Knowledge, concerns, and vaccine acceptance related to Mpox (Monkeypox) among university students in North and Northeast China: An online cross-sectional study

The growing number of Mpox cases in China has posed a challenge to public health. The prevalence of men who have sex with men behaviors among students has been consistently increasing each year in China, accompanied by a high frequency of unprotected anal sex. As crowded places, schools are highly likely to cause an Mpox outbreak among students through long-term close contact. Understanding university students' perceptions about Mpox and willingness to vaccinate play a vital role in implementing preventive measures in schools. This study aimed to assess knowledge, concerns, and vaccine acceptance toward Mpox among university students in North and Northeast China. A cross-sectional study was conducted among 3831 university students from seven universities in North and Northeast China between September 10 and September 25, 2023. This study found a relative insufficiency in Mpox knowledge among university students (71.60%), with less than half expressing concern about the Mpox outbreak (39.57%), and the majority exhibiting a positive attitude to vaccination (76.30%). Multivariate regression analysis revealed that a good knowledge level was associated with age, study discipline, education level, and a high level of concern about Mpox. Male, elderly, or highly educated participants had a low level of concern about Mpox. Participants with a high level of knowledge toward Mpox were more likely to have the vaccination willingness. This study might help governments and schools to understand students' Mpox perceptions and vaccination intentions, enabling them to implement effective measures in addressing the issue of inadequate understanding regarding Mpox among university students.

Donor-linking provisions in New Zealand: counselling roles, concerns and needs

Donor-linking where those genetically related through donor conception (e.g. donor-conceived persons (DCP), donors and siblings), or recipient parents, search for and connect with each other, is increasingly common, both in identity-release jurisdictions where donors' identifying information may be released to DCP, usually when they become adults - and in anonymous jurisdictions, e.g. as a result of direct-to-consumer DNA testing. In this paper, we explore New Zealand fertility clinic counsellors' views regarding their donor-linking roles and their concerns and needs in relation to current and anticipated service provision. Counsellors believed that fertility service providers had a longer-term responsibility to offer donor-linking services to ensure the wellbeing of all parties affected by donor conception. They perceived their role as complex and multifaceted, encompassing psychoeducation, mediation, advocacy, facilitation, relationship counselling, and therapeutic intervention. They identified significant service provision challenges however, including inadequate staffing, training, time and prioritisation of donor-linking, and inadequate legislative provisions to support practice. Counsellors called for clarity in legislation addressing different contexts of donation and providing measures to ensure the recording of and access to identifying information. They expressed a need for comprehensive, funded donor-linking services, therefore facilitating choice, and services staffed by professionally trained and supported staff.

Exploring the perspective of adolescent childhood cancer survivors on follow-up care and their concerns regarding the transition process-A qualitative content analysis

PURPOSE

In Germany, children diagnosed with cancer survive their initial disease in more than 80%, and the majority will become long-term survivors. Around the age of 18, survivors are transferred to adult healthcare. The transition can be a critical period in the process of care at which many childhood cancer survivors discontinue to participate in regular follow-up care. Hence, the objective of the paper was to explore (a) survivors' attitudes towards pediatric follow-up care and (b) their concerns regarding the transition process to draw conclusions for optimizing pediatric care and transition processes.

METHODS

We conducted semi-structured interviews with 21 adolescent childhood cancer survivors between the ages of 14 and 20. The survivors were recruited via a pediatric oncology department of a university hospital in Germany. Based on the principles of qualitative content analysis, a deductive-inductive method according to Kuckartz was applied.

RESULTS

Based on the interview guide and derived from the exploratory research questions, two key categories were generated: (a) Survivors' attitudes towards pediatric follow-up care, which encompasses all formal and emotional aspects of survivors regarding follow-up care, and (b) their concerns regarding transition from pediatric to adult healthcare, where hindering and facilitating factors for a successful transition occur. Our results show high satisfaction among survivors with follow-up care. Nevertheless, they wish to be more integrated into processes and the organization of their follow-up care. Most adolescent survivors do not feel ready for transition.

CONCLUSION

The integration of survivors into the organization processes and routines, and the promotion of emotional detachment from pediatric health care professionals (HCPs) are important to reduce concerns and uncertainties of adolescent survivors regarding the transition process and to promote subjective readiness for transition. To gain confidence in the adult healthcare, it is crucial to provide tailored education depending on individual requirements and needs and to build trusting relationships between survivors and adult HCPs.

[An examination of relevant factors attributable to child health, food behavior, and lifestyle concerns of parents with infants aged at least 18 months: With a view to expanding into Shokuiku (food and nutrition education)]

Objectives　This study focused on food after weaning and examined the children's diet and home environmental factors that influence parents' concerns during health checkup for infants (aged 1.6 and 3 years).Methods　In the analysis, 646 participants, excluding invalid responses, who cooperated with the survey during health checkup for 1.6- and 3-year-old in the Tohoku, Chubu, and Chugoku regions from March 2019 to January 2020, were included. The survey included 56 items of dietary, lifestyle, and health concerns (yes/no answers), child attributes, and frequency of food intake (six options, 18 types). Concern factors were extracted by factor analysis. The association between the worry scores and each factor was analyzed.Results　The 1.6- and 3-year-olds were associated with high scores for (health awareness and lifestyle) and low fruit intake, high salty snacks intake, and low subjective economic status, high scores for (diet content and atmosphere) and low intakes of carotene-rich vegetables, other vegetables, seaweed, and fruits, high scores for (interest and motivation in food) and low carotene-rich vegetables intake, high scores for (food experience and behavior) and high cereals (bread) intake, low subjective economic status. The 3-year-olds were associated with high scores and being boys.Conclusion　We extracted four worry factors that parents with children after the weaning period have and clarified the factors related to each factor and group characteristics.

Reproductive Concerns and Associated Factors Among Adolescent and Young Adult Cancer Survivors in Uganda: A Hospital-Based Cross-Sectional Study

Purpose: Reproductive health (RH) is a critical issue among cancer survivors worldwide. However, in developing countries where RH services for patients with cancer are often lacking, reproductive concerns among adolescent and young adult (AYA) survivors remain uncertain. In this study, we assessed the reproductive concerns of AYA cancer survivors in a resource-limited context of Uganda. Methods: We collected data from AYA cancer survivors at two facilities in Uganda using an interviewer-administered questionnaire. Descriptive statistics were calculated, one-way analysis of variance was used for intergroup comparisons, and multiple regressions were used to test for predictors of reproductive concerns. Results: A total of 110 AYA cancer survivors, with a median age of 20 years (interquartile range [IQR], 18-22), were interviewed. More than half (53.6%) of the respondents were males. The median time since cancer diagnosis was 19 months (IQR, 13.0-35.0). Almost all (91.8%) respondents had a future desire to have children, but only 15.5% received reproductive counseling. The mean total score for the reproductive concern subscales was highest for the fertility concern, followed by the information-seeking and health-related concerns. Reproductive counseling, desire to have children, and respondents' age were the factors influencing reproductive concern. Conclusions: The study shows a strong desire for biological parenthood with very low reproductive counseling among AYA cancer survivors, who remain concerned about their fertility, information needs, and health. This outcome underscores the need to integrate RH services into resource-limited cancer care settings.

Exploring the Impact of the COVID-19 Pandemic on Twitter in Japan: Qualitative Analysis of Disrupted Plans and Consequences

BACKGROUND

Despite being a pandemic, the impact of the spread of COVID-19 extends beyond public health, influencing areas such as the economy, education, work style, and social relationships. Research studies that document public opinions and estimate the long-term potential impact after the pandemic can be of value to the field.

OBJECTIVE

This study aims to uncover and track concerns in Japan throughout the COVID-19 pandemic by analyzing Japanese individuals' self-disclosure of disruptions to their life plans on social media. This approach offers alternative evidence for identifying concerns that may require further attention for individuals living in Japan.

METHODS

We extracted 300,778 tweets using the query phrase Corona-no-sei ("due to COVID-19," "because of COVID-19," or "considering COVID-19"), enabling us to identify the activities and life plans disrupted by the pandemic. The correlation between the number of tweets and COVID-19 cases was analyzed, along with an examination of frequently co-occurring words.

RESULTS

The top 20 nouns, verbs, and noun plus verb pairs co-occurring with Corona no-sei were extracted. The top 5 keywords were graduation ceremony, cancel, school, work, and event. The top 5 verbs were disappear, go, rest, can go, and end. Our findings indicate that education emerged as the top concern when the Japanese government announced the first state of emergency. We also observed a sudden surge in anxiety about material shortages such as toilet paper. As the pandemic persisted and more states of emergency were declared, we noticed a shift toward long-term concerns, including careers, social relationships, and education.

CONCLUSIONS

Our study incorporated machine learning techniques for disease monitoring through the use of tweet data, allowing the identification of underlying concerns (eg, disrupted education and work conditions) throughout the 3 stages of Japanese government emergency announcements. The comparison with COVID-19 case numbers provides valuable insights into the short- and long-term societal impacts, emphasizing the importance of considering citizens' perspectives in policy-making and supporting those affected by the pandemic, particularly in the context of Japanese government decision-making.

