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Le trouble de la personnalité borderline est un trouble psychiatrique fréquent qui apparaît à l'adolescence. La thérapie comportementale dialectique adaptée aux adolescents (TCD-A) a montré son efficacité dans la prise en charge psychothérapeutique des adolescents souffrant de conduites suicidaires ou d'auto-agressivité associées au trouble de la personnalité borderline. Au travers de notre étude nous avons souhaité explorer la faisabilité et l'acceptabilité, pour des adolescents présentant un TPL diagnostiqué ou des troubles de la régulation des émotions, d'un module TCD intitulé « tolérance à la détresse » proposé sur le mode d'un groupe multi-familles. Pour ce faire nous avons mis en place un groupe multi-familles de six adolescents et de leurs parents. L'acceptabilité et la faisabilité du protocole étaient excellentes. Les témoignages des adolescents et de leurs parents nous apportent des informations précieuses sur l'intérêt d'un tel groupe et sur les améliorations à introduire. La mise en place d'un tel groupe est une première en France et nous souhaitions montrer par notre étude pilote, sa faisabilité, son acceptabilité et ses effets afin de promouvoir son développement et son implémentation dans le contexte pédopsychiatrique français. Borderline personality disorder is a common psychiatric disorder emerging in adolescence. Dialectical Behavioral Therapy adapted to adolescents (DBT-A) has proven to be effective as a psychotherapeutic treatment for adolescents suffering from borderline-related behaviors, such as suicidal or self-aggressive behaviors. In our study, we were interested in exploring the feasibility and acceptability of a DBT-A module entitled "distress tolerance", which reduces borderline-related behaviors in borderline adolescents or undiagnosed adolescents who experience difficulties in regulating their emotions. To do this, we set up a pilot study with one multi-family treatment group of six adolescents and their parents. The treatment was fully accepted by all adolescents and parents with an excellent acceptability. Comments from adolescents and parents gave us valuable information about the great interest of a multi-family treatment group and potential improvements for its implementation. This is the first study exploring a DBT-A multi-family treatment group in France. It highlights its feasibility, acceptability and potential positive effects. Further studies are needed to promote the implementation and development of such interventions in the context of child and adolescent psychiatry in France. [ FROM AUTHOR] Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: Phase III trials, corroborated by early post-marketing data globally show that COVID-19 vaccination reduces the risk of severe disease, hospitalisation and death. Despite this, vaccine hesitancy persists amongst some healthcare workers. This study aimed to assess the acceptability of the COVID-19 vaccine amongst South African pharmacists and highlight vaccine-related concerns and predictors of vaccination hesitancy.Methods: Nested within an online survey (14 April 2021 to 18 May 2021) assessing the mental health of South African pharmacists during the COVID-19 pandemic, vaccine acceptability and vaccine-related concerns were studied. A multivariate logistic regression analysis identified factors associated with vaccine hesitancy.Results: From 2 454 registered South African pharmacists sampled, 755 responded to the vaccine acceptability survey (response rate: 30.8%). Vaccine acceptability was 71.9%, while 72.4% and 53.3% were concerned about serious COVID-19 vaccine-related side effects and the lack of vaccine safety data, respectively. Pharmacists aged 20-30 years were more likely to be vaccine-hesitant compared to those aged > 60 years (aOR 3.2, 95% CI 1.1-9.6). Compared to their Caucasian colleagues, Black/African pharmacists were twice as likely to be vaccine-hesitant (aOR2.2, 95% CI 1.2-4.0).Conclusion: COVID-19 vaccine hesitancy among South African pharmacists exists amongst a small but significant proportion. Targeted interventions to address concerns are necessary.
