Attitudes, motivators, and barriers toward influenza vaccination for children: a study from a conflict-ridden country.

BACKGROUND: Despite the increased recommendations for influenza vaccination, particularly among high-risk groups such as young children, Yemen lacks an influenza vaccination program, and the influenza vaccine is not included in the national immunization regime. This is exacerbated by the country's fragile infrastructure, as well as the devastating consequences of the ongoing conflict, which include child undernutrition and strained healthcare resources. Thus, the objective of the current study is to assess the public attitudes and perceptions toward vaccinating children against influenza in Yemen. METHODS: A cross-sectional study was conducted by distributing a validated survey questionnaire to potential participants using convenience sampling. Descriptive statistics were used to summarize sociodemographic data, knowledge of influenza vaccines, and attitudes and perceptions regarding vaccinating children against influenza. Logistic regression analysis was employed to identify associations between independent variables and the acceptance of vaccines for children. RESULTS: A total of 853 eligible individuals, parents and non-parents, successfully completed the survey. The uptake of the influenza vaccine among the participants was notably low as the majority (69.2%) had not previously received the vaccine, although the majority expressed a willingness to get vaccinated in the future (59.4%). The majority (68.5%) were willing to vaccinate children. The largest percentage of the participants who expressed hesitancy toward children's vaccination cited multiple reasons to reject the vaccine (39.7%), with concerns regarding the safety of the vaccine being the predominant barrier to its acceptance for children (29.6%). On the other hand, motivating factors for vaccinating children included the validation of the vaccine's safety and efficacy, endorsement of the vaccine by the government and physicians, integration of the vaccine into the national immunization program, and the provision of the vaccine free of charge and through schools. Significant predictors for vaccine acceptance in children included male gender, knowledge of the protective effect of the influenza vaccine, previous receipt of the vaccine, and a willingness to receive the vaccine in the future. CONCLUSIONS: The study highlights the need for educational health campaigns to raise awareness and remove misconceptions regarding influenza and the role, benefits, and availability of its vaccine. These findings can serve as a robust foundation for the future design and implementation of an influenza vaccination program for children in Yemen.

A narrative review of the role of Eph receptors in head and neck squamous cell carcinoma.

Tyrosine kinase receptors (TKR) coordinate a variety of pathological processes in head and neck squamous cell carcinoma (HNSCC), and eventually play a role in patient outcomes. In this review, the role of Eph receptors in HNSCC progression and the possibility of targeting these receptors are illustrated. All relevant studies were identified through a comprehensive search of four electronic databases, including PubMed, Scopus, web of science, and Embase till August 2022. EphA2 and EphB4, along with ephrin-B2, were the most extensively studied proteins in this family. However, overexpression of EphB4 and its ligand ephrin-B2 were the only proteins that consistently showed association with a poor outcome, indicating that these proteins might serve as valuable prognostic markers in HNSCC. High expression of EphA3 and EphB4 was found to play a crucial role in radioresistance of HNSCC. EphB4 loss, in particular, was observed to induce an immunosuppression phenotypic HNSCC. Currently, ongoing clinical trials are investigating the benefits of EphB4-ephrin-B2 blockade in combination with standard of care treatment in HNSCC. Further efforts are needed to explore the biological role and behavioral complexity of this family of TKR in HNSCC with great attention to avoid heterogeneity of HNSCC subsites.

Knowledge, attitudes, perceptions, and practice toward seasonal influenza and its vaccine: A cross-sectional study from a country of conflict.

Background: The seasonal influenza vaccine is an important preventive measure against influenza and its associated complications. In Yemen, there is no seasonal influenza vaccination policy, and the influenza vaccine is excluded from the national immunization program. Data on vaccination coverage remain scarce with no previous surveillance programs or awareness campaigns implemented in the country. The current study aims to assess the awareness, knowledge, and attitudes of the public in Yemen toward seasonal influenza and their motivators and perceived barriers to receiving its vaccine. Methods: A cross-sectional survey was carried out using a self-administered questionnaire that was distributed to eligible participants using convenience sampling. Results: A total of 1,396 participants completed the questionnaire. The respondents showed a median knowledge score of influenza of 11.0/15.0, and most of them (70%) were able to recognize its modes of transmission. However, only 11.3% of the participants reported receiving the seasonal influenza vaccine. Physicians were the respondents' most preferred information source for influenza (35.2%), and their recommendation (44.3%) was the most cited reason for taking its vaccine. On the contrary, not knowing about the vaccine's availability (50.1%), concerns regarding the safety of the vaccine (17%), and not considering influenza as a threat (15.9%) were the main reported barriers to getting vaccinated. Conclusion: The current study showed a low uptake of influenza vaccines in Yemen. The physician's role in promoting influenza vaccination seems to be essential. Extensive and sustained awareness campaigns would likely increase the awareness of influenza and remove misconceptions and negative attitudes toward its vaccine. Equitable access to the vaccine can be promoted by providing it free of charge to the public.

Pharmacogenetics: a perspective and preparedness of Pharm-D and medical students in Jordan.