Perception, acceptance, and adverse effects of COVID-19 vaccines: Insights from Indian population

Background

Vaccination has been pivotal in eradicating numerous infectious diseases. Nonetheless, concerns about the safety and side effects of the COVID-19 vaccine persist. This study aimed to gauge the perceptions and experiences of the Indian population concerning COVID-19 vaccination.

Methods

This study was a cross-sectional survey of 313 participants aged 18 and above from diverse regions in India. Data was sourced using an electronic questionnaire disseminated via Google Forms. The survey evaluated demographics, vaccine awareness, attitudes, and side effects post-vaccination with Covishield and Covaxin.

Results

22.6% of participants exhibited vaccine hesitancy; however, 78.3% believed the advantages superseded the risks. Most participants (81.5%) were aware of vaccine side effects. Most of the Indian respondents (97.1%) accepted the COVID-19 vaccine. Post-vaccination, 27.9% experienced adverse effects such as fever, headache, malaise, dizziness, and pain at the local site. Only 1.3% necessitated hospitalization.

Conclusion

Our study underscores the dichotomy between vaccine apprehensions and real-world experiences. Although concerns surrounding vaccine safety were prevalent, the majority of the Indian respondents (97.1%) accepted the COVID-19 vaccine, with most experiencing only transient, mild side effects. While 22.6% initially exhibited hesitancy, primarily due to misinformation, the actual experience post-vaccination was largely positive. To further address hesitancy, streamlined vaccine awareness campaigns emphasizing the safety and efficacy of vaccination are essential.

The Delicate Dance of Intraoperative Anesthesia: Addressing Patient and Anesthesiologist Concerns

Background In the realm of surgical procedures, patients and anesthesiologists have distinct concerns that can have an impact on their relationship. Patients are often riddled with anxiety about the unknowns of anesthesia and the possible risks. Anesthesiologists, too, face their own set of concerns. Despite the importance of this interaction, there has been little research on the specific concerns of both parties. Our study aims to fill this gap by describing and comparing the concerns of patients and anesthesiologists in Jordan. Methodology This cross-sectional study evaluated anesthesia-related problems based on specific questionnaires. The responses to the questionnaires were on a voluntary basis. The consent of the participants was granted after the aims of the study were clarified. Data were collected and analyzed using SPSS version 28 (IBM Corp., Armonk, NY, USA). Results A total of 155 Jordanian anesthesiologists and 1,858 participants from the population who had undergone anesthesia participated in the study. In general anesthesia, over 60% of the anesthesiologists were most worried about ventilation and intubation difficulties during anesthesia induction and death at the end of anesthesia. Regarding regional anesthesia, the primary concerns included toxicity from local anesthesia infiltration (64.5%) and total spinal anesthesia (49.0%). Patients were concerned about various anesthesia-related scenarios, with the highest worries about pain (3.41/4), a sharp drop in vital signs (3.40/4), and an irregular heartbeat (3.39/4). Female patients, those with lower incomes, and those with a bachelor's degree reported higher anesthesia concern levels. Additionally, anesthesiologists' mean concern score was significantly lower than that of patients. Conclusions Patients concentrated on pain, a drop in vital signs, and irregular heartbeats, whereas anesthesiologists were worried about ventilation, intubation, and hypoxia. Patients placed more emphasis on personal experiences and social factors than technical issues. Therefore, patient education about anesthesia and discussion about intra and postoperative expectations are imperative to improve the surgical experience and the relationship between patients and anesthesiologists.

Development and Psychometric Evaluation of the Concerns of Grieving Caregivers Scale (COGCS) with Two Clinical Samples

The Concerns of Grieving Caregivers Scale (COGCS) is the first of its kind to explore caregivers' concerns about their own parenting, as well as their relationships with, and specific behaviours of their bereaved child(ren). Using exploratory factor analysis, we evaluate grieving parents' and caregivers' concerns using data collected across clinical populations from two community organizations supporting grieving families (i.e., a children's grief centre and a community hospice). Two identified factors were established: Concerns about Caregiving and Concerns about the Child. The COGCS demonstrates good internal consistency and criterion validity in its application with two distinct clinical samples. The use of this scale could be of value to clinicians supporting bereaved caregivers and their families as they can integrate concern-specific resources into their practice to better support their clients' presenting concerns.

Evaluating Parents' Concerns, Needs, and Levels of Satisfaction with the Services Provided for ASD Children in Saudi Arabia

Background

Supporting children with autism spectrum disorder (ASD) and their parents is vital in improving their children's abilities and their parents' ability to care for them. Thus, parents' perceptions of and levels of satisfaction with the services provided for their children must be assessed.

Aim

This study aimed to understand parents' perceptions of and satisfaction with the speech-language services (SLS) provided for ASD children in different health facilities in Saudi Arabia.

Methods

This cross-sectional study included 109 parents of ASD children. The survey included five sections dealing with (1) general information about the child; (2) assessment of the child's ASD characteristics (including their age when diagnosed, when they first noticed symptoms, and their speech, language, and communication abilities); (3) the reasons for enrollment in SLS sessions; (4) questions about SLS; and (5) parents' perceptions of SLS, satisfaction with the service, descriptions of their children's progress, and the respect and support they received.

Results

Parents' satisfaction levels were significantly higher when they had easy access to SLS, sufficient information and support, proper training in applying therapy exercises at home, and perceived respect and support from speech and language pathologists (SLPs). The reasons for discontinuing SLS included high session costs, the need for initial behavioral sessions, the lack of qualified SLPs, the end of the sessions, the lack of improvement, the nonavailability of specialized centers, and parents' dependence on home training only. They also sought opportunities for work and education, continuous and intensive SLS sessions, reduced costs, centers for adults with ASD, and accessible schools. Parents' main concerns were their children's poor speech and language skills, independence, and social acceptance.

Conclusion and Implications

The study highlighted the importance of understanding parents' experiences with SLS, identifying the factors that enhance SLS use by ASD children, and improving parents' satisfaction with such services.

Association of Age and Gender With Concerns About Live Donor Kidney Transplantation Among Black Individuals

Black individuals are less likely to receive live donor kidney transplantation (LDKT) compared to others. This may be partly related to their concerns about LDKT, which can vary based on age and gender. We conducted a cross-sectional, secondary analysis of the baseline enrollment data from the Talking about Living Kidney Donation Support trial, which studied the effectiveness of social workers and financial interventions on activation towards LDKT among 300 Black individuals from a deceased donor waiting list. We assessed concerns regarding the LDKT process, including their potential need for postoperative social support, future reproductive potential, recipient and donor money matters, recipient and donor safety, and interpersonal concerns. Answers ranged from 0 ("not at all concerned") to 10 ("extremely concerned"). We described and compared participants' concerns both overall and stratified by age (≥45 years old vs <45 years old) and self-reported gender ("male" versus "female"). The participants' top concerns were donor safety (median [IQR] score 10 [5-10]), recipient safety (5 [0-10]), money matters (5 [0-9]), and guilt/indebtedness (5 [0-9]). Younger females had statistically significantly higher odds of being concerned about future reproductive potential (odds ratio [OR] 3.77, 95% CI 2.77, 4.77), and older males had statistically higher mean concern about postoperative social support (OR 1.79, 95% CI 0.19, 3.38). Interventions to improve rates of LDKT among Black individuals should include education and counseling about the safety of LDKT for both recipients and donors, reproductive counseling for female LDKT candidates of childbearing age, and addressing older males' needs for increased social support.

Psychological Distress and Concerns of In-Home Older People Living with Cancer and Their Impact on Supportive Care Needs: An Observational Survey

(1) Background: Cancer patients are experiencing psychological problems after diagnosis, such as emotional distress and social anxiety, which may increase their demands for emotional and supportive care. This study aimed to assess the influence of both emotional distress and concerns on the supportive care needs of cancer patients receiving home-based healthcare. (2) Methods: In this door-to-door screening program, 97 cancer patients were approached, with a mean age of 73 years old (mean = 73.43; SD = 6.60). (3) Results: As expected, 42.3% of patients highlighted their treatment as their main psychological priority, with 20.6% identifying concerns about the future of their family in this regard. No significant associations with respect to sex were identified in terms of focus, though females reported the need for more frequent psychological support (58.7% vs. 37.3%, respectively, p = 0.035) compared to males. Patients who had experienced an increased number of concerns during the last weeks (IRR = 1.02; 95% CI: 1.00-1.03, p = 0.007) had a significantly greater risk of presenting an increased rate of supportive care needs. Notably, male patients with bone cancer presented a significantly greater number of supportive care needs (mean rank 45.5 vs. 9.0, p = 0.031) respectively, in comparison to those with other types of cancer. (4) Conclusions: Supportive care needs arise from a greater concern and specific type of cancer, highlighting the need for supportive care, such as psychosocial and psychological support. This may have significant implications for treatment and patient outcomes in home care settings.