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Background: The coronavirus disease 2019 (COVID-19) pandemic has had an immense impact on psychic health. Children and adolescents are considered especially vulnerable which is why health promotion and prevention programs are important and should be designed in a motivating way to be attractive to this age group. The aim of this work is to investigate whether young people can be reached with the help of innovative digital formats for health promotion. Methods: An app-based training to promote self-regulation was offered to adolescents in lower secondary education in autumn 2020. Data were collected using an app. The types of motivation to participate in the training were analyzed. In addition, the students were able to rate the attractiveness of the training with the help of a self-designed evaluation sheet. Results: Of the 91 registered participants, 39.56% completed the study. In all, 40.91% of the students stated that the training was "very" helpful and 36.36% rated it as "quite" helpful. Although 50% of the respondents found the app-based training "modern and motivating", the other half would have preferred more personal support. Conclusion: The results confirm previous study results with health apps in children and adolescents. This age group is interested in digital formats, but health apps are not used continuously in this age group unless obligatory.
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The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28–43 years;65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different facility levels, and providing adequate vaccine knowledge. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Introduction: Several studies have investigated COVID-19 vaccine acceptability and hesitancy, especially among healthcare workers (HCWs). However, acceptability of the vaccine by HCWs in Sudan remains unclear. Aims: We investigated acceptability of the COVID-19 vaccine and its determinants among HCWs in Sudan. Methods: Using a semi-structured questionnaire, we conducted a web-based cross-sectional study of COVID-19 vaccine hesitancy and its associated determinants among healthcare workers in Sudan during March-April 2021. Results: A total of 576 HCWs responded to the survey. Mean age was 35 years. Females (53.3%), medical doctors (55.4%) and being located in Khartoum State (76.0%) each accounted for more than half of the participants. Absolute refusal of the COVID-19 vaccine was expressed by 16.0% of the respondents. Males were more than twice as likely to accept the vaccine as females. Lower acceptability was statistically significantly associated with the nurses (OR = 0.35, 95% CI: 0.15-0.82, P < 0.001), increased perceived harm from the vaccine (OR = 0.11, 95% CI: 0.05-0.23, P < 0.001), lack of confidence in the source of the vaccine (OR = 0.16, 95% CI: 0.08-0.31, P < 0.001) and lack of confidence in organizations or government sectors supervising the vaccination process (OR = 0.31, 95% CI: 0.17-0.58, P < 0.001). Conclusion: This study highlights a moderate level of COVID-19 vaccine acceptability among HCWs in Sudan. Special consideration should be given to addressing vaccine hesitancy among female HCWs and nurses.
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COVID-19 Vaccines , COVID-19 , Male , Female , Humans , Adult , Sudan , Cross-Sectional Studies , COVID-19/prevention & control , Vaccination , Health PersonnelABSTRACT
Covid-19 has impacted the health and well-being of children worldwide. The aim of this study was to evaluate parental acceptance of and concerns about vaccinating their children against Covid-19 in Ras Al-Khaimah, United Arab Emirates. The study adopted a cross-sectional design. Parental acceptance of and concerns about vaccinating their children were collected using a structured questionnaire. A total of 366 parents were selected, using purposive sampling from the Emirate of Ras Al Khaimah, during the period of November 2021 to February 2022. Of all, 5.3% (56) of the parents expressed a high level of concern regarding vaccinating their children against Covid-19, while 80.6% (295) expressed a medium level and 4.1% (15) a low level of concern. Parental acceptance was found to be medium and high among 71% (260) and 8.8% (69) of the parents respectively, as opposed to 10.1% (37) who were reluctant (low) to do so. The most important concerns for the low acceptance of Covid-19 vaccination were safety, side effects and effectiveness of the vaccination. The study reveals the need to initiate more targeted interventions to improve the acceptability of vaccines and the acceptance of the parents in order to alleviate the concerns of parents about vaccinating their children against Covid-19.
