Actual Uptake Research Articles

Knowledge, Attitude and Uptake of Family Planning among Adolescent Girls in Rural and Urban Areas of FCT, Nigeria

Among female adolescents, maternal deaths due to unsafe abortion and childbirth complications is a leading cause of death. Contraceptive use prevents unwanted pregnancies and reduces the need for unsafe abortion. This cross-sectional study was conducted among 174 adolescent girls, ages 15 – 19yrs, in two different settings (rural and urban). The knowledge of the adolescents on family planning, their attitude to the uptake of family planning and the actual uptake of family planning among them were assessed. A high knowledge level of 77% was observed among the respondents in rural settings and 92% among the respondents in urban settings. The respondents’ attitude was also found to be high, 78% in the rural setting and 84% in urban setting, this was linked to the high knowledge of family planning among the respondents. A low uptake level of 47% was observed among the respondents in rural setting and 67% among respondents in urban setting. The respondents’ overall uptake of family planning was observed to be 58% which is low and not commensurate with the high knowledge of family planning observed among the respondents. Therefore, to improve the uptake of family planning among the adolescents, it is important to create messages that will target their partners, parents, religious institutions, and the society to support contraceptives for adolescents. There should be youth friendly clinics that provide family planning services to adolescents in the communities, they require a comfortable environment where they could access family planning services without fear of prejudice. Keywords: Adolescents, Family planning, Rural, Urban.

COVID-19 vaccination acceptance and trust among adults in Makkah, Saudi Arabia: a cross-sectional study

BackgroundPublic acceptance, trust, and actual uptake of COVID-19 vaccines are crucial to stem the pandemic. Although roll out of vaccines was high in KSA, the public response was not sufficiently studied. We aimed to investigate knowledge level, acceptance, and trust in COVID-19 vaccination and related predictors among adults in Makkah, KSA.MethodsA web-based cross-sectional survey using a snowballing sample was carried on 507 adult Saudi population living in Makkah city. The survey was developed based on literature search. In the logistic analysis, the dependent variables included acceptance rate and trust in effectiveness and safety of COVID-19 vaccines, while the independent variables (predictors) were sociodemographics and level of knowledge.ResultsThe survey included 507 participants, aged 18–78 years, 55.8% were females, and 36.7% had (or one of their family members) previously been exposed to COVID-19 infection. Their knowledge about COVID-19 vaccination was satisfactory (86.2%) with 71.2% intended to receive COVID-19 vaccination, and 56.4% was confident of the vaccine effectiveness. Vaccine efficacy, duration of protection, schedule of vaccination, and recommendation by authorities may favor their decision to accept or decline COVID-19 vaccines. Good knowledge about vaccines (OR = 2.07; CI: 1.24–3.48 for acceptance and OR = 2.67; CI: 1.58–4.51 for trust), higher educational level (OR = 1.80; CI: 1.07–3.40 for acceptance and OR = 3.59; CI: 2.08–6.21 for trust), previous seasonal flu vaccination (OR = 1.66; CI: 1.09–2.53 for acceptance and OR = 1.91; CI: 1.31–2.79 for trust), female sex (OR = 1.62; CI: 1.1–2.39 for acceptance and OR = 4.15; CI: 2.86–6.04 for trust), and history of COVID-19 infection (OR = 1.57; CI: 1.04–2.37 for acceptance and OR = 1.69; CI: 1.17–2.46 for trust) were among significant predictors for both vaccine acceptance and trust in vaccine effectiveness.ConclusionsAdult Saudi population in Makkah city showed satisfactory knowledge about COVID-19 vaccination with moderate rate of vaccine acceptance and a relatively low rate of confidence in vaccine effectiveness. Better understanding of public acceptance and trust in COVID-19 vaccines and addressing barriers to vaccination are recommended to improve vaccine coverage and to reinforce some communication characteristics of the current vaccination campaign.

