The worldwide trend in diabetes awareness, treatment, and control from 1985 to 2022: a systematic review and meta-analysis of 233 population-representative studies.

Background: With the rapid increase in the prevalence of DM, studies on the awareness, treatment, and control of this condition are essential. Therefore, this study aimed to review the literature and pool the awareness, treatment, and control of diabetes at the global, regional, and national levels. Methods: In this systematic review and meta-analysis, several databases, including MEDLINE/PubMed, Institute of Scientific Information (ISI), Scopus, and Google Scholar, were searched using appropriate keywords up to June 2022. Observational studies investigating the awareness, treatment, and control of glucose levels among diabetic individuals were included. Awareness, treatment, and control were defined as the proportion of participants who were aware of their diabetes condition, treated pharmacologically, and achieved adequate glucose control, respectively. Two investigators independently conducted the study selection, data extraction, and quality assessment. Heterogeneity among studies was calculated using Chi-square, and a random-effect meta-analysis was used to pool the rates. Results: A total of 233 studies published between 1985 and 2022 met the inclusion criteria. The included studies had a combined population of 12,537,968. The pooled awareness of DM was 60% (95%CI: 56-63) and ranged from 41% (25-57) in low-income countries to 68% (64-72) in high-income countries, with no significant trend observed over the assessed periods at the global level. The pooled treatment of DM globally was 45% (42-48) and varied from 37% (31-43) in lower-middle-income countries to 53% (47-59) in high-income countries, showing variation over the examined time period. Before 2000, the proportion of adequate DM control was 16% (12-20), which significantly improved and reached 22% (19-25) after 2010. The pooled awareness, treatment, and control of DM were higher in females, high-income countries, and urban areas compared to males, upper and lower-middle-income countries, and rural areas, respectively. The older adults population had higher awareness and treatment rates than the adult population, but their DM control did not differ significantly. Conclusion: Despite the high level of awareness and treatment among the diabetic population, treatment success (control) is considerably low, particularly in low-income countries and rural areas. It is crucial to improve awareness, treatment, and control by strengthening the primary care system in all countries.

Dental unit waterline infection control practice and knowledge gaps.

BACKGROUND: Dental unit waterline (DWL) infection control is critical to infection prevention. Identifying challenges and barriers to its implementation is a first step toward understanding how to improve engagement. METHODS: A survey was distributed to dentists, dental hygienists, and dental assistants via the Qualtrics XM platform (Qualtrics). Responses were analyzed to quantify engagement in practices contrary to Centers for Disease Control and Prevention guidance and identify avenues to improve engagement. RESULTS: Although oral health care providers recognized DWL infection control was important, there was a lack of clarity about appropriate routine engagement (eg, what lines should be tested), what should be noted in practice infection control records, and steps to be taken in response to a failed test result (ie, ≥ 500 colony-forming units/mL), such as taking a chair out of service. CONCLUSIONS: Survey results showed there were considerable gaps in knowledge and practice that could lead to patient harm. Oral health care provider training may not prepare personnel adequately to engage in, let alone supervise, DWL infection control. DWL infection control, like other aspects of infection control, requires action informed via an understanding of what needs to be done. Although good intentions are appreciated, better approaches to DWL infection control information dissemination and strategies to engage dental assistants, dental hygienists, and dentists in best practices are needed. PRACTICAL IMPLICATIONS: Evolving standards of care, including infection control, should be reflected in the provision of dental treatment. Improvements in communicating and ensuring engagement in best practices are needed when it comes to DWL infection control.

Medical Students' Clinical Knowledge of Integrated Management of Childhood Illness: A cross-sectional comparative study.