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Background: The proportion of COVID-19 vaccination in Africa countries remains lower than other low and middle-income countries around the world. This rate is much lower in sub-Saharan Africa especially Cameroon. The low rate among these countries is attributed to vaccine hesitancy, mainly due to misinformation about vaccine origin, efficacy, and safety and the use of local herbs. Methods: From January to April 2022, we gathered latest experiences and opinions on four vaccine hesitancy-related areas, namely policies, perceived low risk, religious factors and use of local herbs in Cameroon in particular and some selected African countries in general;from published information in the literature. Results and recommended local solutions: The report mentions that political influences, religious beliefs and low perceived risk exists, vaccine safety and effectiveness and consumption of local herbs do contribute to COVID-19 vaccine hesitancy, collectively. Systematically monitoring the drivers of COVID-19 vaccine hesitancy, implementing tailored interventions promoting vaccine acceptance, and evaluating the impact of these interventions reduce vaccine hesitancy drastically.
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Background: The coronavirus disease 2019 has been spread almost all over the world in the last two years, including in India. Vaccines are a critical tool in the battle against COVID-19, and India has flagged the largest vaccination drive on 16 January 2021. Although public acceptance was varying, which can lead to non-acceptance. Aim & Objective: To estimate an acceptance of the COVID-19 vaccine and its associated factors. Settings and Design: An analytical cross-sectional study among health care workers in India Methods & Material: It was conducted using a validated, self-administrated online survey questionnaire, and data were analyzed using SPSS 23 version. The outcome variable was healthcare workers' acceptance of a COVID-19 vaccine. Results: A total of 450 HCWs participated, including 205(45.6%) women and 245(54.4%) men. A total of 270 (60%) subjects will accept vaccines, while 33.3% were unwilling to accept and wait for vaccines. Male gender (OR=3.14), being married and experienced (OR=11.49), vaccine effectiveness (OR=6.4), vaccine safety (OR=3.4), and past history (OR=2.28) were significantly associated. On applying logistic regression for associated factors, gender (B= -1.145, S.E.= 0.200, Wald 32.748), being married (B= -1.482, S.E.= 0.216, Wald 46.937), for experienced (B= -0.865, S.E.= 0.200, effectiveness (B= -1.856, S.E.= 0.245, Wald 57.431), Safety (B= -1.224, S.E.= 0.202, Wald 36.633) and past history (B= -0.357, S.E.= 0.248, Wald 2.071) found significant. Recommendation: Proper information is crucial and healthcare workers' attitudes about vaccines are an important factor for acceptance and recommendation of the vaccine to the public for population-wide coverage.
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Objective: COVID-19 pandemic has negatively impacted the diagnosis and management of tuberculosis (TB) cases, and TB-COVID-19 integrated screening was introduced as a strategy to overcome these problems. This study determined the acceptability of the TB-COVID-19 integrated screening by healthcare workers (HCWs) and its impact on achievement of the TB program. Methods: This was a mixed-method study with an embedded design. Data on hospital TB program coverage from the national TB information system for all Muhammadiyah and Aisyiyah Hospitals (MAHs) in Central Java were compared before and after the implementation of TB-COVID-19 integrated screening. The informants consisted of HCWs from 21 MAHs in Central Java. Focus group discussions (FGDs) were carried out with 7 hospital TB, 19 emergency room, 10 outpatient, 6 inpatient, and 4 managerial staff. In-depth interview (IDIs) were also performed with the Technical Officer TB Recovery Head of the Muhammadiyah Center. All IDIs and FGDs were recorded, transcribed verbatim, and subjected to thematic analysis guided by the theoretical framework of acceptability (TFA). Result: Implementation of the TB-COVID-19 integrated screening program led to an increase in the number of new TB case diagnoses at the Central Java Hospitals. Moreover, the program was acceptable based on seven indicators from TFA. Despite the obstacles faced by HCWs during the implementation process, the program still managed to meet the standards. Conclusion: Acceptance by HCWs is a critical factor in the successful implementation of programs, including the TB-COVID-19 integrated screening. Furthermore, a multifaceted and cross-sectoral approach is required to address the constraints associated with the process.
