A Pandemic of Misinformation: Understanding Influences on Beliefs in Health and Conspiracy Myths.

BACKGROUND: Personal characteristics may be associated with believing misinformation and not believing in best practices to protect oneself from COVID-19. OBJECTIVE: To examine the associations of a person's age, race/ethnicity, education, residence, health literacy, medical mistrust level, and sources of health-related information with their COVID-19 health and conspiracy myth beliefs. DESIGN: We surveyed adults with hypertension in Maryland and Pennsylvania between August 2020 and March 2021. Incorrect responses were summed for eight health (mean = 0.68; range 0-5) and two conspiracy (mean = 0.92; range 0-2) COVID-19 questions. Higher scores indicated more incorrect responses. Statistical analyses included two-sample t-tests, Spearman's correlation, and log binomial regression. PARTICIPANTS: In total, 561 primary care patients (mean age = 62.3 years, 60.2% female, 46.0% Black, 10.2% Hispanic, 28.2% with a Bachelor's degree or higher, 42.8% with annual household income less than $60,000) with a diagnosis of hypertension and at least one of five commonly associated conditions. MAIN MEASURES: Sociodemographic characteristics, health literacy, medical mistrust level, source of health-related information, and COVID-19 conspiracy and health myth beliefs. KEY RESULTS: In multivariable analyses, participants who did not get information from medical professional sources (prevalence ratio (PR) = 1.28; 95% CI = 1.06-1.55), had less than a bachelor's degree (PR = 1.49; 95% CI = 1.12-1.99), were less confident filling out medical forms (PR = 1.24; 95% CI = 1.02-1.50), and had higher medical mistrust (PR = 1.34; 95% CI = 1.05-1.69) were more likely to believe any health myths. Participants who had less than a bachelor's degree (PR = 1.22; 95% CI = 1.02-1.45), were less confident filling out medical forms (PR = 1.21; 95% CI = 1.09-1.34), and had higher medical mistrust (PR = 1.72; 95% CI = 1.43-2.06) were more likely to believe any conspiracy myths. CONCLUSIONS: Lower educational attainment and health literacy, greater medical mistrust, and certain sources of health information are associated with misinformed COVID-19 beliefs. Programs addressing misinformation should focus on groups affected by these social determinants of health by encouraging reliance on scientific sources.

Information videos posted on Instagram by orthopaedics and sports traumatology surgeons mostly explain surgical technique, and the least mentioned topics are injury prevention and complications.

PURPOSE: Social media has become the new information acquisition platform for all content producers. In the current literature, there are no studies examining the content quality and the strengths and weaknesses of videos on Instagram that explain anterior cruciate ligament (ACL) injuries, which is the most discussed topic of sports surgery. The aim of this study was to evaluate the quality, strengths and weaknesses of information pertaining to ACL surgery that is disseminated on Instagram. METHOD: An Instagram search was conducted from 30 May 2023 to 30 January 2024. The search encompassed six languages (English, Spanish, German, French, Italian and Turkish) and was performed by six different observers. The investigation focused on eight subheadings derived from current literature on the ACL. These subheadings were addressed in Instagram videos, covering ACL biology or biomechanics, injury mechanism, injury prevention, injury evaluation, surgical technique, injury or surgery complications, injury rehabilitation process and return to sport or work. RESULT: The content was assessed of 127 videos from 127 Instagram accounts, spanning six different languages. Across the review of eight subheadings, the average number covered for the entire group was 3 (range, 0-8). Further analysis revealed that surgical technique was the most frequently mentioned subheading for the whole group (68.5%), followed by injury evaluation (54.3%). Prevention (10.2%) and complications (19.6%) were the least mentioned subheadings. The number of followers showed a correlation with video content quality. CONCLUSION: Although the video quality scores were found to be moderate, the content often focused on surgery and evaluation subheadings. The prevalence of incomplete information underscores the importance of developing strategies to ensure more comprehensive and accurate dissemination of medical knowledge. LEVEL OF EVIDENCE: Level V.