Objectives: This study aimed to investigate and compare the clinical knowledge implications of the integrated management of childhood illness (IMCI) preservice education between pre-clerkship and junior clerkship medical students. Methods: This observational comparative cross-sectional study was conducted between June and August 2022 at Sultan Qaboos University, Muscat, Oman. A self-administered questionnaire was utilised and included questions on sociodemographic data, duration of IMCI preservice training, knowledge of the participants concerning the IMCI objectives and information on a range of childhood conditions. Results: A total of 97 medical students were included in the study. The majority of students (42.3%) had received 2 lectures in IMCI preservice training. The role of the IMCI approach in reducing childhood morbidity and mortality was advocated by the majority of students (80.8% in the junior-clerkship [JCR] group and 73.3% in the pre-clerkship group). The awareness of the IMCI component of improving the health system was higher in JCR compared to pre-clerkship participants (P = 0.044). When compared to pre-clerkship students, the JCR participants demonstrated a slightly higher awareness of skin pinch (P = 0.038), chest indrawing (P = 0.008), anaemia assessment based on nail bed examination (P = 0.002), diagnostic assessment of malnutrition based on palm examination (P = 0.018), sucking capacity in breastfeeding (P = 0.025), and vaccines such as those for tuberculosis (P = 0.001), pneumococcal (P = 0.018) and rotavirus (P = 0.007). Conclusion: The majority of students displayed good IMCI knowledge and JCR students showed better knowledge compared to pre-clerkship candidates.

Evaluation of clinicians' knowledge and practice regarding pharmacotherapy of Non-Hodgkin's lymphoma: A multi-center study in Yemen.

Non-Hodgkin lymphoma (NHL) is a hematological malignancy that requires effective pharmacotherapy for optimal management. There is limited information regarding Yemeni clinicians' knowledge and practice of NHL pharmacotherapy. This study aims to assess the knowledge and practice of physicians and nurses in Yemen regarding pharmacotherapy of NHL. A cross-sectional study was conducted in Sana'a, Yemen, from January 1, 2022, to January 31, 2023. Two self-administrated and validated questionnaires were distributed to 99 physicians and 164 nurses involved in pharmacotherapy for NHL in different oncology centers and units across Yemen. Convenience samples were used to recruit participants. A binary logistic regression analysis was performed to identify factors associated with nurses' and physicians' knowledge and practice. The correlation coefficient was used to examine the relationship between knowledge and practice. A total of 77 physicians and 105 nurses completed the questionnaires. The results showed that 54.3% of nurses and 66.2% of physicians had poor knowledge of NHL pharmacotherapy. In terms of practice, 83.8% of nurses and 75.3% of physicians exhibited poor practice regarding NHL pharmacotherapy. Multivariable logistic regression analysis identified that nurses who received sufficient information about chemotherapy displayed a significant association with good knowledge, while nurses working in the chemotherapy administration department were significant predictors of good practice. Among physicians, those working in the National Oncology Center (NOC) in Sana'a demonstrated good practice. Correlation analysis revealed a positive relationship between nurses' knowledge and their practice. The study's results confirm deficiencies in knowledge and practice of pharmacotherapy for NHL among physicians and nurses in Yemen. Efforts should be made to enhance their understanding of treatment guidelines and to improve patient care. Improvement in educational programs and training opportunities may contribute to improving patient outcomes in the management of NHL.

Medical and dental student knowledge about COVID-19 and influenza vaccines impact opinions about vaccine advocacy and future practice.

Introduction: The World Health Organization has identified vaccine hesitancy as a global public health challenge. Healthcare providers are among the most influential and trusted figures for vaccine counseling. This article focuses on COVID-19 and influenza personal immunization behaviors, vaccine knowledge and opinions, and vaccine counseling confidence among future healthcare providers - dental and medical students. Methods: A cross-sectional anonymous online survey was conducted at four dental schools and one allopathic medical school in the United States. Items included personal vaccination status for the COVID-19 and influenza vaccines and vaccine-specific items developed based on past research to assess knowledge, opinions, and behaviors. Results: Two hundred and thirty-two medical and 221 dental students completed the survey. 68 and 55% scored average/above-average knowledge on COVID-19 and influenza vaccine items, respectively. There were significant differences between those with average/above-average and below-average knowledge scores regarding learning about, recommending, and advocating for vaccines and counseling vaccine-hesitant patients for both vaccines (p < 0.0001). Although higher-knowledge students had higher vaccination rates (p < 0.0001), many had insufficient knowledge about vaccines. Discussion: Healthcare providers play a crucial role in vaccine advocacy. The identified knowledge gaps are significant as they impact quality of patient care. And opinions about future vaccination practice such as recommending, providing, and counseling about vaccines. Equipping students with knowledge and communication skills will enable them to be strong vaccine advocates to improve overall public health.