Adolescents and young adults' concerns under stress, the COVID-19 pandemic: a Portuguese cross-sectional study

Background

Adolescents and young adults are a critical target regarding reducing healthrisk behaviors' adoption, particularly in a stressful context such as the COVID-19 pandemic. Surveying their perceptions and behavioral changes may lead to a revised health promotion approach.

Objectives

This study aims to describe adolescents' and young adults' early reactions to a stressful event, the COVID-19 pandemic, characterizing their social determinants and preferences, such as sources of information, experienced symptoms, habits, and main concerns regarding themselves, their relatives, and the community. We intended to explore the association of their concerns and significant determinants such as age, gender, education, source of information, feelings of fear, prospecting the implications of communication, and individual and social determinants in managing stressful events.

Methods

We conducted a cross-sectional, population-based, self-report survey of 3,898 individuals aged between 16 and 24  years from Portugal.

Results

The main concerns about COVID-19 were the possibility of transmitting to someone and permanent social changes. Our findings present significant differences according to gender, education, age, and expressing fear.

Conclusion

The pandemic deteriorated baseline community inequalities. Young people appreciate official information and are available to contribute to society's safety. However, valuing official information is associated with deeper expressed concerns. Therefore, official information should include strategies to reach young people, promote healthier choices, and avoid distress and disinformation.

Areas of Concern and Support among the Austrian General Population: A Qualitative Content Analytic Mapping of the Shift between Winter 2020/21 and Spring 2022

This study aimed to analyze areas of concern and support of the Austrian general population two years into the COVID-19 pandemic. A representative sample (N = 1031) of the Austrian general population was surveyed online between 19 April 2022 and 26 April 2022. A qualitative study design was used to explore the factors of most considerable current concern (Question 1) and the most important sources of support (Question 2). The responses to the two open-ended questions were evaluated using a conventional content analysis, and categories were formed according to the frequency of the answers. The analysis revealed that inflation and finances (30% of participants) and the war in Ukraine (22%) were the greatest sources of concern, followed by mental health (11%), and physical health (11%). Factors such as social contacts within and outside the family were mentioned most frequently as sources of support (36% of participants), followed by recreational activities (23%) and attitudes and abilities (22%). Compared to data collected at the end of the first year of the pandemic (between 23 December 2020 and 4 January 2021), concern about one's financial situation was now mentioned more frequently (30% vs. 8,5%). On the other hand, different types of pandemic-related concerns were mentioned less often. Social contacts and recreation were mentioned as the most important sources of support at both time points (46% and 36% of the participants). The results suggest that the economic concerns are lagging behind the restrictions imposed by the pandemic. In addition, the impending war in Ukraine seems to have a relevant impact on mental health in Austria. Further nuanced qualitative research, particularly involving vulnerable groups such as low-income individuals and the unemployed, is crucial.

Everybody hurts sometimes: perceptions of benefits and barriers in telemedical consultations

Introduction

Shifts in the age structure, rising needs of care and support, and a lack of (in)formal caregivers require innovative solutions to relieve the whole healthcare system. Applying digital approaches, such as telemedicine, has the potential to support people in need of care, to relieve caregivers in families and professional environments, and to assist medical professionals in their working everyday life: e.g., using telemedicine for acute consultations could contribute to avoid hospitalizations of older people, whereas consultations with the general practitioner could reduce efforts and relive medical personnel. Beyond technical opportunities and potential, the acceptance of future users represents a prerequisite for a sustainable adoption of such innovative approaches, especially in sensitive contexts such as life in older age in nursing homes.

Methods

This study aimed at collecting users' perceptions and evaluations of telemedicine in nursing homes. Two scenarios of telemedical consultations were applied which were either carried out by an emergency physician in acute situations or by the attending general practitioner. In a first approach, advantages and disadvantages of telemedicine were collected with the help of a qualitative interview study (N = 12) with laypersons and medical staff. The identified acceptance-relevant factors were then quantified in a second study using an online questionnaire (N = 204).

Results

Outcomes revealed that both types of telemedicial consultations would be gladly used. However, for telemedical consultations in acute situations, the perceived disadvantages outweighed the advantages; for telemedical consultations with the general practitioner, the advantages outweighed the disadvantages. A prominent barrier in both scenarios was perceived impersonality, which limited the willingness to use. Nevertheless, participants indicated that telemedical consultations can be a support for nursing staff.

Discussion

Outcomes may help to derive specific implications and recommendations to develop and realize digital technologies tailored to the requirements, needs, and wishes of diverse stakeholders (i.e., patients, medical professionals) as potential future users.

Factors that influence a patient's decision to engage in genetic research

Introduction

The most challenging step in clinical research studies is patient recruitment. Many research studies do not reach their targets because of participant rejection. The purpose of this study was to assess patient as well as the community knowledge, motivation, and barriers to participate in genetic research.

Methods

A cross-section study was conducted between September 2018 and February 2020 using face-to-face interviews with candidate patients from outpatient clinics at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia. Additionally, an online survey was conducted to assess the community's knowledge, motivation and barriers to participate in genetic research studies.

Results

In total, 470 patients were interviewed for this study, with 341 being successfully recruited for the face to face interview, and the other patients being refused owing to time constraints. The majority percentage of the respondents were females. The respondents' mean age was 30, and 52.6% reported having a college degree. The survey results from 388 participants illustrated that around 90% of the participants, participated voluntarily due to a good understanding of genetics studies. The majority held positive attitudes toward being part of genetic research, which exceeded the reported motivation score of >75%. The survey indicated that >90% of individuals were willing to participate to acquire therapeutic benefits or to receive continued aftercare. However, 54.6% of survey participants were worried about the side effects and the risks involved in genetic testing. A higher proportion (71.4%) of respondents reported that lack of knowledge about genetic research was one of the barriers to rejecting participation.

Conclusion

Respondents reported relatively high motivation and knowledge for participation in genetic research. However, study participants reported "do not know enough about genetic research" and "lack of time during clinic visit" as a barrier for participation in genetic research.

Male and female Asians living with HIV: a text-mining analysis comparing their concerns

Introduction

Asians are "a forgotten population" whose HIV prevention and treatment needs have long been ignored. Studies on people living with HIV/AIDS (PLWHA) have primarily reported on physical and psychological conditions among men and gender minorities.

Methods

We used data-mining to select words and word patterns from pooled in-depth interviews conducted with 33 women and 12 men (n = 45) who were HIV positive and residing in San Francisco, United States, Shanghai, Beijing, or Taipei, China. We analyzed gender-based data (male vs. female) within the participant responses.

Results

Disclosure of HIV serostatus was discussed by both genders of PLWHA. Participants were concerned whether they should disclose their diagnosis and how to disclose it to their family members. Specifically, for women, family relationships and financial burdens were discussed most often. In terms of men, HIV disclosure was the key concern followed by disclosure of their sexual preference and concerns over what people were saying about them in the community.

Conclusion

This project compared and contrasted concerns of Asian HIV-positive men and women. As healthcare providers promoting self-management by HIV-positive individuals of both genders, it is important to consider that there may be significant differences between them. Future interventions should consider how gender role influences self-management strategies in PLWHA and how support can be targeted to achieve a better quality of life for PLWHA.

Healthcare adjustments and concerns: a qualitative study exploring the perspectives of healthcare providers and administrative staff during the COVID-19 pandemic in Saudi Arabia

Background

Healthcare systems have modified their strategies to manage their staff, supplies, and space to deal systematically with the COVID-19 pandemic. This research aimed to explore the nature of hospital adjustments and the concerns of healthcare providers and administrative staff working in Governmental and private hospitals throughout the Qassim Region of the Kingdom of Saudi Arabia (KSA) during the pandemic.

Methods

A qualitative phenomenological study using semi-structured in-depth interviews were conducted with 75 purposively selected healthcare providers and administrative staff working at three main hospitals in the Qassim Region, KSA. The maximum variation sampling technique was utilized. Recruitment of participants was continued until data saturation was reached. All interviews were audiotaped, transcribed verbatim, and analyzed thematically.

Results

Four core themes were identified in this paper: (1) changes in hospital policy and procedures, (2) workforce management, (3) the well-being of the workforce, and (4) apprehensions and expectations of the workforce. The participants showed satisfaction with timely administrative decisions and new policies during the COVID-19 pandemic. Furthermore, the psychological health of healthcare professionals was affected more than their physical state. Finally, the providers perceived the emergence of multiple concerns in the coming months.

Conclusion

Although healthcare providers were initially overwhelmed, they gradually accepted new administrative policies. Numerous innovative interventions effectively reduced their physical workload and increased their productivity, but they remained significantly affected by a wide range of psychological disorders, with a high prevalence of obsessive-compulsive disorder. There were some concerns about the new SARS-CoV-2 variant, but the majority were optimistic.

