Enhancing ventrolateral prefrontal cortex activation mitigates social pain and modifies subsequent social attitudes: Insights from TMS and fMRI.

Social pain, a multifaceted emotional response triggered by interpersonal rejection or criticism, profoundly impacts mental well-being and social interactions. While prior research has implicated the right ventrolateral prefrontal cortex (rVLPFC) in mitigating social pain, the precise neural mechanisms and downstream effects on subsequent social attitudes remain elusive. This study employed transcranial magnetic stimulation (TMS) integrated with fMRI recordings during a social pain task to elucidate these aspects. Eighty participants underwent either active TMS targeting the rVLPFC (n = 41) or control stimulation at the vertex (n = 39). Our results revealed that TMS-induced rVLPFC facilitation significantly reduced self-reported social pain, confirming the causal role of the rVLPFC in social pain relief. Functional connectivity analyses demonstrated enhanced interactions between the rVLPFC and the dorsolateral prefrontal cortex, emphasizing the collaborative engagement of prefrontal regions in emotion regulation. Significantly, we observed that negative social feedback led to negative social attitudes, whereas rVLPFC activation countered this detrimental effect, showcasing the potential of the rVLPFC as a protective buffer against adverse social interactions. Moreover, our study uncovered the impact role of the hippocampus in subsequent social attitudes, a relationship particularly pronounced during excitatory TMS over the rVLPFC. These findings offer promising avenues for improving mental health within the intricate dynamics of social interactions. By advancing our comprehension of the neural mechanisms underlying social pain relief, this research introduces novel intervention strategies for individuals grappling with social distress. Empowering individuals to modulate rVLPFC activation may facilitate reshaping social attitudes and successful reintegration into communal life.

Influences affecting decision-making regarding use of pre-exposure prophylaxis among black men who have sex with men in the USA: a systematic review and meta-synthesis.

AIM: To systematically identify, evaluate, and synthesise qualitative research examining positive and negative influences affecting decision-making behaviour among black men who have sex with men (BMSM) in the USA regarding use of pre-exposure prophylaxis (PrEP). BACKGROUND: Used correctly, PrEP is highly efficacious in preventing HIV infection and is available via healthcare services throughout the USA. BMSM are a key target population for HIV prevention services, however their engagement with these services is low. With potential barriers to access ranging from systemic to personal, a phenomenological perspective on the influences affecting individuals' decision-making is essential, helping to better understand the needs of this target population and guide development and delivery of more effective future policy and intervention services. DESIGN: Qualitative meta-synthesis with meta-aggregation. DATA SOURCES: The electronic databases Medline, CINAHL, APA PsycInfo, Embase and Ovid Emcare were comprehensively searched from inception to 21 January 2022. REVIEW METHODS: Systematic identification, quality assessment and synthesis of existing qualitative research according to protocols of meta-aggregation. This included identifying salient study findings and corroborating illustrations from the data, sorting like findings into descriptive themed categories and developing transformative synthesised statements from aggregate appraisal of category findings. RESULTS: Seventeen studies met the inclusion criteria and were assessed to be of acceptable quality. Synthesis of study data yielded 30 categories grouped under five themes: Stigma, Discrimination, Mistrust, PrEP positivity and PrEP negativity. Twelve synthesised statements were produced to provide a summary of the results and suggest improvements to the delivery of future PrEP services and interventions. CONCLUSION: A more targeted approach focused on advocacy and ambassadorship outside of clinical settings may be more influential in positive decision-making regarding use of PrEP in BMSM populations than relying on traditional outreach methods via institutions and their representatives where stigma, mistrust and structural inequalities perpetuate.

Effect of educational intervention on the knowledge, attitude and practice of breast self-examination among female students at a private university in Southern Nigeria.