Evaluating the influence of a 3-min online video on the community knowledge of stroke in four Arab countries.

Introduction: Studies from developed and developing countries showed that the knowledge levels of stroke need improvement. Educational campaigns varied and were of limited influence predominantly because of their short duration and the need for financial support. The study aims to test the impact of a 3-min online video on the knowledge of stroke and factors influencing the knowledge score in four Arab countries. Methods: A cross-sectional web-based pre-post study was conducted in Egypt, Jordan, Lebanon, and the United Arab Emirates. The data were collected using the snowball technique. Participants were adults aged 18 years and above. The questionnaire sequence was conducting a pretest, followed by the educational video explaining stroke occurrence, types, risks, warning signs, preventive measures, and treatment, and finally, a posttest to evaluate the differences in knowledge from baseline. Statistical analysis included paired t-tests comparing pre-post-education stroke knowledge scores, while repeated measures ANOVA, adjusting for covariates, assessed mean changes. Results: The total number of participants was 2,721, mainly younger than 55 years. The majority had a university degree and were not healthcare professionals. A significant improvement was noted in the total knowledge score in all countries from a mean average (Mpretest = 21.11; Mposttest = 23.70) with p < 0.001. Identification of the stroke risks (Mpretest = 7.40; Mposttest = 8.75) and warning signs (Mpretest = 4.19; Mposttest = 4.94), understanding the preventive measures (Mpretest = 5.27; Mposttest = 5.39) and the importance of acting fast (Mpretest = 0.82; Mposttest = 0.85) improved from baseline with (p < 0.001) for all score components. Conclusion: The educational tool successfully enhanced public understanding of stroke risks, the identification of stroke signs, and the critical need for emergency action. The advantages of this video include its short length, free online access, use of evidence-based content in lay language, and reflective images. The ultimate goal remains the long-term improvement of sustainability by mandating full-scale trials.

Assessing attitudes towards violence against women and girls, their determinants and health-seeking behaviour among women and men in South Sudan: a cross-sectional national survey.

OBJECTIVE: Investigating attitudes accepting two categories of violence against women and girls (VAWG) (intimate partner violence-IPV-and other expressions of VAWG) and their association with seven demographic/social determinants and health-seeking behaviours in South Sudan. DESIGN: Cross-sectional study using data from the South Sudan National Household Survey 2020. SETTING: South Sudan. PARTICIPANTS AND METHODS: 1741 South Sudanese women and 1739 men aged 15-49 years; data captured between November 2020 and February 2021 and analysed using binary logistic regression. RESULTS: People with secondary or higher education displayed attitudes rejecting acceptance of IPV (OR 0.631, 95% CI 0.508 to 0.783). Women and men living in states with more numerous internally displaced people (IDP) or political/military violence had attitudes accepting IPV more than residents of less violence-affected regions (OR 1.853, 95% CI 1.587 to 2.164). Women had a higher odd of having attitudes accepting IPV than men (OR 1.195, 95% CI 1.014 to 1.409). People knowing where to receive gender-based violence healthcare and psychological support (OR 0.703, 95% CI 0.596 to 0.830) and with primary (OR 0.613, 95% CI 0.515 to 0.729), secondary or higher education (OR 0.596, 95% CI 0.481 to 0.740) displayed attitudes rejecting acceptance of other expressions of VAWG. People residing in states with proportionately more IDP and who accepted IPV were more likely to have attitudes accepting other expressions of VAWG (OR 1.699, 95% CI 1.459 to 1.978; OR 3.195, 95% CI 2.703 to 3.775, respectively). CONCLUSION: Attitudes towards accepting VAWG in South Sudan are associated with women's and men's education, gender, residence and knowledge about health-seeking behaviour. Prioritising women's empowerment and gender transformative programming in the most conflict-affected areas where rates of VAWG are higher should be prioritised along with increasing girls' access to education. A less feasible strategy to decrease gender inequalities is reducing insecurity, military conflict, and displacement, and increasing economic stability.