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Purpose: Disability in knee osteoarthritis (KOA) is known to be largely due to pain, the mechanism of which is complex and multidimensional with alterations in nociceptive processing in the peripheral and central nervous system (CNS) leading to persistent pain. Current clinical practice guidelines for KOA provide strong recommendations for education and exercise including land-based or mind-body approaches. However, individually these strategies are only moderately effective. One potential reason for this is a lack of understanding of their underlying mechanisms and how their combination might impact nervous system modulation. Neuromuscular exercise is known to improve lower extremity strength. Mind-body approaches as well as pain neuroscience education (PNE) are uniquely positioned to potentially reverse CNS adaptations by inducing positive neuroplastic changes and improving descending modulation of pain resulting in decreased pain. To our knowledge, neuromuscular exercise, mind-body techniques, and PNE have not been studied in combination. We therefore aimed to establish the feasibility of an intervention consisting of these three elements referred to as Pain Informed Movement (PIM). The results of this study will inform necessary modifications for a two-arm pilot randomized controlled trial (RCT). Method(s): This study was a single-arm feasibility trial with a nested qualitative component and the primary feasibility outcome of complete follow up. Inclusion criteria: age >= 40 years, KOA clinical diagnosis or people fulfilling the NICE diagnostic criteria, and average pain intensity >=3/10 on the numeric pain rating scale. PIM consisted of twice weekly in-person exercise sessions and a third home exercise session for 8 weeks. In addition, PNE, provided as online videos, covered the following topics: purpose of pain, neurophysiological changes associated with pain, movement guidelines when pain persists, mind-body techniques to impact neurophysiology and support moving with ease that included breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, and relaxation. The mind-body techniques and the PNE topics were implemented during the group exercise sessions that included evidence-based neuromuscular exercises aimed at improving sensorimotor control and functionality of the knee joint. Participants completed questionnaires and in-person assessments at baseline and at program completion. Assessments included weight and height, chair stands as a measure of functional leg strength, and conditioned pain modulation to assess efficiency of the descending modulatory pathways. Participants also had their blood drawn to monitor changes in brain derived neurotrophic factor (BDNF), a marker of neuroplasticity. Questionnaires included the Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale, the Knee Injury and Osteoarthritis Outcome Score - function and pain subscales, Chronic Pain Self Efficacy scale, pain intensity rated in the past 24 hours, the past week, and worst pain in the past 24 hours. Secondary feasibility outcomes included acceptability of the intervention, burden of assessments, recruitment rate, compliance rate, adherence rate, and self-reported adverse events. Feasibility findings were evaluated against a-priori success criteria. In the qualitative component, participants were invited to an online focus group and were asked about their experience and perceptions of the program. Interview recordings were analyzed using thematic content analysis to identify suggestions for program modification. Result(s): In total, 19 participants (mean age 63.3 years (SD 10.5), 73% female) were enrolled, with a complete follow up rate of 74% (n=14) for our primary objective, indicating that modifications would be needed to proceed. Of the 5 dropouts, only one was study related. We will be adding additional inclusion criteria of: ability to get up and down from the floor independently, and no use of mobility aids. Adherence to in-person treatment sessions was 91%, hich indicates proceeding with the protocol for the next phase (i.e., pilot RCT). Some absences were due to unmodifiable factors (e.g., COVID-19). We will make protocol amendments for the purpose of improving the adherence rate to include 'no planned absences'. All other success criteria were met: recruitment rate, compliance to exercise sessions, program acceptability, duration, frequency, and delivery, likelihood of recommending the program to others and taking the program again, burden, and adverse events (Table 1). Analysis of the focus groups revealed that the video content pertaining to the mind-body techniques would benefit from on screen demonstrations by the instructor to assist with participants' execution of breath and muscle tension regulation. The majority of participants improved in most of the physical assessment outcomes and questionnaires (Table 2). Conclusion(s): The PIM program is feasible, acceptable, not burdensome, does not cause adverse events, and had an excellent compliance rate. Minor modifications are needed to optimize enrolment and adherence rates. Although improvements in pain, function, and psychological measures were observed, the feasibility nature of this study precludes any conclusions regarding efficacy. A pilot two-arm RCT will be conducted to establish the feasibility and explore potential effects of PIM when compared to conventional neuromuscular exercise and standard OA education. [Formula presented] [Formula presented]Copyright © 2023