INTRODUCTION: In Nigeria, breast cancer (BC), a disorder marked by the unchecked growth of breast cells, has been the commonest cancer among women in Nigeria. Breast self-examination (BSE) is one of the suggested methods for screening for the early diagnosis of breast cancer. However, studies have reported inadequate knowledge, negative attitudes and poor practices of BSE among undergraduate female students. The study was designed as an interventional study to examine the effect of educational intervention on knowledge, attitude and practice of breast self-examination among female students in a private university in southern Nigeria. METHODS: This pretest posttest design study was carried out on 103 students of Novena University at baseline in 2022, which were chosen through the use of simple random sampling. A validated questionnaire with components on demographics, knowledge, attitude, and BSE practice was used to gather the data. After that, the students participated in three hourly sessions of an educational intervention for two weeks. A month later, the students' data were once again collected, and SPSS 20 software was used to evaluate the results using the mean, paired t test, and logistic regression at the P < 0.05 level of significance. RESULTS: The mean age of the respondents was 22.37 ± 1.92 years. Only 53 (51.3%) were aware of BSE. The mean knowledge, attitude and practice of BSE at pretest significantly increased at posttest after the educational intervention (1.58 ± 1.48 vs. 4.31 ± 1.15, 2.37 ± 1.27 vs. 4.80 ± 0.49 and 1.97 ± 0.09 vs. 5.81 ± 3.26, respectively). Furthermore, age and family history of BC were predictors of knowledge (OR = 4.00 95% CI = 0.29-41.99, OR = 141, 95% CI = 0.15-13.18), attitude (OR = 2.39, 95% CI = 0.28-12.32, OR = 1.15, 95% CI = 0.24-8.34) and practice of BSE (OR = 2.66, 95% CI = 0.38-18.41, OR = 1.44, 95% CI = 0.24-8.34) respectively. CONCLUSION: The findings showed that using an educational intervention strategy will improve the knowledge, attitude and practice of BSE among undergraduate students.

Pain attitudes and pain outcomes among people with bleeding disorders: Results from community voices in research.

INTRODUCTION: Among people with bleeding disorders (PwBD), pain is a major problem and pain treatments are often ineffective. Understanding of psychological factors involved in pain processing is limited. Maladaptive pain attitudes are associated with worse pain outcomes and adaptive pain attitudes are associated with better outcomes in high pain conditions, but relationships between pain attitudes and pain outcomes are so far unexplored among PwBD. AIM: To investigate relationships between pain attitudes and pain outcomes among PwBD. METHODS: Pain attitudes were measured with the Survey of Pain Attitudes, containing two adaptive scales (Control and Emotion) and five maladaptive scales (Disability, Harm, Medication, Solicitude, Medical Cure). Adults with bleeding disorders, who had pain, and were enrolled in Community Voices in Research were eligible. Participants (n = 72) completed an online survey. Cross sectional associations between pain attitudes and pain outcomes (pain and prescribed pain medication use) were investigated using logistic regression. RESULTS: After adjustment for covariates, greater Control attitudes were associated with lower odds of more severe pain, and greater Disability, Harm, and Medication attitudes were all associated with higher odds of more severe pain and with higher odds of any prescribed pain medication use and opioid pain medication use. CONCLUSIONS: We presented compelling evidence of relationships between pain attitudes and pain outcomes in PwBD, though corroboration is needed from other populations. Our findings suggest that modification of pain attitudes presents a possible avenue for interventions to improve pain outcomes and increase patient satisfaction with pain management.

Perceptions of reproductive healthcare providers regarding their involvement in offering expanded carrier screening in fertility clinics: a qualitative study.

RESEARCH QUESTION: What are the main arguments of reproductive healthcare providers in favour or against their involvement in offering expanded carrier screening (ECS) for recessive disorders at fertility clinics in the Netherlands? DESIGN: Semi-structured interview study with 20 reproductive healthcare providers between May 2020 and January 2021. Participants included 11 gynaecologists, seven fertility doctors, one nurse practitioner and one clinical embryologist, recruited from academic medical centres (n = 13), peripheral facilities associated with academic centres (n = 4), and independent fertility treatment centres (n = 3) in the Netherlands. An interview guide was developed, and thematic content analysis was performed using ATLAS.ti software. RESULTS: Arguments of reproductive healthcare providers in favour of their potential involvement in offering ECS included: (i) opportunities offered by the setting; (ii) motivation to assist in reproduction and prevent suffering; and (iii) to counter unwanted commercialization offers. Arguments against involvement included: (i) lack of knowledge and familiarity with offering ECS; (ii) insufficient staff and resources, and potential high costs for clinics and/or couples; (iii) the emotional impact it may have on couples; (iv) perceived complexity of counselling and expected elongation of waiting lists; and (v) expected low impact on reducing the burden of diseases. Participants felt that more evidence and research on the costs-benefits, implications and demand are needed prior to their involvement. CONCLUSION: While agreeing that the field of medically assisted reproduction provides a unique opportunity to offer ECS, reproductive healthcare workers feel a lack of capability and limited motivation to offer ECS to all or a selection of couples at their fertility clinics.