Levels and sources of adolescents' sexual knowledge in traditional societies: A cross-sectional study.

Gender rules, patriarchy, and cultural taboos on sexual issues in traditional societies may compel adolescents to seek sexual information from informal and inadequate sources. The aim of this cross-sectional study was to determine whether the level and sources of sexual knowledge differed by gender in the traditional community comprising Palestinian-Israeli high school students. Guided by the Human Ecological Systems Model and informed by a community-based participatory research approach, a convenience sample of high school students (n = 558) was recruited. Although findings indicated that both boys and girls had low levels of sexual knowledge, the areas of knowledge deficits varied by gender. The model demonstrated good fit for boys but not for girls. Post hoc analyses indicated that girls obtained sexual knowledge solely from close family members, while boys obtained sexual knowledge from multiple sources. Very few students of either gender obtained sexual knowledge from doctors or nurses, but with community input on cultural issues, nurses can play a pivotal role in creating comprehensive, school-based sex education for adolescents living in traditional societies.

A Global Survey of the Views of Practicing Companion Animal Veterinarians on Their Undergraduate Curriculum and Their Access to Continuing Education Resources.

A global survey was developed to gain insight into the opinion of companion animal veterinarians about their undergraduate education and their access to continuing education on the following topics: client communication, animal welfare, surgical techniques, human-animal bond, dentistry, animal behavior, and zoonotic disease/epidemiology. In 2016, the survey was distributed via SurveyMonkey® in five languages to companion animal veterinarians around the world. A total of 1,167 respondents returned to the survey. The distribution of survey responses differed by geographic region (number of respondents in parentheses; where respondents work/have been trained): Europa (including the Russian Federation, 359/423), Asia (311/205), North America (77/89), South America (24/16), Africa (46/41), and Oceania (147/167). The results were strongly influenced by a large number of respondents (in parentheses) who graduated in the Russian Federation (180/162), Australia (133/154), Israel (136/82), the Netherlands (64/64), the United Kingdom of Great Britain and Northern Ireland (36/46), and the United States of America (46/44). On the basis of the responses, all topics were poorly covered or not taught, except for surgical techniques and zoonotic disease/epidemiology, which were covered adequately or well. However, there were country and geographic regional differences. This was also true for continuing education resources, which were-in addition to countries and geographic regions-also influenced by the educational topic. As already stated by Dhein and Menon in 2003, time away from the practice, travel distance, and expense may be reasons why companion animal veterinarians do not follow continuing education. Online continuing education could fill in the gap and is more time and cost-efficient.

COVID-19 Knowledge, Beliefs, and Behavior Among Patients in a Safety-Net Health System.

Examine COVID-19 knowledge, concerns, behaviors, stress, and sources of information among patients in a safety-net health system in Louisiana. Research assistants surveyed participants via structured telephone interviews from April to October 2020. The data presented in this study were obtained in the pre-vaccine availability period. Of 623 adult participants, 73.5% were female, 54.7% Black, and 44.8% lived in rural small towns; mean age was 48.69. Half (50.5%) had spoken to a healthcare provider about the virus, 25.8% had been tested for COVID-19; 11.4% tested positive. Small town residents were less likely to be tested than those in cities (21.1% vs 29.3%, p = 0.05). Knowledge of COVID-19 symptoms and ways to prevent the disease increased from (87.9% in the spring to 98.9% in the fall, p < 0.001). Participants indicating that the virus had 'changed their daily routine a lot' decreased from 56.9% to 39.3% (p < 0.001). The main source of COVID-19 information was TV, which increased over time, 66.1-83.6% (p < 0.001). Use of websites (34.2%) did not increase. Black adults were more likely than white adults (80.7% vs 65.6%, p < 0.001) to rely on TV for COVID-19 information. Participants under 30 were more likely to get COVID-19 information from websites and social media (58.2% and 35.8% respectively). This study provides information related to the understanding of COVID-19 in rural and underserved communities that can guide clinical and public health strategies.

Sources of information on diabetes and its demographic correlates: a nationwide survey among Singapore residents.