BACKGROUND: Pharmacogenetics (PGx) science has evolved significantly with a huge number of studies exploring the effect of genetic variants on interindividual variability of drug response. In this study, we assessed the knowledge, attitudes and preparedness of Pharm-D vs. medical students toward PGx. METHOD: A paper-based cross-sectional survey was performed. A pilot-tested questionnaire consisting of 21 questions (demographics 5, knowledge 6, attitude 6, and preparedness 4) was administered to 900 healthcare students at different years of study. Descriptive and inferential analyses were used. RESULTS: Out of the 900 students approached, 852 (94.7%) completed the questionnaire. The overall students' mean (SD) percentage knowledge score (PKS) was poor [46.7% (18.7)]. The mean (SD) attitude and preparedness scores for all students were 4.68 (1.32), and 1.9 (1.40), respectively, indicating overall positive attitudes, but low preparedness to apply PGx to clinical care. Pharm-D students' overall PKS was significantly higher than medical students (P < 0.0001). However, there was no significant difference in terms of attitude and preparedness scores. Interestingly, as the year of study increased, the knowledge scores increased as well, with 6th-year students had the highest knowledge scores, while preparedness in applying PGx was higher among the junior students (the 3rd and 4th year of study). CONCLUSION: Pharm-D and medical students have inadequate knowledge and low preparedness despite the overall positive attitude towards PGx. There is a need to raise knowledge and to enhance the level of preparedness of medical and Pharm-D students towards PGx and its applications in clinical practice.

Perceptions, knowledge, and perceived barriers of Yemeni pharmacists and pharmacy technicians towards evidence-based practice.

RATIONAL, AIMS, AND OBJECTIVE: The aim of this study was to assess the knowledge and perception towards evidence-based practice (EBP) and identify the perceived barriers to practicing EBP among Yemeni pharmacists and pharmacy technicians. METHODS: A cross-sectional survey study was carried out among 153 Yemeni pharmacists and pharmacy technicians who are working in hospitals or community pharmacies. This study took place between the 15th of August and the 8th of November 2017 using a self-administered validated questionnaire. The study was approved by the ethics committee/scientific research center of Yemen University, Yemen (Reference number: ERC/2017/103). RESULTS: Completed questionnaires were received from 153 (46.6% response rate). Most of the respondents showed a positive attitude towards EBP; however, their understanding of the basic terms used in EBP was poor (34.6%). The types of source that the respondent used in high percentage to make their decisions were own judgement and consulting the colleagues that can no longer be accurate and evidence based. The barriers to practicing EBP identified by most respondents were the limited access to EBP sources and lack of personal time. CONCLUSION: These results reveal strong support for EBP among pharmacists and pharmacy technicians in Yemen but only a minority indicated that they understood the technical terms of EBP. Training and continuing education programs on EBP and guidelines for pharmacists are strongly needed. These findings may help in planning the use and the application of EBP process in pharmacy practice.

Extended-spectrum ß-lactamase producing E. coli in urinary tract infections: A two-center, cross-sectional study of prevalence, genotypes and risk factors in Amman, Jordan.

BACKGROUND: To determine the prevalence, phenotypes, and genotypes of extended spectrum ß-lactamase (ESBL)-producing Escherichia coli (E. coli) among patients with urinary tract infection along with identifying the associated risk factors. METHODS: A cross-sectional study was conducted at two tertiary hospitals in Amman, Jordan between June and October, 2016. One hundred twenty one E. coli isolates from hospitalized patients with urinary tract infection were phenotypically assessed for ESBL production using the double disc diffusion test. Positive isolates to ESBL production were further genotyped using multiplex PCR. A nested case-control study was used to determine the independent risk factors. RESULTS: ESBL-producing E. coli were found in 75/121 (62%) isolates. Molecular genotyping demonstrated that CTX-M group1 (42.7%) predominated followed by combination of SHV and CTX-M group1 (20%). In the regression model, previous hospitalization and use of urinary catheter were identified as independent risk factors for ESBL-producing E. coli infections. CONCLUSION: We report a high prevalence of ESBL-producing E. coli which is in concordance with other studies from developing countries. Additionally, CTX-M group1 has emerged as the predominant ESBL produced by E. coli, which is consistent with reported results throughout the world. Independent risk factors to UTI infections due to ESBL-producing E. coli include previous hospitalization and use of urinary catheter.

The prevalence and clinical seriousness of medication discrepancies identified upon hospital admission of pediatric patients.

BACKGROUND: Medication discrepancies are seen frequently in hospital setting upon admission or discharge. Medication Reconciliation service is a practice designed to ensure that patients' medications are ordered in a correct manner upon hospital admission, thus reducing the risk of having medication discrepancies. This study aimed to determine the prevalence of medication discrepancies and their clinical seriousness in pediatric patients at the time of hospital admission. METHODS: A prevalence cross-sectional study was conducted at the pediatric departement at the Jordan University hospital between March-May 2018. During the study period, 100 pediatric patients were enrolled using a convenience sampling method. Patients' medical records were reviewed by two clinical pharmacist-reserachers to obtain patients' demographic, medical, and admission medication information. All parents were interviewed to obtain information regarding their children's Best Possible Medication History (BPMH). Following data collection, differences between patient's current admission medications and the BPMH were identified as medication discrepancies, and then they were classified into either undocumented intentional or unintentional discrepancies. RESULTS: Among the 100 medication records reviewed, 13.0% (13 out of 100) contained at least one unintentional discrepancy, with the majority (n = 11, 84.6%) being classified to be associated with mild potential harm to patients. Of those discrepancies, 8 were omission of medications (61.5%) and 5 were addition of unnecessary medication (38.5%). On the other hand, 35.0% (35 out of 100) of medication records contained at least one intentional undocumented discrepancy. CONCLUSIONS: This study revealed that unintentional medication discrepancies exist at the time of hospital admission for pediatric patients but with low proportion. The low proportion of medication discrepancies might be explained by the recent implementation of medication reconciliation service at the studied hospital. Also, intentional undocumented discrepancies were common, which may carry a potential harm to such vulnerable population at discharge. These data may inform the need for a strict policies to regulate medication documentation, thus decreasing the possibilities of medication errors.