"How I would like AI used for my imaging": children and young persons' perspectives.

OBJECTIVES: Artificial intelligence (AI) tools are becoming more available in modern healthcare, particularly in radiology, although less attention has been paid to applications for children and young people. In the development of these, it is critical their views are heard. MATERIALS AND METHODS: A national, online survey was publicised to UK schools, universities and charity partners encouraging any child or young adult to participate. The survey was "live" for one year (June 2022 to 2023). Questions about views of AI in general, and in specific circumstances (e.g. bone fractures) were asked. RESULTS: One hundred and seventy-one eligible responses were received, with a mean age of 19 years (6-23 years) with representation across all 4 UK nations. Most respondents agreed or strongly agreed they wanted to know the accuracy of an AI tool that was being used (122/171, 71.3%), that accuracy was more important than speed (113/171, 66.1%), and that AI should be used with human oversight (110/171, 64.3%). Many respondents (73/171, 42.7%) felt AI would be more accurate at finding problems on bone X-rays than humans, with almost all respondents who had sustained a missed fracture strongly agreeing with that sentiment (12/14, 85.7%). CONCLUSIONS: Children and young people in our survey had positive views regarding AI, and felt it should be integrated into modern healthcare, but expressed a preference for a "medical professional in the loop" and accuracy of findings over speed. Key themes regarding information on AI performance and governance were raised and should be considered prior to future AI implementation for paediatric healthcare. CLINICAL RELEVANCE STATEMENT: Artificial intelligence (AI) integration into clinical practice must consider all stakeholders, especially paediatric patients who have largely been ignored. Children and young people favour AI involvement with human oversight, seek assurances for safety, accuracy, and clear accountability in case of failures. KEY POINTS: Paediatric patient's needs and voices are often overlooked in AI tool design and deployment. Children and young people approved of AI, if paired with human oversight and reliability. Children and young people are stakeholders for developing and deploying AI tools in paediatrics.

Evaluation of knowledge, attitude, and awareness of liver transplant patients toward xenotransplantation.

BACKGROUND: Xenotransplantation (XTx) is an alternative treatment for organ scarcity. Investigating the acceptance of XTx among patients from diverse cultural and religious backgrounds is essential. This study aimed to evaluate the knowledge, attitudes, and awareness of XTx among patients undergoing liver transplant (LT). METHODS: This descriptive study was conducted between November 2022 and August 2023. The study population comprised LT patients aged ≥18 years who were admitted to the hepatology clinic of a university hospital in Turkey. Of the 360 patients (n = 360) interviewed, 351 were deemed eligible for inclusion. A questionnaire was used to collect data. The Kolmogorov-Smirnov test, median, standard deviation, minimum-maximum, number, percentage, and Pearson's chi-square test were used for statistical analysis. RESULTS: Of the patients, 78.3% were religious and adhered to religious requirements, and 87.2% considered their religious beliefs when making important decisions. In all, 41.3% of the participants believed that organ or tissue transplantation from animals to humans is ethical, while 70.1% of the participants believed that organ and tissue transplantation from non-halal animals to humans was impossible. Specifically, 56.7% would not allow organ or tissue transplantation from a non-halal animal to themselves or a relative. Knowledge and attitude towards XTx were not affected by transplantation type (p > .05), but were affected by sex and educational level (p < .05). CONCLUSION: This study found that LT patients generally oppose XTx. To enhance knowledge and awareness, religious leaders and healthcare professionals should organize comprehensive and effective seminars on this topic.

Perceptions of antibiotic resistance among hospital healthcare professionals in high-income countries: A systematic review of causes, consequences, and solutions.