Diabetes is a major public health concern in Singapore, and the Singapore Government declared a 'War on Diabetes', which included a nationwide public health campaign. It is important to identify what sources of diabetes information reach the general population, whether this differs by socio-demographic characteristics and if the sources of information influence knowledge of diabetes to aid the successful dissemination of health information. Two thousand eight hundred ninety-five respondents were part of a population-based cross-sectional study conducted from February 2019 to September 2020. Respondents rated on a five-point scale whether they had obtained information on diabetes from eight different information sources, and responses were dichotomized into 'endorsed receiving information' or 'not endorsed receiving information'. Poisson regression models were conducted with the 'endorsement of receiving information' from each source as the outcome and socio-demographic variables as predictors. 95.9% of the study population had received information on diabetes from at least one source, and the mean number of sources was 4.2 ± 2.0. The leading source was media articles (82.1%), followed by health promotion videos/advertisements (77.9%), online websites (58.5%), books (56.5%), healthcare professionals (55.0%), radio (54.4%), public forums (27.7%) and support groups (15.5%). Endorsing a greater number of informational sources was associated with being younger, belonging to Malay or Indian instead of Chinese ethnicity, and having diabetes. An intensive nationwide diabetes awareness campaign successfully reached the public in Singapore with specific sources of information depending on socio-demographic characteristics. Findings suggest that diabetes information campaigns should utilize multiple channels for dissemination considering the different socio-demographic subgroups.

Nurses' sources of information to inform clinical practice: An integrative review to guide evidence-based practice.

BACKGROUND: Evidence-based practice in nursing is challenging and relies on the sources of information used by nurses to inform clinical practice. An integrative review from 2008 revealed that nurses more frequently relied on information from colleagues than information from high-level sources such as systematic reviews and evidence-based clinical practice guidelines. AIMS: To describe the information sources used by registered nurses to inform their clinical practice. METHODS: An integrative review was conducted according to the PRISMA guidelines, based on empirical research studies published from January 2007 until June 2021. The included studies were appraised, following which the identified sources of information from quantitative studies were compiled and ranked. Finally, the qualitative text data were summarized into categories. RESULTS: Fifty-two studies from various countries were included. The majority of studies employed a quantitative design and used original instruments. Peers were ranked as the number one source of information to inform nurses' clinical practice. However, computers and reference materials are now ranked among the top four most used information sources. LINKING EVIDENCE TO ACTION: Improvement in computer and information searching skills, as well as the availability of computerized decision support tools, may contribute to nurses' frequent use of digital sources and reference material to inform clinical practice. This review shows that nurses' most frequently reported peer nurses as their source of information in clinical practice. Information sources such as computers and reference materials were ranked higher, and information from patients was ranked lower than in the 2008 review. Developing and standardizing instruments and ensuring high-quality study design is critical for further research on nurses' sources of information for clinical practice.

Effect of Internet use for searching information on vaccination on the uptake of human papillomavirus vaccine in France: A path-analysis approach.

Internet is a popular source of information regarding vaccination. This study aimed to determine whether there is a negative association between Internet use among French vaccine-hesitant mothers and HPV vaccine uptake by their daughters, and to gain insight into the pathways that would link Internet use to the lack of HPV vaccine uptake. We conducted a pooled cross-sectional analysis across the 2015, 2016, 2017 and 2018 Vaccinoscopie® Survey. Multivariate logistic regression and path models were used in the analysis. The study sample included a total of 2038 respondent mothers. Of those, 89 (4.4%) declared having never been in the situation of searching for information regarding a vaccination they had hesitated about, leaving 1949 mothers for the present analysis. Approximately 24% (466/1949) of the mothers declared using the Internet as a source of vaccine information. In multivariate logistic regression adjusted for physician recommendation of HPV vaccination, attitudes towards vaccines in general, perception of HPV vaccine usefulness, maternal level of education, region of residence, and the survey year, the use of Internet by the mothers was significantly associated with a lower HPV vaccination among their daughters (adjusted odds ratio (aOR), 0.66; 95% confidence interval (CI), 0.47-0.91). Path analysis further confirmed the negative effect of Internet use (ß = -0.10, standard error (SE) = 0.02, P < 0.0001), highlighting how the Internet plays a detrimental role in HPV vaccine uptake through a lower perceived level of HPV vaccine usefulness, a lower perceived level of information on childhood vaccination, and unfavorable attitudes towards vaccination in general.

