Time and skeptical opinion content erode the effects of science coverage on climate beliefs and attitudes.

Although experiments show that exposure to factual information can increase factual accuracy, the public remains stubbornly misinformed about many issues. Why do misperceptions persist even when factual interventions generally succeed at increasing the accuracy of people's beliefs? We seek to answer this question by testing the role of information exposure and decay effects in a four-wave panel experiment (n = 2,898 at wave 4) in which we randomize the media content that people in the United States see about climate change. Our results indicate that science coverage of climate change increases belief accuracy and support for government action immediately after exposure, including among Republicans and people who reject anthropogenic climate change. However, both effects decay over time and can be attenuated by exposure to skeptical opinion content (but not issue coverage featuring partisan conflict). These findings demonstrate that the increases in belief accuracy generated by science coverage are short lived and can be neutralized by skeptical opinion content.

Historical representations of social groups across 200 years of word embeddings from Google Books.

Using word embeddings from 850 billion words in English-language Google Books, we provide an extensive analysis of historical change and stability in social group representations (stereotypes) across a long timeframe (from 1800 to 1999), for a large number of social group targets (Black, White, Asian, Irish, Hispanic, Native American, Man, Woman, Old, Young, Fat, Thin, Rich, Poor), and their emergent, bottom-up associations with 14,000 words and a subset of 600 traits. The results provide a nuanced picture of change and persistence in stereotypes across 200 y. Change was observed in the top-associated words and traits: Whether analyzing the top 10 or 50 associates, at least 50% of top associates changed across successive decades. Despite this changing content of top-associated words, the average valence (positivity/negativity) of these top stereotypes was generally persistent. Ultimately, through advances in the availability of historical word embeddings, this study offers a comprehensive characterization of both change and persistence in social group representations as revealed through books of the English-speaking world from 1800 to 1999.

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.

Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review.

BACKGROUND: Cervical cancer is the second-leading cause of death among all cancers in Ethiopia. Ethiopia plans to eliminate cervical cancer as a public health problem by 2030, following the World Health Organization's call for action. A scoping review was conducted on the status of the cervical cancer continuum towards elimination in Ethiopia. METHODS: We searched articles in PubMed, Scopus, and Google Scholar. All studies conducted on cervical cancer in Ethiopia, from first date of publication to March 15, 2023, type of article, or language of publication, were included. However, conference abstracts, commentaries, and letters to the editors were excluded. We used EndNote X9 software to merge articles from different databases and automatically remove duplicates. Screening of titles, abstracts, and full texts was performed independently by two co-authors. The cancer care continuum was employed as a framework to guide data synthesis and present the findings. RESULTS: Of the 569 retrieved articles, 159 were included in the review. They found that most of the articles focused on knowledge, attitude, and practice. However, there were few studies on health-seeking behavior, perception and acceptability of cervical cancer services, as well as the availability and readiness of a screening program. The review identified inadequate knowledge, attitude, and perception about cervical cancer, and highlighted that screening for cervical cancer is not widely utilized in Ethiopia. Knowledge, attitude, education status, and income were repeatedly reported as precursors influencing cervical cancer screening. Most studies concluded that there is a high prevalence of precancerous lesions and cervical cancer, as well as high mortality rates or short survival times. The review also identified significant heterogeneity in findings across time and geographic settings within each component of the cancer care continuum. CONCLUSIONS: Overall, there is inadequate knowledge, perception, health-seeking behavior, screening, and treatment services, indicating that the country is falling behind its targets in eliminating cervical cancer, despite the availability of effective interventions and tools. We argue that implementation research is necessary to identify implementation issues, challenges, and strategies to scale up both primary and secondary prevention services. By doing so, Ethiopia can address cervical cancer as a public health problem and work towards its elimination.

A History of Polymyalgia Rheumatica: A Narrative Review.

Polymyalgia rheumatica (PMR) is characterised by stiffness and pain in the shoulders, hips, and neck and presents most commonly in the eighth decade. It can coexist with giant cell arteritis and the two diseases may share some pathophysiological mechanisms. This narrative review considers present-day ideas about PMR in a historical context, from the first names and descriptions of this disease entity, via successive generations of classification criteria sets, and finally to implications for clinical diagnosis. The characteristic distribution of musculoskeletal inflammation in PMR, and its relationship to vasculitic and synovitic diseases, have framed the way that PMR is described, classified, diagnosed and treated. A response to glucocorticoids is not specific to PMR and so it is important for rheumatologists to support general practitioners in making a definite diagnosis. Multi-stakeholder collaboration will improve current pathways for fast, accurate diagnosis and safe and effective treatment.