OBJECTIVE: Antibiotic resistance (ABR) is a major threat to public health. Hospital healthcare professionals are important stakeholders in curbing ABR. To be able to encourage healthcare professionals to act against ABR, information on their perceptions is needed. Yet, summary evidence on how healthcare professionals perceive ABR causes, consequences, and solutions is outdated. This review aims to elucidate these perceptions. METHODS: We searched MEDLINE, EMBASE, PsycINFO, and CINAHL for literature published until July 6th, 2022, and used Web of Science and Scopus to identify reports citing included studies. Reports of quantitative original research from high-income countries were included if they investigated hospital healthcare professionals' perceptions about ABR. Descriptive data and data on perceptions about causes, consequences, and solutions regarding ABR were extracted. PROSPERO registration: CRD42022359249. RESULTS: The database search and citation tracking yielded 13,551 and 694 papers respectively. Forty-eight reports from 46 studies were included in the review. These studies were performed between 1999 and 2023 and included between 8 and 1362 participants. Healthcare professionals perceived ABR as a problem that is more severe nationally than locally and they primarily recognize ABR as a distant and abstract problem. Studies mostly concurred on prescribing behavior as a cause and a solution for ABR, while external causes and solutions (e.g., in agriculture) elicited less agreement. CONCLUSIONS: Studies with a primary focus on the perceptions of healthcare professionals about ABR are limited. Healthcare professionals perceive prescribing behavior as a major cause of ABR and a focus area for ABR solutions.

Perceptions of nicotine vaping products among Australians living with HIV.

People living with HIV (PLHIV) are two to three times more likely to smoke tobacco compared to the general community. Evidence from the general population suggests that nicotine vaping products (NVPs) can be acceptable and effective smoking cessation aids, but there is limited evidence on the extent to which this is the case among PLHIV. This manuscript reports findings from the Tobacco Harm Reduction with Vaporised Nicotine (THRiVe) trial, a mixed-methods study investigating the feasibility of NVPs as smoking cessation aids among 29 PLHIV who smoked tobacco. Surveys and semi-structured interviews explored participants' experiences and perceptions of NVPs, their features and functions, and support for various NVP regulatory policy options. Participants described seven reasons why NVPs were acceptable cessation aids: they satisfied nicotine cravings; differences between NVPs and cigarettes facilitated habit breaking; fewer adverse effects compared to traditional cessation aids; NVPs allowed for a "weaning process" rather than requiring abrupt abstinence; tobacco became increasingly unpleasant to smoke; NVPs provided an increased sense of control; and participants experienced a deeper understanding of personal smoking behaviours. This study provides valuable insight into the preferred features of NVPs among PLHIV and reasons why NVPs may be effective for promoting smoking cessation among PLHIV.

Knowledge, attitudes, and practices of caregivers with children diagnosed with epilepsy attending a pediatric outpatient clinic: a descriptive, cross-sectional, questionnaire-based study in Addis Ababa, Ethiopia.

BACKGROUND: Caregivers' knowledge and attitudes influence help-seeking behavior and treatment decisions of patients with epilepsy, which in turn significantly impacts epilepsy care. In Ethiopia, epilepsy is often misunderstood, associated with misconceptions and accompanied by persistent negative attitudes. The objective of this study is to assess the knowledge, attitude, and practice of caregivers of children with epilepsy. METHODS: We conducted a hospital-based survey at the Yekatit 12 Hospital Pediatric Neurology Clinic, Addis Ababa, Ethiopia, between May and July 2022. We invited caregivers of children with epilepsy taking one or more daily anti-seizure medications to participate. Caregivers were invited to complete a structured questionnaire with guidance from a trained nurse to estimate knowledge and attitudes towards epilepsy and its treatment. Knowledge and attitudes were categorized as "good" and "favorable" (correct answers to ≥ 50% of questions) or "bad" and "unfavorable" (< 50% correct answers), respectively. Attitudes towards standard care versus non-standard (e.g., spiritual) care were also estimated. RESULTS: A total of 120 caregivers completed the questionnaire. Many caregivers were familiar with the term 'epilepsy', with more than half (51.7%) having heard or read about it previously. The reported causes of epilepsy varied, with birth injury being the most common cause (44 out of 120 caregivers). Notably, there was association between the caregiver's gender and their knowledge score, with a p-value = 0.05. Caregivers exposed to information about epilepsy through hearing or reading demonstrated significantly higher levels of knowledge, with a p-value < 0.001. Additionally, knowing someone with epilepsy other than the index child was significantly associated with higher knowledge scores (p-value < 0.001). The study also revealed negative attitudes toward epilepsy: for example, 56.7% of surveyed caregivers believed it is unlikely that a child with epilepsy has normal cognitive abilities and 39.1% believed they should never be allowed to attend regular school. Additionally, a high proportion of caregivers (70%) sought alternative treatments (e.g., spiritual help) alongside standard medical care. CONCLUSIONS: A significant knowledge gap was identified among caregivers, revealing prevalent misconceptions and negative attitudes. Improving epilepsy awareness, attitudes, and practices among caregivers will potentially contribute to overall improved quality of life for children with epilepsy.