Perceptions of adult Arkansans regarding trusted sources of information about the COVID-19 pandemic.

BACKGROUND: The United States leads the world in confirmed COVID-19 cases; Arkansas ranks fifth in average daily cases per 100,000. Historically, Americans relied on health communications from governmental sources and the news media. However, there has been a documented decline of trust in these sources. The present study seeks to understand trusted sources of information about COVID-19 to improve health messaging because research shows the level of trust is associated with adherence to recommendations. METHODS: Data were collected using an online survey from participants (N = 1221) who were 18 years of age or older and residing, employed, or accessing health care in Arkansas. A qualitative descriptive design was used to summarize participants' experiences and perceptions related to trusted sources of COVID-19 information. RESULTS: Two primary themes related to participants' perceptions of sources of information about COVID-19 are reported: 1) trusted sources of information and 2) distrust or lack of trust in sources of information. Several subthemes emerged within each primary theme. Results showed high trust in the academic medical center, federal and state public health agencies, and local health care providers. The study also documents diverging voices of distrust and uncertainty in making sense of contradictory information. Participants reported the main reason for their lack of trust was the rapidly changing information and the lack of consistency in information provided across sources. CONCLUSIONS: This finding provides insight into the importance of coordination between national, state, and local communications to bolster trust. Personal recommendations and testimonies from trusted health care providers and professionals could inform public health messaging interventions to increase vaccine uptake.

Key characteristics of 86 agents known to cause cancer in humans.

Since the inception of the International Agency for Research on Cancer (IARC) in the early 1970s, the IARC Monographs Programme has evaluated more than 1000 agents with respect to carcinogenic hazard; of these, up to and including Volume 119 of the IARC Monographs, 120 agents met the criteria for classification as carcinogenic to humans (Group 1). Volume 100 of the IARC Monographs provided a review and update of Group 1 carcinogens. These agents were divided into six broad categories: (I) pharmaceuticals; (II) biological agents; (III) arsenic, metals, fibers, and dusts; (IV) radiation; (V) personal habits and indoor combustions; and (VI) chemical agents and related occupations. Data on biological mechanisms of action (MOA) were extracted from the Monographs to assemble a database on the basis of ten key characteristics attributed to human carcinogens. After some grouping of similar agents, the characteristic profiles were examined for 86 Group 1 agents for which mechanistic information was available in the IARC Monographs up to and including Volume 106, based upon data derived from human in vivo, human in vitro, animal in vivo, and animal in vitro studies. The most prevalent key characteristic was "is genotoxic", followed by "alters cell proliferation, cell death, or nutrient supply" and "induces oxidative stress". Most agents exhibited several of the ten key characteristics, with an average of four characteristics per agent, a finding consistent with the notion that cancer development in humans involves multiple pathways. Information on the key characteristics was often available from multiple sources, with many agents demonstrating concordance between human and animal sources, particularly with respect to genotoxicity. Although a detailed comparison of the characteristics of different types of agents was not attempted here, the overall characteristic profiles for pharmaceutical agents and for chemical agents and related occupations appeared similar. Further in-depth analyses of this rich database of characteristics of human carcinogens are expected to provide additional insights into the MOA of human cancer development.

Population preferences for sources that offers information about dietary fibres health effects - an international cross-sectional survey.