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In England, approximately 1 in 6 people have a common mental health condition, with certain groups experiencing worsening mental health since the start of the COVID-19 pandemic. Therefore, improving mental health remains a key priority for policy makers and practitioners. Community-based interventions are increasingly used to improve health and reduce inequalities. Evaluation of such interventions is important to ensure they are effective and to maintain financial support for continued delivery. Hesitation to complete administratively demanding evaluative measures by service users, which may not be suited to evaluating low intensity activities, point to the need to identify acceptable, unobtrusive methods of data collection. This review focuses on identifying unobtrusive methods that have previously been used to examine service user's perceptions of community-based interventions and their effectiveness, and the acceptability of the methods. A review of peer reviewed, and grey literature was undertaken in July 2022. Literature was identified via six databases, Google searches, and by contacting experts. Literature was included if it described unobtrusive methods to gather service users' perceptions of an intervention and/or reported the acceptability of such methods. Literature was excluded if it described traditional methods to gather service users' perceptions of an intervention. Our search identified 930 citations from searching databases (n = 886), Google (n = 40), and from contacting 15 experts directly, and over 300 experts indirectly via three e-mail lists (n = 4). No literature met our inclusion criteria. We report an empty review. There is no peer reviewed or grey literature that describes unobtrusive methods of data collection for mental health and wellbeing focused community-based interventions, or their perceived acceptability. The findings from this review indicate the need to develop unobtrusive methods of data collection in the field of public mental health, suitable for low intensity activities, and examine the acceptability and feasibility of such methods.
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BACKGROUND: The opioid epidemic worsened during the coronavirus disease 2019 (COVID-19) pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development, and insight is needed into its acceptability. METHODS: Using a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically. RESULTS: Among N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision making. Reactions to vignettes revealed complex attitudes toward fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain. CONCLUSIONS: Positive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.
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COVID-19 , Drug Overdose , Fentanyl , Opiate Overdose , Opioid-Related Disorders , Adult , Analgesics, Opioid/adverse effects , Drug Overdose/drug therapy , Drug Overdose/epidemiology , Drug Overdose/prevention & control , Female , Fentanyl/adverse effects , Humans , Male , Opioid-Related Disorders/complications , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/prevention & control , Pain , VaccinesABSTRACT
Aim This study aimed to assess the awareness and acceptance of COVID-19 vaccines and associated factors among pharmacy students in Zambia. Materials and Methods We conducted a cross-sectional study among 326 undergraduate pharmacy students in Lusaka, Zambia, from February to April 2021. Data were analysed using Stata version 16.1. Multivariable logistic regression was used to determine key factors influencing vaccine acceptance. Results Of the 326 participants, 98.8% were aware of the COVID-19 vaccines, but only 24.5% would accept vaccination. Compared to other religions, being of Christian faith was associated with reduced odds of awareness of the COVID-19 vaccine (aOR=0.01, 95% CI: 0.01-0.20). Conversely, factors associated with vaccine acceptance were being male, single and unemployed. Compared to females, male respondents were 86% more likely to accept the vaccine if it was made available (aOR=1.86, 95% CI: 1.10-3.14). In addition, unmarried respondents were 2.65 times as likely to accept vaccination than married respondents (aOR=2.65, 95% CI: 1.06-6.63). Conversely, unemployed respondents were less likely to accept vaccination than their employed counterparts (aOR=0.32, 95% CI: 0.16-0.46). Barriers to the acceptability of the vaccine were possible side effects (78.5%) and scepticism about its effectiveness (10.2%). Conclusion There was significant vaccine hesitancy toward COVID-19 vaccines among Zambian pharmacy students despite their awareness of the vaccines. Health authorities must work collaboratively with training institutions to mitigate vaccine hesitancy, especially with healthcare students being a key part of the future healthcare workforce overseeing disease prevention strategies.