BAKUNANAYS guidelines for communicating COVID-19 vaccination information to pregnant women in the Philippines and other developing countries

COVID-19 remains a pressing global health disaster, and pregnant women and their unborn child/ren continue to be extremely at risk. In the Philippines, a developing country in Southeast Asia, pregnant women were generally excluded from initial vaccination drives to avoid adverse effects in their offspring, amidst findings from animal studies and post-trial monitoring on the vaccines' safety. In August 2021, the Philippine Obstetrical and Gynecological Society (POGS) and the Department of Health (DOH) released guidelines for the vaccination of pregnant women due to the eventual increase in their mortality during outbreaks of the Delta variant. This perspective presents various forms of scientific communication on COVID-19 vaccination to Filipino pregnant women and forwards recommendations to improve communication in various settings. First, we present three modalities on how information on COVID-19 vaccination is disseminated to pregnant women in the Philippines and discuss their potential impacts on knowledge promotion and actual vaccination uptake, taking into account the Filipino cultural value of “pakikipagkapwa”. These include government and doctor-led initiatives, social media posts and comments, and experiences of one of the authors in vaccination drives in rural and remote communities. Findings are used to develop the BAKUNANAYS guidelines, comprised of 10 recommendations for healthcare workers, health agencies, and doctors vaccinating pregnant women in the Philippines and other developing countries, especially those with a similar socio-economic profile and cultural values.

Adoption of renewable home heating systems: An agent-based model of heat pumps in Ireland

Consumer adoption of renewable energy technologies such as heat pumps for home heating is crucial in reducing greenhouse gas emissions and reliance on imported fossil fuels. In recognition of their potential, policymakers in several countries have introduced various financial incentives to encourage the uptake of renewable energy technologies. However, consumers' purchasing decisions and choice of a particular technology is a complex process that goes beyond financial aspects. In this paper, we examine the adoption decisions and diffusion of heat pumps for residential home heating using an agent-based modeling and simulation approach. In particular, we model the influence of three factors: economic, psychological, and social networks, on the future uptake of heat pumps. We utilize recent nationally representative Irish household survey data and historical heat pump uptake data to derive model parameters for decision rules based on empirical data and simulate the adoption of heat pumps in existing Irish homes until 2030. We further analyze the implications of those future uptakes on electricity demand, bill savings, and reduction in CO2 emissions. The findings of this research based on the case study of Ireland should be useful to policymakers and companies in devising monetary and non-monetary interventions aimed at increasing future actual uptake of heat pumps and other renewable energy technologies.

Physiological and Sprint Kinetics Associated With the Yo-Yo Intermittent Recovery Test Level 1 Performances in Soccer Players.

The Yo-Yo Intermittent Recovery Test Level 1 (YYIR1) is often utilized to indirectly assess the cardiorespiratory fitness of team-sport athletes due to its proposed association with match-play high-speed running performance and predicted maximal oxygen uptake. No previous research has investigated the relationships between YYIR1 performances, actual oxygen uptake recorded during the YYIR1, and true all-out sprint kinetics (eg,maximal sprint speed, maximal force capacity, and maximal power output), which therefore served as the primary objective of this study. To assess the true physiological kinetics (V˙O2 and heart-rate responses) during the YYIR1 and to evaluate the correlations between the physiological kinetics, sprint kinetics, and YYIR1 performance parameters. A total of 23 amateur male soccer players were recruited for the study (age 22.52 [2.86]y; height 1.75 [0.06]m; body mass 65.61 [8.43]kg). Each participant completed a YYIR1 and 2 all-out sprint tests. Significant differences were observed between actual and predicted maximal oxygen-uptake values (Mdiff = 17.57mL·kg-1·min-1, P < .001, r = .63). Shuttle distances showed statistically significant correlations with maximal sprint speed (r = .42, P = .044) and theoretic maximal speed (r = .44, P = .035). However, no other correlations with sprint kinetic parameters (eg,maximal force or power output) were observed. Practitioners should carefully consider the outcomes and utilities of the parameters derived from the YYIR1. The estimations of maximal oxygen uptake from shuttle performances as a proxy for cardiorespiratory fitness are not adequate. However, shuttle distances appear to be positively associated with all-out sprinting capacities.