Pain medication beliefs in individuals with headache.

OBJECTIVE: To evaluate pain medication beliefs in a community sample of individuals with headache. BACKGROUND: Previous studies of medication adherence for individuals with headache have identified a high rate of prescription nonfulfillment, frequent medication discontinuation, and widely varying levels of medication-related satisfaction. Still, there is a limited understanding of how these individuals view their medications and their relationships with health-care providers. Insight into these perceptions could prove useful in explaining medication adherence behaviors. METHODS: In this secondary analysis of a cross-sectional study, data from N = 215 adults with headache were analyzed. Participants completed the Pain Medication Attitudes Questionnaire (PMAQ), Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Inventory Form Y-2, Weekly Stress Inventory Short Form, and Migraine Disability Scale. These participants also provided a list of their current pain medications. RESULTS: Using the PMAQ, participants could be characterized as having medication beliefs that were "trusting and unconcerned" (n = 83/215 [38.6%]), "skeptical and somewhat worried" (n = 99/215 [46.0%]), or "skeptical and concerned" (n = 33/215 [15.3%]). Individuals with skeptical and concerned beliefs expressed elevated concerns (z > 1.15) about side effects, scrutiny, perceived need, tolerance, withdrawal, and addiction. Individuals who were trusting and unconcerned expressed low levels (z < -0.40) of these beliefs. Increasing levels of mistrust and medication concerns were correlated with higher depression scores on the CES-D, with values ranging from r = 0.23 to r = 0.38. CONCLUSIONS: Subgroups of pain medication beliefs were identified, including two groups of patients with at least some concerns about their medical providers. Beliefs ranged from a lack of concern about using pain medications to worries about scrutiny and harm. It is unclear if poor experiences with pain medications cause these beliefs or if they prevent individuals from effectively utilizing medications. Additionally, more negative beliefs about pain medications were associated with more depressive symptoms.

Physician Perceptions of Medication Prescribing in Heart Failure: A Scoping Review.

INTRODUCTION: The swift uptake of new medications into clinical practice has many benefits; however, slow uptake has been seen previously with other guideline-directed medical therapies (GDMT) in heart failure (HF). Sodium glucose co-transporter 2 inhibitors are a novel therapy in HF proven to be efficacious and will have beneficial clinical outcomes if prescribed. Understanding physician perspectives on prescribing GDMT in HF can help target strategies to bridge the gap between guidelines and practice. METHODS: The study followed the PRISMA guide for scoping reviews. A search was conducted using EMBASE, Medline, and PubMed databases in April 2024. Studies included were those using qualitative methods to assess physician perspectives towards prescribing any HF medication. Common themes were identified through thematic synthesis following the methods from Cochrane Training and using software MAXQDA Analysis Pro. RESULTS: 708 studies were found in the search, with 23 full studies included. The most pertinent barriers identified were concern for medication adverse effects, unclear role responsibilities between physicians of different specialities, patient co-morbidities, and unwillingness to alter therapies of stable patients. The most identified enablers included awareness of efficacy, influence from colleagues, and the use of multi-media approaches for information dissemination. Perceptions were also found to change over time and vary among prescriber groups. CONCLUSIONS: Physicians perceive common barriers and enablers of prescribing GDMT in HF, despite differences in prescriber groups and time periods. The identified barriers and enablers may be targeted to improve implementation of GDMT into clinical practice.

Knowledge, attitudes and practices towards epilepsy in morocco: A cross-sectional study.