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Introduction: COVID-19 caused healthcare professional workers have faced the pandemic on the frontline at the risk of being infected with the virus. Despite the low mortality rate at present and the low presence of patients with COVID-19 in health care centers, the application of a fourth booster dose has generated different positions among several countries. Background: to determine whether personnel considered being at high risk of vulnerability in the city of Santo Domingo de los Colorados, Ecuador, have favorable intentions for receiving the fourth booster dose of the COVID-19 vaccine. Method: a quantitative study of correlational scope and cross-sectional design was developed. A questionnaire consisting of 16 questions measured the following variables: risk of infection, perceived knowledge of the vaccine, confidence in the vaccine and intention to be vaccinated;this questionnaire was applied to 375 participants. Statistical analyses were developed using the microsoft Excel spreadsheed and Statistical Packagefor Social Sciences 21 (SPSS 21). Results: statistical analyses showed that the risk of infection (beta = 0.178**), perceived knowledge about the vaccine (beta = 0.218**) and confidence about the vaccine (beta = 0.192**) are significantly correlated with the intention to be fully vaccinated, thus showing the need for a fourth booster dose by vulnerable sectors. Conclusion: this is the first research that presents results regarding the intention to vaccinate vulnerable people and highlights the intention to access a fourth booster dose.
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Objective: The present study assessed the public's perception and Knowledge about COVID-19 and factors that could affect vaccine acceptability in Ghana. Design: We carried out a cross-sectional population-based study. A structured questionnaire was used to capture data on socio-demographic information, knowledge, and the public's perception of COVID-19 infection, as well as COVID-19 vaccine acceptability from consented participants. Factors affecting vaccine acceptability in Ghana were explored. Robust ordinary least square linear regression analysis was adopted to assess factors associated with vaccine acceptability. Setting: Five communities (Labone, Lartebiorkoshie, Old Fadama, Chorkor, and Ashiyie) in Accra in the Greater Accra district were selected. Participants: WHO modified cluster-sampling method was applied to select households of 997 participants in the five communities. Results: Most respondents were males (57.6%), and the median age of participants was 30 years. The study participants demonstrated a good knowledge of COVID-19 and had high perceptions of the COVID-19 pandemic. The results revealed that the highest educational level, marital status, self-rated Knowledge of COVID-19, Knowledge of COVID-19 definition, Knowledge of COVID-19 symptoms, and perception of the COVID-19 pandemic were significantly associated with vaccine acceptability. Self-reported impact of COVID-19 lockdown/movement restrictions on agriculture and job as a source of livelihood was associated with vaccine acceptability. Conclusion: Higher subjective and objective knowledge of COVID-19 increases vaccine acceptability scores significantly thus, education on COVID-19 and the vaccination against SARS-CoV-2 infection must be intensified to improve vaccine acceptability in Ghana, especially among those with lower educational backgrounds. © 2023 Ghana Medical Association. All Rights Reserved.
