Research Fellowships. The remaining 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 © 2022 McGuinness, Josphin, Eades, Clifford, Fisher, Kirkman, Russell, Hodgson, Kelsall, Lane, Skouteris, Smith and Leder.)

Introduction: Sugar-sweetened beverage (SSB) consumption among adolescents contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health., Objective: To better understand adolescents' perceptions, attitudes, and consumption behaviors around SSBs by conducting virtual workshop discussions with adolescents in NC., Materials and Methods: Adolescents ages 11-17 in communities with a high proportion of Supplemental Nutrition Assistance Program (SNAP) eligible households were selected to participate in a series of virtual group workshops during summer 2021. A semi-structured discussion guide was used by a workshop facilitator. Workshop discussions centered around general health perceptions, SSB perceptions, and consumption behaviors. A thematic analysis was used to summarize knowledge, beliefs, attitudes, and perceptions around SSBs., Results: Approximately 36 adolescents participated across four group workshops. Parents and caregivers influenced adolescents most when it came to making beverage choices. Positive SSB perceptions included liking the taste and the association with special times and social events. Negative opinions focused on associated health risks (diet-related chronic disease and poor oral health). Some adolescents acknowledged SSBs were not healthy but suggested they could be consumed occasionally. Very few participants mentioned any benefits from SSBs; those that mentioned benefits stated they provided energy, replaced electrolytes, and tasted good., Conclusion: Findings provide several key insights that can contribute to the development of messages aimed at curbing SSB consumption among adolescents. For example, messages that focus on catching adolescents' attention and sharing short- and long-term health consequences of high SSB consumption resonated with adolescents, but because occasional SSB intake was not seen as consequential, messages that suggest abstinence from SSBs may not be helpful in reducing consumption., 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 © 2022 Haynes-Maslow, Ray and Giombi.)

Work in agriculture is a significant area of research that highlights the problem of the integration of young people in the former, in particular, in the recent period. Work in agriculture is hard and not prestigious, and young people tend to leave rural areas in the search for alternative activities in urban areas. The study addresses the problem of how the youth should be integrated into agricultural workforce by focusing on identification of the reasons behind the (un)willingness to work in agriculture. The aim of the study is to assess the reasons behind the youth's (un)willingness of work in agriculture, using Lithuania as the case study. The data were collected by means of a questionnaire designed to investigate the perception and opinions toward work in agriculture. The Binary Logistic Regression was used to identify the factors affecting the youth's opinion about (un)willingness to work in agriculture. The study analyzed 430 young people 's responses to the questionnaires survey. The BLR has revealed that youth's unwillingness to work in agriculture is mostly affected by gender, area of residence and youths' beliefs that work in agriculture does not provide any opportunities for self-realization. In summary, this paper argues that the major motivation to work in agriculture is associated with having parents who are engaged in agricultural activities, love of animals and natural environment, and the availability of specialized training. The findings have confirmed the need to attract young people to work in agriculture. Its results are necessary for the scientific community, policy makers, farmers, and practitioners exploring the possibilities for integration of the youth into the agricultural workforce., 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 © 2022 Girdziute, Besuspariene, Nausediene, Novikova, Leppala and Jakob.)

Background: The Canada's Food Guide (CFG) is recognized as the most prominent authoritative guideline for healthy eating in Canada. In 2019, Health Canada released the latest iteration of the CFG with substantial changes to its messaging and format from the previous 2007 CFG., Objective: This study compared the awareness, use, knowledge, and opinions of the 2007 and 2019 CFGs among parents with children aged 18 months to 5 years who are participants in a family-based intervention trial, the Guelph Family Health Study., Methods: The sample consisted of 327 parents (59% women) who responded to questions about the 2007 CFG and 177 parents (60% women) who responded to questions about the 2019 CFG. Parents' awareness and knowledge of the 2007 and 2019 CFGs were compared using Pearson's Chi-Square, while parents' opinions of the two CFGs were compared using Wilcoxon Rank-Sum tests. To describe and provide context about how parents used the 2007 and 2019 CFG descriptive analysis was used. To analyze the open-answer comments parents provided for the 2007 and 2019 CFGs thematic coding was used., Results: Awareness of the 2007 and 2019 CFGs was high with 94.5 and 90.4% of parents reported having heard about the 2007 and 2019 CFGs, respectively. Knowledge of the plate proportion recommendations in the 2019 CFG was significantly higher than knowledge of the recommended number of servings in the 2007 CFG with 93.4% of parents identifying the Vegetable and Fruit Plate Proportions in the 2019 CFG. Parents identified that the 2019 CFG was a helpful and trustworthy resource, and that it was easier to follow and understand, and more representative of their culture and traditional foods than the 2007 CFG., Conclusion: Our results suggest that parents' knowledge of the 2019 CFG recommendations was higher than for the 2007 CFG recommendations. Parents also had more positive opinions about the 2019 CFG as compared to the 2007 CFG. Future research is needed to explore whether these higher levels knowledge of the 2019 CFG recommendation translate to healthier eating patterns among Canadian families., 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 © 2022 Ramuscak, Ma, Forbes, Duncan, Sadowski and Haines.)