COVID-19 Pandemic Responses among National Guard Service Members: Stressors, Coping Strategies, Sleep Difficultiesand Substance Use

The National Guard (NG) served as a critical component of the US COVID-19 response while concurrently managing personal COVID-19 responses. Understanding pandemic-related concerns, sleep difficulties, increased substance use, and stress management strategies can promote readiness for subsequent disasters. We surveyed 3221 NG service members (75% Army; 79% enlisted; 52% 30-49 years; 81% male) during COVID-19 (August-November 2020). Almost half were activated in response to COVID-19 (mean = 18.6 weeks) and completed the survey 2-3 months post-activation. Service members indicated great concern about family health (39%), the indefinite nature of the pandemic (35%), and their financial situation (23%). Over one-third reported changes in usual sleep amount, 33% described poor sleep quality, and 21% had trouble falling/staying asleep. Increased substance use was reported by 30%, including increased alcohol (13.5%), tobacco (9%), and caffeine/energy drinks (20.1%) consumption. Chi-square analyses and analyses of variance found those who activated reported more increased tobacco and caffeine/energy drink use versus non-activated, with no sleep difficulties nor alcohol use differences. Helpful stress management strategies included spending time outdoors (53%), exercising (48%), talking to family/friends (38%), and having a daily routine (38%). Specific health-, financial-, and job-related stressors were associated with COVID-19. Incorporating stress management in planning/preventive efforts promotes resilience during disasters.

Gender-Specificity of Fatigue and Concerns Related to the COVID-19 Pandemic-A Report on the Polish Population

BACKGROUND

The COVID-19 pandemic, which is now going on its third year, and its consequences experienced in almost every sphere of life may eventually lead to pandemic fatigue. Previous research indicates that one of the important determinants of the negative consequences of the pandemic is gender. Based on the WHO's definition of pandemic fatigue, a study was undertaken to determine the level of pandemic fatigue and concerns expressed in relation to the pandemic in Poland.

METHODS

A survey among 1064 respondents was conducted using the CATI technique during the fourth wave of the COVID-19 pandemic in Poland. Questionnaires adopted: the Polish adaptation of the Pandemic Fatigue Scale (PFS), Subjective Fatigue Symptoms (SFS), and the COVID-19 Concerns Checklist (CCC) and sociodemographic questions. The following statistical methods were employed: ANOVA analysis of variance, Mann-Whitney U test or Kruskal-Wallis test, and Chi-square test.

RESULTS

The analysis showed that women received higher overall PFS, information PFS, SFS, and pandemic-related concerns scores. Other factors that were associated with pandemic fatigue were age, treatment for chronic diseases, receipt of the COVID-19 vaccine, and COVID-19 survivor status.

CONCLUSIONS

Women in Poland are experiencing pandemic fatigue, subjective fatigue symptoms, and concerns associated with the COVID-19 pandemic at a higher rate than men. Along with implementing interventions focused on public health safety, it seems reasonable to put in place strategies to assist people who are less capable of coping with prolonged stressful situations.

School Nurses' Reports on Reopening Roles, Practices, and Concerns During the COVID-19 Pandemic at the Start of the 2020-2021 School Year

The COVID-19 pandemic has caused major disruptions to U.S. school systems since March 2020. To facilitate our understanding of how school nurses participated in school reopening and what support school nurses needed beginning the 2020-2021 school year during the COVID-19 pandemic, we conducted a national survey in late summer 2020. A sample of 747 school nurses from 43 states responded to an online survey about roles, practices, and concerns. Over one-third (36.9%) reported not being included in school reopening planning. Mitigation practices reported by respondents primarily included measuring temperatures of students before school (21.3%), mask wearing by students (79.9%), and 6 feet social distancing (76.7%). The respondents' greatest concerns were the educational impact on students with individualized education plans, parents sending children to school with COVID-19 symptoms, and the economic impact on families. Our results point to opportunities for greater school nurse involvement, improvements in practices, and measures to address school nurses' concerns.

Parental Concerns of Their Sexual and Gender Minority Adolescents Using HIV Pre-Exposure Prophylaxis

Although parents of sexual and gender minority (SGM) adolescents are key stakeholders in SGM adolescents using HIV pre-exposure prophylaxis (PrEP), there is limited understanding of parental concerns and attitudes about their SGM adolescents taking PrEP. Fifty-four parents in the West South Central region of the U.S. completed an online, mixed-method, cross-sectional questionnaire to explore their concerns and questions about PrEP. Quantitative and qualitative results show that participants were more concerned about side effects, drug interactions, (non)adherence, and eligibility and duration of PrEP. Parents are less worried about picking PrEP from a pharmacy or returning to follow-up lab testing every three months. Most parents reported receiving medication information their adolescent takes from a medical provider and the media. Findings from this study can inform the development of parent-based PrEP interventions. Without further parent-based research and programming, SGM adolescents may continue to be disproportionately affected by HIV.

[Survey on Preparedness, Concerns, and Support Demands for Autonomous Management of Chemical Substances]

The management of workplace chemicals shifted from a regulatory-based to a self-managed approach as of April 2023. To assess readiness, concerns, and necessary support for this change, a free-response questionnaire survey was conducted for the participants of the "Promoting self-management of chemicals in enterprises" seminar held by the Department of Occupational Health, Graduate School of Medicine, University of Occupational and Environmental Health, Japan, in January-February 2023. Text-mining using KH Coder (Ver.3) was conducted to investigate relationships between words that appeared in sentences using a co-occurrence network and hierarchical cluster analysis. From the questionnaire's description text, combinations of the terms "information" and "collection," "small and medium-sized" and "enterprise," and "chemical" and "substance" were extracted. Results suggest a need for "information gathering" and "support for small and medium-sized enterprises."

Family Caregivers' Challenges in Cancer Pain Management for Patients Receiving Palliative Care

CONTEXT

Family caregivers (FCs) of cancer patients play a crucial role in managing their care partner's pain, but little research has examined FCs' specific challenges regarding the provision of pain management (PM) to cancer patients receiving palliative care.

OBJECTIVES

To determine the demographic and clinical characteristics of FCs who encounter challenges in PM and to elucidate the specific challenges that FCs face when managing pain for their care partner with cancer.

METHODS

We conducted a secondary analysis of 40 interview transcripts of FCs who were caring for persons with cancer. Interviews were audio-recorded, transcribed verbatim, and analyzed using deductive thematic analysis.

RESULTS

The three major identified challenges to PM for FCs of persons with cancer were: (1) communication and teamwork issues, (2) caregiver-related issues, and (3) patient-related issues. Communication and teamwork issues encompassed caregivers' receipt of inadequate information regarding PM, and inappropriate and ineffective communication from the healthcare team. Caregiver issues pertained to caregivers' fear and beliefs, concurrent responsibilities, and lack of pain-related knowledge and skills. Patient issues related to their own fear and beliefs, psychological and physiological well-being, adherence to medications, and reluctance to report pain.

CONCLUSION

Findings of this study have implications for future research and practice related to cancer PM in palliative care. Results suggest the need for FC training in PM as well as clear clinical practice guidelines and resources to help providers prepare, educate, and communicate with FCs regarding PM.

Concerns, perceived impact, practices, preventive measures, and stress among healthcare workers during COVID-19 pandemic in Malaysia

Introduction

Healthcare workers (HCWs) have been continually exposed to patients with COVID-19 and are at higher risk of contracting the disease. Their psychological health is important for overall wellbeing and productivity, which could lead to a reduction in human errors during the pandemic crisis. This study aimed to measure the level of concerns, work practices, adequacy of preventive measures among HCWs, and the impacts on their life and work, including mental health status during the second wave of the COVID-19 pandemic in Malaysia.

Methods

An online questionnaire was distributed randomly to 1,050 HCWs from the Ministry of Health facilities in the Klang Valley who were involved directly in managing or screening COVID-19 cases from May to August 2020. The questionnaire was divided into five domains, which were concerns, impact on life and work, practice, perceived adequacy of preventive measures, and Revised Impact of Event Scale (IES-R). Logistic regression was used to identify sociodemographic predictors of the five domains.

Results

A total of 907 respondents (86.4%) participated in this survey. Approximately half of the respondents had a low concern (50.5%), most of them had a good practice (85.1%), with 67.5% perceiving there were adequate preventive measures, and they perceived the outbreak had a low impact (92%) on their life and work. From the IES-R domain, 18.6% of respondents potentially suffered from post-traumatic stress disorder (PTSD).

Conclusion

During the second wave of the COVID-19 outbreak in Malaysia, HCWs practiced high levels of precautions and preventive measures because they were aware of the risk of infection as an occupational hazard. With the adequate implementation of policy and control measures, the psychological wellbeing of the majority HCWs remained well and adequately supported.