Site-specific irrigation scheduling using one-layer soil hydraulic properties and inverse modeling

Site-specific soil hydraulic properties (SHPs) are critical for determining irrigation thresholds and adopting the best irrigation practices. In this study, we optimized two single-layer SHPs for two management zones (namely, zone 1 and zone 2) delineated in a crop field using topographic attributes, soil texture, and historical crop yield to demonstrate the need for zone-specific SHPs. The inverse HYDRUS-1D model was used to optimize a single-layer zone-specific SHPs using multilayered observed soil water pressure heads (h) measured in both zones. Statistical indices for goodness of fit showed that a single layer SHPs simulate h during the growing season well. The irrigation thresholds and amounts determined using zone-specific optimized SHPs were used to trigger irrigations. Different irrigation scenarios using 15 cm, 30 cm, and 60 cm soil depths were developed using the zone-specific optimized SHPs in the HYDRUS-1D model to meet irrigation water demand and reduce water stress. The ratio of actual root water uptake (ARWU) and potential root water uptake (PRWU) were calculated to compare improvements in satisfying daily water demand and to reduce the water stress under different irrigation scenarios. Out of the total irrigation water triggered during growing seasons, greater than 61 % and 75 % in zone 1 was triggered in July 2018 and in May-June 2019, respectively. However, greater than 73 % in July 2018 and greater than 72 % in May-June 2019 were triggered in zone 2. Based on the simulations of various irrigation scenarios in HYDRUS-1D, we found that installing sensors at 15 cm or 30 cm can help meet the daily irrigation water demand on time than sensors at 60 cm depth. This study discussed the importance of critical water demands due to the distribution of precipitation over the growing season and need of zone-specific optimized SHPs for site-specific irrigation management within the field.

Fantastic perspectives and where to find them: involving patients and citizens in digital health research

BackgroundDigital contact tracing and exposure notification apps have quickly emerged as a potential solution to achieve timely and effective contact tracing for the SARS-CoV-2 virus. Nonetheless, their actual uptake remains limited. Citizens, including patients, are rarely consulted and included in the design and implementation process. Their contribution supports the acceptability of such apps, by providing upstream evidence on incentives and potential barriers that are most relevant to users. The DIGICIT (DIGITal CITizenship) project relied on patient and citizen partnership in research to better integrate public perspectives on these apps. In this paper, we present the co-construction process that led to the survey instrument used in the DIGICIT project and the interpretation of its results. This approach promotes public participation in research on contact tracing and exposure notification apps, as well as related digital health applications.ObjectivesThis article has three objectives: (1) describe the methodological process to co-construct a questionnaire and interpret the survey results with patients and citizens, (2) assess their experiences regarding this methodology, and (3) propose best practices for their involvement in digital health research.MethodsThe DIGICIT project was developed in four steps: (1) creation of the advisory committee composed of patients and citizens, (2) co-construction of a questionnaire, (3) interpretation of survey results, and (4) assessment of the experience of committee participants.ResultsOf the 25 applications received for participation in the advisory committee, we selected 12 people based on pre-established diversity criteria. Participants initially generated 84 survey questions in the first co-construction meeting, and eventually selected 36 in the final version. Participants made more than 20 recommendations when interpreting survey results and suggested carrying out focus groups with marginalized populations to increase representativity. They appreciated their inclusion early in the research process, being listened to and respected, the collective intelligence, and the method used for integrating their suggestions. They suggested that the study objectives and roles be better defined, that more time in the brainstorming sessions be allowed, and that discussion outside of meetings be encouraged.ConclusionHaving patients and citizens actively participating in this research constitutes the main methodological strength. They enriched the study from start to finish, and recommended the addition of focus groups to seek the perspective of marginalized groups that are typically under-represented from digital health research. Clear communication of the project objectives, good organization in meetings, and continuous evaluation from participants allow best practices to be achieved for patients' and citizens' involvement in digital health research. Co-construction in research generates critical study design ideas through collective intelligence. This methodology can be used in various clinical contexts and different healthcare settings.