Objectives: This study was conducted to evaluate COVID-19 vaccine booster dose willingness and identify predictors and factors of willingness and hesitance in the vaccinated population of Pakistan., Methods: A cross-sectional web-based survey was undertaken between January and February 2022 to highlight the public perceptions regarding the COVID-19 booster dose and evaluate the willingness to get the additional dose. Demographic information and booster dose willingness were recorded through the questionnaire. Additionally, a 5-point Likert scale was employed to explore fears and beliefs regarding COVID-19 vaccinations. Univariate and multivariate regression was performed to identify booster dose willingness and hesitance factors., Results: Of the 787 respondents, 69.6% were females, 75.3% fell in the 18-30 years age group, 53.5% were university students or had a Bachelor's degree. Overall, a 77.8% booster dose willingness was reported. Participants showed absence or low fear levels associated with a booster dose (47.3%). 60.1% agreed it was safe to receive an additional vaccine dose, with 44.1% agreeing that boosters are effective against coronavirus variants. Independent predictors of willingness included the absence of comorbidities, whereas not being willing to pay for the booster dose was a predictor of hesitance., Conclusion: This study showed a suboptimal willingness level of booster dose uptake among the vaccinated Pakistani population. Public health policymakers must undertake necessary awareness campaigns to strategize vaccination drives and dispel myths., 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 © 2022 Moeed, Najeeb, Saleem, Asghar, Rafi, Khattak, Bilal and Seboka.)

Background: COVID-19 vaccination is a key public health measure to mitigate the crippling effects of the pandemic. COVID-19 vaccination began in adults and targeted adolescents at a later stage. However, medical decision-making on its uptake among the latter was unknown, which could be affected by their literacy and concerns about the vaccine. The study aimed to elucidate the awareness, concerns and barriers of adolescents toward the COVID-19 vaccine., Methods: A cross-sectional online survey using a self-developed questionnaire was conducted between June to November 2021. The adolescent participants were students from institutes of post-secondary education who were recruited via convenience sampling. The data were collated from an officially approved electronic platform, audited and analyzed. Continuous and categorical variables were expressed as mean (standard deviation) and percentages, respectively., Results: A total of 460 adolescents participated in the study (mean age: 16.99 ± 0.99; 73% female). Most of them (91.5%) were aware of the COVID-19 vaccines. The main barriers to vaccination were uncertainty about long-term health risks (38.6%) and vaccine efficacy (37.3%). Regarding the potential vaccine side effects, they were concerned about: anaphylactic shock (73.2%), low blood pressure (58.3%) and fast heartbeat (58.0%). Only 58% expressed willingness for repeated COVID-19 vaccination., Conclusion: Despite high COVID-19 vaccine awareness, the adolescents were concerned about the potentially severe but rare side-effects. The study identified apprehension regarding vaccine efficacy and the potential long-term health impact as the main barriers to vaccination. Future studies should address these concerns to scale vaccination programs among adolescents., 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 © 2022 Oka, Thia, Gunalan, Kwan, Ng, Aau, Wee and Tan.)