Consumers' Attitudes towards Animal Suffering: A Systematic Review on Awareness, Willingness and Dietary Change

Planetary and human health depend on Westerners' ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated with cancer and cardiovascular disease, among others. Effective reasons and motivations are needed for consumers to change their diet. The fact that modern animal agriculture inflicts a great deal of pain on animals from their birth to their slaughter, animal welfare/suffering may drive consumers to curtail their meat consumption. This systematic review examined a total of 90 papers to ascertain consumers' awareness of the pain animals experience in animal agriculture, as well as consumer attitudes towards meat reduction due to animal welfare. Results show that consumers have low awareness of animal agriculture. Awareness of animal agricultural practices and animal sentience is associated with increased negative attitudes towards animal suffering. Animal suffering due to farming practices, transportation, slaughter, and animal sentience are factors that may encourage a reduction in meat consumption, and even dietary change in the short term. There is also evidence that animal suffering may be a more compelling motivation for consumers' willingness to change their diet than for health or environmental reasons. Therefore, increasing consumers' awareness of animal suffering in meat production is paramount to contributing to reduced pressure on the environment and improved human health.

Parents' concerns and attitudes towards school reopening during COVID-19 pandemic: a cross-sectional survey-Tripoli, Libya, 2021

The issue of school reopening has raised several concerns; therefore, the parent’s opinion is essential to consider. This study aimed to evaluate the parent’s attitudes and concerns toward school reopening in the COVID-19 era. A cross-sectional survey was performed using in-person self-administered questionnaires, the data was collected in the period between January and April 2021 covering parents’ concerns and attitudes toward school reopening. A total of 402 parents participated in the survey. Analysis showed that 56.7% of parents have agreed with school reopening, but 54% have raised some legitimate concerns. Importantly, there was a strong correlation between parents’ opinions towards school reopening and their level of education, and their concerns about their children’s safety if the school was reopened. Despite parents’ concerns, it does seem that slightly over half were in favour of school reopening and would send their children to school only if the schools did apply strict precautions and restriction measures. Sharing parents’ views toward school reopening with school leaders and decision-makers is important to assess the feasibility and effectiveness of return to schools and to improve existing prevention programs.

Family Caregiver Challenges in Pain Management for Patients with Advanced Illnesses: A Systematic Review

Although pain management is integral to the caregiving role, there is a paucity of evidence synthesizing specific challenges family caregivers (FCs) face when managing pain for their care partners. This review comprehensively identified and summarized such challenges in the setting of advanced illnesses. Electronic databases (PubMed, CINAHL, PsycINFO, Scopus, and Health and Psychosocial Instruments) were searched using index and keyword methods for all articles published before April 2021. Fifty-five studies were included in this review. Most articles were published within the last 10 years (54%) in community settings, with home hospice care comprising the majority (50%). Most studies included patients with an advanced cancer diagnosis (84%), and 16% of the studies included patients with a noncancer diagnosis. Four major categories of challenges were identified: (1) caregiver-related issues (e.g., fears, beliefs, function), (2) caregivers' limited knowledge and skills in pain management (e.g., verbal and nonverbal pain assessment skills, pharmacological knowledge, documentation, safe management of medication), (3) communication challenges with health care providers, and (4) patient-related issues (e.g., inability to report pain). Many of these challenges have not been fully addressed in prior literature. Thus, this review provides a framework for needed future research to develop interventions that target FCs' specific challenges in providing pain management. The results also highlight a significant lack of research surrounding challenges faced by caregivers of care partners having a noncancer, dementia, or multimorbidity diagnosis.

Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review

BACKGROUND

Home health monitoring shows promise in improving health outcomes; however, navigating the literature remains challenging given the breadth of evidence. There is a need to summarize the effectiveness of monitoring across health domains and identify gaps in the literature. In addition, ethical and user-centered frameworks are important to maximize the acceptability of health monitoring technologies.

OBJECTIVE

This review aimed to summarize the clinical evidence on home-based health monitoring through a scoping review and outline ethical and user concerns and discuss the challenges of the current user-oriented conceptual frameworks.

METHODS

A total of 2 literature reviews were conducted. We conducted a scoping review of systematic reviews in Scopus, MEDLINE, Embase, and CINAHL in July 2021. We included reviews examining the effectiveness of home-based health monitoring in older adults. The exclusion criteria included reviews with no clinical outcomes and lack of monitoring interventions (mobile health, telephone, video interventions, virtual reality, and robots). We conducted a quality assessment using the Assessment of Multiple Systematic Reviews (AMSTAR-2). We organized the outcomes by disease and summarized the type of outcomes as positive, inconclusive, or negative. Second, we conducted a literature review including both systematic reviews and original articles to identify ethical concerns and user-centered frameworks for smart home technology. The search was halted after saturation of the basic themes presented.

RESULTS

The scoping review found 822 systematic reviews, of which 94 (11%) were included and of those, 23 (24%) were of medium or high quality. Of these 23 studies, monitoring for heart failure or chronic obstructive pulmonary disease reduced exacerbations (4/7, 57%) and hospitalizations (5/6, 83%); improved hemoglobin A1c (1/2, 50%); improved safety for older adults at home and detected changing cognitive status (2/3, 66%) reviews; and improved physical activity, motor control in stroke, and pain in arthritis in (3/3, 100%) rehabilitation studies. The second literature review on ethics and user-centered frameworks found 19 papers focused on ethical concerns, with privacy (12/19, 63%), autonomy (12/19, 63%), and control (10/19, 53%) being the most common. An additional 7 user-centered frameworks were studied.

CONCLUSIONS

Home health monitoring can improve health outcomes in heart failure, chronic obstructive pulmonary disease, and diabetes and increase physical activity, although review quality and consistency were limited. Long-term generalized monitoring has the least amount of evidence and requires further study. The concept of trade-offs between technology usefulness and acceptability is critical to consider, as older adults have a hierarchy of concerns. Implementing user-oriented frameworks can allow long-term and larger studies to be conducted to improve the evidence base for monitoring and increase the receptiveness of clinicians, policy makers, and end users.

Climate Anxiety, Loneliness and Perceived Social Isolation

AIM

The goal of this study was to investigate the association of climate anxiety with loneliness and perceived social isolation (also stratified by age group).

METHODS

Data were taken from the general adult population aged 18 to 74 years (n = 3091). Data collection took place in March 2022. Climate anxiety was measured using the Climate Anxiety Scale. The De Jong Gierveld tool was used to quantify loneliness and the Bude and Lantermann tool was used to assess perceived social isolation.

RESULTS

Multiple linear regressions revealed an association between higher climate anxiety and higher loneliness (β = 0.06, p < 0.001) as well as higher perceived social isolation (β = 0.10, p < 0.001) among the total sample. A similar picture was identified in age-stratified regressions (i.e., among individuals aged 18 to 29 years, 30 to 49 years, and among individuals aged 50 to 64 years). However, climate anxiety was neither associated with loneliness nor with perceived social isolation among individuals aged 65 to 74 years.

CONCLUSIONS

Our current study adds first evidence regarding the link between climate anxiety and loneliness as well as perceived social isolation and can serve as a basis for upcoming studies.

The PURPLE N study: objective and perceived nutritional status in children and adolescents with cerebral palsy

PURPOSE

To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers.

MATERIALS AND METHODS

A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived nutritional status) was developed and tested for the study. Correlation between nutritional status and Gross Motor Function Classification System (GMFCS) levels was assessed using continuous variables (Z-scores for weight-for-age, height-for-age, weight-for-height, and body mass index-for-age), and categorical variables (being malnourished, stunted, or wasted). HCP and caregiver perceptions of the child's nutritional status as well as agreement between perceived and objective nutritional status and agreement between perceived nutritional status and concerns about the nutritional status were analyzed.

RESULTS

Data were available for 497 participants from eight European countries. Poorer nutritional status was associated with higher (more severe) GMFCS levels. There was minimal agreement between perceived and objective nutritional status, both for HCPs and caregivers. Agreement between HCP and caregiver perceptions of the child's nutritional status was weak (weighted kappa 0.56). However, the concerns about the nutritional status of the child were in line with the perceived nutritional status.

CONCLUSIONS

The risk of poor nutritional status is associated with more severe disability in children and adolescents with CP. There is a mismatch between HCP and caregiver perceptions of participants' nutritional status as well as between subjective and objective nutritional status. Our data warrant the use of a simple and objective screening tool in daily practice to determine nutritional status in children and adolescents with CP. Clinical trial registration: ClinicalTrials.gov Identifier: NCT03499288 (https://clinicaltrials.gov/ct2/show/NCT03499288). IMPLICATIONS FOR REHABILITATIONUse of the ESPGHAN recommendations and simple screening tools in daily practice is needed to improve nutritional care for individuals with CP.Attention should be paid to the differences in the perception of nutritional status of individuals with CP between professionals and caregivers to improve appropriate referral for nutritional support.Objective measures rather than the professional's perception need to be used to define the nutritional status of individuals with CP.