Using the Theory of Planned Behavior to assess community pharmacists’ intention to prescribe using the Formulary and Protocol Compendia

BackgroundOregon pharmacists can autonomously prescribe hormonal contraception, naloxone, and various medications and devices from a Formulary and Protocol Compendia (FPC). Prescribing using the FPC has seen limited uptake. Objectives(1) Assess Oregon community pharmacists' intention to prescribe using the FPC; (2) Determine the impact that attitudes, subjective norms (SN), perceived behavioral control (PBC), perceived obligation, and past prescribing behavior have on pharmacists' intention to prescribe; (3) Examine the relationship between beliefs and pharmacists’ attitudes, subjective norms, and perceived behavioral control. MethodsThis study was conducted as a cross sectional survey, which was developed based on the results of a previously conducted research project. A modified version of the Theory of Planned Behavior (TPB) was the study framework. All Oregon community pharmacists with a public email address were invited to participate. The questionnaire collected information on TPB constructs as well as demographic and practice information. TPB constructs were measured directly (intention, attitudes, SN, PBC, perceived obligation, and past prescribing behavior) and indirectly (attitudes, SN, and PBC). Descriptive statistics were used for all items. Multiple linear regression was used to assess Objectives 2 and 3. ResultsThere were 175 useable responses included in the analysis of the estimated 1015 community pharmacists that received the survey invitation (17%). Respondents had 16.5 ± 13.3 years in practice, 60% held a PharmD degree, and 69% had prescribed in some manner before. Mean intention to prescribe using the FPC was 5.0 ± 1.5 (7-point scale with 7 indicating higher intention). Attitudes, SN, PBC, and PO were significant predictors of intention to prescribe, while past prescribing behavior was not (Adj R2 = 0.741, p < .0001). Attitudes were explained by beliefs about increasing patient access (p = .0179). PBC was explained by beliefs about having policies and procedures in place (p = .004) and feeling comfortable prescribing (p = .008). ConclusionsOregon community pharmacists have a positive intention to prescribe using the FPC, but actual uptake remains low. Efforts to increase uptake should focus on the beliefs that contribute most strongly to pharmacist intention.

Disparities in the offer of COVID-19 vaccination to migrants and non-migrants in Norway: a cross sectional survey study

BackgroundVaccination is key to reducing the spread and impacts of COVID-19 and other infectious diseases. Migrants, compared to majority populations, tend to have lower vaccination rates, as well as higher infection disease burdens. Previous studies have tried to understand these disparities based on factors such as misinformation, vaccine hesitancy or medical mistrust. However, the necessary precondition of receiving, or recognizing receipt, of an offer to get a vaccine must also be considered.MethodsWe conducted a web-based survey in six parishes in Oslo that have a high proportion of migrant residents and were hard-hit during the COVID-19 pandemic. Logistic regression analyses were conducted to investigate differences in reporting being offered the COVID-19 vaccine based on migrant status. Different models controlling for vaccination prioritization variables (age, underlying health conditions, and health-related jobs), socioeconomic and demographic variables, and variables specific to migrant status (language spoken at home and years lived in Norway) were conducted.ResultsResponses from 5,442 participants (response rate of 9.1%) were included in analyses. The sample included 1,284 (23.6%) migrants. Fewer migrants than non-migrants reported receiving a vaccine offer (68.1% vs. 81.1%), and this difference was significant after controlling for prioritization variables (OR 0.65, 95% CI: 0.52–0.82). Subsequent models showed higher odds ratios for reporting having been offered the vaccine for females, and lower odds ratios for those with university education. There were few to no significant differences based on language spoken at home, or among birth countries compared to each other. Duration of residence emerged as an important explanatory variable, as migrants who had lived in Norway for fewer than 15 years were less likely to report offer of a vaccine.ConclusionResults were consistent with studies that show disparities between non-migrants and migrants in actual vaccine uptake. While differences in receiving an offer cannot fully explain disparities in vaccination rates, our analyses suggest that receiving, or recognizing and understanding, an offer does play a role. Issues related to duration of residence, such as inclusion in population and health registries and health and digital literacy, should be addressed by policymakers and health services organizers.