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In recent years, the maritime trade of crude oil has suffered notable perturbations caused by the unbalanced relationship between supply and demand. The COVID-19 pandemic caused a drop in oil consumption in 2019, followed by a reduction in production in 2020. The seaborne transport of oil accounts for approximately 50–60% of all crude oil in world production. The crude oil market is a crucial regulator of the global economy and instabilities in this market have noticeable effects on collective risks. The immediate risks that the society see are the changes in the cost of living, which are followed by political uncertainties. Less visible are the risks that these uncertainties have on shipping companies and the level of management stability they have to maintain in order to keep seagoing safe. This paper presents an update on the overall state of risk management for the crude oil tanker fleet, evidenced by EMSA and other international marine organisations. The previous paper, entitled Safety Assessment of Crude Oil Tankers, which applied the methodology of the Formal Safety Assessment (FSA), was published in 2018 and covered the historical data related to the fleet size, accident reports, amount of oil spilled on sea and the economic value of the crude oil transport business. The particular focus of this paper is on the evolution of the risk acceptance criteria over the years and the difference in the predictions from 2018 to the present day. The effects of the pandemic on crude oil shipping are discussed through the changes in the risks. Three of them are analysed: PLL (potential loss of lives), PLC (potential loss of containment) and PLP (potential loss of property). The representation of the risk applies the F-N curves among the risk acceptance criteria lines observed for different tanker sizes. Among the three risks, the paper exposes the vulnerability of the loss of containment risk, where the strong economic impact of the oil trade outweighs the environmental concerns. In relation to the PLC, the paper proposes the approach of relating the oil spill acceptability with the spill quantity and ship revenue instead of to the cost of cleaning or the cost of environment recovery.
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Background/Purpose: Receiving a cancer diagnosis during adolescence and young adulthood (AYA;15-39) coincides with a period of pivotal developmental milestones. Coping with the stress of cancer diagnosis exacerbates risk for distress and feelings of isolation among AYAs. Mind-body resiliency programs may offer a compassionate approach for tackling these negative post-treatment psychosocial experiences. The present mixed methods study explores the acceptability of an 8-week, synchronous, virtual group Relaxation Response Resiliency Program (3RP) adapted to address the unique challenges facing AYAs (3RP-AYA). Method(s): Recruitment occurred at an academic hospital in Boston, MA from 03/2019 to 09/2020. Participants (N = 72, Mage = 23.8, female = 73.6%, non-Hispanic White = 59.7%, Hispanic/Latino = 20.8%, 1.6 years post-treatment) were randomized to receive 3RP-AYA immediately (intervention group;n = 35) or after 3 months (waitlist control;n = 37) via Zoom. Electronic surveys were collected before and after participants completed treatment;we report post-treatment survey data measuring acceptability across five domains (enjoyability, helpfulness, convenience, future use, and satisfaction) using 4-point Likert scales (1 = not at all to 4 = very). Qualitative post-treatment interviews further queried program acceptability. Result(s): Program acceptability responses indicated program satisfaction: enjoyability (M = 3.62, SD = 0.69), helpfulness (M = 3.45, SD = 0.75), and convenience (M = 3.67, SD = 0.71). More specifically, 76.7% of participants found the virtual delivery to be very convenient, and 71.7% rated the sessions as very enjoyable. 91.7% of participants reported they were likely/very likely to use learned skills in the future and 91.7% reported the intervention as helpful/very helpful. Additionally, 96.6% reported satisfaction with the overall content. Exit interviews highlighted session intergroup connectivity as a particular strength. Conclusions and Implications: Across multiple domains, the 3RPAYA was deemed acceptable by AYAs. Participants valued the opportunity to learn mind-body skills and connect with other young survivors. The synchronous virtual study platform showed promise for being a convenient and helpful tool to deliver mind-body programs to AYA survivors during the Covid-19 pandemic.