BACKGROUND: This study aims to assess knowledge, practices and attitudes of the general Moroccan population towards epilepsy and to highlight predictive factors. METHOD: A cross-sectional study was conducted in the Casablanca-Settat Moroccan region. A questionnaire was used to collect sociodemographic data and item answers from 400 people with epilepsy (PWE) and without epilepsy caregivers on dependent variables: knowledge, attitudes, and practices towards epilepsy. Bivariate and logistic regression analyses were performed using IBM SPSS Statistics 21.0. Statistical significance was set when P value < 0.05. RESULTS: The rates of poor knowledge, practices, and attitudes toward epilepsy were 11.5 %, 41 %, and 66.6 %, respectively. In the multivariate analysis, the risk of having poor knowledge about epilepsy was favored by lack of education (ORa = 4.31;CI95%:1.83-10.13;p = 0.001) and the absence of familiarity with epilepsy (ORa = 4.05;CI95%:1.92-8.54;p < 0.001). The risk of preferring allopathic practices to treat epilepsy was associated with lack of education (ORa = 2.21;CI95%:1.01-4.82;p = 0.046), residence in a city outside Casablanca (ORa = 2.33;CI95%:1.06-5.15;p = 0.035), age over 59 years (ORa = 2.50;CI95%:1.26-4.95; p = 0.008), residence in a rural areas (ORa = 4.41;CI95%:2.61-7.47;p < 0.001) and absence of familiarity with epilepsy (ORa = 4.08;CI95%:2.33-7.15;p < 0.001). Predictors of stigma towards epilepsy were female sex (ORa = 3.05;CI95%:2.04-4.56;p < 0.001) and the tendency to abandon anti-seizure medication for allopathic alternatives (ORa = 3.98;CI95%:2.21-7.17;p < 0.001), whereas advanced age was a protective factor (ORa = 0.57;CI95%:0.36-0.89;p = 0.014[39-59 years vs 18-29 years];ORa = 0.44;CI95%:0.23-0.82;p = 0.011[>59 years vs 18-29 years]). CONCLUSIONS: The rate of poor attitudes and treatment-seeking behavior was high. This socio-cultural context certainly impacts the quality of life and care of Moroccan PWE. These results should be considered to raise awareness in the Moroccan population.

A community-based awareness program improves knowledge and attitudes toward epilepsy: An interventional study.

OBJECTIVE: Little interventional studies were conducted to improve knowledge, improve attitude, and eliminate stigma against patients with epilepsy. This study was conducted to investigate the effect of a community-based epilepsy awareness program (CBEAP) on knowledge, attitude, and stigma against patients with epilepsy among the Palestinian general public. METHODS: This interventional study used a pre-post design. Knowledge and attitudes were assessed using a reliable and internally consistent questionnaire before and 1 month after receiving a CBEAP. Knowledge was assessed using a 16-item and attitudes were assessed using 13 items. RESULTS: A total of 150 participants completed the questionnaire before the CBEAP. Of those, 136 (90.7 %) completed the CBEAP, and 129 (86.0 %) completed the questionnaire 1 month after receiving the CBEAP. The CBEAP significantly (p-value < 0.05) increased knowledge about the nature of epilepsy and seizures, triggers and treatment options, and patients with epilepsy. Similarly, the CBEAP significantly (p-value < 0.001) improved the attitudes of the participants toward epilepsy or having epilepsy, patients with epilepsy, relationships with patients with epilepsy, and working or staying with patients with epilepsy. Greater changes in knowledge and attitude scores were predicted by younger age and having a close friend or family member with epilepsy. CONCLUSION: The CBEAP developed and implemented in this interventional study significantly increased the knowledge of the participants about epilepsy and improved their attitudes toward epilepsy and patients with epilepsy. Large-scale implementation of such interventional programs is still needed to increase knowledge and improve attitudes toward epilepsy and patients with epilepsy.

Knowledge and attitude toward proton radiotherapy among oncology patients: a multi-center, cross-sectional study.

Aim: To explore the knowledge and attitude among oncology patients toward proton radiotherapy. Materials & methods: This cross-sectional study was performed using self-designed questionnaire. Results: Based on 546 valid questionnaires, mean knowledge and attitude scores of 3.4 ± 3.6 (range: 0-12) and 31.1 ± 3.5 (range: 10-50) were observed. Multivariate analysis demonstrated that higher education (p = 0.021), higher monthly income (p = 0.005), and proton radiotherapy history (p < 0.001) were independently associated with higher knowledge scores. Higher knowledge (p = 0.020), older age (p = 0.030), not smoking (p = 0.032) and medication use (p = 0.035) were independently associated with higher attitude scores. Conclusion: Oncology patients have insufficient knowledge and negative attitude toward proton radiotherapy, which might be affected by their age, education, income, proton radiotherapy history, employment, smoking and medication use.