OBJECTIVE: To investigate the perceived importance of information about dietary fibre with regard top opulation socio - demographic characteristics and consumption patterns. METHODS: The cross-sectional study was conducted from September to November, 2016, in six different counties and 57 cities across Romania, and was part of a larger project that had nine other countries as well. Data of the Romanian subjects was collected using a validated questionnaire that was disseminated across the 10 countries at the same time. Knowledge about dietary fibre was explored through 10 questions, and the respondents were asked to answer on a 5-point Likert scale varying from 1 (totally disagree) to 5 (totally agree). SPSS 22 was used for data anaylsis. RESULTS: Of the 670 subjects, 358 (53.4%) were females, and the overall mean age was 35.81±15.61 years (range: 18-89 years). There were 298 (44.5%) subjects with a university degree, 314(46.9%) had completed high school and 57 (8.5%) had done primary school. Besides, 568 (84.8%) participants lived in an urban environment. Internet was the main source of getting information for 368(54.9%) subjects, while the lowest was hospitals 122 (18.2%). The percentage of correct answers regarding knowledge about health effects of dietary fibre was 23.12%. Most accurate answers were related to deficiency of vitamins and minerals 370 (55.5%), breast cancer 202(30.3%), vision problems 202(30.3%) and diabetes 168 (25.2%). The question with least accurate answer was the one about general preventive characteristics of dietary fibres 65 (9.7%). CONCLUSION: A proper and friendly way to transmit information about the importance of dietary fibre consumption is critical in promoting healthy diet patterns and in preventing non-transmissible diseases.

A Cross-sectional Investigation of Cancer-Screening Intentions, Sources of Information, and Understanding of Cancer in Japanese Adolescents.

The purpose of this study was to describe the cancer-screening intention, sources of cancer information, and cancer understanding among Japanese adolescents. A cross-sectional nationwide survey involving a self-administered questionnaire was conducted. Response rates of the target schools were 46.4 % (n = 103) for junior high schools and 55.8 % (n = 116) for high schools. From these, we analyzed the data of 2960 junior high school students (1520 males, 1440 females) and 3703 high school students (1546 males, 2157 females) to examine the association between cancer-screening intention and sources of cancer-related information and understanding. A significant association between cancer-screening intention and sources of cancer information and cancer understanding was observed. The screening intention group identified more sources of cancer information than the no-screening intention group did. Understanding about cancer was reported by a higher proportion of students in the screening intention group compared with the no-screening intention group. Recognition that healthy people must take part in cancer screening was significantly associated with screening intention in both junior high (odds ratio (OR), 1.859; 95 % confidence interval (CI), 1.582-2.185; P < 0.001) and high school (OR, 2.485; 95 % CI, 2.139-2.887; P < 0.001) students. Health education at school was indicated by a high proportion of students as a source of cancer-related information, although the association was not significant. The present survey indicated that those in of our sample who intended to undergo future cancer screening (67.8 %) had more sources of information and understanding regarding cancer. Thus, schools should enrich health education curricula with more information and understanding about cancer to promote cancer-screening intention among Japanese adolescents.

Traits of riparian woody plants responding to hydrological and hydraulic conditions: a northern Swedish database.

The main goal of this study was to create a database that ultimately serves further studies on riparian vegetation and flow response guilds in the boreal region and on transferability of results across different regions. To achieve this aim, we compiled traits for all woody riparian species in northern Sweden which, directly or indirectly, underlie their responses to hydrological and hydraulic conditions, between October 2012 and April 2015. Consulted sources of information were diverse, ranging from scientific to informative and whose accuracy might or might not be verified. They were focused on particular or several traits and species from concrete areas to a worldwide perspective. Sources were characterized by different degrees of accessibility and showed a wide variety of descriptions, categorical and ordinal classifications, and numerical information for each trait. Our effort was to synthesize information for each trait from all sources into the common frame of our own database, following own defined criteria so that comparisons between species are congruent. Therefore, this data set is unique in that it comprehensively combines and homogenizes morphological, phenological, reproductive, and ecological data for 59 woody, riparian, boreal species and from 118 sources of information, that would otherwise be scattered and hardly available.

Sources of information on Gestational Diabetes Mellitus, satisfaction with diagnostic process and information provision.