Perceptions of Telehealth Services for Hearing Loss in South Africa's Public Healthcare System.

Telehealth promises increased access to hearing healthcare services, primarily in areas where hearing healthcare resources are limited, such as within the South African public healthcare system. Telehealth for hearing healthcare is especially important during the COVID-19 pandemic, where physical distancing has been essential. This study aimed to describe audiologists’ perceptions regarding telehealth services for hearing loss within South Africa’s public healthcare system. This study was divided into two phases. During Phase 1, 97 audiologists completed an electronic survey regarding their perceptions of telehealth for hearing loss within South African public sector hospitals. Synchronous virtual focus-group discussions were conducted during Phase 2. Results indicated that audiologists recognized telehealth services’ potential to improve hearing healthcare efficiency within the public sector, and most (84.1%) were willing to use it. However, telehealth’s actual uptake was low despite almost doubling during the COVID-19 pandemic. Prominent perceived barriers to telehealth were primarily related to hospital resources, including the unavailability of equipment for the remote hearing/specialized assessments, internet-related barriers, and limited IT infrastructure. An increased understanding of telehealth in South Africa’s public healthcare system will assist in identifying and in improving potential barriers to telehealth, including hospital resources and infrastructure.

Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial

BackgroundInfluenza vaccination coverage rate among the elderly is low in China. We aimed to evaluate the impact of video-led educational intervention on influenza vaccine uptake among the Chinese elderly.MethodsA randomized controlled trial was conducted in 8 communities of Xi’an, a representative city in western China. Elderly aged over 60 years were randomized to the control group and intervention group (12-minute video education on influenza and its vaccination). Participants’ knowledge, attitudes, and practices (KAP) of influenza was assessed by using a questionnaire survey before and after the intervention. The primary outcomes were participants’ willingness to get influenza vaccinated and their actual uptake rates in the 2020-21 flu season. Secondary outcomes were the variations of pre- and post-intervention KAP scores. Intention-to-treat analysis was performed to analyze the data, and sensitivity analyses were conducted to examine the robustness of the results.ResultsA total of 350 people were enrolled, with 175 individuals for each group. Participants in the intervention group were more willing to receive influenza vaccination than those in the control group (64.6% vs. 51.4%, p<0.05). The influenza vaccination uptake rate occurred in 10.3% of participants in the intervention group and 3.4% in the control group (odds ratio, 3.23; 95% CI 1.25-8.32, p<0.001). The post-intervention KAP scores in the intervention group were significantly higher compared to those in the control group (p<0.001).ConclusionVideo-led education was an effective and feasible approach to improve old people’s willingness and uptake of influenza vaccination in western China.

Test-drives &amp; information might not boost actual battery electric vehicle uptake?

Many scholars have suggested driving experiences and information campaigns to promote battery electric vehicle (BEV) uptake. Especially, when BEVs are powered with green energy, they reduce transport emissions, which is vital for mitigating climate change. Nevertheless, BEVs are still adopted far less than conventional cars, which motivates studying whether information on and experience with BEVs changes household car fleet compositions through the adoption of BEVs in a randomised control trial (RCT). A large random sample (N = 4,149) of conventional vehicle (CV) drivers was randomly assigned to one of three conditions: a comprehensive information sheet on BEVs, the same information plus a multiple day-long test drive with a BEV, and a control group receiving no intervention. For the first time, information and test-driving were assessed side-by-side to measure effects on actual BEV adoption. The results do not point towards substantial effects of these interventions after around 18 months. Larger samples or faster growing BEV markets would be needed to find (possible) significant effects.