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"Not me!" a qualitative, vignette-based study of nurses' and physicians' reactions to spiritual distress on neuro-oncological units.

PURPOSE: People with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients. METHODS: Neurospirit-DE is a qualitative vignette-based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis. RESULTS: A total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection. CONCLUSIONS: Most neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient's spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients' distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.

The protective effects of cognitive empathy and emotional empathy on gambling disorder are mediated by risk aversion and responsible gambling attitude.

BACKGROUND: Based on social cognitive theory, this study aimed to examine whether and how social abilities (i.e., cognitive empathy and emotional empathy) are associated with gambling disorder (GD) by incorporating attitudes toward general risk (i.e., risk aversion) and responsible gambling as potential mediators of this link. METHODS: A convenience sample of 580 past-year lottery gamblers (Mage = 34.07, SD = 13.36; 50.4% female), recruited near lottery sales shops, completed an anonymous paper-version questionnaire on site. Data were collected using the DSM-5 diagnostic criteria for GD, Interpersonal Reactivity Index, Risk Aversion Scale, Positive Play Scale, and demographic items. Path analysis and mediation analysis were applied to examine the effects of cognitive empathy and emotional empathy on GD and the mediating roles of risk aversion and responsible gambling attitude. RESULTS: Our results showed that cognitive empathy, but not emotional empathy, was significantly and negatively correlated with GD. Also, the effect of cognitive empathy on GD was fully mediated by risk aversion and responsible gambling attitude, whilst the total indirect effect of emotional empathy on GD was nonsignificant. As hypothesized, the indirect paths from both types of empathy to GD were significantly and serially mediated by risk aversion and responsible gambling attitude. CONCLUSION: Cognitive empathy, distinct from emotional empathy, was a statistically significant correlate of GD. Moreover, the path model results also suggest that responsible gambling attitude was a salient protective factors against GD. Future GD prevention efforts may benefit from paying more attention to the role of responsible gambling attitude.

Knowledge and attitude towards preconception care and associated factors among women of reproductive age with chronic disease in Amhara region referral hospitals, Ethiopia, 2022.

INTRODUCTION: Preconception care (PCC) is an important window to target maternal morbidity and mortality, especially for women with chronic diseases. However, little is known about knowledge and attitudes towards preconception care among women with chronic disease. Therefore, this study aimed to assess knowledge and attitude towards preconception care and associated factors among women of reproductive age with chronic disease in Amhara region referral hospitals, Ethiopia, 2022. METHOD: A multicenter cross-sectional study was conducted in Amhara region referral hospitals from April 15 to June 1, 2022. A total 828 women of reproductive age with chronic disease in four referral hospitals were selected using a stratified and systematic random sampling technique. Data was collected by using a structured interviewer-administered questionnaire and chart review. Bivariate and multivariable logistic regression analyses were carried out. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed to see the strength of association between outcome and independent variables. P-value < 0.05 was considered as statistically significant. RESULTS: This study found that 55.6% of respondents had a good knowledge of preconception care, and 50.2% had a good attitude towards PCC. Formal education (AOR: 1.997, 95% CI: 1.247, 3.196), primiparity (AOR: 2.589, 95% CI: 1.132, 5.921), preconception counseling (AOR: 3.404, 95% CI: 2.170, 5.340), duration of disease ≥ 5 years (AOR: 6.495, 95% CI: 4.091, 10.310) were significantly associated with knowledge of PCC. Older age (≥ 35years) (AOR: 2.143, 95% CI: 1.058, 4.339), secondary education and above (AOR: 2.427, 95% CI: 1.421, 4.146), history of modern family planning use (AOR: 2.853 95% CI: 1.866, 4.362), preconception counseling (AOR: 2.209, 95% CI: 1.429, 3.414) and good knowledge of PCC (AOR: 20.629, 95% CI: 12.425, 34.249) were significantly associated with attitude towards PCC. CONCLUSIONS: Women's knowledge and attitude towards preconception care were found to be low. Important measures include promoting secondary education and carrying out awareness campaigns, incorporating preconception counseling into routine medical follow-up care, and encouraging the use of modern family planning methods.

Knowledge, attitude, practices and associated factors of family planning among women living with hiv at the university of Gondar specialized hospital: a cross sectional study.