Modified WHO Partograph in Labour Room: A Quality Improvement Initiative to Find Out Concerns, Challenges and Solutions

Every day many women die in pregnancy and childbirth, most of which are preventable. Regular and timely labour monitoring by partograph is of utmost importance. The aim of this study was to increase partograph use by residents in the Department of Obstetrics and Gynecology in all eligible women from existing 25% to 90% over six months through a quality improvement (QI) process. A team of six members including consultants, residents, and staff nurses did a root cause analysis through fishbone analysis to identify why the rate of use of partograph is only 25% of all cases. Many strategies were implemented through Plan-Do-Study-Act (PDSA) cycles for the cause identified. The interventions were allocation of triage area for timely identification of eligible women in the active phase of labour, training of residents, involving interns and nurses for use in shortage of staff, making departmental written policy, and assigning checking authority, to shift patients with attached partograph only; partograph has to be attached in the file right from the beginning when sisters make women admission file. These were done in five PDSA cycles and the outcome was measured by a control chart. The rate of partograph use increased from 25% to 92% over the study period of six months from September 2020 to February 2021. Regular audits were conducted to maintain the results. It can thus be concluded that partograph appears easy to implement and inexpensive, but its use still has enormous difficulties. But a QI approach can help in improving adherence to partograph use, by solving the root cause of the concern and challenges.

Eliciting patients' healthcare goals and concerns: Do questions influence responses?

There is increasing interest in asking patients questions before their visits to elicit goals and concerns, which is part of the move to support the concept of coproducing care. The phrasing and delivery of such questions differs across settings and is likely to influence responses. This report describes a study that (i) used a three-level model to categorize the goals and concerns elicited by two different pre-visit questions, and (ii) describes associations between responses elicited and the phrasing and delivery of the two questions. The questions were administered to patients with rheumatic disease, and patients with inflammatory bowel disease (IBD). Paper-based responses from 150 patients with rheumatic disease and 338 patients with IBD were analyzed (163 paper, 175 electronic). The goals and concerns elicited were primarily disease or symptom-specific. The specific goal and concern examples featured in one pre-visit question were more commonly reported in responses to that question, compared to the question without examples. Questions completed electronically before the visit were associated with longer responses than those completed on paper in the waiting room. In conclusion, how and when patients' goals and concerns are elicited appears to have an impact on responses and warrants further investigation.

Attentional Bias Toward Reproduction-Related Stimuli and Fertility Concerns Among Breast Cancer Survivors

The current study examined whether an attentional bias exists for reproduction-related visual cues among breast cancer survivors and its relationship with fertility concerns and emotional distress. Breast cancer survivors (n = 38) aged 18-40 were compared to 37 healthy women recruited from the general population. Attentional bias was investigated using a visual dot-probe task and response times (RT) were measured. Participants also completed several questionnaires, including the Reproductive Concerns After Cancer Scale (RCACS) and the Hospital Anxiety and Depression Scale (HADS). Biased cognitive processing toward reproduction-related stimuli was observed for all young women. However, attentional bias was a significant predictor of concerns about partner disclosure of fertility status, with higher bias scores associated with higher levels of concern only for breast cancer survivors. The desire to have a (or another) biological child was also a significant predictor of higher concerns related with fertility potential for all young women. Higher vigilance regarding reproduction-related cues seems to lead to higher concerns among women with breast cancer history whose fertility is threatened. This result may have important research and clinical implications. Interventions focused on goal-oriented attention self-regulation and problem-solving can help to manage fertility concerns and distress in the course of the disease.

Concerns of Prelicensure Nursing Students Before a Maternal-Newborn Clinical Rotation

OBJECTIVE

To describe the concerns of prelicensure nursing students before their clinical rotation in the maternal-newborn setting.

DESIGN

Qualitative descriptive design with one open-ended survey question.

SETTING/PROBLEM

A private U.S. Midwest master's entry prelicensure nursing program. Students' concerns before beginning a maternal-newborn clinical rotation have not been fully explored in the literature and may differ from those reported by students in other clinical rotations. If not addressed, these concerns could negatively affect the clinical learning experience and hinder student success.

PARTICIPANTS

Prelicensure nursing students enrolled in the Nursing Care of Women and Newborns course at an urban graduate college of nursing.

INTERVENTION/MEASUREMENTS

On the first day of the course, students were asked to write on an index card their most pressing concern related to their upcoming maternal-newborn rotation. Participation was voluntary and anonymous. Course directors analyzed the responses for themes and further divided them by setting: labor and birth, newborn, postpartum, generalized (concerns across maternal-newborn clinical areas), and miscellaneous (nonclinical concerns).

RESULTS

A total of 130 concerns were reported by 125 students. Of these concerns, 47% (n = 62) were related to labor and birth, and 4.6% (n = 6) were related to caring for newborns; 40% (n = 51) were general clinical concerns, and 8.5% (n = 11) were of a nonclinical nature. No students in this study expressed concern about being assigned to care for individuals on the postpartum unit. Although some concerns were similar to those reported previously in the literature, others were unique to the maternal-newborn setting.

CONCLUSION

Prelicensure nursing students have concerns that are unique to the maternal-newborn setting. When student concerns are known before clinical rotations, course faculty, clinical instructors, and staff nurses can adapt strategies to reduce stress and improve the clinical learning environment for students so that they can be successful.

'It's the economy, stupid': Lessons of a longitudinal study of depression in Argentina

BACKGROUND

On March 20, 2020, the Argentine Ministry of Health imposed a mandatory quarantine, which still persists.

AIM

The aim of this study is to determine the variation in the prevalence of depression since the beginning of the quarantine and the evolution of risk factors, with special emphasis on the population's concerns.

METHODS

A longitudinal study was carried out using a digital questionnaire disseminated in social networks. The first stage (T1) was carried out from March 29 to April 12 and the second stage (T2) from May 23 to June 12, 2020. The prevalence of depression was measured using the 9-item Patients Health Questionnaire (PHQ-9).

RESULTS

The prevalence of moderate/severe depression increased from 24.3% in T1 to 47.8% in T2 (p: 0.000). Risk factors increased significantly: age 18-27, female, primary and secondary school, smoking and having a poor sleep quality (p: 0.000). The concerns about 'a family member getting sick' (OR: 1.28; CI: 1.04-1.58; p: 0.016), 'changes at work' (OR: 2.24; CI: 1.79-2.81; p: 0.000), 'running out of money' (OR: 1.43; CI: 1.20-1.71; p: 0.000) and 'being unemployed' (OR: 2.99; CI: 2.55-3.52; p: 0.000) were risk factors for depression. On the other hand, the concern about 'getting the virus' (OR: 0.73; CI: 0.61-0.87; p: 0.001) was not a risk factor.

CONCLUSIONS

The extended quarantine in Argentina is associated with an increase in the prevalence of depression; the high impact of economic and social concerns on mental health must be considered in order to avoid long-term effects.

The Role of Mindfulness in Business Administration (B.A.) University Students' Career Prospects and Concerns about the Future

In a challenging work environment, entrepreneurship orientation (hereafter, EO) can be an important asset for university students. In this study, we investigated the EO and concerns about the future of B.A. students, focusing on the role of mindfulness levels. A total of 204 students, including those coming from family businesses (hereafter, FB), were asked about their intention of creating their own business and future concerns with an ad hoc questionnaire, and about their mindfulness levels with the Mindful Attention Awareness Scale. The results showed no differences in concerns about the future between those students coming from a family business and those who did not. However, in that group of students who were uncertain about starting a business career, a negative association between mindfulness and future concerns was found. This paper sheds light on the relationship between mindfulness and concerns about the future in Business Administration (hereafter, B.A.) students, concluding that, in the face of uncertainty, higher levels of mindfulness help to reduce concerns about the future. Finally, we indicate the relevance of this study for entrepreneurs, family business members, policymakers and B.A. Faculties and Business schools.

Do the Child Welfare and Protection Services Involve Children in Cases With Parental Mental Health Problems? A Norwegian Case-File Study

Background: Parental mental health problems is a common source of concern reported to child welfare and protection services (CWPS). In this study we explored to what extent the child was invited to participate in the investigation process. We aimed to study: (a) what was the current practice in the child protection service in Norway when the CWPS received a report of concern about children whose parents were affected by mental health problems or substance abuse, (b) to what extent were children involved and consulted, (c) which factors predicted the decision to involve the children, and (d) in cases in which conversations with children were conducted: what was the main content of the conversations. Method: The study was a cross-sectional case file study (N = 1,123). Data were collected retrospectively from case records in 16 different child protection agencies. The cases were randomly drawn from all referrals registered in the participating agencies. Differences in how investigations were conducted in cases with and without concerns about parental mental health were analyzed using t-tests and chi-square testes. Predictors of child involvement in cases with parental mental health problems (N = 324) were estimated by logistic regression analyses. Results: When the referral to the CWPS contained concerns about parental mental health, there were more consultations with parents, more frequent home visits and the investigation took longer to conclude. The children, however, were less likely to be involved. Children in such cases were consulted in 47.5% of cases. Predictors for involving the children in those cases were child age, concern about the child's emotional problems and if the child was known from previous referrals. Conclusion: In Norwegian child protection investigations, in which there were concerns about the parent's mental health, conversations with children were conducted to a significantly lower degree compared to cases where the child's problem was the main concern. In such cases, the CWPS workers have to overcome a threshold before they consult with the child. The threshold decreases with child age and when case worker already knows the child.