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.

Conceptualization of Breast Cancer and Attitudes toward Breast Cancer Screening: A Qualitative Study on Iranian and Australian Women.

OBJECTIVE: Regular screening can lead to early diagnosis of breast cancer. Australia is one of the countries with a high rate of participation in breast cancer screening, while in Iran, most patients are diagnosed in advanced stages. This qualitative study used a thematic analysis method to examine the attitudes and beliefs of Iranian and Australian women toward breast cancer and breast cancer screening. METHOD: In-depth interviews were conducted with eight Iranian and seven Australian women. Data were collected through semi-structured interviews and analyzed using thematic analysis with an inferential approach. RESULTS: According to the results, four main themes were extracted for the perceptions of breast cancer, including "the meaning of breast cancer", "causes of breast cancer", "prevention of breast cancer" and "effects of significant people in life". Considering the perceptions of breast cancer screening, three themes were identified, including "beliefs about breast cancer screening," "sources of information about breast cancer screening," and "barriers to breast cancer screening." CONCLUSION: Cultural and social factors influence women's perceptions of breast cancer and screening. Therefore, investigating the cultural meaning of breast cancer and breast cancer screening for women can be useful for screening and prevention purposes.

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.

Factors Influencing Knowledge and Acceptance of Nonavalent Human Papillomavirus Vaccine Among University Population in Southern China: A Cross-Sectional Study.

BACKGROUND: Vaccine hesitancy among young Chinese remains a challenge, contributing to low vaccination rates for the nonavalent Human Papillomavirus (HPV) vaccine. This study evaluated the knowledge and acceptance of this vaccine among students at a southern Chinese university and identified factors influencing these outcomes. METHODS: This cross-sectional, anonymous questionnaire survey was conducted from April to November 2023 at a multi-campus university in southern China. The questionnaire was comprised of three sections: the first collected demographic data; the second evaluated students' knowledge of the nonavalent HPV vaccine on a scale from 0 to 15, with cut-off points at 5 and 10 delineating low, medium, and high knowledge levels, respectively; the third section assessed vaccine acceptance on a scale from 8 to 40, using scores above the 50th percentile as the benchmark for positive acceptance. RESULTS: Among the participants, 18% demonstrated low-level, 40.20% medium-level, and 41.70% high-level knowledge of the nonavalent HPV vaccine. Notably, 71.95% of respondents showed positive acceptance, whereas 28.05% expressed negative acceptance. Male students and those with lower economic conditions (monthly living expenses below 1000 RMB, P = 0.004; 1000-1499 RMB, P = 0.012) exhibited lower knowledge levels. As for acceptance, female students and those with higher monthly living expenses (1000-1499 RMB, P = 0.007; 1500-1999 RMB, P = 0.002; over 2000 RMB, P = 0.002) demonstrated greater vaccine acceptance. A positive correlation was noted between the level of knowledge and vaccine acceptance (rs = 0.256, P < 0.001). CONCLUSIONS: Gender and economic status are significantly associated with nonavalent HPV vaccine knowledge and acceptance among university students. These findings highlight the potential impact of targeted educational initiatives, especially for economically disadvantaged male students, in enhancing vaccine uptake rates.

Many young people in China are hesitant to get the nine - valent HPV vaccine, which protects against certain types of viruses that can cause cancer. This study looked at how much students at a university in southern China know about the nine - valent HPV vaccine and whether they are willing to get vaccinated. We asked students to fill out a survey between April and November 2023 to gather this information. The survey showed that knowledge about this vaccine varied: about 18% of the students knew very little, 40% had a moderate understanding, and roughly 42% knew a lot about this vaccine. Interestingly, more than 70% of the students were open to getting the vaccine, but about 28% were not. We found that male students and those with less money generally knew less about the vaccine and were more likely to not accept it. There was also a clear link between how much students knew about the vaccine and their willingness to get vaccinated. This suggests that teaching students more about this vaccine, especially boys and those from poorer backgrounds, could encourage more of them to get vaccinated. This is important because increasing vaccine rates can help prevent diseases spread by the virus.

Belief that Progress has Been Made in Curing Cancer Varies by Perception of Social Media Health Mis- and Disinformation, Education, Frequency of Social Media Use, and Healthcare System Trust: A Cross-Sectional Study.

