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OBJECTIVE: Internally displaced persons (IDPs) can have limited access to HIV and hepatitis C Virus (HCV) treatment and prevention. IDPs comprise > 7% of Georgian population but prevalence and levels of HIV and HCV knowledge in this population remain unknown. We tested 100 IDPs in Georgia for HIV and HCV, many of whom had drug injecting experience, and interviewed them about their migration experience, sexual and drug injecting practices, and HIV/HCV transmission knowledge. RESULTS: The average age of participants was 37.5 years (range 18-63); 31% were women. Almost half (N = 48) of participants reported ever injecting drugs; 17% of those (N = 8) started injecting drugs within the last year. Anti-HCV and HIV prevalence was 11% and 0%, respectively. Fewer people without drug use experience compared to people who inject drugs correctly answered all questions on the HIV knowledge test (13% vs. 35%, p = 0.015) or knew where to get tested for HIV (67% vs 98%, p

BACKGROUND: Middle age is increasingly acknowledged as a critical window for prevention of Alzheimers disease and related dementia (ADRD) since research has shown that AD develops in the course of 20-30 years (1) but we know very little about middle-aged individuals perspectives on ADRD. Knowledge gaps are particularly large for Latinas living in regions typically underrepresented in ADRD research, such as rural and/or agricultural regions. This is important given that over the next 40 years Latinos are projected to have the largest increase in ADRD cases in the U.S. Therefore, this study aims to assess knowledge, perceptions, and feelings associated with ADRD among a sample of middle-age, Spanish-speaking Latina women. METHOD: Using qualitative methods involving semi-structured interviews, we examined knowledge, perceptions, and feelings associated with ADRD among a subsample of the Center for Health Assessment of Mothers and Children of Salinas (CHAMACOS) study. Participants are Latina women residing in an underserved agricultural community entering mid-life (mean = 46.5 years old). Interviews were conducted with 20 women and data was analyzed with inductive thematic content analysis. RESULTS: We identified themes regarding perceptions, knowledge, and feelings. First, participants perceive ADRD as involving (1) Loss of memory, (2) Getting lost; (3) Losing the person they once were. With regard to knowledge about ADRD, participants reported: (1) Some knowledge about protective and risk factors for ADRD, (2) No awareness of the links between cardiovascular risk factors and ADRD; (3) A desire to learn prevention methods alongside signs and symptoms of ADRD. Themes related to feelings about ADRD were: (1) Fear of developing ADRD and not being aware of reality or who they are; (2) Worry about losing relationships with loved ones and caretaking if diagnosed with ADRD; (3) Sadness about forgetting ones family and depending on others if diagnosed with ADRD. CONCLUSION: The knowledge gaps and negative feelings associated with ADRD highlighted in this study underscore the need for ADRD interventions to include CVD prevention, particularly for mid-life Latino populations residing in rural regions.

INTRODUCTION: The goal of our research programme is to develop culturally appropriate patient-specific interventions for primary and secondary prevention of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) among people living with HIV (PLWH); PLWH are at a higher risk for OPC than the general population and, as with many cancers, there are disparities in OPC health outcomes by race and ethnicity. Our study incorporates an anti-racist research framework that proposes considering racism as a foundational sociocultural system that causes ill health. We expand the framework to include biases due to gender, sexual orientation, HIV status and membership in other non-dominant groups. Our research programme focuses on HPV-related OPC among people living with PLWH, and on how intersecting identities may impact an individuals experience with oral health, obtaining regular and appropriate oral healthcare, knowledge and perceptions of oral HPV infection, risk factors for OPC and HPV vaccination. METHODS AND ANALYSIS: We will follow a grounded theory (GT) qualitative research methodology using focus group discussions (FGDs) to collect data. We will invite PLWH with intersecting identities to participate in one of 12-18 FGDs with 5-8 participants per group. Focus groups will be formed based on self-reported domains, including race, ethnicity, gender identity, sexual orientation and other identities that could impact oral health, such as smoking status, experience with homelessness or experience with drug use disorders. We do not know which aspects of intersecting identities are most salient to accessing oral healthcare. Using FGDs will allow us to gain this knowledge in a setting where participants can build on and reinforce shared understandings about oral healthcare. Following our GT methodology, analysis will occur concurrently with data collection, and emerging concepts or theories may result in changes to focus group guide questions. Initial focus group questions will be organised around our main objectives: (1) to identify individual, interpersonal and structural health equity factors that serve as barriers or facilitators to oral health status and care; (2) to explore knowledge and perceptions about causes, risk factors, prevention and screening for oral or OPC and (3) to elicit recommendations for improving access to regular and appropriate oral healthcare and suggestions on engaging PLWH from diverse identity groups in prevention interventions. ETHICS AND DISSEMINATION: All methods and procedures were approved by the University of California, San Francisco, Institutional Review Board (approval number: 23-39307) and are in accordance with the Declaration of Helsinki of 1975, as revised in 2000. Participants are required to provide informed consent. The results of this study will be presented at scholarly meetings and published in peer-reviewed journals. In addition, a lay summary of results will be created and distributed to our participants and community through our website and social media. TRIAL REGISTRATION NUMBER: NCT06055868.

Researchers have studied human perception-action systems during interceptive tasks in real or virtual situations. Training and practice may enhance perception and action in dynamic gap interception tasks like crossing a road. For relevant studies, we thoroughly searched PubMed, PsycINFO, ScienceDirect, ResearchGate, and SPORTDiscus. We reviewed and summarized research to determine how task-specific practice, exercise, and sports experience affect perception-action capacities when intercepting a moving gap. Specifically, we examined how sports experience influences perception-action coupling in street crossing. Task-specific and sports skills may improve perception-action in everyday activities. Hence, task-specific practice and perception-action coupling in sports may increase perceptual-motor skills for dynamic gap interception tasks. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prostate cancer mortality rates are high in Nigeria. While prostate cancer is highly curable with early detection and effective multidisciplinary management, the quality of care is suboptimal in this setting. Sustainable delivery of high-quality care for patients with localized prostate cancer is needed to save more lives. To inform future interventions to improve care, this study aimed to identify barriers and facilitators that influence prostate cancer detection and management in Nigeria. METHODS: Six focus group discussions (FGDs), stratified by stakeholders were conducted with a purposive sample of prostate cancer patients (n = 19), caregivers (n = 15), and healthcare providers (n = 18), in two academic tertiary hospitals in northern and southern Nigeria. A discussion guide organized based on the socio-ecological model was used. FGDs were recorded, transcribed, and analysed using the framework technique. RESULTS: Barriers and facilitators were identified at the individual, interpersonal, and organizational levels. Barriers to detection included limited knowledge and misperceptions among patients, caregivers, and community-based non-specialist healthcare providers, and limitations of centralized opportunistic screening; while facilitators included the potential for religious institutions to encourage positive health-seeking behaviour. Barriers to management included non-uniformity in clinical guideline usage, treatment abandonment amidst concerns about treatment and survival, absence of patient interaction platforms and follow-up support systems, difficulty in navigating service areas, low health insurance coverage and limited financial resource of patients. Facilitators of management included the availability of resource stratified guidelines for prostate cancer management and the availability of patient peers, caregivers, nurses, and medical social workers to provide correct medical information and support patient-centred services. Participants also provided suggestions that could help improve prostate cancer detection and management in Nigeria. CONCLUSION: This study identified multiple determinants affecting the detection and management of localized prostate cancer. These findings will inform the refinement of implementation strategies to improve the quality of prostate cancer care in Nigeria.