Background: Older adults represent the largest consumers of health care. It is, therefore, important that they receive adequate patient-centered care to empower them to be proactive in managing their health., Aims: This study examined the proportion of older community-dwelling individuals who report receiving patient-centered care during healthcare consultations., Methods: A cross-sectional study was conducted with 117 clients of an Australian aged care provider. Clients completed a survey examining their perceptions of whether they received patient-centered care (11-items) from healthcare professionals., Results: The mean number of patient-centered care items reported was 8.7 (±3.1). Speaking to the patient with respect was the item most often reported to be patient-centered (94%). Asking patients about treatment goals or expectations (62%) and how involved they would like to be in treatment (67%) were the items least reported to be patient-centered., Conclusion: Older adults perceived some important aspects of care were not provided with a patient-centered approach. There is a need to improve healthcare providers' elicitation of older patients' care preferences, enabling patients to determine their level of involvement in their health management., 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 © 2022 Hobden, Mansfield, Freund, Clapham and Sanson-Fisher.)

The COVID-19 pandemic has exerted a significant influence on university student's learning, life and mental health. Using the method of inductive content analysis, this study examined the experience and perceptions of Chinese university students regarding the COVID-19 pandemic. Eighteen university students including seven males and eleven females were involved in this study. In this study, we identified five themes concerning experience and perceptions of Chinese university students regarding the COVID-19 pandemic, that is, emotional reactions toward the COVID-19 pandemic, the influence of the COVID-19 pandemic on the participant's learning, the influence of the COVID-19 pandemic on the participant's daily life, participants' positive responses to the COVID-19 pandemic, and China's moves toward the COVID-19 pandemic. This study elaborated on experience and perceptions of Chinese university students regarding the COVID-19 pandemic, which would provide us a better understanding of how university students perceive the COVID-19 pandemic and to what extent the COVID-19 pandemic has influenced their learning and daily lives., 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 © 2022 Wu, Yin and Zhang.)

Medical students' perceptions of the medical school learning environment (MSLE) have an important impact on their professional development, and physical and mental health. Few studies reported potential factors that influenced medical students' perceptions of MSLE. Thus, the main goal of this study was to identify influencing factors for medical students' perception levels of MSLE. The perception levels of MSLE were assessed by the Johns Hopkins Learning Environment Scale. The univariate and multivariate logistic regression analyses were performed to identify significant predictors for the perceptions of MSLE. The nomograms were established to predict medical students' perception levels of MSLE. In the multivariate logistic regression model, gender, university category, grade, mother education level, learning environment of schools, interests in medicine, and Kolb learning experience were significantly associated with medical students' perceptions of MSLE. Correspondently, the nomograms were built based on significant variables identified by the univariate logistic regression analysis. The validation of the nomograms showed that the model had promising predictive accuracy, discrimination, and accordance (area under the curve (AUC) = 0.751). This study identified influencing factors of medical students' perceptions of MSLE. It is essential to implement corresponding interventions to improve medical students' perceptions., 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 © 2022 Zhou, Huang, Zhang, Gong, Xian, Yin, Meng, Wang, Wang, Chen, Zhang, Du, Lin, Liu, Lin, Ji, Wu, Huang and Zhang.)

University students represent a highly active group in terms of their social activity in the community and in the propagation of information on social media. We aimed to map the knowledge, attitudes, and perceptions of University students in Cyprus about severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and Coronavirus disease 2019 (COVID-19) to guide targeted future measures and information campaigns. We used a cross-sectional online survey targeting all students in conventional, not distance-learning, programs in five major universities in the Republic of Cyprus. Students were invited to participate through the respective Studies and Student Welfare Office of each institution. The survey was made available in English and Greek on REDCap. Participation was voluntary and anonymous. The questionnaire was developed based on a consensus to cover the main factual information directed by official channels toward the general public in Cyprus at the time of the survey. In addition to sociodemographic information ( N = 8), the self-administered questionnaire consisted of 19 questions, assessing the knowledge regarding the characteristics of SARS-CoV-2 and COVID-19, infection prevention and control measures ( N = 10), perceptions related to COVID-19, for instance, whether strict travel measures are necessary ( N = 4), and attitudes toward a hypothetical person infected ( N = 2). Furthermore, participants were asked to provide their own assessment of their knowledge about COVID-19 and specifically with regard to the main symptoms and ways of transmission ( N = 3). The number of students who completed the survey was 3,641 (41% studying Health/Life Sciences). Amongst them, 68.8% responded correctly to at least 60% of knowledge-related questions. Misconceptions were identified in 30%. Only 29.1% expressed a positive attitude toward a hypothetical person with COVID-19 without projecting judgment (9.2%) or blame (38%). Odds of expressing a positive attitude increased by 18% (95% CI 13-24%; p < 0.001) per unit increase in knowledge. Postgraduate level education was predictive of better knowledge (odds ratio (OR) 1.81; 95% CI 1.34-2.46; p < 0.001 among doctoral students] and positive attitude [OR 1.35; 95% CI 1.01-1.80; p = 0.04). In this study, we show that specific knowledge gaps and misconceptions exist among University students about SARS-CoV-2 and COVID-19 and their prevalence is associated with negative attitudes toward people with COVID-19. Our findings highlight the integrated nature of knowledge and attitude and suggest that improvements to the former could contribute to improvements in the latter., 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 © 2021 Middleton, Tsioutis, Kolokotroni, Heraclides, Theodosis-Nobelos, Mamais, Pantelidou, Tsaltas, Christaki, Nikolopoulos and Dietis.)