Assessing nutrition-related knowledge, attitudes, and practices towards breast cancer prevention among female students at the Federal University of Oye-Ekiti, Nigeria.

BACKGROUND: Breast cancer remains a complex disease and leading cause of cancer-related death in Nigerian women. Recently, the role of nutrition has been highlighted in the etiology of breast cancer. METHODS: The aim of this research was to evaluate the nutrition-related knowledge, attitude, and practices of female university students. We also investigated the correlation between their demographic characteristics and their knowledge and attitudes of the survey participants. A descriptive cross-sectional study was carried out among female students at the Federal University of Oye (FUOYE), Nigeria. Participants completed self-administered questionnaires designed to assess their knowledge, attitude, and practices concerning cancer prevention. Statistical analysis was performed using SPSS 20, and significance was set at p < 0.05. RESULTS: Out of the 402 students who received the questionnaire, 300 completed it. The average age of the participants was 21.26 years with a standard deviation of 2.68. There was generally limited knowledge regarding breast cancer risk factors, with 45% of participants citing family history as the most recognized risk factor. Overall, knowledge level was influenced by the participants' permanent place of residence and course of study. Attitudes towards the impact of maternal and paternal nutrition on breast cancer prevention were notably low. Additionally, less than half of the participants demonstrated good dietary practices. CONCLUSION: This study revealed low levels of nutrition-related knowledge concerning cancer prevention, accompanied by poor dietary habits among the participants. These results suggest a possible link between inadequate knowledge about breast cancer prevention and the observed poor dietary practices among the participants. The frequent consumption of unhealthy foods among the participants may be a pointer to higher risk of breast cancer in the future, emphasizing a need for health education targeted at this group.

Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban-Rural Comparison.

INTRODUCTION: Maternal mortality is a major public health problem. Birth preparedness and complication readiness (BP/CR) constitute a veritable strategy for reducing maternal mortality, yet adoption is low with wide urban-rural discrepancies. OBJECTIVES: The objectives of this study were to compare the practice of BP/CR amongst women in rural and urban areas of Rivers State, Nigeria, and determine the individual-level predictors. METHODS: A facility-based cross-sectional comparative study using a multistage sampling method was employed in the selection of 924 (462 urban and 462 rural) women who gave birth within the last 12 months in urban and rural local government areas. Outcome measures were birth preparedness (defined as undergoing antenatal care (ANC) with a skilled birth provider, voluntary counselling and testing for HIV and saving money for childbirth at an agreed place of delivery with a skilled birth attendant) and complication readiness (defined as being knowledgeable about danger signs, identifying decision-maker, a nearest functional institution in case of emergency, emergency means of transport and funds and a suitable blood donor). Bivariate and multivariate analyses were performed at P < 0.05. RESULTS: The proportion of women who were birth prepared was significantly higher amongst women in urban areas (85.9%; 95% confidence interval [CI]: 82.7%-89.1%) versus rural counterparts (56.7%; 95% CI: 52.2%-61.2%), whereas the proportion of complication readiness was significantly higher in rural (31.8%; 95% CI: 27.6%-36.1%) than urban (18.2%; 95% CI: 15.2%-47.8%) groups. Predictors were possession of secondary educational level or higher (adjusted odds ratio [AOR]: 4.9; 95% CI: 1.5-15.5), being employed (AOR: 2.7; 95% CI: 1.5-15.0) and ANC attendance (AOR: 29.2; 95% CI: 8.8-96.9) in urban, whereas amongst the rural, it was ANC attendance (AOR: 20.0; 95% CI: 9.1-43.7). CONCLUSION: In urban areas, more women were birth prepared while fewer women were complication ready compared to the women in rural areas, with predictors such as education, employment and ANC attendance in urban areas and only ANC attendance in rural areas. Measures to promote ANC uptake, maternal education and empowerment could promote BP/CR.