OBJECTIVE: This study explored the relationship between perceptions of health mis/disinformation on social media and belief that progress has been made in curing cancer. METHODS: We analyzed cross-sectional, retrospective data collected from 4246 adult social media users in the 2022 Health Information National Trends Survey (HINTS 6). The outcome variable was the belief in whether progress has been made in curing cancer. The primary predictor variable was the perception of health mis/disinformation on social media, categorized as 'Substantial' and '< Substantial'. We also examined whether the relationship varied by health care system trust, frequency of social media use, and education. The analysis controlled for demographic, socioeconomic, and health-related factors. RESULTS: Perception of substantial social media health mis- and disinformation was associated with a lower likelihood of believing progress has been made in curing cancer (odds ratios = 0.74, 95% CI = 0.59-0.94). Persons who perceived substantial social media health mis-and disinformation and had low trust in the health care system were less likely to believe progress has been made in curing cancer: 36% (95% CI: 28-45%). Persons who perceived substantial social media health mis-and disinformation and used social media less than daily were less likely to believe progress has been made in curing cancer: 44% (95% CI: 36-52%). Persons without a college degree who perceived substantial social media health mis-and disinformation were less likely to agree that progress has been made in curing cancer: 44% (95% CI: 39-50%). CONCLUSION: Exposure to misinformation on social media may be associated with negative attitudes about advances in curing cancer, particularly among social media users with low trust in the health care system trust, less frequent social media users, or those without a college degree.

"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.

An evaluation of the license to save lives program to promote organ, eye, and tissue donation among teenagers.

As the number of designated organ donors continues to lag behind the number of waiting list patients, teenagers remain a promising demographic of potential organ donors. The current study enlisted Michigan and Ohio driver education students to participate in an online digital learning intervention, License to Save Lives (LTSL). Students were randomly assigned to either an interactive or noninteractive LTSL intervention. Across both states, the pretest-posttest design revealed greater knowledge among students following exposure to either the interactive or noninteractive LTSL program. No attitudinal or behavioral differences emerged between the interactive and noninteractive conditions. Michigan (39.82%) and Ohio (58.10%) students registered to be organ donors at a respectable rate. The results are discussed with an emphasis on feasibility and sustainability as well as the promise for digital games to promote organ donation knowledge, attitude, and registration among teenagers.

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.

A mixed method evaluation of knowledge, attitude and practice on dengue fever among Lalitpur Metropolitan City residents: a cross-sectional investigation.

BACKGROUND: Dengue poses a significant global public health challenge, including in Nepal. Understanding community's knowledge, attitudes, and behaviors concerning dengue fever is imperative to developing effective prevention and control strategies. This study aimed to assess the knowledge, attitude, and practices related to dengue fever among residents of Lalitpur Metropolitan City. METHODS: A descriptive cross-sectional household study was conducted using a mixed-method approach, which included quantitatively studying 636 individuals and conducting 20 qualitative interviews. The data was collected between April 2023 and June 2023. The multistage cluster sampling method was applied for household selection during the quantitative study and a purposive judgmental sampling method was used to identify participants for the qualitative interviews. Face-to-face interviews were conducted using a structured questionnaire for the quantitative study and an interview guide for the qualitative study. Quantitative data were analysed using logistic regression in STATA version 13, and thematic analysis was applied to the qualitative data. The findings were validated through triangulation of results from both the qualitative and quantitative study. RESULTS: Regarding knowledge, 64.94% (n = 413/636) reported being informed about dengue fever. In terms of attitude, a substantial majority, 91.51% (n = 582/636), expressed a positive attitudes toward dengue fever, indicating a favorable perception and knowledge of its significance. Concerning practice, 49.84% (n = 317/636) of respondents reported actively engaging in dengue fever prevention measures. The variables gender, previous history of dengue fever and residency were the determinants of dengue fever knowledge. Additionally, gender, residency, and attitude were predictors of preventive practices concerning dengue fever. CONCLUSION: Our study revealed that while the community demonstrated good knowledge of dengue fever and positive attitudes toward prevention, their preventive practices were inconsistent, indicating a gap between knowledge and action. A positive attitude was linked to better adherence to preventive measures. To address this gap, it is crucial to promote a positive attitude toward dengue prevention through initiatives like education efforts and social mobilization programs. Implementing Social and Behavior Change Communication (SBCC) programs focused on dengue prevention and control measures can help bridge this knowledge-action gap.