Ongoing education on sexual health and other health promotion topics is critical as young people transition into adulthood. A booster round of education may be an effective strategy to reinforce information previously taught and expand to additional topics relevant later in adolescence. In partnership with a Youth Advisory Council, we co-designed READY, Set, Go!, a booster curriculum for older adolescents with modules covering adult preparation skills, sexual identity, relationships, reproductive health, and mental health. From November 2021 to January 2023, we provided the curriculum to 21 cohorts of 12th grade students (N = 433) in rural communities of Fresno County, CA, and conducted an implementation evaluation to assess its feasibility in school settings, acceptability by participants, and changes in short-term outcomes. Health educators completed implementation logs to track program adaptations. Youth completed pretest/posttest surveys to assess changes in outcomes and participant satisfaction. We used descriptive statistics to examine program adaptations and satisfaction. We used multivariable regression models to examine changes in outcomes, adjusted for sociodemographic characteristics. Health educators completed most activities as planned, with adaptations occurring in response to youth needs and scheduling limitations. Sexual health knowledge, confidence in adult preparation skills, awareness of local sexual and mental health services, and willingness to seek health services all increased significantly from pretest to posttest. Youth feedback was strongly positive. We conclude that booster sexual health education is a promising strategy to address critical knowledge gaps and support health promotion, especially in rural and other under-resourced communities.

The aim of this project was to increase willingness to receive the influenza vaccine to the optimal rate of ≥ 70%. Low acuity adult patients who visited an Emergency Department (ED) were assessed regarding their willingness to receive the influenza vaccine before and after an educational intervention that included a provider recommendation and an educational handout. A total of seventy-six patients (n = 76) were assessed. Patients willingness to receive the influenza vaccine rose from 29% pre-intervention to 72% post-intervention without disrupting the clinical flow in a busy ED. Similar vaccine educational strategies can be applied to influenza and other vaccines in EDs  to increase vaccination willingness in patients, including those who use the ED as a primary point of contact for healthcare, decreasing the burden of influenza illness in the community.

BackgroundCervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites.MethodsHPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score.ResultsAmong the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p

Working memory, the process through which information is transiently maintained and manipulated over a brief period, is essential for most cognitive functions1-4. However, the mechanisms underlying the generation and evolution of working-memory neuronal representations at the population level over long timescales remain unclear. Here, to identify these mechanisms, we trained head-fixed mice to perform an olfactory delayed-association task in which the mice made decisions depending on the sequential identity of two odours separated by a 5 s delay. Optogenetic inhibition of secondary motor neurons during the late-delay and choice epochs strongly impaired the task performance of the mice. Mesoscopic calcium imaging of large neuronal populations of the secondary motor cortex (M2), retrosplenial cortex (RSA) and primary motor cortex (M1) showed that many late-delay-epoch-selective neurons emerged in M2 as the mice learned the task. Working-memory late-delay decoding accuracy substantially improved in the M2, but not in the M1 or RSA, as the mice became experts. During the early expert phase, working-memory representations during the late-delay epoch drifted across days, while the stimulus and choice representations stabilized. In contrast to single-plane layer 2/3 (L2/3) imaging, simultaneous volumetric calcium imaging of up to 73,307 M2 neurons, which included superficial L5 neurons, also revealed stabilization of late-delay working-memory representations with continued practice. Thus, delay- and choice-related activities that are essential for working-memory performance drift during learning and stabilize only after several days of expert performance.

As behavioural science is increasingly adopted by organizations, there is a growing need to assess the robustness and transferability of empirical findings. Here, we investigate the transferability of insights from various sources of behavioural science knowledge to field settings. Across three pre-registered randomized controlled trials (RCTs, N = 314,824) involving a critical policy domain-COVID-19 booster uptake-we field tested text-based interventions that either increased vaccinations in prior field work (RCT1, NCT05586204), elevated vaccination intentions in an online study (RCT2, NCT05586178) or were favoured by scientists and non-experts (RCT3, NCT05586165). Despite repeated exposure to COVID-19 vaccination messaging in our population, reminders and psychological ownership language increased booster uptake, replicating prior findings. However, strategies deemed effective by prediction or intention surveys, such as encouraging the bundling of COVID-19 boosters and flu shots or addressing misconceptions, yielded no detectable benefits over simple reminders. These findings underscore the importance of testing interventions transferability to real-world settings.

BACKGROUND: Following a breast cancer diagnosis, it is uncertain whether womens breast density knowledge influences their willingness to undergo pre-operative imaging to detect additional cancer in their breasts. We evaluated womens breast density knowledge and their willingness to delay treatment for pre-operative testing. METHODS: We surveyed women identified in the Breast Cancer Surveillance Consortium aged ≥ 18 years, with first breast cancer diagnosed within the prior 6-18 months, who had at least one breast density measurement within the 5 years prior to their diagnosis. We assessed womens breast density knowledge and correlates of willingness to delay treatment for 6 or more weeks for pre-operative imaging via logistic regression. RESULTS: Survey participation was 28.3% (969/3,430). Seventy-two percent (469/647) of women with dense and 11% (34/322) with non-dense breasts correctly knew their density (p

PURPOSE: Little is known about the shared decision-making (SDM) needs, barriers, and facilitators of patients with newly diagnosed advanced cancer in the hospital. Understanding this may improve SDM and cancer care quality in this vulnerable population. METHODS: A single-site, mixed-methods study of hospitalized patients with newly diagnosed advanced cancer, caregivers, and oncologists was conducted. After discharge, patient ± caregiver semi-structured interviews exploring SDM needs, barriers, and facilitators regarding their most important upcoming cancer-related decision were conducted. Oncologists were surveyed about patient knowledge and SDM needs using closed- and open-ended questions, respectively. Thematic analysis was performed for qualitative data with a focus on themes unique to or amplified by hospitalization. Descriptive statistics and the Chi-squared test were performed for quantitative data. RESULTS: Patients and caregivers reported high SDM needs surrounding treatment and prognostic information, leading to decisional conflict. Eight themes emerged: anticipated cancer treatment decisions, variable control preferences in decision-making, high cancer-related information needs and uncertainty, barriers and facilitators to information gathering during and post hospitalization, and decision-making facilitators. Among 32 oncologists, most (56%) reported patients were poorly informed about treatment and prognosis. Oncologists reported variable expectations about patient knowledge after hospitalization, facilitators to patient decision-making, and patient uncertainty while awaiting an outpatient oncologist appointment. CONCLUSION: Patients newly diagnosed with advanced cancer in the hospital have high SDM needs and experience decisional conflict. This may be due to barriers unique to or exacerbated by hospitalization. Further research is needed to develop strategies to address these barriers and enhance the facilitators identified in this study.

Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'V: ways of thinking-honing the therapeutic self', authors present the following sections: 'Reflective practice in action', 'The doctor as drug-Balint groups', 'Cultivating compassion', 'Towards a humanistic approach to doctoring', 'Intimacy in family medicine', 'The many faces of suffering', 'Transcending suffering' and 'The power of listening to stories.' May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.