Assessment of Knowledge of Legal Provisions on Organ Donation and Transplantation amongst Healthcare Workers in Nigeria: A Cross-sectional Study.

BACKGROUND: Advancements in the medical field have made organ transplantation an attractive treatment option for patients when indicated. Shortage of organs and commodification of organs are major challenges encountered in organ donation and transplantation. These could potentially breed unethical practices, if the process is not well regulated. AIM: The aim of this study was to assess the knowledge of healthcare workers (HCWs) on the legal provisions regulating organ donation and transplantation in Nigeria. METHODOLOGY: This cross-sectional study was conducted amongst physicians and nurses across Nigeria. Knowledge of legal provisions on organ donation and transplantation was assessed using a validated questionnaire that had 21 questions derived from the National Health Act. Each correctly answered question was given 1 point with a total obtainable score of 21 points. A score of ≥14 points was classified as good knowledge. P <0.05 was considered significant. RESULTS: A total of 836 physicians and nurses with a mean age of 37.61 ± 9.78 years participated in the study. Females and physicians constituted 53.3% and 62.9% of the respondents, respectively. The mean knowledge score of the respondents was 9.70 ± 2.91 points. Eighty-three (9.9%) respondents had a good knowledge score. There was a significantly higher proportion of male HCWs (P < 0.037) and older HCWs (P = 0.017) with good knowledge of legal provisions. On logistic regression, age was the only factor found to be associated with good knowledge of legal provision (adjusted odds ratio: 3.92; confidence interval: 1.33-11.59; P = 0.01). CONCLUSION: The overall knowledge of legal provisions on organ donation and transplant was very poor amongst HCWs in Nigeria. There is a need to educate them on these provisions to curb unethical practices.

Cardiovascular Risk Awareness, Exercise Practices and Metabolic Outcomes among Patients with Diabetes Mellitus in Northern Nigeria: A Cross-sectional, Multicentre Study.

BACKGROUND: Physical exercise helps to mitigate cardiovascular risks in people with diabetes mellitus (DM), but there are limited data in Nigeria. This study aimed to assess cardiovascular risk awareness, exercise practices and metabolic outcomes among Nigerians with diabetes. MATERIALS AND METHODS: We conducted a cross-sectional study at five tertiary hospitals using questionnaire interviews and clinical assessments. Participants' knowledge of cardiovascular risk factors and knowledge of exercise were assessed on 12- and 5-item scores, while exercise practices were classed as adequate if performed regularly on 3 or more days weekly for a total of 150 min or more based on the American Diabetes Association recommendations. Mean body mass index (BMI), blood pressure (BP), fasting blood glucose, serum haemoglobin A1C (HbA1c), lipid profile, urea, creatinine and uric acid were then compared among participant groups. RESULTS: We studied 426 participants with DM, 58.7% females. The mean age was 52.9 ± 13.1 years, with males significantly older than females (54.6 ± 12.2 vs. 51.8 ± 13.5 years; 95% confidence interval: 0.27-5.28, P = 0.03). The mean age at diabetes diagnosis was 44.8 ± 11.7 years, and the median duration of diabetes was 84 months. There was low knowledge of cardiovascular risk factors and low knowledge of exercise (mean scores of 2.94 and 2.31, respectively). Forty-three per cent of participants reported adequate exercise, which was significantly associated with younger age (P = 0.007), male gender (P = 0.001) and formal education (P = 0.021). Participants with adequate exercise had lower systolic BP and serum urea compared to those with inadequate exercise, but there were no significant differences in BMI, fasting glucose, HbA1c, serum lipids, creatinine or uric acid. CONCLUSION: Participants had low knowledge of cardiovascular risks and the appropriate exercise practices for diabetes patients. There is a need for better patient education on diabetes self-care and exercise at clinic visits.

Nurses' knowledge and practice regarding venous-thromboembolism prevention in tertiary hospitals of Addis Ababa, Ethiopia: A cross-sectional study.