A mobile learning framework for higher education in resource constrained environments

It is well documented that learning oppourtunities afforded by mobile technology (m-learning) holds great potential to enhance technology-enhanced learning in countries and communities with low socio-economic conditions where web-based e-learning has failed because of limited infrastructure and resources. Despite the potential for m-learning, its actual uptake has been low. The extant literature in this sphere provides some theoretical insight, with evidence of limited on-the-ground practical studies that often do not progress beyond the pilot phase. Failure to embed sustainable learning opportunities has been attributed to the absence of a contextual framework suitable for the heterogeneous nature of many developing countries. This paper thus presents an m-learning framework that considers the sociocultural and socio-economic contexts of low-income economies. The framework is based on a range of studies conducted over four years, including the outcome of two empirical studies conducted in a Nigerian university. Documenting the research underpinning the design provides practitioners and policymakers with a framework for a potentially sustainable strategy for long-term mainstream m-learning integration in higher education in low-income countries.

To Boost or Not to Boost: Acceptability of a COVID-19 Booster Dose among Osteopathic Medical Students: A Cross-Sectional Study from a Medical School in New York.

The COVID-19 pandemic continues to evolve, with new variants emerging and vaccine-induced immunity waning. Protecting and retaining the healthcare force remains crucial in fighting this pandemic, as healthcare workers (HCWs) are a critical driver in increasing vaccine uptake among the public. This study explored the uptake of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) booster shots among medical students at the New York Institute of Technology College of Osteopathic Medicine (NYITCOM). Predictors for actual booster uptake were also examined. An electronic survey was distributed to Osteopathic Medical Students (OMS I-IV) in January 2022. The survey was distributed to 1762 students total, with 319 responses received (18%). Of those who responded, 70.2% (224/319) reported that they had already received a booster, while 29.5% (94/319) reported they had not yet received it. We identified that pharmaceutical mistrust, building long-lasting immunity via vaccines, and vaccines' adverse effects were the most significant predictors for how willing participants were to accept a booster dose. Vaccine hesitancy around the COVID-19 booster was prevalent during the surge of the highly transmissible variant Omicron. This finding necessitates some evidence-based approaches to enhance booster uptake among a population subgroup whose impact is critical.

Knowledge, attitude, and behaviour towards nutrition radio programmes in mothers of children under five years with severe acute malnutrition in Northern Nigeria

Introduction: Although the mass media are increasingly becoming a platform for disseminating health messages to promote attitude and behavioural changes, little is known about how radio programmes influence safe child feeding practices among mothers of infants and children. Consequently, this study examined the knowledge, attitude and behaviour towards food and nutrition radio programmes in mothers of children under five years with severe acute malnutrition in Northern Nigeria. Methods: This study employed a survey research design using data derived from a structured questionnaire undertaken with mothers (N=402) of children suffering from severe acute malnutrition (SAM) and who have been listening to radio programmes on tackling malnutrition within six months to the time of the fieldwork. Results: Findings revealed that while mothers appeared to have a higher comprehension of child feeding programmes on the radio, their attitude and actual uptake of the messages were not encouraging. Furthermore, being young, having few children, having a primary education, and frequent listening to SAM-related messages on the radio were associated with mothers’ positive knowledge, attitude and actual uptake of the messages disseminated. Conclusion: The findings provided a link between demographic characteristics of mothers and how they comprehend, believe and act on the messages they received from these radio programmes. It is therefore argued that the understanding of this link might inform the focus of future intervention aimed at promoting best child feeding practices in Northern Nigeria

New insight on Fe-bioavailability: Bio-uptake, utilization and induce in optimizing methane production in anaerobic digestion