INTRODUCTION: HIV/AIDS poses a significant health challenge in sub-Saharan African countries, with a disproportionate impact on women of reproductive age. The disparities in knowledge, attitudes, and practices related to family planning among women living with HIV can be intricate and multi-faceted. This study aimed to assess the knowledge, attitude, practice, and associated factors regarding family planning among the women living with HIV at the University of Gondar specialized hospital, Gondar, Ethiopia. METHOD: A cross-sectional study was carried out at the University of Gondar Teaching Referral Hospital, focusing on HIV-positive women of reproductive age who visited the ART unit from July 8-28, 2022. Data collection involved the use of pre-tested, structured questionnaires administered through interviews. The gathered data were entered into the electronic Kobo Collect platform and subsequently exported for analysis using SPSS version 26. Descriptive summaries, including frequencies, means, and percentages, were presented through tables and figures. Logistic regression was employed to identify potential predictors, presenting adjusted odds ratios with a 95% confidence interval and a significance level set at a P-value of 0.05. RESULTS: A total of 328 study participants were included. About 93% of the study population had good knowledge about modern contraceptives, and about 94% of the study population had good knowledge about safer conception. Only 30.2% of the study population had knowledge of the dual contraceptive method. The attitude and practice of women towards family planning (FP) were 71.0% and 55.8%, respectively. The study revealed that the most commonly employed contraceptive method was injectable contraceptives, constituting 34.2% of usage. Having one and a greater number of children (AOR = 2.25, 95% CI: 1.10, 4.49), having discussions on fertility plans with healthcare providers (AOR = 2.20, 95% CI: 1.02, 4.761), and having good family planning practices (AOR = 2.15, 95% CI: 1.19, 3.87) were significantly associated with the attitude toward family planning. Married women (AOR = 1.88, 95% CI = 1.11, 3.1), able to read and write (AOR = 2.12, 95% CI:1.04,4.32), college and above educational level (AOR = 4.51, 95% CI:1.93,10.87), had discussion on fertility plan with healthcare providers (AOR = 5.09, 95% CI: 1.96, 13.24), knowledge about dual method (AOR = 1.95, CI: 1.08, 3.50), and knowledge about modern contraceptive methods (AOR = 7.24, 95% CI: 1.56, 33.58) were significantly associated with good practice of family planning. CONCLUSION: Women living with HIV exhibited notably high levels of knowledge regarding modern contraceptive methods and safer conception. The knowledge of the dual method was low. More than half of the study population had good practice in family planning. More than two-thirds of HIV-positive reproductive-age women had a good attitude about family planning. Having one or a greater number of children, having a discussion on a fertility plan with a healthcare provider, and having a good practice of family planning were significantly associated with a good attitude toward family planning. Married women, education status, discussions on fertility plans with healthcare providers, knowledge about dual methods, and knowledge about modern contraceptive methods were significantly associated with good family planning practices. The stakeholders should design interventions based on the aforementioned factors to improve the attitude and practice of family planning.

Exploring women's perception and attitude towards antidepressant use: a cross-sectional study.

BACKGROUND: The World Health Organization reports that depression affects more than 280 million people globally. Women are approximately 50% more likely to experience depression compared to men. Depression during pregnancy leads to deterioration of the mother's and the fetus's health. We aim to explore women's perceptions and attitudes toward using antidepressants and to identify the factors that influence decision-making regarding antidepressant use. METHOD: A cross-sectional survey, employing a convenience sampling method, was conducted on a university campus in Riyadh, Saudi Arabia. The survey was developed by the investigators and validated by health practitioners. Answers were reported using a 5-point Likert scale. The responses were summed up to give a total score for each respondent. Respondents who scored above or equal 75% of the total score was considered positive perception or favorable attitude. Binary logistic regression analysis was used to identify factors influencing participants' perception and attitude toward taking antidepressants. RESULTS: A total of 991 subjects were surveyed. The majority of women had negative perceptions and favorable attitudes towards using antidepressants during pregnancy reaching 64%. While women with positive perceptions and favorable attitudes represented about 20% of the study subjects. Participants reported that social stigma, religious beliefs, and fear of addiction significantly influenced their attitudes toward antidepressant use. CONCLUSIONS: This study explores women's perceptions of depression and antidepressant use, revealing that a significant proportion of Saudi women have a negative perception. The research emphasizes the need for tailored awareness programs to promote informed decision-making regarding antidepressant usage among Saudi women.