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose© software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency., 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 © 2021 Ky-Zerbo, Desclaux, Kouadio, Rouveau, Vautier, Sow, Camara, Boye, Pourette, Sidibé, Maheu-Giroux and Larmarange.)

Introduction: Older adults have the poorest coronavirus (COVID-19) prognosis with the highest risk of death due to complications, making their COVID-19 experiences particularly important. Guided by the stress-appraisal-coping theoretical model, we sought to understand COVID-related perceptions and behaviors of older adults residing in the United States. Materials and Methods: We used convenience sampling to recruit persons with the following inclusion criteria: Aged ≥ 65 years, English fluency, and U.S. residency. Semi structured in-depth interviews were conducted remotely and audio recorded between April 25, 2020 and May 7, 2020. Interviews were professionally transcribed with a final study sample of 43. A low-inference qualitative descriptive design was used to provide a situated understanding of participants' life experiences using their naturalistic expressions. Results: The mean age of participants was 72.4 ± 6.7. Slightly over half were female (55.8%), 90.6% were White, and 18.6% lived alone. The largest percentages of participants resided in a rural area (27.9%) or small city (25.6%). We identified four themes, including (1) risk perception, (2) financial impact, (3) coping, and (4) emotions. Most participants were aware of their greater risk for poor COVID-19 outcomes but many did not believe in their increased risk. Financial circumstances because of the pandemic varied with largely no financial impacts, while others reported negative impacts and a few reported positive impacts. Coping was problem- and emotion-focused. Problem-focused coping included precautionary efforts and emotion-focused coping included creating daily structure, pursuing new and/or creative activities, connecting with others in new ways, and minimizing news media exposure. Overall, emotional health was negatively affected by the pandemic although some participants reported positive emotional experiences. Conclusions: Perceiving themselves as high risk for COVID-19 complications, older adults used precautionary measures to protect themselves from contracting the virus. The precautionary measures included social isolation, which can negatively affect mental health. Older adults will need to be resourceful and draw on existing resources to cope, such as engaging in creative activities and new strategies to connect with others. Our findings underscore the importance of the preservation of mental health during extended periods of isolation by taking advantage of low-to-no-cost existing resources., 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 © 2021 Goins, Anderson, Minick and Daniels.)

Background: School closures have inevitably deprived students of their traditional source of information. The objective of this study was to determine knowledge, attitudes, and safety practices about COVID-19 among high school students in Iran. Methods: This study was conducted from March 24th-April 3rd, 2020. Data were collected via an online-parent-administrative questionnaire. Results: Responses of 704 students were analyzed. Students' mean (SD) knowledge score was 21.5 (4.6) of 30. More than 90% of students knew about the cause of the disease, the routes of transmission, and the most renowned symptoms: dyspnea and cough. Social-and- audiovisual-media were the leading information source. Most students believed that people need to keep safe physical distancing, everyone should isolate themselves upon symptoms onset, people should avoid unnecessary in-person contact with family and friends, and that cities need to go under lockdowns if needed. Students' mean (SD) practice score was 20.2 (2.5) of 24. Most students did not go on a trip, and more than 80% said they would wear facemasks when going outside. Conclusions: High school students' knowledge and safety practices about COVID-19 were somewhat satisfactory, and their attitudes toward the disease were mainly positive. Nevertheless, some witnessed knowledge gaps, negative attitudes, and unsafe practices in the study highlighted the need for targeted education on the pandemic. Social and mass media's significant role and potential could be utilized to battle misinformation and deliver proper knowledge to young adolescents., 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 © 2021 Hatami, Abbasi-Kangevari, Malekpour and Kolahi.)