BACKGROUND: This study aimed to investigate the percentage of the needs and expectations of pregnant women with Gestational Diabetes Mellitus (GDM) about the best sources of information on GDM, their satisfaction with the diagnostic process and information provision. METHODS: Questionnaires were completed by 116 pregnant women aged 18-45 years, diagnosed with GDM and recruited from maternity diabetes clinic. Eligible women were invited to participate in the study and informed consent was obtained from each participant prior to enrolment. Descriptive statistics, Kruskal-Wallis test, t-test and chi-square test were used to analyse data. RESULTS: Most women (64.2 %) expected general practitioners (GPs) to be the best source of GDM information, following by diabetes educator nurses (45.9 %), diabetes support groups (33.9 %) and internet (32.1 %). However, women found that diabetes educator nurses were more helpful than GPs (32.6 and 20.2 %, respectively). Participants' age and country of birth were statistically significant. For women aged over 30 years and women born overseas the internet was the most useful information source (68.9 and 77.1 % respectively). Overall, women were very satisfied (33.0 %) or satisfied (45.0 %) with how they were informed of the GDM diagnosis, although 26.0 % were informed by telephone and 16.0 % by text message. More than one-third (39.0 %) of women were not referred to sources of information by GPs at time of diagnosis of GDM (p <0.0001). Women who were referred reported that they were very satisfied (40.0 %) or satisfied (44.0 %) with information they received. Only 8.0 % of women reported dissatisfaction with the manner of health professionals. CONCLUSION: The results suggest that health professionals should be aware of the needs and expectations of women who have been diagnosed with GDM, with most women expecting to receive information on GDM from their GPs and diabetes educator nurses. The findings suggest that there is scope for improving how women are informed of the GDM diagnosis and given information, and in clinicians' manner.

[Quality of life or life expectancy? Criteria and sources of information in the decision-making of patients undergoing aortic valve surgery]. / Lebensqualität oder Lebenserwartung? Kriterien und Informationsquellen für die Entscheidungsfindung bei Patienten im Vorfeld von Aortenklappenoperationen.

OBJECTIVES: Physicians are expected to involve patients adequately in the decision-making process prior to surgery. To this end, it is essential to have knowledge about the potential reasons for such a decision. In this study we investigated which information sources and decision criteria are important to patients prior to aortic valve surgery. METHODS: A consecutive sample of 468 patients (70.1%m, aged 66.9±14.2 years) was examined 2 years after aortic valve replacement or reconstruction with a self-developed questionnaire. RESULTS: Preoperative discussion with a cardiologist or a cardiac surgeon was the information source patients used most frequently and felt to be the most helpful. The most important decision criterion was quality of life, followed by life expectancy and likelihood of reoperation. Two years postoperatively, 97.3% of the patients were satisfied with their decision. CONCLUSIONS: Preoperative counseling by a physician plays an essential role in the decision-making process prior to cardiac surgery. Patients want to be involved in decision-making, though they do not want to bear the full responsibility.

Patterns of Dietary Supplement Use among GBT2Q Men and Non-Binary Individuals in Canada.

There is a lack of research regarding dietary supplement (DS) use among Gay, Bisexual, Transgender, Two-Spirit, Queer (GBT2Q) men and non-binary individuals, despite the higher prevalence of body image issues and societal pressure within this community. This study aimed to investigate patterns and predictors of DS use in this population, including types of DS used, sources of information, and reasons for DS use. A validated and anonymous online questionnaire was completed by 204 participants (52.5% men, 43.1% gay, mean age 29.34 + 6.77 years) across Canada, who were consuming DS at the time of the study. Analyses included descriptive statistics to characterize the sample based on gender, sexuality, age, ethnicity, and other demographic attributes, using Pearson's chi-square tests and multi-way cross-tabulation analyses. Additionally, regression analyses, including binary and logistic regressions, were employed to identify predictors of DS use. Data analysis concluded that vitamins/minerals (92.2%), proteins (84.3%) and carbohydrates (75.5%) were the most consumed types of supplements. Identifying as certain genders and sexualities was significantly associated with supplement preferences, such that men reported higher use of amino acids (p = 0.033) and non-vitamins/mineral antioxidants compared to individuals identifying as other genders (p = 0.006). Moreover, bisexual participants consumed amino acids (p = 0.043) and carbohydrates (p = 0.026) more frequently when compared to non-bisexual participants. The most listed reason for DS use was to improve immunity (60.3%), with health care professionals being listed as the source of information by most participants (51.0%). Findings from this study can serve as a foundation for further research in this area and can guide the formulation and implementation of adequate policies targeting this underserved population.