KEY POINTS: In one hospital-based safety-net dialysis unit, only one half of patients with ESKD knew their cause of kidney failure, which did not differ by English proficiency status. Patients with limited English proficiency (versus English-proficient patients) reported poorer communication with the dialysis care team (less listening, fewer clear explanations, less time spent). We highlight the need for tailored, patient-centered communication between limited English-proficient patients and dialysis care team members. BACKGROUND: ESKD is a chronic health condition for which communication between health care teams and patients is important to guide patient self-management activities. Yet, little is known about the quality of communication among patients with ESKD and their care team members. We examined the influence of patient's limited English proficiency (LEP) status on communication experiences at one dialysis center. METHODS: A survey was administered to adults receiving ESKD care at a dialysis unit within a public health care delivery system between July 2022 and February 2023, to ascertain kidney disease knowledge and perceptions of communication quality with the dialysis care team. Multivariable logistic and ordinal logistic regression models adjusted for age and sex were used to determine associations between LEP status and CKD knowledge. RESULTS: Among 93 eligible patients, 88.2% (n=82) completed the survey. Approximately 37.8% (n=31) had LEP, mean age was 58.8 years, 68.3% were men, mean dialysis vintage was 3.9 years, and 25% had a positive depression screen (LEP 30%; English-proficient 22%). A higher proportion of English-proficient patients screened positive for limited health literacy compared to those with LEP (74.5% versus 38.7%, P = 0.002). Overall, knowledge of assigned cause of ESKD (53.4%) and CKD/transplant knowledge (57.3%) was suboptimal. After adjustment, LEP status was not significantly associated with knowing the correct cause of kidney failure (odds ratio, 0.49; 95% confidence interval, 0.19 to 1.27) but was significantly associated with having a higher score on a CKD/transplant knowledge scale (odds ratio, 3.99; 95% confidence interval, 1.66 to 9.58). Patients with LEP reported poorer communication quality with dialysis providers and staff (less listening, fewer clear explanations, less time spent with patients) compared with English-proficient patients, although differences were not statistically significant. CONCLUSIONS: Overall communication between patients with ESKD and members of the dialysis care team was suboptimal, regardless of English proficiency. Interventions to enhance communication for ESKD patients are needed.

BACKGROUND: Midlife residential exposure to greenspace may slow cognitive decline by increasing opportunities for physical activity and social connection, restoring attention, or reducing stress or adverse environmental exposures. However, prospective studies on the association between greenness and cognitive decline are sparse. OBJECTIVE: We investigated the prospective association between greenness at midlife and cognitive decline later in life. We explored effect measure modification by apolipoprotein E (APOE)-E4 carrier status, neighborhood socioeconomic status (NSES), and rural/urban regions. METHODS: The Nurses' Health Study (N = 121,700) started in 1976 with married female nurses, 30-55 years of age, located across 11 US states. We examined 16,962 nurses who were enrolled in a substudy starting in 1995-2001 (mean age = 74 y) through 2008. We assessed average summer residential greenness in a 270-m buffer using Landsat Normalized Difference Vegetation Index data from 1986-1994. Starting in 1995-2001, participants underwent up to four repeated measures of five cognitive tests. A global composite score was calculated as the average of all z-scores for each task to evaluate overall cognition. We used linear mixed models to evaluate the association of average greenness exposure at midlife with cognitive decline in later life, adjusted for age, education, NSES, and depression. RESULTS: In adjusted models, higher midlife greenness exposure [per interquartile range (IQR): 0.18] was associated with a 0.004-unit (95% CI: 0.001, 0.006) slower annual rate of cognitive decline. For comparison, we found that 1 year of age is related to a -0.006 mean annual difference for global cognition in the full sample; thus, higher midlife greenness appeared equivalent to slowing cognitive decline by ~ 8 months. In analysis exploring gene--environment interactions, we found that among APOE-E4 carriers, an IQR increase in greenness was associated with a rate of decline that was slower by 0.01 units of global composite score (95% CI: 0.0004, 0.02). This association was attenuated among APOE-E4 noncarriers. We did not observe associations between greenness and baseline or annual rate of cognitive decline of verbal memory. DISCUSSION: Higher midlife greenness exposure is associated with slower cognitive decline later in life. Future research is necessary to confirm these findings. https://doi.org/10.1289/EHP13588, Introduction Literature has suggested that Alzheimer's disease and related dementia (ADRD), the seventh leading cause of death in the United States, (1) may begin [greater than or equal to]20 y [...]

BACKGROUND: Dementia is a global public health priority. The World Health Organization adopted a Global Action Plan on Dementia, with dementia awareness a priority. This study examined the knowledge, attitudes, and self-confidence with skills required for providing dementia care among primary health care providers in Vietnam. METHODS: A cross-sectional study was conducted with 405 primary health care providers who worked at commune health stations and district health centers in eight provinces across Vietnam. RESULTS: The results showed that primary health care providers had poor knowledge and little confidence but more positive attitudes toward dementia care and management. CONCLUSIONS: The results suggest the training needs for building capacity amongst primary health care providers, which will be critical as Vietnams population ages.

BackgroundDespite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India.MethodsA pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024.ResultsMen had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community.ConclusionsMen in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. TRIAL REGISTRATION CLINICALTRIALS.GOV : 03/13/24.NCT06320964.

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) represents an important but limited treatment for patients with severe COVID-19. We assessed the effects of an educational intervention on a persons ECMO care preference and examined whether patients and providers had similar ECMO preferences. METHODS: In the Video+Survey group, patients watched an educational video about ECMOs purpose, benefits, and risks followed by an assessment of ECMO knowledge and care preferences in seven scenarios varying by hypothetical patient age, function, and comorbidities. Patients in the Survey Only group and providers didnt watch the video. Logistic regression was used to estimate the probability of agreement for each ECMO scenario between the two patient groups and then between all patients and providers. RESULTS: Video+Survey patients were more likely (64% vs. 17%; p = 0.02) to correctly answer all ECMO knowledge questions than Survey Only patients. Patients in both groups agreed that ECMO should be considered across all hypothetical scenarios, with predicted agreement above 65%. In adjusted analyses, patients and providers had similar predicted agreement for ECMO consideration across six of the seven scenarios, but patients showed greater preference (84% vs. 41%, p = 0.003) for the scenario of a functionally dependent 65-year-old with comorbidities than providers. DISCUSSION AND CONCLUSIONS: An educational video increased a persons ECMO knowledge but did not change their ECMO preferences. Clinicians were less likely than patients to recommend ECMO for older adults, so advanced care planning discussion between patients and providers about treatment options in critically ill patients with COVID-19 is critical.

BackgroundDelivering methadone treatment in community health facilities by primary care providers is a task-shifting strategy to expand access to drug use treatment, especially in rural mountainous areas. This study aims to investigate factors related to confidence in providing methadone treatment among primary care providers in Vietnam to inform good practice development.MethodsWe conducted a cross-sectional survey with 276 primary care providers who were physicians, physician assistants, nurses, pharmacists or dispensing staff from 67 communes in a mountainous province in Northern Vietnam. Using self-report scales, we measured providers' confidence in providing methadone treatment, beliefs in harm reduction, perceived work-related support, perceived stigma and risk in working with drug-using patients, and empathy towards this population. We used multiple linear regression analyses to explore factors associated with providers' confidence in providing methadone treatment in the whole sample and to compare two groups of providers who did and did not have experience providing methadone. Potential associated factors were measured at facility and provider levels.Result114 (41.3%) participants had previously experience in providing methadone treatment. Providers with methadone treatment experiences had higher confidence in and more accurate knowledge of methadone treatment, perceived less stigma of working with drug-using patients, and reported more work-related support than those without experiences. Higher medical education is associated with lower confidence in providing methadone treatment among providers without methadone experiences, but higher confidence among providers with methadone experiences. Better methadone knowledge was associated with greater confidence in providing methadone treatment among inexperienced providers but not among those with experiences. Receiving work-related support was associated with greater confidence in providing treatment in both groups, regardless of their past methadone experiences.ConclusionIn rural provinces where methadone treatment has been expanded to primary care clinics, interventions to improve primary care providers' confidence should benefit professionals with diverse experiences in providing methadone treatment. Continued training and support at work for providers is essential to ensuring quality in decentralized methadone treatment.