BACKGROUND: The prevalence of venous thromboembolism is steadily increasing in developing nations including Ethiopia. Nurses play a vital role in the prevention of venous thromboembolism. However, the level of nurses' knowledge, practice, and associated factors in venous thromboembolism prevention is not well-known across Ethiopia. This study aimed to assess nurses' knowledge, practice, and associated factors regarding venous-thromboembolism prevention in tertiary Hospitals of Addis Ababa, Ethiopia METHODS: An institutional-based cross-sectional study was conducted among 339 randomly selected nurses working at tertiary hospitals in Addis Ababa, Ethiopia. A validated questionnaire was used to collect data. Data were analyzed with SPSS version 25. Both descriptive and inferential statistics were used to describe and test the association between selected variables. RESULTS: Out of the total 339 participants, only (51.6%) and (45.4%) had adequate knowledge and practice towards venous thromboembolism prevention respectively. Attending in-service training (AOR=1.701, p = 0.044) was significantly associated with knowledge of VTE prevention. Educational level (AOR= 3.871, P = 0.048), work experience (AOR=5.207, P<0.001), work location (AOR= 0.507, P = 0.019), working department (AOR= 2.959, P = 0.048), knowledge level (AOR= 0.477, P=0.005) were significantly associated with better preventive practice. CONCLUSION: This study suggests that nurses' level of knowledge and practice towards venous thromboembolism prevention was inadequate. Nurses' educational level, attending in-service training, work experience, work location, and working department were determinant factors associated with nurses' knowledge and practice towards venous thromboembolism prevention. Therefore, upgrading nurses' educational level and providing in-service training on venous thromboembolism prevention is crucial for positive patient outcomes.

What young women (aged 24-29 years) in Australia think about self-collection for cervical screening: a brief report.

Background In mid-2022 Australia's National Cervical Screening Program made self-collection of a vaginal sample an option for screening for young women or people with a cervix aged 25 to 29 years for the first time. This study explored what young women thought about, and wanted to know about, self-collection, and what their future screening preferences are. Methods Young women (n =21), aged 24-29years, were recruited through social media. Semi-structured interviews explored screening history, screening preferences and thoughts about self-collection. Data were analysed using an a priori coding framework informed by the Theoretical Framework of Acceptability. Results Young women valued the addition of self-collection to the national cervical screening program, believing it to be less invasive and more convenient. However, they also valued the choice to opt for a clinician-collected specimen if preferred. Conclusions Self-collection is a valuable addition to the National Cervical Screening Program. This study suggests that continued efforts are needed to raise awareness of its availability, and improve understanding about its accuracy, the ease of collection, that you still need to engage with a primary healthcare service to access it and that you can still opt for a clinician-collected test.

Factors Influencing Patient Selection of Sunscreen.

Sunscreen is an essential component of sun protection. The most important characteristics for patient selection of sunscreens have not been evaluated. A cross-sectional survey study was performed at an academic dermatology office. The sunscreen characteristic chosen most frequently was SPF (75.2%). Fewer patients selected broad-spectrum (20.7%) and water-resistance (22.7%). There remains a gap in patient knowledge regarding AAD recommendations for sunscreen characteristics and educational initiatives may be required. J Drugs Dermatol. 2024;23(6):e154-e155.     doi:10.36849/JDD.8324e  .

Sunscreen Practices and Preferences of Skin of Color Patients.