A Survey on the Knowledge and Awareness of Testicular Cancer and Testicular Self-Examination Among Men in Saudi Arabia.

Objectives The aim of the study was to assess the knowledge and awareness of testicular cancer (TC) and testicular self-examination (TSE) and to identify the associated factors in men in Saudi Arabia. Methods An online questionnaire-based study was conducted in Saudi Arabia with a representative sample of 794 participants. The questionnaire comprised knowledge, awareness and attitude questions regarding TC and TSE in addition to signs/symptoms and risk factors. Multivariate logistic regression analysis was conducted to identify the significant variables associated with knowledge of TC and TSE. Results Around 43% (n=340) of the participants had inadequate knowledge of TC, whereas 26% (n=205) had heard about TSE and only 65 (8.2%) performed TSE. The first model for knowledge found that participants with a low level of education [2.75 (1.18, 6.42)]; no past history of a testicular problem [2.20 (1.22, 3.95)] and those who had not heard about TSE [1.79 (1.24, 2.57)] were at higher odds for inadequate knowledge, whereas those whose mothers had received college-level education [0.39 (0.19, 0.79)] and those who received information from school/college [0.61 (0.37, 0.97)] were more likely to have adequate knowledge about TC. The second model for TSE found that a low level of education 5.24 (1.34, 20.52) was associated with not performing TSE. Receiving information from social media [0.08 (0.03, 0.17)], school/college [0.06 (0.02, 0.13)], family and friends [0.17 (0.05, 0.57)] and medical staff [0.08 (0.03, 0.17)] were associated with higher odds of performing TSE. Conclusion The majority of Saudi males have knowledge about TC. On the contrary, only a small percentage of the respondents have heard of or performed TSE as a screening technique. Educated sources of information can be a reliable way of giving correct knowledge on sensitive topics like TSE.

Awareness of Breast Cancer Risk Factors in Women with vs. Without High Breast Density.

Purpose: Women with high breast density (HBD) carry an increased risk for breast cancer (BC). The aim of the study was to provide data on awareness and knowledge gaps among women with vs w/o HBD about BC risk factors (BCRFs), which is the basis for effective communication about screening. Patients and Methods: This was a web-based survey of 3000 women aged ≥30 and ≤70 from six countries. It comprised of 45 questions. T-tests and chi-square tests with False Discovery Rate adjustments were conducted as applicable, with significant differences reported at α=0.05. Results: Three-thousand women were included in the analysis, 733 (24.4%) had HBD. Overall, 39% of women were familiar with the concept of HBD in the context of BC. Thirty-one percent of women were aware of HBD as BCRF and for 24% of women HBD was personally applicable. A significantly higher proportion of women with HBD were aware of almost all BCRFs compared to women w/o HBD (p ≤ 0.05). Similarly, a significantly higher proportion of women with HBD have undergone screening procedures compared to women w/o HBD (p ≤ 0.05). Women with HBD were significantly better aware of basic facts about BC (p ≤ 0.05). A total of 1617 women underwent mammography, 904 ultrasound and 150 MRI during their last screening. The most relevant source of information about BC was the health care professional, as reported by 63% of women. Conclusion: Overall 39% of women were familiar with HBD as BCRF. Lack of BCRF awareness may contribute to delayed screenings, missed opportunities for early detection, and potentially poorer outcomes for individuals with dense breast tissue. Thus, this information should be communicated more widely.

Pregnant women's perceptions on Information Sources on Zika Virus: a qualitative study.