Concerns and mental health of teachers from digitally underdeveloped countries regarding the reopening of schools after the first wave of the COVID-19 pandemic

BACKGROUND

Torn between the decision to return to school classrooms or continue holding online classes during COVID-19, teachers around the world feel great uncertainty.

OBJECTIVE

Bearing in mind that the study of mental health during the pandemic is of great importance for vulnerable categories, and given the role of teachers in society, the aim of this research is to assess teachers' concerns and anxiety before the start of the school year, and also to examine the factors related to them and propose measures in line with the results.

METHODS

The study was conducted as a cross-sectional study before the start of the 2020/2021 school year. The research sample consisted of 286 teachers. For the purposes of this research, a special questionnaire was constructed consisting of a general questionnaire and a Generalized Anxiety Disorder 7-item scale (GAD-7).

RESULTS

The strongest predictor of a teacher's answer that they were concerned about the reopening of schools was their concern for their own life and health and for the life and health of their family members, followed by the amount of information received about COVID-19, and, finally, older age. Only 2% of teachers had mild anxiety.

CONCLUSIONS

This research indicated that it is necessary to examine in more detail the degree of teachers' concern and its impact on their functionality and work process. It is also necessary to repeat the research on the mental health status of teachers and implement procedures in the form of a regular screening program of the mental health status of teachers or implement procedures of support in concern management.

Factors associated with health care providers speaking with older patients about being subjected to abuse

Health care providers have difficulties responding to elder abuse. This study aimed to investigate factors associated with health care providers speaking with older patients about being subjected to abuse, and what facilitating measures staff preferred to help them achieve this. A cross-sectional questionnaire survey was conducted among hospital health care providers (n = 154) in Sweden. Half of the respondents had experience of speaking about elder abuse. A high sense of professional responsibility (OR 3.23) and being less concerned about inflicting damage to the therapeutic relationship (OR 3.97) were associated with having spoken with older patients about being subjected to abuse. Written guidelines about elder abuse and a patient information sheet were the most preferred facilitating measures. Our findings indicate that increasing care providers' sense of responsibility and addressing concerns about damaging the therapeutic relationship might be important factors to target in future interventions to improve health care response to elder abuse.

Public attitudes in Japan toward the creation and use of gametes derived from human-induced pluripotent stem cells

AIM

To ascertain to what extent the Japanese general public accept the creation and use of in vitro derived (IVD)-gametes derived from human-induced pluripotent stem cells.

MATERIALS & METHODS

We conducted an online survey and obtained answers from 3096 respondents.

RESULTS

78.6% of the respondents answered that they would accept the creation and use of IVD-gametes for research purposes, 51.7% answered that they would accept the creation and use of embryos with IVD-gametes for research purposes, and 25.9% answered that they would accept childbirth using embryos with IVD-gametes.

DISCUSSION

The results that approximately half of the respondents answered that they would accept the creation of embryos with IVD-gametes, which has not been allowed in the current Japanese research guidelines, is astonishing.

The perspectives of survivors of Hodgkin lymphoma on lung cancer screening: A qualitative study

BACKGROUND

Hodgkin lymphoma survivors (HLS) are at excess risk of lung cancer as a consequence of HL treatment. HLS without a heavy smoking history are currently unable to access lung cancer screening (LCS) programmes aimed at ever smokers, and there is an unmet need to develop a targeted LCS programme. In this study we prospectively explored HLS perspectives on a future LCS programme, including motivating factors and potential barriers to participation, with the aim of identifying ways to optimise uptake in a future programme.

METHODS

Semistructured telephone interviews were conducted with HLS, aged 18-80 and lymphoma-free for ≥5 years, selected from a clinical database (ADAPT). Participants provided informed consent. Data were analysed using inductive thematic analysis.

RESULTS

Despite awareness of other late effects, most participants were unaware of their excess risk of lung cancer. Most were willing to participate in a future LCS programme, citing the potential curability of early-stage lung cancer and reassurance as motivating factors, whilst prior experience of healthcare was a facilitator. Whilst the screening test (a low dose CT scan) was considered acceptable, radiation risk was a concern for some and travel and time off work were potential barriers to participation.

CONCLUSIONS

Our results suggest that most HLS would participate in a future LCS programme, motivated by perceived benefits. Their feedback identified a need to develop educational materials addressing lung cancer risk and concerns about screening, including radiation risk. Such materials could be provided upon an invitation to LCS. Uptake in a future programme may be further optimized by offering flexible screening appointments close to home.

Mixed-methods study protocol for explanation of pregnant women's concerns about antenatal anomaly screening process: Designing, implementing and evaluation of intervention

AIM

This study aims to investigate the concerns of Iranian pregnant women in the antenatal anomaly screening process (AASP) and propose an intervention to reduce these concerns.

DESIGN

This exploratory sequential mixed-methods study is conducted in three stages (qualitative, intervention design and quantitative), in Tehran.

METHODS

A qualitative study is carried out to collect pregnant women's concerns during the AASP. Then, a two-step procedure is implemented. In the first step (expert session), the concerns extracted in the qualitative part are prioritized. Next, the interventions used to reduce the concerns of pregnant women in the AASP are reviewed by considering the priority determined in the previous stage. The information obtained from this step is used to design intervention. Ultimately, a randomized controlled trial is used to evaluate the effectiveness of the intervention.

DISCUSSION

The results can be used for framing policies in health systems to address pregnant women's concerns in the AASP and to promote their mental health.

Nurses' knowledge, concerns, perceived impact and preparedness toward COVID-19 pandemic: A cross-sectional survey

Aim

This study aimed to assess the nurses' knowledge, concerns, perceived impact and preparedness toward the COVID‐19 pandemic.

Background

As COVID‐19 is a new disease, its spread and emergence cause fear, anxiety and confusion among the general population. Nurses are in close contact with infected persons, and their knowledge plays an important role in preventing the transmission chain.

Methods

In this cross‐sectional study, 207 nurses were selected using convenience sampling from 29 March to 19 April 2020. The study used a questionnaire assessing the nurses' baseline characteristics, their source of information, knowledge, concerns, the perceived impact and their preparedness for the COVID‐19 pandemic.

Results

Around half of the surveyed nurses (51.2%) reported that the Ministry of Health's and World Health Organization's websites and official pages were their main sources of information. The majority of nurses (81.6%) knew the nature of the virus, 83.6% agreed that their job puts them at risk of infection with COVID‐19 and 72% felt personally prepared for the pandemic.

Conclusion

The majority of nurses had an acceptable level of knowledge regarding COVID‐19. However, psychological interventions are needed to be addressed in the planning stage before any pandemic.

What is already known about this topic?

It is well established that COVID‐19 is a highly infectious disease with a fatality rate of about 6.48% in Egypt.

Studies about nursing and COVID‐19 are relatively few.

There is a lack of data regarding the nurses' knowledge, concerns, perceived impact and preparedness toward COVID‐19.

What does this paper add?

Nurses prefer gaining their knowledge regarding COVID‐19 from the Ministry of Health's and the World Health Organization's websites and official pages rather than the social media websites.

Nurses have an acceptable level of knowledge regarding COVID‐19. The majority of surveyed nurses knew the nature of the virus along with its signs and symptoms.

The majority of surveyed nurses feel that their job puts them at the risk of infection with COVID‐19, and they are quite afraid of being infected.

The implications of this paper:

Psychological interventions are needed in the planning stage before any pandemic to enhance the protection of nurses and health care workers and to reduce the psychological impact.

Sustainable awareness programmes are required for health care workers, keeping them up to date with the most recent information regarding prevention and management methods from the World Health Organization's guidelines and other instructional materials.

Hospitals can hold meetings and organize regular psychological support groups to allow nurses to manage their fears and acquire stress reduction strategies.

Parental experience of the neuromotor development of children with congenital heart disease: an exploratory qualitative study

BACKGROUND

Children with severe congenital heart disease (CHD) are a group of children at risk for neurodevelopmental impairments. Motor development is the first domain to show a delay during the first year of life and may significantly contribute to parental concerns, stress, and difficulties in early child-parent attachment. Thus, the aim of the study was to better understand the wishes and concerns of parents of children with CHD and explore their experience of their children's neuromotor development in the first year of life.

METHODS

In this qualitative study, fourteen families were recruited. Their children were aged 1-3 years and had undergone open heart surgery within the first 6 months of life. Semi-structured interviews were audio-recorded and transcribed. The data was explored within an expert group, and a qualitative content analysis was conducted using VERBI MAXQDA software 2020. The study was conducted in accordance with the COREQ checklist.