Background: Currently, the popularity of female genital cosmetic procedures is on the rise worldwide. Despite the multiple roles of healthcare practitioners at different stages of women's decision-making for these procedures, limited studies have been conducted in this area. This systematic review aimed to summarize the available qualitative and quantitative data from observational studies that investigated healthcare practitioners' knowledge, attitudes and practices regarding female genital cosmetic procedures. Method: The present systematic review was performed based on PRISMA guidelines. All published studies that examined the knowledge, attitudes and practices of healthcare practitioners regarding female genital cosmetic procedures were included. PubMed/Medline, Scopus, Web-of-science, ScienceDirect and Google Scholar were searched using related keywords until 30 November 2023. Quality assessment was performed using the Appraisal Tool for Cross-Sectional Studies and Checklist for Qualitative Research from the Joanna Briggs Institute. Results: Eight studies comprising 2063 healthcare practitioners met the inclusion criteria and were analysed. Based on the results, some healthcare practitioners in the included studies acknowledged the naturalness of the variety of female genitalia, but others considered very small labia as attractive. There was little agreement on the positive effects of female genital cosmetic procedures on improving women's quality of life and sexual function in the included studies. Nearly all healthcare practitioners have seen women who had concerns about being natural of their genitalia. Meanwhile, approximately two-thirds of them had encountered women requesting female genital cosmetic procedures. Only three-quarters of healthcare practitioners felt confident in assessing the normality of genital appearance. The willingness to perform female genital cosmetic procedures was higher among male healthcare practitioners and plastic surgeons than among females and gynecologists. Conclusion: The results indicated that although a large number of healthcare practitioners had encountered women who were concerned about genitalia or requested genital cosmetic procedures, they did not have sufficient knowledge or favorable attitudes and practices in most related fields. Therefore, it is recommended to design educational interventions, formulate guidelines and make policies. [ABSTRACT FROM AUTHOR]

Effective self-management is essential for patients with heart failure, but many struggle with acquiring the necessary skills. Given the complexity of heart failure management and the importance of patient adherence to prescribed regimens, this study aims to investigate the knowledge, attitudes, and practices (KAP) concerning the prevention of heart failure recurrence among patients. A cross-sectional study was conducted at the Third People's Hospital of Yancheng City from September 1, 2023, to December 31, 2023, employing a self-administered KAP questionnaire. The study included 421 heart failure patients, of whom 230 (54.6%) were male. Median scores for knowledge, attitudes, and practices were 12.00 [10.00, 13.00] (possible range: 1–18), 20.00 [19.00, 21.00] (possible range: 5–25), and 16.00 [15.00, 17.00] (possible range: 5–22), respectively. Pearson's correlation analysis indicated a positive correlation between knowledge and attitude scores (r = 0.183, P < 0.001), as well as between knowledge and practice scores (r = 0.169, P < 0.001). A higher attitude score was significantly associated with a higher practice score (r = 0.245, P < 0.001), as supported by structural equation modelling. Multivariate logistic regression revealed that attitude score (OR = 1.238), suburban residence (OR = 2.524), monthly household income exceeding 5000 RMB (OR = 3.539), BMI less than 20 kg/m2 (OR = 2.155, P = 0.029), BMI between 20 and 24 kg/m2 (OR = 2.387), and BMI between 25 and 29 kg/m2 (OR = 4.063) were independently linked to proactive practices (all P < 0.05). Additionally, Structural Equation Modelling (SEM) elucidated the intricate relationship between sociodemographic factors and KAP dimensions. Despite positive attitudes and proactive prevention efforts, heart failure patients exhibit a knowledge gap. Tailored educational interventions by healthcare providers could effectively bridge this gap, leveraging patients' positive attitudes and proactive behaviours to reinforce preventive measures. [ABSTRACT FROM AUTHOR]

The Response Time Concealed Information Test can reveal that a person recognizes a relevant item (probe, e.g., a murder weapon) among other, irrelevant items (controls), based on slower responses to the probe compared to the controls. A previous study (Lukács, 2022, JARMAC) analyzed the data of 14 experiments and demonstrated that classification accuracy is increased by increased test length (i.e., increased number of trials included in the analysis). However, that study left the important question open whether prior practice (whose trials are not included in the analysis) influences the classification accuracy of subsequent testing (i.e., subsequent trials included in the analysis). Reanalyzing the same data from the 14 experiments (comprising 2223 individual tests), we show that different sections of the test (each with the same number of trials), such as the first and second half of each examined test, do not differ substantially in their classification accuracy. The main implications for real‐life application are that, at least up to about 600 trials, prior practice does not affect subsequent tests' results, and the number of examined relevant items or their order of presentation may be freely chosen without compromising the method's validity. [ABSTRACT FROM AUTHOR]

Despite commitment to the values of one school for all in Norway, there has been an increasing number of segregated units for students with special educational needs (SEN) over the years, highlighting a discrepancy between legislative intentions and the practical implementation of inclusive education. Barriers to inclusion can emerge in any setting, especially when there is a lack of a shared understanding of inclusion and inclusive education within legislative frameworks. This study investigates how the new Norwegian Education Act (EA) could constrain and facilitate inclusive education practices for students with SEN by analysing the EA and its preparatory documents through the lens of Theory of Practice Architectures (TPA). The findings indicate that the EA promotes a discourse consistent with a broad definition of inclusion. The enhanced focus on students’ democratic rights to be involved in decision-making aligns with the values of the Nordic model of education. However, the broad definition of inclusion, the ambiguous concept of students with SEN, the reduced emphasis on SEN in legislation and the endorsement of alternative educational settings in preparatory work could exacerbate the segregation of students with SEN, thus undermining the fundamental values of the Nordic educational model. [ABSTRACT FROM AUTHOR]

Background: The Stroop task was used to investigate differences in cognitive function between Long COVID (LC), Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and healthy control subjects. Methods: Subjects viewed four color words or neutral (XXXX) stimuli with the same (congruent) or different color ink (incongruent). Cognitive conflict was inferred from response times for pairings of prestimuli and subsequent stimuli. Overall effects were assessed by univariate analysis with time courses determined for binned response times. Results: LC and ME/CFS had significantly longer response times than controls indicating cognitive dysfunction. Initial response times were ranked LC > ME > HC, and decreased according to power functions. At the end of the task (900s), times were ranked LC = ME > HC. Response times were significantly slower for stimuli following an incongruent prestimulus. Time series for Stroop effect, facilitation, interference, surprise index and practice power law parameters were generally similar in LC, ME/CFS and HC suggesting comparable patterns for recruitment of cognitive resources. The prestimulus data were analyzed and generated positive Stroop and interference effects that were distinct from stimulus effects. Conclusion: LC and ME/CFS have global slowing of response times that cannot be overcome by practice suggesting impaired communications between network nodes during problem solving. Analysis of matched prestimulus – stimulus effects adds a new dimension for understanding cognitive conflict. Brief Summary: Cognitive dysfunction in Long COVID and ME/CFS was demonstrated using the Stroop task which found global slowing of response times and limitations of practice effects. [ABSTRACT FROM AUTHOR]