The Zika virus (ZIKV) epidemic had a sanitary, psychosocial, and economic impact on individuals of reproductive age. The primary concern revolved around infection during pregnancy due to possible vertical transmission and its association with adverse fetal and infant outcomes, known as Congenital Zika Syndrome (CZS). This qualitative study employs phenomenology and grounded theory. This study includes interviews with 98 women, some pregnant during the ZIKV epidemic in Brazil, Colombia, and Puerto Rico, who had children with CZS or without diagnosed neurological impairment. Additionally, the study included a group of women who were pregnant during the COVID-19 pandemic in these same countries. In both groups, interviewees had varying levels of knowledge about ZIKV. The study found that messages conveyed through the media tended to be alarmist, in contrast to the information provided by healthcare professionals, which was considered more trustworthy. Pregnant women during the ZIKV epidemic reported receiving their ZIKV and CSZ infection diagnoses late, either during or after childbirth. The study underscores the needs of pregnant women in high-risk scenarios, the importance of health education processes, and the necessity to reinforce communication and continuing education.

A epidemia do vírus Zika (ZIKV) teve impacto sanitário, psicossocial e econômico sobre pessoas em idade reprodutiva. A principal preocupação foi a infecção durante a gravidez devido a possível transmissão vertical e sua associação com resultados fetais e infantis adversos, conhecida como síndrome congênita associada à infecção pelo Vírus Zika (SCZ). Este estudo qualitativo utiliza a fenomenologia e a teoria fundamentada. O estudo inclui entrevistas com 98 mulheres, parte grávida durante a epidemia de ZIKV no Brasil, Colômbia e Porto Rico e que tiveram filhos com SCZ ou sem comprometimento neurológico diagnosticado. Além disso, o estudo inclui um grupo de mulheres grávidas durante a pandemia de COVID-19 nos mesmos países. Em ambos os grupos, as entrevistadas tinham diferentes níveis de conhecimento sobre ZIKV. O estudo constatou que as mensagens veiculadas por meio da mídia eram alarmistas; em contraste com as informações fornecidas por profissionais de saúde, consideradas mais confiáveis. Mulheres gestantes durante a epidemia do ZIKV relataram ter recebido seu diagnóstico de infecção por ZIKV e SCZ tardiamente ou após o parto. O estudo destaca as necessidades das mulheres grávidas em cenários de alto risco, a importância de processos de educação em saúde e a necessidade de reforçar a comunicação e a educação continuada.

The effect of fear on health information searching behavior during the pandemic: The case of COVID-19.

BACKGROUND AND OBJECTIVES: Fear can cause people to panic, lead to erroneous decisions, and trigger inappropriate behavior. This study aims to investigate the effects of fear of COVID-19 on the perception of the reliability and the use of health information sources. METHODS: This study is both a cross-sectional and explanatory study. The participants selected by convenience sampling method were 323 students attending a state university in Turkey. The Fear of COVID-19 Scale (FCV-19S) and the Health Information Sources Survey were used as data collection tools. Descriptive statistics, correlation coefficients, and linear regression analyses were used. RESULTS: The participants' mean FCV-19S score was 2.30 ± 0.93 on a five-point Likert scale. In the range of 0-10, the information source with the highest reliability perception mean score was the doctor (8.05 ± 2.54), whereas that with the highest usage was the Internet (7.98 ± 2.77). Although the fear of COVID-19 had a negative effect on Internet use (b = -0.38; p < 0.05), the effects on the use of other health information sources were positive (b = 0.37-0.83; p < 0.05). Trust in radio (b = 0.60; p < 0.05) and newspapers/magazines (b = 0.49; p < 0.05) also increased with fear. CONCLUSIONS: These results showed that as university students' fear of COVID-19 increased, the use of the Internet for health information decreased; however, the use of doctors, nurses, pharmacists, other health workers, scientific articles, television, radio, and newspapers/journals increased. Nurses were the source of information whose use increased the most, along with increased fear. The findings can guide health policies to be followed. Not only doctor talks but also nurse talks and scientific videos should be increased on the Internet, social media, and other mass media.