Fe-bioavailability is an essential factor affecting CH4 production from anaerobic digestion (AD). However, the actual uptake and utilization process of iron in complex microbial communities remains unclear. In this study, the effects of Fe-bioavailability in six iron dosages on CH4 production were compared. The results showed that CH4 production increased to 144.37 mL CH4/g COD (154.1% higher than the control group) when dosing is 50 mg/L with the best Fe-bioavailability (3.125 mg Fe/g TS). Flow cytometry and enzyme analysis further demonstrated that the reactor with the highest Fe-bioavailability had the protective mechanism of ferroptosis and the highest living cell and DNA content. Metagenomic analysis of microbial communities and metabolic pathways revealed the potential pathways of iron bio-utilization in pyruvate metabolism dominant by Candidatus Cloacamonas Acidaminovorans and methane metabolism dominant by acetophilic methanogens were improved. In view of the significant improvement of lipopolysaccharide biosynthesis, the two-component system, ABC transporter, quorum-sensing, and ribosome metabolic pathways, it can propose that iron-induced signaling molecule accelerates matter and energy exchange on the membrane, thus enhancing the microbial function of the anaerobic system. This study revealed the process of iron uptake and utilization by microbial communities and the potential mechanism of promoting interspecific iron uptake, improving the carbon conversion efficiency of organic matter in AD.

COVID-19 Vaccine Booster Hesitancy among Healthcare Workers: A Retrospective Observational Study in Singapore.

Background: COVID-19 booster uptake remained poor among healthcare workers (HCW) despite evidence of improved immunity against Delta and Omicron variants. While most studies used a questionnaire to assess hesitancy, this study aimed to identify factors affecting booster hesitancy by examining actual vaccine uptake across time. Method: COVID-19 vaccination database records among HCW working at seven Singaporean public primary care clinics between January to December 2021 were extracted, with sex, profession, place of practice, vaccination type, and dates. Time to booster was calculated from the date of vaccination minus date of eligibility. Chi-square test was used to compare the relationship between first dose and booster hesitancy, Kaplan–Meier method and log-rank test were adopted to evaluate differences in cumulative booster uptake. Multivariate Cox regression was used to investigate predictors for timely booster vaccination. Vaccination rate was charted across time and corroborated with media releases pertaining to legislative changes. Results: A total of 877 of 891 (98.9%) primary care HCW were fully vaccinated, 73.8% of eligible HCW had taken the booster. HCW were less booster hesitant [median 16 (5–31.3) days] compared to the first dose [median 39 (13–119.3) days]. First dose-hesitant HCW were more likely to be booster hesitant (OR = 3.66, 95%CI 2.61–5.14). Adjusting for sex, workplace, and time to first dose, ancillary (HR = 1.53, 95%CI 1.03–2.28), medical (HR = 1.8, 95%CI 1.18–2.74), and nursing (HR = 1.8, 95%CI 1.18–2.37) received boosters earlier compared with administrative staff. No temporal relationship was observed between booster uptake, legislative changes, and COVID-19 infection numbers. Conclusion: Vaccine hesitancy among HCW had improved from first dose to booster, with timely booster vaccination among medical and nursing staff. Tailored education, risk messaging, and strategic legislation might help to reduce delayed booster vaccination.

Attitude, perceptions and willingness to receive COVID-19 vaccine and their associated factors among general population of Uttar Pradesh, Northern India

Several vaccines have been developed and tested against COVID-19 around the globe. Vaccine hesitancy and misinformation poses major challenges to the achievement of coverage and population immunity. Understanding key determinants that influence the preferences and demands of a COVID-19 vaccine by the community may help to develop strategies for improving coverage. To assess willingness for the corona virus disease 2019 (COVID-19) vaccine and identify the factors associated with it. A web-based cross-sectional study was conducted among unvaccinated general population of Uttar Pradesh, Northern India adopting an exponential, non-discriminative snowball sampling technique. A bilingual, self-administered anonymous structured questionnaire in google form was designed and sent to the study participants through social media platforms. Data collected were extracted in excel sheets and analyzed using SPSS software, version 21.0. Bivariate analysis was performed to identify the key determinants for vaccine acceptance among the participants.Out of 254 participants completing the questionnaire, 219 (86.2%) showed willingness to receive a COVID-19 vaccine, whereas 10 (4.0%) admitted hesitancy and 25 (9.8%) were not sure. Younger age-group (18-44 years), female gender, absence of any co-morbidity, lower education level, current employment status, positive history of confirmed COVID-19 infection in the person and positive history of confirmed COVID-19 infection in any family member/friend were the factors found to be significantly associated with the willingness to receive a COVID-19 vaccine. During the second wave of COVID-19 pandemic in India, high acceptance for COVID-19 vaccination was found among the general population of Uttar Pradesh, whereas concerns about vaccine safety may hinder the actual vaccine uptake. (1). Mass vaccination against COVID-19 is one of the effective way of controlling the ongoing pandemic of COVID-19 (2). There is a variable acceptance of COVID-19 vaccines in different populations and sub-groups across the globe (3). Vaccine hesitancy for COVID-19 vaccines can disrupt the efforts for containment of the pandemic. (1) Acceptance for COVID-19 vaccines among the general population of a North Indian state is seemingly high; (2). However, concerns about vaccine safety may hinder the actual vaccine uptake; (3). Targeted health education interventions are needed to increase the uptake of the COVID-19 vaccines in this population.