Background: Hepatitis virus infection remains a serious public health concern worldwide. Percutaneous, mucosal, or non-intact skin exposure to infectious blood, semen, and other body fluids are the major routes of infection in endemic areas, including Ethiopia, where little is known about the community's knowledge, attitudes, and practice toward hepatitis infection. Thus, this study aimed to determine the knowledge, attitude, and practices towards hepatitis infection among adults in Gondar town. Methods: A community-based cross-sectional study was conducted from July to August 2021 on a total of 390 participants. Proportional sample allocation was used in 3 randomly selected sub-cities. Then, study participants from randomly selected households were recruited by using a systematic random sampling technique. Socio-demographic data and questions regarding KAP were collected via a self-administered and interviewer-administered questionnaire. Statistical analysis was performed using SPSS version 20. Logistic regression analyses were used to identify the associated factors and a p-value < 0.05 was considered statistically significant. Results: The mean age of the study participants was 30 ± 8.43 years and more than half ½ (53.3%) ranged from 26 to 40 years old. In this study, 335 (85.9%) of study participants had poor knowledge about hepatitis infection. About 344 (88.2%) had a negative attitude toward hepatitis infections, and 344 (88.2%) of the participants had a poor practice to prevent hepatitis infections. Multivariate analysis affirmed that having vaccination for hepatitis infection was significantly associated with a positive attitude (AOR, with 95% CI: 2.135 (1.006–4.532) and good practice levels (AOR, with 95% CI: 22.623 (0.032–0.156). Conclusions and recommendations: In this study majority of the participants have poor knowledge, attitudes, and practices toward hepatitis infection. Therefore, targeted community-based interventions are necessary. However, this study revealed that having vaccination for hepatitis infection was significantly associated with a positive attitude and good practice levels among the study participants. [ABSTRACT FROM AUTHOR]

To evaluate the knowledge, attitudes, and practices (KAP) of patients with age-related macular degeneration (AMD) regarding anti-VEGF treatment within a one-stop intravitreal injection service model. A cross-sectional study was conducted from July 1, 2023, to January 31, 2024, at the One-stop Intravitreal Injection Center at Tianjin Medical University Eye Hospital. Data were collected using a specially designed KAP questionnaire. The study successfully enrolled 493 participants. Of these, 214 (43.4%) were aged between 70 and 79 years, and 226 (45.8%) had been diagnosed with AMD for 1–3 years. The median knowledge, attitude, and practice scores were 6.00 [3.00, 8.00] (possible range: 0–9), 42.00 [37.00, 48.00] (possible range: 11–55), and 23.00 [18.00, 27.00] (possible range: 6–30), respectively. Multivariate logistic regression for practice showed that knowledge score (OR = 1.329, P < 0.001), attitude score (OR = 1.150, P < 0.001), aged 60–69 years (OR = 0.398, P = 0.022) were independently associated with proactive practice. Mediating effect significance showed that knowledge directly affected attitude (β = 0.625), knowledge (β = 0.398) and attitude (β = 0.503) directly affected practice (P < 0.001). Meanwhile, knowledge also indirectly affected practice through attitude (β = 0.315, P < 0.001). Regarding the factors impacting their selection of anti-VEGF treatment, 63.5% of patients emphasized the crucial role of its effectiveness. Additionally, over 40% of patients considered both family circumstances and insurance coverage to be highly significant in their decision-making process. This study found that patients with AMD exhibit suboptimal knowledge yet hold positive attitudes and engage actively in practices concerning anti-VEGF treatment within a one-stop intravitreal injection service model. It is recommended that healthcare providers enhance educational interventions at intravitreal injection centers to boost patient knowledge, which is likely to further improve attitudes and proactive management practices among AMD patients. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionWith the rising incidence and mortality rates of stroke, understanding the knowledge, attitudes, and practices (KAP) of patients with hyperlipidemia towards stroke is crucial for improving their health management and preventing stroke. This study aimed to investigate the KAP of patients with hyperlipidemia towards stroke.A cross-sectional study was conducted at the First Hospital of Hebei Medical University between November 2, 2023, and December 31, 2023. Demographic information and KAP scores of the participants were collected via questionnaire administration.In this study, a total of 385 patients diagnosed with hyperlipidemia were included. Among them, 211 (54.8%) were male, and 214 (55.6%) had been dealing with hyperlipidemia for less than one year. Multivariate analyses showed that age greater than or equal to 55 years (OR = 4.016, 95% CI: [2.128,7.579], p < .001) and attitude score greater than or equal to 21 (OR = 5.673, 95% CI: [3.432,9.376], p < .001) were independently associated with proactive practice. Mediation analysis showed that knowledge directly affected the attitude (β = 0.637, p = .010) and attitude directly affected the practice (β = 0.721, p = .010). Meanwhile, the direct effect of knowledge on practice was not significant (β = −0.059, p = .438), however, knowledge was found to indirectly affected practice through attitude (β = 0.459, p = .010).Our study reveals that patients with hyperlipidemia exhibit a concerning gap in their understanding of stroke, despite holding positive attitudes and displaying suboptimal preventive practices. [ABSTRACT FROM AUTHOR]

Background: Regional anesthesia (RA) can improve patient outcomes and reduce perioperative complications including deaths. Despite its benefits, RA is less utilised in low-resource settings. The purpose of this study was to assess practice and challenges related to RA in Amhara Regional Hospitals, Northwest-Ethiopia. Methods: A web- based survey was distributed among 360 anesthetists working in Amhara Regional Hospitals, Northwest-Ethiopia from November 15 - January 30, 2023. An English, semi-structure, self-administered questionnaire was disseminated by email and telegram following ethical clearance. The survey included questions about the use of RA, socio-demographic characteristics of anesthetist, types of practiced regional blocks, and barriers to perform RA. All volunteer respondents who filled online questionnaire during study period were included. The data were coded and analyzed using statistical package for social Sciences (SPSS) software-version 20. Both inferential and descriptive statistics were used to describe the results. Results: The overall response rate was 63.3% (223 out of 360 completed surveys). A total of 132 respondents (36.7%) did not provide a response, and 5 respondents (1.4%) submitted incomplete) surveys. The most frequently self-reported barriers to performing peripheral nerve blocks were a lack of equipment (regional procedure kit including block needle, ultrasound, nerve stimulator, or epidural set) 185 (82.9%), lack of knowledge 171(76.7%), lack of practical skills 112 (50.2%), and lack of drugs/medication 50 (22.4%). Conclusions: The principal findings indicate that all respondents perform spinal anaesthesia, while the practice of peripheral RA varies. Reported barriers to performing RA are related to knowledge and training, as well as a lack of equipment (there aren't enough regional procedure kits available that include an epidural set, block needle, nerve stimulator, and ultrasound). A more stringent approach with specific requirements, distinguishing between neuraxial and peripheral blocks, enhance training opportunities for peripheral nerve blocks are required in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training. Aim: To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey. Methods & Procedures: An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e‐mail lists of researchers and stakeholders. Outcomes & Results: A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia. Conclusions & Implications: The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. WHAT THIS PAPER ADDS: What is already known on the subject: Many studies confirm the importance of speech and language therapy in the non‐pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. What this paper adds to existing knowledge: This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. What are the potential or actual clinical implications of this work?: The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings. [ABSTRACT FROM AUTHOR]