Sunscreen is an essential way to protect against photodamage from ultraviolet (UV) radiation. Despite the recognized benefits of sunscreen in preventing skin damage from UV light, its use varies across different patient groups. This cross-sectional, questionnaire-based study aims to uncover the sunscreen usage patterns, preferences, and barriers among non-Hispanic White (NHW) and skin of color (SOC) individuals. Our findings demonstrate that NHW individuals are more likely to wear sunscreen daily (31% NHW vs 25% SOC) and reapply sunscreen at least once a day (76% NHW vs 45% SOC) compared with SOC individuals. SOC individuals demonstrate a willingness to use sunscreen, but they face barriers such as cost (2% NHW vs 16% SOC), lack of knowledge in finding suitable products (22% NHW vs 41% SOC), and concerns about white cast (7% NHW vs 25% SOC). SOC individuals are less likely to know the difference between mineral and chemical sunscreen (49% NHW vs 29% SOC), less likely to learn about sunscreen from dermatologists (36% NHW vs 22% SOC), and more likely to prefer sunscreen from brands owned by people of color (13% NHW vs 47% SOC).  In addition to analyzing the broader categories of NHW and SOC, subgroup analysis was conducted on specific subgroups, including Black, Asian, and Hispanic groups. Herein, we highlight differences in motivations, sunscreen preferences, sources of information, and knowledge levels about sun protection between NHW and SOC individuals. By uncovering the unique needs and challenges faced by SOC individuals, we aim to improve culturally competent patient education and promote effective sun protection practices across diverse populations. J Drugs Dermatol. 2024;23(6):456-462.     doi:10.36849/JDD.8268.

Inequities in human papillomavirus vaccination among children aged 9-14 years old under constrained vaccine supply in China.

BACKGROUND: Inequities in access to human papillomavirus (HPV) vaccine are becoming a growing critical issue globally. Few studies investigate the factors determining HPV vaccine uptake disparities when vaccine supply is constrained, especially in low- and middle-income countries. The aim of this study was to investigate inequities of HPV vaccination and related factors under the constrained vaccine supply in China. METHODS: A cross-sectional survey was conducted in a developed eastern coastal province and a developing western one in China between November and December 2022. Employing multistage stratified cluster random sampling, the study collected data from parents of children aged 9-14. Mixed-effects logistic regression models with school units as random effects were used for analysis. RESULTS: From 4,127 eligible parents (as vaccine decision makers for girls), 1,346 (32.6%) intended to vaccinate their daughters against HPV, of which 836 (62.1%) attempted to schedule a vaccination appointment. Only 16.4% succeeded in booking an appointment. More than half of the intended parents expected the imported 9-valent HPV vaccine. There were significant disparities in HPV vaccine awareness, intention, and vaccination behavior across educational, income, geographic, ethnic, gender, and health literacy levels. Vaccine awareness and intentions were higher among parents with higher socioeconomic status; however, girls from lower socioeconomic families were more likely to receive the HPV vaccine and had a higher domestically produced vaccination rate. Significant disparities exist in vaccination intentions and actual vaccination behaviors, primarily due to large supply constraints of the HPV vaccine. CONCLUSIONS: Sustained health education campaigns are needed to raise awareness of the HPV vaccine, improve health literacy, and decrease over-preference for the 9-valent HPV vaccine. A mother's HPV vaccination behavior was positively associated with increased intention and actual vaccination behavior for her daughter. This study advocates for complementary cervical cancer prevention programs targeting both mothers and daughters.

Cluster analysis of cancer knowledge, attitudes and behaviors in the Moroccan population.

BACKGROUND: Cancer has become a major health concern due to the increasing morbidity and mortality rates, and its negative social, economic consequences and the heavy financial burden incurred by cancer patients. About 40% of cancers are preventable. The aim of this study was to assess the knowledge, attitudes, and practices regarding cancer prevention, and associated characteristics to inform the development of targeted cancer prevention campaigns and policies. METHODS: We conducted a cross-sectional survey of adult patients at Mohamed Sekkat and Sidi Othmane Hospitals in Casablanca, Morocco. Data collection was conducted by two trained interviewers who administered the questionnaire in-person in the local language. An unsupervised clustering approach included 17 candidate variables for the cluster analysis. The variables covered a wide range of characteristics, including demographics, health perceptions and attitudes. Survey answers were calculated to compose qualitative ordinal categories, including a cancer attitude score and knowledge score. RESULTS: The cluster-based analysis showed that participants in cluster 1 had the highest mean attitude score (13.9 ± 2.15) and percentage of individuals with a high level of knowledge (50.8%) whereas the lowest mean attitude score (9.48 ± 2.02) and knowledge level (7.5%.) were found in cluster 3. The participants with the lowest cancer attitude scores and knowledge levels were aged 34 to 47 years old (middle age group), predominantly females, living in rural settings, and were least likely to report health professionals as a source of health information. CONCLUSIONS: The findings showed that female individuals living in rural settings, belonging to an older age group, who were least likely to use health professionals as an information source had the lowest levels of knowledge and attitudes. These groups are amenable to targeted and tailored interventions aiming to modify their understanding of cancer in order to enhance the outcomes of Morocco's on-going efforts in cancer prevention and control strategies.