Utilization of Different Carbon Sources by Nordic Microalgae Grown Under Mixotrophic Conditions

Microalgae are promising candidates for sustainable wastewater treatment coupled to the production of biofuel, bioplastic and/or bio-fertilizers. In Nordic countries, however, light is a limiting factor for photosynthesis and biomass production during the winter season. Compared to municipal wastewater, industrial wastewater streams from the pulp and paper industry contain lower amounts of nitrogen, but high concentrations of carbon sources, which could be utilized by microalgae to enhance biomass production in limiting light. This study focused on the utilization of methanol, glycerol and xylose by five different Nordic microalgae [Chlorella vulgaris (13–1), Coelastrella sp. (3–4), Desmodesmus sp. (2–6), Chlorococcum sp. (MC1) and Scotiellopsis reticulata (UFA-2)] grown under mixotrophic conditions. Two of these strains, i.e., Chlorococcum sp. (MC1) and Scotiellopsis reticulata (UFA-2) were able to grow in the presence of xylose or methanol at concentrations of 6 g L–1, or 3%, respectively, in a 12/12 h day/night cycle. HPLC analysis confirmed the consumption of those substrates. Glycerol (2.3 g L–1) was tolerated by all strains and increased growth for Chlorella vulgaris (13–1), while higher concentrations (20 g L–1) were only tolerated by Chlorococcum sp. (MC-1). Fourier-transform infrared spectroscopy, performed after growth in presence of the dedicated carbon source, indicated an increase in the fingerprint region of the carbohydrate fraction. This was particularly the case for Chlorococcum sp. (MC1), when grown in presence of glycerol, and Scotiellopsis reticulata (UFA-2), when grown in presence of xylose. Therefore, these strains could be potential candidates for the production of biofuels, e.g., bioethanol or biogas. We could show that Nordic microalgae are able to grow on various carbon sources; the actual uptake rates are low during a 12/12 h day/night cycle requesting additional optimization of the cultivation conditions. Nonetheless, their potential to use pulp and paper waste-streams for cheap and sustainable biomass production is high and will support the development of new technologies, turning waste-streams into resources in a circular economy concept.

Community Volunteers and Primary Care Providers Supporting Older Adults in System Navigation: A Mixed Methods Study.

Introduction:Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). This study aimed to explore the experiences and impacts of system navigation in a complex intervention supporting older adults.Methods:We used a convergent mixed methods design. Participants included primary care team members (n = 67), community volunteers (n = 38), and programme clients (n = 128) across six communities in Ontario, Canada. Data sources included focus groups, interviews, system navigation function survey for volunteers, CBHSS use survey for clients, and implementation data on CBHSS recommended by providers and volunteers and used by clients.Results:Results showed the different patterns of how CBHSS categories were recommended and ultimately used. Exercise-related CBHSS were both recommended and used, independence-related CBHSS were mostly only recommended with less uptake, and chronic health condition and diet/nutrition CBHSS were most often used by clients.Discussion:Primary care teams’ practice of system navigation was impacted by programme participation, including through learning about local CBHSS. However, volunteers felt more confident in tasks that did not include connecting to CBHSS. The programme did seem to result in many referrals, though the actual client uptake tended to be to more clinical rather than healthy lifestyle resources.