RESULTS

Parents of children with CHD reported several burdens and needs. Parental burdens concerned the child's motor development, their own physical and psychological strain, and difficulties in communication with healthcare professionals. The needs, parents reported included supporting their child's motor development, a medical coordinator, and better communication between healthcare professionals and parents. During the first phase of their children's illness, parents underwent a dynamic transitional phase and expressed the need to rely on themselves, to trust their children's abilities, and to regain self-determination in order to strengthen their self-confidence.

CONCLUSIONS

It is essential to involve parents of children with CHD at an early stage of decision-making. Parents are experts in their children and appreciate medical information provided by healthcare professionals. Interprofessional teamwork, partnering with parents, and continuous support are crucial to providing the best possible care for children and their families. Family-centred early motor intervention for CHD children might counteract the effect of parental overprotection and improve children's motor development and thus strengthen child-parent interaction. In future work, we aim to evaluate a family-centred early motor intervention for children with CHD developed on the basis of this qualitative study.

TRIAL REGISTRATION

Not applicable.

Research on Migrant Works' Concern Recognition and Emotion Analysis Based on Web Text Data

Based on the characteristics of convenience, autonomy, and equality, online self-media has become an important way for contemporary migrant workers to observe the world, understand society, examine themselves and express their demands. On the basis of the analysis of the domestic migrant works' concerns and their emotion analysis, we crawl data on Weibo about migrant works' topics as the basic corpus of migrant works' concerns, and then uses a combination of TF-IDF and Word2Vec methods to construct a recognition model of migrant workers' concerns. We found that wages, children's education, medical care and returning home are the main concerns of migrant workers. Meanwhile, further emotion analysis of the migrant works' concerns of using a deep learning model fused with Bi-LSTM and CNN was conducted. The results show that the proportion of negative emotion such as worries, complaints and impetuosity was significantly higher than that of other positive and neutral emotion like encourage and comfort. And the time when the negative emotion are concentrated is significantly related to the social events that occur in the corresponding time period. On the one hand, it shows that the concerns and emotion of migrant workers can be effectively observed and predicted through web text data. On the other hand, it also shows that the core well-being issues of migrant workers in the process of urban integration have not been effectively solved, and the government and relevant departments need to take targeted measures and give priority attention.

Factors Affecting COVID-19 Vaccination among the General Population in Saudi Arabia

Vaccine refusal or hesitancy is one of the significant issues that can have an adverse impact on people’s health and their countries’ economy. Additionally, vaccine acceptance or refusal could have a decisive role in controlling the COVID-19 pandemic. This study aims to investigate the factors affecting COVID-19 vaccine refusal and hesitancy among the general population in Saudi Arabia. The method is a cross-sectional survey using an online questionnaire, and data were collected from 1935 participants between 18 February 2021 and 1 April 2021. Out of 1935 participants aged ≥18 years and residing in Saudi Arabia, 46.9% reported their intention to receive the COVID-19 vaccine, 22.4% had received the vaccine, 9.5% did not intend to receive the vaccine, and 21.2% had not made their decision. In the multinomial logistic regression models, vaccine refusal was associated with age (OR: 0.961), nationality (OR: 0.182), monthly income of more than SAR 18,000 (OR: 2.325), chronic diseases (OR: 0.521), knowledge about the vaccine (OR: 0.937), and concerns about the vaccine (OR: 1.5). The hesitancy was associated with age (OR: 0.977), nationality (OR: 0.231), monthly income between SAR 6000 to 12,000 (OR: 0.607), chronic diseases (OR: 0.640), knowledge about the vaccine (OR: 0.907), and concerns about the vaccine (OR: 1.3). The main concerns about the vaccine were “COVID-19 vaccines are not tested enough on people”, “drug companies are interested in COVID-19 vaccine sales only”, and “COVID-19 vaccines have serious adverse effects”. Awareness programs and vaccination campaigns should consider people’s concerns and correct their misinformation.

The Attitude towards Polypills Questionnaire (APPQ): a phase I-III development and validation study in patients with cerebrovascular disease

Background and purpose

The polypill approach has been proposed to reduce patients’ pill burden, increase medication adherence and lower stroke incidence. However, little is known about patients’ attitudes towards polypills for cerebrovascular medication.

Methods

Based on the European Organization for Research and Treatment of Cancer Quality of Life Group questionnaire development guidelines, a questionnaire to measure patients’ attitudes towards polypills for the secondary prevention of stroke (phase I–III) was developed. In phase I, issues were generated via literature review and interviews with patients and healthcare professionals. The issues were operationalized into items in phase II. In phase III the questionnaire was validated in a large single‐centre sample, and test–retest and internal validity were evaluated.

Results

In phase I, 34 relevant issues were identified through literature search and interviews. Pre‐testing the questionnaire indicated high applicability and comprehensibility. The final Attitudes towards Polypills Questionnaire was tested in N = 260 patients and showed a two‐factor structure. The factors were labelled ‘concerns’ and ‘benefits’. The scales showed acceptable and good internal validity (concerns, Cronbach's α = 0.85; benefits, α = 0.93), but the scales’ test–retest validity was ambiguous. On a 0 to 3 rating scale, concerns were rated lower than benefits (mean 1.07, SD 0.69 vs. mean 1.87, SD 0.89).

Conclusions

The Attitudes towards Polypills Questionnaire showed high comprehensibility and content validity to assess German language patients’ attitudes towards a polypill medication. Our data and questionnaire may aid the implementation of polypill treatments in clinical practice and can be used in the design of future clinical trials on polypill therapy. Further validation of the questionnaire is advised.

Digital Natives' Preferences on Mobile Artificial Intelligence Apps for Skin Cancer Diagnostics: Survey Study

Background

Artificial intelligence (AI) has shown potential to improve diagnostics of various diseases, especially for early detection of skin cancer. Studies have yet to investigate the clear application of AI technology in clinical practice or determine the added value for younger user groups. Translation of AI-based diagnostic tools can only be successful if they are accepted by potential users. Young adults as digital natives may offer the greatest potential for successful implementation of AI into clinical practice, while at the same time, representing the future generation of skin cancer screening participants.

Objective

We conducted an anonymous online survey to examine how and to what extent individuals are willing to accept AI-based mobile apps for skin cancer diagnostics. We evaluated preferences and relative influences of concerns, with a focus on younger age groups.

Methods

We recruited participants below 35 years of age using three social media channels—Facebook, LinkedIn, and Xing. Descriptive analysis and statistical tests were performed to evaluate participants’ attitudes toward mobile apps for skin examination. We integrated an adaptive choice-based conjoint to assess participants’ preferences. We evaluated potential concerns using maximum difference scaling.

Results

We included 728 participants in the analysis. The majority of participants (66.5%, 484/728; 95% CI 0.631-0.699) expressed a positive attitude toward the use of AI-based apps. In particular, participants residing in big cities or small towns (P=.02) and individuals that were familiar with the use of health or fitness apps (P=.02) were significantly more open to mobile diagnostic systems. Hierarchical Bayes estimation of the preferences of participants with a positive attitude (n=484) revealed that the use of mobile apps as an assistance system was preferred. Participants ruled out app versions with an accuracy of ≤65%, apps using data storage without encryption, and systems that did not provide background information about the decision-making process. However, participants did not mind their data being used anonymously for research purposes, nor did they object to the inclusion of clinical patient information in the decision-making process. Maximum difference scaling analysis for the negative-minded participant group (n=244) showed that data security, insufficient trust in the app, and lack of personal interaction represented the dominant concerns with respect to app use.

Conclusions

The majority of potential future users below 35 years of age were ready to accept AI-based diagnostic solutions for early detection of skin cancer. However, for translation into clinical practice, the participants’ demands for increased transparency and explainability of AI-based tools seem to be critical. Altogether, digital natives between 18 and 24 years and between 25 and 34 years of age expressed similar preferences and concerns when compared both to each other and to results obtained by previous studies that included other age groups.

Palliative Oncological Patients with Insomnia: Concerns of the Patients and Their Relatives' Perception

Insomnia is one of the most frequent symptoms and usually generates significant stress in 60% of patients with advanced cancer. Worries from the patients' and relatives' perspective are crucial to improve the patients' quality of life but have received limited attention. The aims were to identify the concerns of patients with insomnia in the terminal illness stage in a palliative care unit and the relatives' perception, and to compare both. Here, 63 patients and 53 relatives answered a questionnaire about worries in the personal, spiritual, family-related and economic area, as well as a quality-of-life uniscale. The results showed that the relatives' most frequent concern was "Having lived life to the fullest" (100%), and the most intense was "The possible suffering during the process" (9.2/10). The patients' most expressed concern was: "Having unfinished business" (100%), and the most intense was "Suffering during the process" (9.3/10). Quality of life showed an average value of 6.95 out of 10. Relatives only coincided significantly in: "Not knowing what happens after death" (r = 0.600; p = 0.000). These results bring visibility to concerns during the final stage of oncological palliative patients with insomnia from the patients' and relatives' perspective. Knowing both is useful for professionals to foster the well-being for a short, yet very important, period for patients, relatives and the caregiving team.