There is a dearth of understanding about the international literature on military social work with active service members. This narrative review spans the literature between 1944 and 2019 in an effort to grow the international military social work knowledge base. Of the 92 countries searched, 24 produced at least one publication about military social work with active military service members. Major themes identified among the articles reviewed included: the general scope of practice, practice in mental health and trauma, practice with special populations, practice with families, interdisciplinary practice and collaboration, ethical issues and dilemmas, and education and training. [ABSTRACT FROM AUTHOR]

Despite a large amount of critical research literature, traditional examinations continue to be widely used in higher education. This article reviews recent literature in order to assess the role played by the approaches adopted by researchers in the gap between research on exams, and the way exams are used. Viviane Robinson's 'problem-based methodology' focuses on the need for researchers to engage with the challenges and priorities of practitioners. Drawing on Robinson's approach, the article investigates how the strengths and weaknesses of exams and their alternatives are framed in the literature published between 2016 and 2021. The article concludes that there is an absence of evidence about how and why practitioners make decisions about assessment. This hinders the ability of assessment researchers to appropriately connect their work with the assessment challenges practitioners face. To make a difference, assessment research needs to live in the real world; a world which, at least as far as practitioners' assessment decisions are concerned, we do not yet sufficiently understand. [ABSTRACT FROM AUTHOR]

Given the realities of external pressures on our daily lives, work-life balance is important now more than ever. Although we often advocate for work-life balance, are we equipped with the appropriate tools and an adequate support network to handle what life might throw at us? How do we continue to be productive when dealing with distressing matters that we seemingly have little control over? Contributors from different areas of the world, with a diversity of voices, offer their perspectives on how to navigate life's obstacles while continuing to meet the expectations of departments, universities, and the profession to achieve career success and fulfillment. This forum highlights authors at different career stages, who have lived through a myriad of experiences including singleness/dating, marriage, pregnancy, parenting, serving as a caretaker, the death of a loved one, toxic work environment, and personal health to share their experiences and provide insights on how to cope with adversity at any point in one's academic career. [ABSTRACT FROM AUTHOR]

Bridging the divide between research and practice has become a growing concern within international studies. One under-explored avenue through which international studies scholars can enhance their "real world" impact is by serving as country conditions experts in asylum cases. This article provides an overview of the asylum process, the role of country conditions experts within it, and how scholars with in-depth country knowledge can leverage their expertise to make a difference, using examples from the United States and the United Kingdom. It also details several key issues one should consider when deciding whether to undertake expert witness work and the challenges and dilemmas it often entails. Finally, we provide actionable ways for international studies scholars to get involved and expand the community of individuals engaged in expert witnessing. [ABSTRACT FROM AUTHOR]

The Jikei Academic Nursing Practice Center for the Community developed a community nursing practice that matched community health problems and concerns in Chofu and Komae cities, suburban areas of the Tokyo Metropolis. This study aimed to identify health problems and high‐risk populations via an understanding of the practice of health behaviors, health literacy, and quality of life. This was an online, cross‐sectional study conducted in September 2023. In total, 1520 (Chofu: n = 1170; Komae: n = 350) participants were enrolled. Participants' demographic characteristics, health literacy, health behaviors, and quality of life scores were obtained. Sleep quality was poor compared with national data. Younger participants had higher poor health literacy, did not practice health behaviors, and had a lower quality of life. In addition, parenting and informal nursing care for family members were associated with unhealthy eating, smoking, drinking, and poor quality of life. This study found that health problems and concerns before planning were significant in increasing the salience of interventions for community residents. Based on the findings of this study, an action plan for community‐wide nursing practice was created. [ABSTRACT FROM AUTHOR]

Endourology plays an important role in modern urological practice. Compared to open surgery, it offers many advantages. In Africa, endourology is not widely practiced or non‐existent in some referral centres. Several factors have been linked to this challenge. This article explores and proposes strategies to improve endourology practice in the African context. Recognising the unique challenges and opportunities in the region, the document discusses key initiatives and recommendations to promote the growth and development of endourological practices, including the identification of local needs, training, technological adaptation, etc. It aims to provide valuable information on the advancement of endourology in Africa. [ABSTRACT FROM AUTHOR]

Many practices available for use in health service psychology are ineffective or harmful. How we describe these practices is important to scientific discourse and science communication with policy-makers and the general public. The label "pseudoscience" is typically applied in these cases, though the meaning of pseudoscience varies widely creating a quagmire for transparent and accurate communication. To clarify this issue, we review several prominent definitions of pseudoscience as well as consider how the term is used amongst psychology scholars and science-communicators. We define two additional terms adapted from the medical literature, contemporary and alternative psychotherapies and low-value practices, and discuss their strengths and limitations. Finally, we recommend the broader category of low-value practices for use due to its definitional clarity, lack of competing definitions, and potential for clarifying research programs. [ABSTRACT FROM AUTHOR]

Introduction: To investigate current practices, changes, and perceptions of rheumatologists regarding GC use in RA patients. Methods: A cross-sectional survey was conducted using a structured questionnaire between April and August 2023. Rheumatologists from 31 province-level regions of Mainland China were invited to participate. Chi-squared tests were adopted to investigate the differences by sociodemographic characteristics. Results: 1,717 rheumatologists from 598 hospitals completed the survey with a response rate of 92%. Up to 60% of participants expressed currently infrequent initiation of GC co-therapy with csDMARDs (hardly ever 7.0%; occasionally 24.6%; sometimes 29.1%), accompanied by a decline of frequency over time reported in 64.2%. Regarding attitudes towards bridging therapy with GC, 604 (35.2%) participants supported this approach, 468 (27.3%) opposed it, and 645 (37.6%) remained inconclusive. Time to GC discontinuation in context of csDMARDs was commonly reported within 6 months in current practice which has been narrowed over time. Reasons for chronic GC use were mostly reported due to suboptimal disease control, followed by the need of RA complications, and pre-existing comorbidities. After failure of GC cessation, majority of respondents (84.4%) would escalate RA therapy (commonly by addition of JAK inhibitors, TNF inhibitors), which usually or often facilitated the GC cessation. The most frequently reported advantages and weaknesses of GC were rapid and strong efficacy, adverse events, respectively. Regarding long-term low-dose GC use for RA, the percentage of respondents who supported, opposed, or depended on the situation were 15.9%, 17.2%, and 66.9%, respectively. Conclusions: The current data demonstrate that GC initiation for RA treatment is not as frequent as before and the awareness of GC discontinuation is growing in current practice. Attitudes towards GC co-therapy with csDMARDs vary considerably and long-term low-dose GC use remain situation dependent. [ABSTRACT FROM AUTHOR]