Background: Adolescent population face a number of health concerns which calls for objective and comprehensive assessment of their wellness during their critical development phase. This study aimed to determine adolescent wellness and its predictors amongst adolescents in secondary schools in Fiji. Methods: This quantitative cross sectional study was conducted in four purposively selected schools in Suva and the greater Suva area, Fiji, between August and September, 2019. Students of Fijian nationality, enrolled into years 11-13 in the selected schools were purposively selected. A structured self-administered questionnaire was used to collect data on four dimensions of wellness including physical, emotional, social, and spiritual. Spearman's Rho correlation was conducted to test for associations. Descriptive and inferential statistical tests were applied to analyze the data by the SPSS software version 25. A p -value < 0.05 was considered significant. Results: A total of 350 students participated in the study. Mean raw scores for wellness dimensions were as follows: physical = 51 (out of 60), psychological = 63 (out of 80), social = 42 (out of 50), and spiritual = 34 (out of 40). For overall wellness, two significant differences were observed: students of Fijian Itaukei descent (193.68 ± 14.2) and participants with a family income of $40,000-50,000 (199.08 ± 12.60) ( p = 0.04) had a higher overall wellness score. There were three significant differences observed for psychological wellness dimension; Fijians of Indian descent (64.68 ± 9.30), participants enrolled into year 13 (64.68 ± 9.30) and those with a family income of $40,000-50,000 had higher psychological score. For social wellness, a significant difference was observed: Itaukei participants had higher scores (43.34 ± 4.42) when compared to other ethnic groups ( p < 0.05). In terms of spiritual wellness, a significant difference was observed for ethnicity: Itaukei participants had a higher mean score (35.59 ± 4.26) when compared to other ethnic groups ( p < 0.05). Strong correlations were observed for all dimensions of wellness. Conclusions: Findings of this study highlighted different factors affecting adolescents' wellness in Fiji. It is recommended that health education and awareness program be carried out for developing adolescent wellness by considering these factors. It is also recommended that parental and family support are provided to adolescents., 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 © 2021 Odrovakavula, Mohammadnezhad and Khan.)

Background: Containment of the coronavirus pandemic relied extensively on the combination of early implementation of quarantine and massive behavioral changes to ensure effectiveness. Decision-makers need to constantly monitor the outbreak situation and the impact of the measures implemented. Yet little is known about the factors influencing adherence and understanding of lockdown measures among the Palestinian community. This study aimed to assess the impact and factors affecting these early public health interventions. Materials and Methods: A cross-sectional web-based questionnaire was distributed throughout social media (Facebook and Instagram). We used a snowball recruiting technique to target Palestinian adult citizens during the coronavirus pandemic quarantine between 6 and 16 April 2020, which corresponded to almost the middle interval of the strict massive lockdown measures in Palestine that lasted from 22 March to 5 May 2020. Multivariate logistic regression models were developed for the outcome variables (staying home adherence, in-home precautions adherence, and quarantine understanding). Results: Our questionnaire was completed by 2,819 participants. The mean (range) age was 29.47 (18-71) years. Of them, 1,144 (40.6%), 1,261 (44.7%), and 1,283 (45.5%) reported low levels of staying home adherence, in-home precautions adherence, and quarantine understanding, respectively. Females, city residents, those with higher educational levels, and those informed by official government sources were associated significantly with higher levels of both staying home adherence and quarantine understanding. Adequate food supply was associated with a higher level of staying home adherence. Higher levels of in-home precautions adherence were noticed in the elderly and those with a high-risk group living at home. Higher monthly income was inversely associated with higher levels of in-home precautions adherence and lower levels of quarantine understanding ( P < 0.05). Conclusions: The socio-economic and financial status of the general population and coordination between the major information resources (official government), social media, and the press were the major factors affecting the community in regard to quarantine adherence. For maximum effectiveness and commitment levels amongst the people to decrease the spread of infection, policymakers need to address all those factors. In addition, clear communication between policymakers and the population is essential for reassuring the people and minimizing their fears regarding the unknown future., 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. The reviewer MA declared a shared affiliation with the authors to the handling editor at time of review., (Copyright © 2021 Al Zabadi, Yaseen, Alhroub and Haj-Yahya.)