Assessment of patterns and related factors in using social media platforms to access health and oral health information among Sri Lankan adults, with special emphasis on promoting oral health awareness.

BACKGROUND: Social media has evolved beyond its conventional purpose of communication and information sharing to become a potent tool for disseminating health and oral health awareness. This study seeks to assess the patterns and related factors of using social media platforms to access health and oral health information among Sri Lankan adults, with special emphasis to promotion of oral health awareness. METHODS: In March 2023, individuals aged ≥ 18 years residing in Sri Lanka, who are users of social media participated in this electronic questionnaire-based survey. Statistical analyses of the collected data were done using the SPSS version 21 software, with a p-value of < 0.05 set to determine the level of statistical significance. RESULTS: A total of 421 persons participated in this survey. Majority (68.4%) belonged to the age category of 18 to 30 years, and 55.5% were females. WhatsApp (96.8%) was the most frequently used social media platform across all age groups and both genders. Statistically significant differences were identified between genders in the usage of Telegram, Twitter, and Viber within the 18-30 years age category, with a higher percentage of males using these platforms (p ≤ 0.05). Similar significant differences were observed in the 31-40 years age group for WhatsApp and Telegram (p ≤ 0.05). Among 95.4% of online health information seekers, YouTube (74.9%) was the most popular platform. One-quarter of the respondents preferred social media platforms, and 22.3% preferred websites for obtaining oral health information. Furthermore, 74.9% had positive opinions on obtaining oral health information via social media, while only 17% reported pleasant experiences with social media platforms for oral health promotion. In assessing the reliability of oral health information on social media, 48% relied on the quality of the information. The most preferred source of oral health information was short videos from professionals (43.1%). Additionally, 69.5% reported changes in their oral health behaviours after accessing information through social media. CONCLUSION: Social media is a viable platform for promoting public oral health awareness in Sri Lankan; hence, workable strategies need to be employed, to further ensure its effective and wider use in a culturally and socioeconomically diverse country like Sri Lanka.

Explaining the perception and experiences of breastfeeding in mothers who have a high risk pregnancy: a protocol study.

INTRODUCTION: Enhancing breastfeeding practices, even in affluent nations, significantly reduces child mortality rates. Nevertheless, three out of five newborns do not receive breastfeeding within the first hour of birth. Research indicates that under high-risk pregnancy circumstances, there may be challenges in initiating and sustaining breastfeeding. Infants born from high-risk pregnancies are particularly vulnerable to illnesses and mortality. Although breastfeeding serves as a protective measure against various infant and post-infancy ailments, many mothers encounter difficulties in commencing or maintaining breastfeeding due to complications associated with their conditions. The present study aims to illuminate the understanding and experience of breastfeeding in mothers with high-risk pregnancies, considering the cultural and social context of Iran. METHOD: This study is a qualitative research utilizing a conventional content analysis approach. In this qualitative study, mothers who have undergone a high-risk pregnancy and currently have infants under 6 months old will be chosen through purposeful and snowball sampling. Their breastfeeding experiences will be gathered through individual, semi-structured, and face-to-face interviews. In addition to interviews, observation and focus groups will also be used to collect data. Data analysis was performed using Graneheim and Lundman's method with MAXQDA software version 10, VERBI Software GmbH, Berlin. The study will utilize the criteria of Lincoln and Guba (1985) for validity and reliability. DISCUSSION: This qualitative study aims to investigate the experiences and challenges of breastfeeding in mothers with high-risk pregnancies to pinpoint breastfeeding barriers in this demographic and develop essential interventions and strategies to address these obstacles.