Unhealthy eating habits and a high intake of energy, salt, sugar, fat and trans-fatty acids are introduced as dietary risk factors for non-communicable diseases (NCDs). Since one of the key strategies to combat high-risk food behaviors in families is the establishment of healthy eating habits by mothers, this study aims to investigate the effect of nutrition traffic light (TL) education on mothers’ knowledge, attitude and practice. This semi-experimental intervention was conducted among 84 mothers covered by the health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran. The participants were randomly divided into the intervention and control groups (42 participants in each group). Data were collected through a standard questionnaire at three points (before, one week after, and one month after the intervention) across 12 sessions from June 15 to August 15, 2022. The data were analyzed using repeated measures ANOVA, t-test, and chi-square test through SPSS software, version 21. After education, the mean scores of knowledge, attitude and practice improved from 8.61±1.36, 25±2.81 and 22.61±8.6 to 11.71±0.63, 28.04±2.52 and 28.38±4.74, respectively. A comparison of the two groups revealed a significant increase in the scores of knowledge, attitude and practice in the intervention group compared to the control group (P<0.05). Thus, training on food TL labeling can enhance mothers’ knowledge, attitude, and practice related to choosing healthier food. This method of education can be considered effective in both quantitatively and qualitatively improving families’ eating habits. [ABSTRACT FROM AUTHOR]

Background: Dengue fever (DF) is one of the most prevalent arboviral infections worldwide. In Iran, the dengue-positive serological cases as well as the presence of the dengue vector Aedes aegypti have raised health concerns, highlighting the need to enhance the dengue surveillance system. This study aims to assess the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding dengue fever in a large and high-risk region of southeastern Iran. Methods: A total of 492 HCPs were recruited using a multi-stage sampling method from May 2022 to July 2023. Data were collected using a self-administered questionnaire. Data analysis was done using independent t-tests, one-way analysis of variance (ANOVA), one-factor and multi-factor general linear models, and simple and multiple regression models. Results: About two-thirds (71%) of the participants did not receive any training on DF. A small percentage of participants were familiar with ovitrap (32.6%) and only 21.7% knew that destroying larval breeding sites could not eliminate the dengue vector. The knowledge of disease symptoms among HCPs was found to be lower in border areas compared to non-border areas (P = 0.018). However, the practice situation in HCPs working in border areas was better than in non-borders (P = 0.003). According to the multiple regression model, the most influential factors associated with knowledge, attitude, and practice were the type of healthcare facility and passing the DF training course. Additionally, education level, work experience, and gender were identified as other factors associated with it, respectively. Significant correlations were found between knowledge and practice (P < 0.001), indicating that higher knowledge led to better practice. Similarly, a positive attitude was significantly linked to better practice (P < 0.001). Conclusion: Regular, targeted, and continuous training courses are necessary to improve the knowledge level of HCPs, particularly those with lower education levels working in low-level health centers. Utilizing comprehensive dengue KAP studies to evaluate the status and impact of health education programs and identify gaps between knowledge and practice should be a research priority. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to conduct a process evaluation of Supporting Family Doctors to Address Elder Abuse (SAFE) intervention, a training program, and clinical guidelines developed to assist the family doctor in intervening in elder abuse (EA). Method: 160 family doctors answered pre-and post-training questionnaires on knowledge of EA, attitude, subjective norms, and the perceived behavioral control to intervene in EA, followed by semi-structured interviews post-intervention with a purposive sample of family doctors who participated in the SAFE intervention (N = 39). Results: There is a significant increase in mean scores of the knowledge, attitude, and subjective norms six months post-intervention (p < 0.001). The mean scores of perceived behavioral control of family doctors to intervene in EA decreased but were statistically insignificant (p > 0.05). Qualitative data explained the observed effect and process underlying the knowledge transfer and implementation of the SAFE intervention. Knowledge improvements due to awareness enhancement led to empowerment and confidence as the training program was effectual and comprehensive. Family doctors' self-reflection and empathy toward older adults contribute to attitude changes. Family doctors are better coordinated and receive support in intervening in EA. However, various roadblocks affect their perceived ability to intervene in EA and enhancement strategies necessary to assist family doctors to intervene in EA efficiently. Conclusion: The SAFE intervention was feasible and effective in improving family doctors' competency to intervene in EA. However, findings showed that doctors' capacities must go hand in hand with empowering older adults, creating awareness among community members, and pushing for law and policy reforms. [ABSTRACT FROM AUTHOR]

Using many years of experience in the UK's state primary schools, I consider that a limited understanding of time has damaging implications for both pupils and adults within the education system. The sector neglects the fact that time has much potential, many definitions and is a powerful influence on man. I share how education took clock‐time and manipulated it to an extreme, leading to the rule clock‐time now has over our schools. We are being held to account by time, and it has become our foe; however, I believe that it can become our friend. I explain why education should accept time's many facets and use them to help reshape its structure and practice. Time, in educational spaces, could be understood and experienced differently, taking in to account the human and all manner of other relevant things, for the greater good. This article began as a combined work of spoken word, poetry recital and research paper. [ABSTRACT FROM AUTHOR]

Introduction: A sterile technique is a standard to reduce microorganism transmission during surgery. Gaps in knowledge and practice in sterile techniques by nurses are common causes of surgical site infections for surgical patients. Even though surgical site infection is a global problem due to lack of knowledge and practice, almost no study has been done in Ethiopia regarding nurses' knowledge and practice of sterile techniques in the operating room. Therefore, this study aimed to assess nurses' knowledge, practice, and associated factors of sterile techniques in Addis Ababa public hospitals, Ethiopia. Method: An institutional-based cross-sectional study was conducted on 423 nurses who were working in sixty-six operation rooms at seven public hospitals in Addis Ababa, Ethiopia, from May 11 to June 26/2022. A simple random sampling method was employed to select study participants. A pre-tested, self-administered questionnaire was used to collect data. Data were entered by Epi-data version 4.6 and analyzed by SPSS version 25. Descriptive statistics were presented by text, table, and figure. Multivariable analysis was used to identify the association between the dependent variable and independent variables. Variables with a P-value < 0.05 were considered statistically significant. Result: Nearly three-fifths (58.1%; 95%CI: 53.2 to 63.7) of respondents had good knowledge, and 56.1% with 95%CI (51.5 to 61.1) had good practice with respect to sterile techniques in the operation room. Training [AOR = 1.989; 95%CI (1.120 to 3.530)], availability of guidelines [AOR = 6.4; 95%CI (3.773 to 10.856)], and supervision [AOR = 2.963; 95%CI (1.693 to 5.184)] were associated with nurses' knowledge about sterile techniques in the operating room. Availability of guidelines [AOR = 1.890, 95%CI (1.123 to 3.182)], presence of supervision [AOR = 4.732; 95%CI (2.643 to 8.471)], and having good knowledge of sterile techniques [AOR = 5.419; 95%CI (3.087 to 9.512)] were associated with nurses' practice of sterile techniques in the operation room. Conclusion: Operative theater nurses' knowledge and practice of sterile techniques were found inadequate. Training, supervision, availability of guidelines, and knowledge of nurses towards sterile techniques are factors associated with sterile techniques in the operating room. So, it is better to strengthen training, equip wards with standardized guidelines, and provide supervision, which is crucial to enhancing their knowledge and practice. [ABSTRACT FROM AUTHOR]