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OBJECTIVES: To evaluate the acceptability of and preferences for a blended psychological intervention (combining face-to-face sessions and web-based interventions) for the treatment of postpartum depression among Portuguese women presenting depressive symptoms and to explore the factors associated with its acceptability. BACKGROUND: Despite its high prevalence and the existence of effective treatment, still few women seek professional help for postpartum depression, demanding for new treatment formats, such as blended interventions. METHODS: Women (n = 235) presenting postpartum depressive symptoms (EPDS>9) completed an internet survey assessing sociodemographic and clinical information, depressive symptoms, e-health literacy and the acceptability of and preferences for a blended intervention for postpartum depression. RESULTS: Most of the participants considered a blended intervention for postpartum depression to be useful and would be available to use it. Women reported significantly more advantages than disadvantages in regard to this treatment format. Married women, employed, with younger babies and with less severe depressive symptoms had a higher likelihood of finding a blended intervention useful. Higher educational levels increased the likelihood of being available to obtain a blended treatment. Most participants preferred an equal distribution of content across face-to-face and online sessions. Approximately one-third of the sample preferred a 75% face-to-face/ 25% online proportion. Most of the women preferred a duration of 45-60 minutes for face-to-face sessions and 30-45 minutes for online sessions. CONCLUSION: Our findings support and inform the development of blended psychological treatments for postpartum depression, according to women's preferences, and highlight the prioritisation of this format according to women's characteristics.
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Receiving digital healthcare consultations for weight management, in place of in-person appointments, has proliferated in recent years, accelerated by the COVID-19 pandemic. The objective of the present study was to investigate patients' experiences of digital weight management services (DWMS) provided by the National Health Service (NHS). Particular emphasis was placed on examining the perceived benefits and limitations of DWMS so as to identify potential means of improving provision. Sixteen patients (eight male; eight female) accessing digital consultations at one of two West Midlands (UK) NHS trusts, participated in semi-structured interviews. Interviews were transcribed verbatim and analysed via thematic analysis. We identified three overarching themes and associated sub-themes that reflect the perceived benefits and limitations of service provision as identified by patients. These were technology acceptability (sub-themes 'challenges', 'requirements/facilitators', and 'beneficial features'); treatment acceptability (sub-themes 'treatment features', 'patient attributes', and 'practitioner skills'); and treatment efficacy (sub-themes 'treatment features', 'patient attributes', and 'practitioner skills'). Themes identified in this study have informed recommendations intended to enhance acceptability of DWMS technology and treatment, potentially encouraging engagement and increasing treatment efficacy. Limitations of the present study and recommendations for further research are also presented.
Subject(s)
COVID-19 , State Medicine , Humans , Male , Female , Pandemics , Qualitative Research , Referral and ConsultationABSTRACT
BACKGROUND: Universal screening for neonatal hyperbilirubinemia risk assessment is recommended by the American Academy of Pediatrics to reduce related morbidity. In Bangladesh and in many low- and middle-income countries, there is no screening for neonatal hyperbilirubinemia. Furthermore, neonatal hyperbilirubinemia may not be recognized as a medically significant condition by caregivers and community members. We aimed to evaluate the acceptability and operational feasibility of community health worker (CHW)-led, home-based, non-invasive neonatal hyperbilirubinemia screening using a transcutaneous bilimeter in Shakhipur, a rural subdistrict in Bangladesh. METHODS: We employed a two-step process. In the formative phase, we conducted eight focus group discussions with parents and grandparents of infants and eight key informant interviews with public and private healthcare providers and managers to explore their current knowledge, perceptions, practices, and challenges regarding identification and management of neonatal hyperbilirubinemia. Next, we piloted a prenatal sensitization intervention and home-based screening by CHWs using transcutaneous bilimeters and evaluated the acceptability and operational feasibility of this approach through focus group discussions and key informant interviews with parents, grandparents and CHWs. RESULTS: Formative findings identified misconceptions regarding neonatal hyperbilirubinemia causes and health risks among caregivers in rural Bangladesh. CHWs were comfortable with adoption, maintenance and use of the device in routine home visits. Transcutaneous bilimeter-based screening was also widely accepted by caregivers and family members due to its noninvasive technique and immediate display of findings at home. Prenatal sensitization of caregivers and family members helped to create a supportive environment in the family and empowered mothers as primary caregivers. CONCLUSION: Adopting household neonatal hyperbilirubinemia screening in the postnatal period by CHWs using a transcutaneous bilimeter is an acceptable approach by both CHWs and families and may increase rates of screening to prevent morbidity and mortality.