Background: Inappropriate use of antimicrobials can push the environment out of balance, and cause unnecessary waste that can contaminate our soil, animals and waterways. Health professional education is committed to preparing students for antimicrobial stewardship (AMS) and supporting planetary health, but a more multidisciplinary action is needed to curb the expansion of antimicrobial resistance (AMR). The aim of this scoping review is to showcase the current antimicrobial knowledge of undergraduate students across the disciplines of medicine, pharmacy, nursing, dentistry and veterinary. This will consequently showcase the gaps and trends across the different disciplines and countries to help inform planetary health multidisciplinary undergraduate curriculums. Methods: A search of the existing literature published prior to December 2023 was conducted using CINAHL, EMBASE, MEDLINE, SCOPUS, and ERIC databases. Studies were excluded if they included postgraduate students or discussed the knowledge, attitude and practice (KAP) of students towards antimicrobial prescribing, AMR and AMS related to a specific learning activity. Results: A total of 144 articles were included. The most represented countries were India and Pakistan accounting for 17% and 8% of the studies, respectively. Single-disciplinary research accounted for approximately 80% of the studies. Medicine was the most represented discipline in both single-disciplinary and multidisciplinary research, appearing in approximately 62% of the studies, followed by pharmacy appearing in approximately 30% of the studies and dentistry appearing in approximately 18% of the studies. Three major priority themes were identified: students are more familiar with the term AMR compared to AMS; inappropriate use of antimicrobials is seen as the main driver of AMR; and the need for more training and education in the field of appropriate antimicrobial prescribing, AMR and AMS. Conclusion: This review has highlighted that there is a need for more AMS interprofessional education (IPE) activities in all five disciplines, and especially within the disciplines of nursing, veterinary and dentistry, as shown by a lack of multidisciplinary research in this area. Most of the knowledge assessments have just touched the surface of AMS and focused on inappropriate antimicrobial use alone. Interdisciplinary planetary health education needs to go beyond these skills and broaden the understanding of other factors that can contribute to AMR such as inappropriate disposal, environmental contamination, monitoring and surveillance, one health, false allergies, and more importantly, how each health professional can contribute to a team. [ABSTRACT FROM AUTHOR]

Objective: Optimal therapeutic drug monitoring (TDM), including clinical pharmacokinetics, appropriate interpretation, and dose adjustment of drugs, is required to effectively monitor specific therapeutic drugs. Hospital pharmacists (HPs), being the most qualified healthcare professionals to implement TDM, must understand its applications to determine and adjust drug doses and avoid adverse drug reactions and toxicity. Therefore, in this knowledge, attitude, and practice (KAP) study, we assessed TDM level among HPs in Saudi Arabia. Methods: This cross‐sectional study was conducted with 414 HPs in the Makkah region with a valid pharmacy license from the Saudi Commission for Health Specialties. An overall score of 50% or higher of the total responses in each section was considered good, whereas an overall score lower than 50% was considered poor. Categorical data are expressed as frequency and percentage. Correlations were measured using Pearson's correlation coefficient (r). Results: The TDM‐KAP levels of the participants were 50%, 80%, and 62% for KAP, respectively. Significant positive linear correlations were found between knowledge and attitude, knowledge and practice, attitude and practice, knowledge and classification, practice and classification, practice and experience, and knowledge and experience. The participants showed acceptable knowledge and practice of TDM levels with elevated attitude levels. Conclusion: As a lack of TDM knowledge directly contributes to reduced practice levels, increasing TDM knowledge and practice by introducing more intensive pharmaceutical programs that illustrate TDM clinical applications in hospitals is recommended, which will enhance HP integration. [ABSTRACT FROM AUTHOR]

Background: Women may lack awareness of the existence of Hormone Replacement Therapy (HRT), its benefits, and potential drawbacks. Furthermore, they may be uninformed about the treatability of menopausal symptoms. Consequently, there is a need to evaluate the knowledge, attitudes, and practices related to HRT among menopausal women within the Malaysian population. Presently, no studies have reported on the inside, attitudes, and practices regarding HRT among menopausal women in Kuala Lumpur. This study sought to determine the prevalence, knowledge, attitude, and practice (KAP) towards HRT and its association with socio-demographic characteristics of the study population. Method: A cross-sectional study was conducted among menopausal women (n = 404) living in Kuala Lumpur, Malaysia. Data was collected using convenient sampling. This research consists of 5 major parts which are (A) Socio-demographic characteristics of participants, (B) HRT knowledge among respondents, (C) Attitudes towards HRT, (D) Practice of HRT, and (E) Menopausal symptoms. All appropriate data from the project was analyzed using IBM SPSS Statistics Ver 26. Results: A total of 404 participants were recruited in this survey. Overall, participants had good knowledge (n = 254, 62.9%) and negative attitude (n = 213, 52.7%) towards HRT. The majority of them (83.4%) had never taken HRT. The common menopausal symptoms reported were hot flashes (35.4%), irritability/ mood swings (31.9%), and night sweats (29.2%). There was a significant association between knowledge of menopause and HRT and attitude towards HRT use. Participants (68.7%, n = 103) with poor knowledge of menopause and HRT showed a negative attitude towards HRT (p < 0.01). Conclusions: Overall, the prevalence of HRT use among the respondents is low. 83.4% of them have never taken HRT before. There was a positive correlation between knowledge and attitude towards HRT use. Healthcare systems should educate the public using various educational tools and social media. [ABSTRACT FROM AUTHOR]

Background: ICU nurses play a critical role in managing delirium in critically ill patients, yet their competency in this area remains under-explored. Aim: To assess ICU nurses' competency including their knowledge, practice, and attitudes toward delirium among critically ill patients. Methods: A correlational descriptive study was conducted with 67 nurses in the medical intensive care unit at Suez Canal University Hospitals. Data was collected using an online survey and analyzed using descriptive statistics, ANOVA, and Pearson's correlation. Results: Nurses showed a moderate knowledge level (M = 8.55), a low practice level (M = 6.62), and positive attitudes (M = 21.65) toward ICU delirium. ANOVA results indicated significant differences in practice scores based on educational level, F (2, 64) = 3.361, p =.041, and in knowledge scores based on ICU experience, F(3, 63) = 6.455, p <.001. Nurses with Master of Science in Nursing (MSN) degrees had higher practice scores than those with diplomas or Bachelor of Science in Nursing (BSN) degrees. There were no significant differences in knowledge and attitude scores based on educational level or age. Gender differences were minimal, with male nurses slightly outperforming female nurses. Correlation analysis showed positive relationships between age, education, ICU experience, and ICU nurses' levels of knowledge and practice. Conclusion: ICU nurses demonstrate a knowledge-practice gap in delirium management. Targeted educational interventions, mentorship programs, and a focus on practical skills are essential to enhance delirium care. Relevance to clinical practice: These findings highlight the urgent need for comprehensive delirium education and training programs for ICU nurses. By improving nurses' knowledge and practice, healthcare organizations can significantly enhance the early detection, prevention, and management of delirium, ultimately leading to improved patient outcomes and reduced length of stay in the ICU. [ABSTRACT FROM AUTHOR]

Newsworkers have utilised the game format to create innovative storytelling through newsgames, a hybrid form of journalism. Newsgames blend journalism's pursuit of truth with the fictional elements of video games, creating a tension between “fact” and “fiction”. Existing literature lacks sufficient exploration of how this tension is managed in the production and consumption of newsgames. This study addresses this gap by examining how newsgame practitioners navigate truth claims and how players engage with these claims. Through semi-structured interviews with practitioners (n = 27) and gaming sessions with players (n = 28), the study reveals that practitioners take deliberate steps to justify newsgames, while players employ various strategies to evaluate their truth claims. These findings underscore the performative dimension of truth negotiation in newsgames, positioning audiences as active participants at the heart of this process. [ABSTRACT FROM AUTHOR]